• 제목/요약/키워드: Integrated Care

검색결과 630건 처리시간 0.029초

미숙아를 위한 지역중심 건강관리사업의 모델개발 (Development of the Model for Community-based Health Care Program for Premature Infants and Family)

  • 안영미
    • Child Health Nursing Research
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    • 제8권2호
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    • pp.129-140
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    • 2002
  • The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.

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Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries

  • Paul Jie Wen Tern;Amar Vaswani;Khung Keong Yeo
    • Korean Circulation Journal
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    • 제53권9호
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    • pp.594-605
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    • 2023
  • Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

사례기반 추론을 이용한 암 환자 진료비 예측 모형의 개발 (Development of a Medial Care Cost Prediction Model for Cancer Patients Using Case-Based Reasoning)

  • 정석훈;서용무
    • Asia pacific journal of information systems
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    • 제16권2호
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    • pp.69-84
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    • 2006
  • Importance of Today's diffusion of integrated hospital information systems is that various and huge amount of data is being accumulated in their database systems. Many researchers have studied utilizing such hospital data. While most researches were conducted mainly for medical diagnosis, there have been insufficient studies to develop medical care cost prediction model, especially using machine learning techniques. In this research, therefore, we built a medical care cost prediction model for cancer patients using CBR (Case-Based Reasoning), one of the machine learning techniques. Its performance was compared with those of Neural Networks and Decision Tree models. As a result of the experiment, the CBR prediction model was shown to be the best in general with respect to error rate and linearity between real values and predicted values. It is believed that the medical care cost prediction model can be utilized for the effective management of limited resources in hospitals.

진료와 술기 수행의 교육전략 (Educational Strategies for Clinical and Technical Skills Performance)

  • 노혜린
    • 의학교육논단
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    • 제18권3호
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    • pp.132-144
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    • 2016
  • The aim of this study is to provide the background of developing guides to clinical performance and basic clinical skills and to introduce how to teach and learn using the guide. The students' performance problems presented in an objective clinical skills examination were disease-centered tertiary hospital clinical care, incomplete performance, doing by rote, and an exam-oriented learning attitude. The problems were caused by a tertiary hospital-based educational environment as well as schools and faculty who are unfamiliar with the concept of patient-centered care. The purpose of the guide to clinical performance and basic clinical skills is to overcome these problems and address the causes. The guides show a clinical presentation approach to primary care; clinical care integrated with knowledge, skills, and attitude; a schematic approach; and a patient-centered attitude. To achieve these goals, a strategy to change the educational culture is important. Curricular reform, faculty development, and improving educational facilities and environments are suggested.

지속 가능한 보건의료의 혁신 방향 (Direction of Healthcare Reform for Sustainability)

  • 박은철
    • 보건행정학회지
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    • 제29권4호
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    • pp.379-381
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    • 2019
  • Korea's healthcare is in great danger of sustainability. In 2020, the baby boomer will begin to be older, and there is no promise that the total fertility rate of 1.0 or less will rebound, and Korea's economic growth rate is predicted to be less than 2%. Together with these phenomena, Plan for Benefit Expansion in Nation Health Insurance (Moon Jae-in Care) will seriously threaten the sustainability of health insurance finance. In addition, health care in Korea has many problems: excessive medical utilization, rapidly increasing elderly medical costs, concentrating patients into big hospitals, low healthcare personnel but many healthcare facilities and equipment, bad quality of primary and mental care, and fast-growing health expenditure. For sustainability, healthcare of Korea should be reformed. The direction of the reform is people-centered and integrated healthcare in the community which is composed of empowering and engaging people, strengthening governance and accountability, reorienting the model of care, coordinating services, and creating an enabling environment.

한국의료패널 자료를 활용한 노년기 연령그룹에 따른 의료이용 (Health Care Utilization of Age Group in the Elderly on the Korean Health Panel)

  • 최령;황병덕
    • 보건의료산업학회지
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    • 제8권3호
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    • pp.49-61
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    • 2014
  • Due to the rapid population's aging, the life span's expansion and social & cultural characteristics, the standards of age classes in senescence are changed. Thus, this study aimed to identify the influential factors on health care utilization in the elderly by age class, and targeted 2,937 adults in their ages over 55 years old from the Korea Health Panel's 2009 Yearly Integrated Data. This study investigated the target health care utilization in the elderly in relation with the gender, the education level, the health-care insurance type, the income, the current job state, the chronic disease. In order to analyze the influential factors on health care utilization in the elderly, the multiple linear regression analysis was conducted to the data. As the results from this study, Concerning the influential factors on the health care utilization, the income, the subjective health state, the chronic disease and the regularly meals for the young-old influenced. Concerning the influential factors on the health care utilization, the subjective health state for the old. Concerning the influential factors on the health care utilization, the subjective health state, the income for the older-old influenced. Concerning the influential factors on the health care utilization, the education level, the spouse, the economic activity and the drinking oldest-old influenced. Therefore, it will need to provide systemic health-care & medical services, to develop health-care & medical programs and the health-care & medical policies and to execute them according to the age classes in senescence.

노인의 라이프케어 향상을 위한 지역사회 통합돌봄사업 미래 방향에 대한 제시 (A Suggestions of Future Direction of the Integrated Community Care Business for Improvement of the Elderly's Life Care)

  • 양승훈
    • 한국엔터테인먼트산업학회논문지
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    • 제15권8호
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    • pp.423-432
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    • 2021
  • 본 연구에서는 노인의 라이프케어 및 삶의 질향상을 위해 도입되어 시행되고 있는 통합돌봄사업의 미래 가치성 확대와 방향성 제시를 위하여 현황과 문제점들을 알아보고 이를 통해 다음과 같은 연구적 결론을 제시하였다. 첫째, 서비스 수혜 노인의 욕구분석은 조사자 중심이 아닌 환자 중심으로 구성하며, 특히 의료진의 진료방문을 통한 의학적관리 부분이 강화되어야 하며, 성별과 연령, 장애유형과 개인적 욕구취향에 따른 특화된 서비스 항목 부분이 점진적으로 강화되어야 할 것이다. 둘째, 서비스 항목에 대한 만족도 및 중복성 그리고 효과성 등을 분석하여 예산을 절감하며 수요자 중심의 서비스 항목구성과 신규 서비스 필요 항목 적용 등을 고려해 나간다. 셋째, 통합 스케줄관리시스템 도입을 통하여 서비스 제공 직역단체와 수혜자 간의 사전예약 및 방문 스케줄 관리의 전문화가 필요하다. 넷째, 재원 문제해결을 위한 노력으로, 보건의료 재정과 장기요양보험제도 그리고 사회복지재정사업 등과 합리적 재원공유 제도마련이 필요하며, 서비스 관련 산업분야와의 재원의 연계나 순환, 지방 공공의대 출신 인력투입 방안을 고려할 수 있다. 이상의 제안을 통해 통합돌봄사업은 보편적 노인 케어시스템으로의 완성과 미래 가치를 지닐 수 있게 될 것이다.

말기 암환자의 호스피스 교육프로그램 개발 II - 죽음의식에 미치는 효과 검정 - (Development of an Education Program for Hospice Care and Its Performance)

  • 김분한;김문실;김흥규;정태준;탁영란;김혜령;전미영
    • 대한간호학회지
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    • 제29권3호
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    • pp.576-584
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    • 1999
  • The purpose of this study was to develop an education program for hospice care and to examine the effect of the program. The education program for hospice care was developed based on the philosophy and principle of Hospice and integrated with various professional areas related to the problems with which terminal patients and their family might be associated. The program was continued for 16 weeks and consisted of lectures and practices. The courses of this program were The Concept and Principle of Hospice, The Role of the Hospice Nurse, The Characteristics of Terminal Disease, Physical Care in Terminal Patients, Death Orientation, Psychological care for Terminal Patients, Spiritual care for Terminal Patients, and Care for the Family. To identify the effect of the education program for hospice care, the difference in death orientation of subjects between the pre and post performance of the education program was examined using the t-test. The finding of this statistic indicated that this education program for hospice care was effective in terms of changing the death orientation of subjects with positive direction. The education program for hospice care was performed several times at Kwangrim Hospice Missionary, Chungbuk University Hospital, and Wooam Church. Case studies were reported for a description of content of hospice care experienced by subjects after the performance of education, put this at the beginning 8 the sentence. In conclusion, the education program for hospice care was developed effectively. Therefore, this program should be used to educate and activate the subjects in community to be participants in hospice care.

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재가.방문 건강관리 통합정보시스템 구축을 위한 관련 서식지 항목 매핑 연구 (Data Mapping of the Terms for Developing an Integrated Information System in Home and Visiting Healthcare Documents)

  • 김정은;박성애;윤순녕;이인숙;박현애;김진현;이경순
    • Perspectives in Nursing Science
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    • 제8권1호
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    • pp.32-41
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    • 2011
  • Purpose: This study sought to determine the possibility of developing the data-sharing infrastructure of an integrated information system to improve the quality of home and visit-based healthcare services. Methods: The articles of study here were the forms used by a visiting healthcare agency, a home healthcare system of a home healthcare agency, and those used in long-term care insurance for elderly. We visited a visit-based healthcare agency and a home healthcare agency to survey their forms and interviewed relevant practitioners, and we searched for forms associated with long-term care insurance for the elderly on the Internet. We then organized the terms in each form and mapped them among the form after analyzing the concepts as a whole to inquiry into the possibility of integration. Results: The mapping procedure divided the terms into those related to personal information, problems and interventions. Mapping between the standard system (Omaha system) and the type of form was also done. Conclusion: In this study, we found that programs were configured differently depending on the objectives of the service. It is necessary to develop the program with an integrated information system by comparing the three services in terms of their distinct advantages, after which such a service should be utilized. The results of this study can serve as a database for the creation of a new integrated system.

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Korean Immigrant Women's Taekyo Practices in the United States as a Traditional Prenatal Self-care

  • Lee, Kyoung-Eun
    • 여성건강간호학회지
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    • 제21권3호
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    • pp.241-251
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    • 2015
  • Purpose: The purpose of this study was to explore preserved belief system supporting Korean immigrant women's Taekyo practices and influencing factors while they observe the tradition within US sociocultural context. Methods: Leininger's exploratory focused ethnographic approach was used. Semi-structured in-depth interviews were conducted with purposive sample of sixteen Korean immigrant women who gave birth in the US within last 6 months. Researcher's observation and reflective field notes were also integrated into the interview data. Leininger and McFarland's four phases of ethnographic analysis guided data analysis process. Results: The perceived belief system supporting Taekyo practices included Taekyo as an enculturated Korean tradition, connecting parents with fetus, and positive impacts on fetal development. And Korean immigrant women's Taekyo practices were influenced by resources of information, woman's orientation toward Taekyo, pressure from local Korean community, and child order. Conclusion: The findings from this research would serve as an important knowledge base to expand US health care providers' understanding of Korean traditional Taekyo practices observed by Korean immigrant women's as important prenatal self-care practices. The findings could also aid in providing more patient-centered and culturally-tailored prenatal care plan to Korean immigrant by including Korean traditional belief system supporting Taekyo practices.