• 대한간호학회지
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• 제31권5호
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• pp.932-947
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• 2001

The purpose of this study was 1) analyze the current state of Sanhojoriwon; and 2) to suggest the new model for the community based mother infants health care delivery system: strategies of TMIC are related to Public Health policy, cost-effectiveness, mother infant care provision of medical professionalism, and so on. Method: Forty-seven workers from seventeen Sanhojoriwon participated to analyze several aspects of Sanhojoriwon. Using a questionnaire developed at Korean Sanhojori Research Forum (KSARF), such as the traditional and medical concept of the Sanhojori, postpartum care, Korean traditional postpartum care, job description on women and infant care at Sanhojoriwon, professional management, health care policy and the educational need. Results: Based on the descriptive study results, the TMIC, the community based transitional mother infants care center was suggested as a new model for the cyclic public health care system related on the reproductive health, using an already existing related center, Sanhojoriwon. Also, several strategies were presented on the TMIC.

• 한국보건간호학회지
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• 제24권2호
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• pp.211-225
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• 2010

Purpose: This comparative study analyzed information systems including manpower, contents of service, clients, and costs among four nations. Methods: A literature review of relevant publications from Korea, United States, Japan, and Germany supported the use of several plans to activate home nursing care services under the long-term care insurance system in Korea. Results: Korean home nursing care services require quality improvements. The results indicated that a rule is necessary that rations simple visiting service and home nursing care services under the long-term care insurance system, that an integrated management system for elderly care is required, and that the revised delivery of services needs to establish and reflect on various factors to estimate the value in a home visiting nursing care cost system. Conclusion: The data should be valuable in establishment of home nursing care services under the long-term insurance system in Korea.

• 보건행정학회지
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• 제8권1호
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• 지역사회간호학회지
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• 제23권4호
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• pp.415-426
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• 2012

Purpose: This study aimed to investigate trends in home-visit nursing care by agencies' characteristics under the national long-term care insurance system. Methods: Cochran-Mantel-Haenzel tests were conducted, using data drawn from the nationwide long-term care insurance claim database of the Korean National Health Insurance Corporation from 2009 to 2011. Results: The number of home-visit nursing care agencies has decreased continuously since 2009. There were also similar trends in the total amount of service provided by home-visit nursing care agencies, the number of recipients, the number of employees, and payments. This study showed that there were statistically significant differences in the trends in home-visit nursing care by agencies' characteristics. Despite the overall downward trend, there were some increases in the percentage of home-visit nursing care provided by agencies which were established by individuals, located in large cities, and which combined home-visit care with home-visit bathing. Conclusion: Home-visit nursing care agencies are responsible for providing community-based healthcare services. For past three years, however, they have not been utilized to their full potential. Understanding the trends in home-visit nursing care by agencies' characteristics is important to develop utilization strategies for home-visit nursing care.

• 보건의료산업학회지
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• 제6권2호
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• pp.193-200
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• 2012

The purpose of this study was to research the opinion and acknowledgement about the clinical chronic disease care system subject to Medical Practitioners that copied the internal medicine and family medicine as a treatment subject and was fulfilled in the purpose of providing a basic data for the improvement and stable establishment of the chronic disease care system and the high blood pressure and diabetes mellitus patient's promotion of health. Results from the research the internal medicine was 79% and the subject's average age was 52.3 years, the proportion that the high blood pressure and the diabetes mellitus took was average 28% and the interest about the system was 65.9%. In the chronic disease care system expansion status the opposition was 75.7%, and the detail field knowledge level was 56.9%. In the opinion field about the system, all fields were shown negative. The chronic disease care system is an important government policy enforcing purposed to effectively manage the yearly increasing chronic disease, but the due to the cold attitude of Medical Practitioners that must actively accept it, the stable establishment of the system is being concerned. Therefore even if it's a good policy if it cant gain the support and agreement of the accepter, in the future when trying to implement a system there should be no idleness in the effort to gain cooperation and understanding to relevant involved ones.

• 지역사회간호학회지
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• 제14권1호
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• pp.75-82
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• 2003

The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

• 지역사회간호학회지
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• 제5권2호
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• pp.101-108
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• 1994

This study was conducted by community survey of 215 community health practitiner's posts and literature review of official documents. The result was as follows ; 1. The role and responsibility of community health practitioner's post must be studied by the community health practitioner and the community health leader, and on the basement of community health needs, community development plan, and reforom of health care system. 2. Comprehensive health care of community is very important role and responsibility of community health practitioners. However, it was supervised by the senior community health practitioner in provincial government. 3. The community health practitioner must be trained by formal inservice educational program focused on comprehensive health care. 4. The community health practitoner must be the health guider and health leader as the member of community.

• Radiation Oncology Journal
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• 제36권1호
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• pp.79-84
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• 2018

Deep inspiration breathing hold (DIBH) compared to free-breathing (FB) during radiotherapy (RT) has significantly decreased radiation dose to heart and has been one of the techniques adopted for patients with breast cancer. However, patients who are unable to make suitable deep inspiration breath may not be eligible for DIBH, yet still need to spare the heart and lung during breast cancer RT (left-sided RT in particular). Continuous positive airway pressure (CPAP) is a positive airway pressure ventilator, which keeps the airways continuously open and subsequently inflates the thorax resembling thoracic changes from DIBH. In this report, authors applied CPAP instead of FB during left-sided breast cancer RT including internal mammary node in a patient who was unable to tolerate DIBH, and substantially decreased radiation dose the heart and lung with CPAP compared to FB.

• 농촌의학ㆍ지역보건
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• 제15권1호
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• pp.21-27
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• 1990

During the last half a century the Korean rural society have experienced drastic changes : the retreat of Japan from the colonial interference and suppression in 1945, the Korean war and disorder in the 1950s, the implementation of the first and second five-year economic development plans in the 1960s, the ambitious implementation of the new village movement called Saemaul Undong to modernize the traditionally stagnant rural village in the 1970s, and socioeconomic and political turmoil in the 1980s. In this complex process of change the rural health care system in Korea was grdually reformed. This paper reviews the socioeconomic change and the basis of the changing structure of the health care system in rural Korea, on the basis of the existing literature and secondary data. Thus this is not a research paper but a review article in its nature. After reviewing the past and present situation, the directions and strategies for the reformation of the rural health care system are suggested.