• 제목/요약/키워드: Integrated Care

검색결과 630건 처리시간 0.024초

미국 조기헤드스타트의 문헌고찰을 통한 한국의 영아보육에 관한 연구 (Implications of American Early Head Start for the Korean Infant/toddler Care System)

  • 김지은
    • 대한가정학회지
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    • 제43권12호
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    • pp.97-111
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    • 2005
  • Early Head Start (EHS) can provide services to a child and family from pre-birth until the child is three years old. Services are comprehensive, intensive, individualized and flexible according to child and family needs, and integrated with community service delivery systems. The local program designs and operations were developed and carried out within the framework of the Head Start Revised Performance Standards, which included specific provisions for services to pregnant women, infants and toddlers and emphasized prevention, early intervention, safety, and health education. As with preschool Head Start, EHS programs are required to make available 10 percent of their enrollment for infants and toddlers with disabilities as defined by Part C regulations of the state in which the program operated. Quality child care has become a priority for EHS. A majority of EHS children need child care, and the quality is important to their development. An evaluation of EHS in 17 programs selected from the first program cohorts showed that the program had significant and positive impacts on a wide range of parent and child dimensions, some with implications for children's later school success. Among the issues for policy attention identified by American EHS for the Korean system are: - The need to create a comprehensive infant/toddler care system - The need to address access of teachers for young children - The need to improve quality.

만성 폐쇄성 폐질환자의 자가관리측정도구 개발 (Development of a Scale to Measure Self-Care for Korean Patients with Chronic Obstructive Pulmonary Disease)

  • 전정자;김애경;최상옥;애정희;최미경;장선아
    • 대한간호학회지
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    • 제33권1호
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    • pp.9-16
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    • 2003
  • Purpose : The objective of this study was the development and validation of a scale to measure the self-care of patients with chronic obstructive pulmonary disease(COPD) in Korea. Method: Self-care scale was developed based on the self-care activities patients had to carry out in order to manage their COPD. The original scale contained 34 items rated along a five-point Likert scale and was reviewed by 18 professional nurses and 10 Korean patients with COPD for content validity. Subsequently, patients with COPD were asked to complete this 23-item scale and further tests were done with the 125 useable responses. Result: Factor analysis identified eight factors-'maintaining a clean air way', 'taking medication', 'support from family', 'preventing infection', 'managing symptoms', 'breathing exercising', and 'taking in nutrition'. The internal consistency of the total scale was Cronbach's α=0.7226. These eight factors explained 60.8% of total variance. There was correlation among Korean Self-Care Scale score, administration level, and knowledge level but there was no correlation to patients' satisfaction with medical services. Conclusion: The 23 item questionnaire positively identified 8 areas defined important for COPD patients. Further studies are required to see how these can be integrated into patient education.

근골격센터의 프로그램 및 공간구성에 관한 연구 (A Study on the Medical Program and Spatial Organization for Musculoskeletal Center)

  • 윤우용;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제21권4호
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    • pp.49-58
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    • 2015
  • Purpose: Musculoskeletal disorder is one of diseases with high medical demand over-65 populations. Considering complex, chronic property of diseases, it is important for patients to provide specialized medical service. The musculoskeletal center is one of the most essential facility type in order to give adequate care to the patient suffering from musculoskeletal diseases. Methods: Statistical analysis relating to the component ratio of patients for the demand for medical care. Literature analysis for characteristic of the musculoskeletal diseases. The Status Survey of health care facilities operating in the musculoskeletal center. Results: It is necessary for the musculoskeletal center to be composed of four major areas such as consultation, examination, diagnosis, intervention for continuity of care. For continuum of care, it is essential to build medical environment integrated with each level of care such as consultant, examination, diagnosis procedure. Implications: This study is a basic research for design of musculoskeletal center, and need to be followed by further study using various perspectives and methods.

데이터 통합 모델 기반 e-Transformation 전략 : 장기요양기관 사례 (e-Transformation Strategy of Data Integration Model : Long-Term Care Agency Case)

  • 엄혜미
    • Journal of Information Technology Applications and Management
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    • 제28권3호
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    • pp.23-30
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    • 2021
  • Korea currently provides long-term care benefits for the elderly with poor functionality, but most of the service providers are private businesses. This is the time when quality management of care services is required, which is just around the corner of the super-aged era. In this study, we would like to look at the case in which 'A company', which operates a long-term care institution, attempted to make voluntary changes ahead of social demands. The company tried to transform the social needs of quality management by judging them as opportunities, not threats, and establishing an integrated database of centers. First, the company processed data and built a cloud-based database system. Second, the company automatically linked data from existing systems for the efficiency of data utilization. Third, the company pursued visualization for the convenience of data utilization. This allowed the company to make data-driven strategic decisions internally. This is expected to increase sales as it will soon lead to securing new customers and pioneering new markets. It is also significant in that it can provide best practices for the long-term care industry.

퇴원환자 진료정보 DB의 데이터 수집 과정 재설계 (Reengineering of the Data Collection Process for Discharge Abstract Database)

  • 홍준현;최귀숙;이은미
    • 한국의료질향상학회지
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    • 제7권1호
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    • pp.106-116
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    • 2000
  • Background : Severance Hospital is an university hospital which has 1,580 beds. A LAN system was installed in the Medical Record Department in 1992 and discharge abstract data have been added to the discharge abstract database(DB) The previous work flow in the Medical Record Department had 5 levels: 1) chart collection from wards, 2) assembling, 3) abstracting data from medical record on worksheet by 2 RRAs, 4) checking deficiencies and coding diagnosis and procedures by 4 RRAs, 5) inputting the data into the discharge abstract data base by 1 RRA. The average processing time took 19.3 days from the patient discharge date. It had the production of monthly statistical report delayed. Besides, it caused the users in the hospital to complain. Methods : A CQI team was organized to find a way to shorten the processing time less than 10 days. The team identified the factors making the processing time long and integrated three levels from the 3rd level into one. Each of 7 RRAs performed the integrated level on her workstation instead of taking one of three separate levels. The comparison of processing time before and after the changes was made with 3'846 discharges of April, 1999 and 4,189 discharges of August, 1999. Results : The average processing time was shortened from 19.3 days to 8.7 days. Especially the integrated level took only 3.6 days, compared with 12.3 days before the change. The percentage of finishing up the whole processing within 10 days from discharge was increased up to 77.6%, which was 2.4% before the integration. The prevalence of error in data input was not increased in the new method. Conclusions : The integrated processing method has the following advantages: 1) the expedition of production of monthly statistical report, 2) the increase of utilizing rate of dischare abstract data by Billing Dept, Emergency Room, QI Dept., etc., 3) the improvement of intradepartmental work follow, 4) the enhancement of medical record quality by checking the deficiencies earlier than before.

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통합예술치료가 초기치매노인의 인지기능과 우울에 미치는 영향에 관한 연구 (A Study on the Effect of Integrative Art Therapy on Cognitive Function and Depression in Elderly People with Early Dementia)

  • 백승숙;신동열
    • 산업진흥연구
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    • 제9권1호
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    • pp.149-157
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    • 2024
  • 본 연구의 목적은 통합예술치료가 초기치매노인의 인지기능과 우울에 미치는 영향을 객관적으로 살펴보고, 통합예술치료가 초기치매노인의 변화과정을 행동변화 관찰일지를 이용하여 종합적인 분석을 통해, 이를 규명하고 논의하는 데 있다. 연구방법으로 통합예술치료가 초기치매노인의 인지기능과 우울에 미치는 영향에 대한 양적연구와 함께 질적연구를 통한 심층 분석을 이용한 혼합연구를 설계하였다. 양적연구는 수원시 P 구의 주간보호센터를 이용하는 초기치매노인 20명을 실험대상으로 사전 사후검사를 하였고, 질적연구는 초기치매노인 10명을 대상으로 행동변화 관찰일지 분석을 하였다. 이러한 연구결과는 첫째, 통합예술치료가 초기치매노인의 인지기능에 유의한 영향(p<.001, t=-5.871을 미쳤다. 둘째, 통합예술치료가 초기치매노인의 우울에 유의한 영향(p<.001, t=5.325)을 미쳤다. 셋째, 통합예술치료 프로그램이 초기치매노인의 인지기능과 우울에 사전, 사후 변화에도 긍정적인 태도로 변화하였다. 본 연구결과를 통해 통합예술치료가 초기치매노인의 인지기능과 우울에 미치는 영향을 밝힘으로써 초기치매노인과 관련된 통합예술치료프로그램 등에 실효적 정보를 제공할 뿐 아니라 초기치매노인과 관련된 연구의 기초자료로 의미가 있다.

중첩된 이기종 무선망에서의 다중 무선 서비스 프레임워크 (A Framework for Multiple Wireless Services in Heterogeneous Wireless Networks)

  • 신충용;조진성
    • 한국컴퓨터정보학회논문지
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    • 제13권5호
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    • pp.85-94
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    • 2008
  • WLAN, WiBro, cdma2000, HSDPA와 같은 여러 이기종 무선 네트워크 서비스가 늘어나고 무선 서비스를 사용하기 위한 사용자의 선택의 폭도 점점 커짐에 따라 다양한 이기종 무선인터페이스를 동시에 사용하고자 하는 Multiple Care-of Address 방안이 IETF MONAMI6 WG에서 제안되었다. 이 방안을 통해 단말은 다중 인터페이스를 사용하여 동시에 여러 네트워크로의 접속이 가능하다 이처럼 다양한 무선 접속 기술은 All-IP 기반 핵심망에 연결되어 통합되는 형태로 발전하고 있으며 무선 접속 기술의 커버리지에 따라 이기종 무선망이 중첩되어 운영되고 있어, 이에 대한 고려가 요구되고 있다. 이에 따라 4G를 위한 차세대 네트워크와 현존하는 이기종 인터페이스를 지원하는 서비스 프레임워크가 요구되는 실정이다. 본 논문에서는 현재 서비스되고 있는 환경을 고려한 이기종 무선 서비스 프레임워크를 제안하고 여러 인터페이스 특성과 사용자 정의를 고려하여 효율적인 네트워크를 선택하는 수정된 MCoA (Multiple Care-of Address) 방안과 다중 인터페이스 핸드오버 상황에 따른 패킷 손실을 최소화하는 방안을 제안한다.

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입원환자의 낙상 실태 및 위험요인 조사연구 (Incidence of Falls and Risk Factors of Falls in Inpatients)

  • 윤수진;이천균;진인선;강중구
    • 한국의료질향상학회지
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    • 제24권2호
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    • pp.2-14
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    • 2018
  • Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.

서울특별시 지역사회 거주 노인의 통합돌봄 요구 (Needs for Integrated Care for Older Adults in Seoul)

  • 김형수;고영;손미선
    • 융합정보논문지
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    • 제10권5호
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    • pp.177-187
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    • 2020
  • 본 연구는 65세 이상 노인의 돌봄요구군을 분류하고, 군간 특성을 확인하기 위하여 수행되었다. 한국보건사 회연구원이 진행한 '2017년도 노인실태조사'의 자료를 이용한 이차자료 분석연구로, 분석대상은 2017년 노인실태 조사 참여자 중 서울시 노인 999명, 가중치 부여 1,295,491명이다. 돌봄요구군의 분류를 위하여, 의료요구, 일상생활수행 지원요구, 사회적 활동 지원요구의 특성을 파악하였다. 지원요구가 하나도 없는 일반군이 50.4%, 의료요구군이 17.9%, 일상생활수행 지원요구 또는 사회적 활동 지원요구가 있는 복지요구군이 14.2%, 의료요구와 복지요구가 모두 있는 복합요구군이 17.5%이었다. 성별, 흡연, 치매검진, 지난 1년간 외래이용, 일상생활수행 도움 여부, 비동거 자녀 또는 손녀 여부를 제외한 일반적 특성, 장기요양등급 및 장애등급 현황, 경제적 부담 및 일상생활 도움 정도, 건강행태와 건강상태, 삶의 만족도에서 돌봄요구군간 유의미한 차이를 보였다(p<.001). 복합요구군에게 의료와 복지의 통합돌봄 서비스를 우선 제공해야 한다. 특히 복합요구군은 의료, 복지, 운동, 영양, 정신건강, 간호의 요구를 모두 가지고 있는 대상자로 다학제적 팀 접근이 필요하다.

실태조사를 통한 장기요양시설과 요양병원의 효율적 연계방안 (Study on the Efficient Integration of Long-term Care Facilities and Geriatric Hospitals by Using NHIC Survey Data)

  • 최인덕;이은미
    • 한국노년학
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    • 제30권3호
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    • pp.855-869
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    • 2010
  • 본 연구는 노인장기요양보험 도입이후 장기요양시설과 요양병원의 효율적 연계방안을 모색하기 위한 기초조사 연구이다. 본 연구는 문헌고찰을 기반으로 국민건강보험공단 노인장기요양운영센터를 이용 장기요양시설 192곳과 요양병원 168곳 시설관계자(시설장, 병원장 및 이용자 등)에게 운영현황과 효율적 연계방안에 대해 면접조사를 실시 분석하였다. 자료분석은 기술통계, χ2검증 등을 SPSS 13.0으로 분석하였다. 연구결과 운영현황에서는 요양시설과 요양병원 모두 본인부담의 차이가 미미하나 식대에 대한 편차가 크게 나타났다. 경영수지적자에 대해서는 양 기관 모두 수가보전에 문제점을 지적하고 있으며, 교통과 환경요인이 입지조건을 좌우하는 것으로 파악되었다. 둘째 이용행태면에서는 양 기관 모두 비용할인 경험이 높은 것으로 나타났고, 면회를 오지 않는 경우가 많은 것으로 파악되었다. 반면, 요양시설이 사망 시까지 있는 경우가 요양병원에 비해 더 높게 나타나고 있다. 셋째, 기관의 서비스제공문제점으로는 일률적인 서비스제공, 가족의 지지나 방문 부족 등을 들 수 있다. 끝으로 양 기관의 효율적 연계방안으로는 수가현실화, 간병비 지급, 복합시설 허용, 판정기준 강화, 주치의, 요양병원의 장기요양보험 관리 방안 등을 제시하였다.