• Korean Journal of Social Welfare
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• v.48
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• pp.359-402
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• 2002

In Korea we should prepare for the exploding need to nursing according to the rapid change to the aged society. Therefore the german model; of "Pflegeversicherung (a nursing social insurance)" which is introduced in 1995, could help us to plan for the aged society in next Years. In Germany the discussion about the proper measures against the need to nursing as social risk was begun in early 1990s. The need to nursing was thought as social risk because of the aged society, the burden of the family member who take the responsibility for the nursing, and the fiscal crisis of social assistance system which was caused to the exploding cost of nursing for the poor people. Among the some alternatives the "Pflegeversichrung" as a social insurance model! with the' pay-as-you-go system' was introduced step by step in the years of 1995 and 1996. Such german modell was possible on the basis of the stabil social insurance system, especially medical insurance system, the corporatism between the employer and the employee and the developed democratic political system in which the compromise is achieved at the cost of all concerned parties. In Korea we have no experience as like in Germany. But, in Korea, we can start more effectively to look after the possibility of any system which helps the people with need to nursing, when we have understood the factors in policy-making for the introduction of "Pflegeversicherung."

• Women's Health Nursing
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• v.17 no.4
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• pp.328-336
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• 2011

Purpose: The purpose of this study is to develop the optimal nursing fee for nurse-midwifery center (MC) in the national health insurance system. Methods: The three methodologies used to calculate the conversion factors for the MCs in the national health insurance include cost accounting method, sustainable growth rate (SGR) model, and index model. In this study, the macro-economic indicators and the national statistics were used to estimate the conversion factors for the MCs. Results: The optimal nursing fee for the MCs in 2011 was estimated to be an increase of 57.7% by cost accounting analysis, a decrease of 17.1% by SGR model, and a decrease of 16.1% by index model. The results from SGR model and index model could had been biased due to the upswing of medical spendings in the short-term period (2008~2009). A sensitivity analysis of pre-delivery subsidy program for OB & GYN hospitals and clinics showed that the program has substantially diminished the demand for the MC services. Conclusion: More reliable methodologies to estimate nursing fees precisely are required to prove the value of nurses' services and a government subsidy program for the MC services should be followed from a social perspective.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.119-128
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• 2017

This study estimated the optimal nursing workforce and financial costs of providing comprehensive nursing services at hospitals under the national health insurance system. Data on registered nurses, nursing aids, medical institutions, and number of patients were obtained from the Health Insurance Review and Assessment Service. The optimal size of the nursing workforce was calculated using the workload model. A bottom-up approach was used to estimate the annual total financial cost of comprehensive nursing services. The number of registered nurses and nursing aids would need to be increased by 81.75% and 83.23%, respectively, in order to fully apply comprehensive nursing care on a national scale. The additional financial costs for comprehensive nursing services at all hospitals was estimated to be as much as 110.39% of the current cost. For the comprehensive nursing service, nurses with a career and newcomers need to be retained at their hospitals, and the validity of the nurse-patient ratio should be continuously checked. The financial shock to the national health insurance system could be minimized by gradually extending the system to all hospitals.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.3
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• pp.391-400
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• 2000

A long-term bed rest results in an inevitable foot drop. Yet preventive device such as a foot board and high-neck tennis shoes, are not widely used. This study was conducted to compare the effects of a pillow-type foot board with that of the band-type device. The band-type device of a resonable price is designed for an effective prevention of foot drop, and the convenience for it use. Among the non-equivalent control group design, foot drop preventive effects, usefulness of the device, as well as its cost effectiveness were examined. The study was carried out for four months from December 1999, and its subject had been patients and nurses of two intensive care units at K medical center in Seoul. According to the study purpose, the data collected were analyzed by $x^2-test$ and t-test. The results are as follow : 1. The ROM of ankle joint is promoted in the experimental group with a band-type device comparing the control group with a pillow type one. Dorsiflexion is particularly increased in the experimental group as compared with the control group, while planterflexion hardly shows any change. 2. The usefulness score of the experimental group nurses using the band-type device (23.97) is higher than that of the control group nurses (18.88). 3. In an aspect of the unit production cost, band-type devices are low-priced compare with pillow-type or other foot board (wooden) or high-neck tennis shoes. In summary, the newly developed band-type device is both useful and preventive for a foot drop. It is also desirable regarding to the production cost and the cost effectiveness. This fact proves that the new anti-foot drop device could be practical both for clinical care and home care. Yet the results were obtained by some subjects, it should be used after a further examination. More effective nursing intervention could be observed throughout general studies, including proper positioning and foot and ankle exercises which are the important variables of the foot drop prevention.

• Journal of muscle and joint health
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• v.3 no.2
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• pp.166-176
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• 1996

This is a study through survey with the purpose of analysing of treatment cost for arthritis. Treatment cost can be devided Into two characteristics, one is the direct cost and the other is the indirect cost. Direct cost contains fees of medical treatment Including cost of self treatment & purchsing price of herb durg. On the other hand indirect cost means the using money of tansportation, lodging charge & labor-losing-time cost. For the succession of medical treatment of chronic diseases patients have to control themselves to go shopping around for the cure remeadies. And also it is important that the cost for unefficient or probably hamful folk remeadies should be reduced in order to distribute appropriatively the limited financial resources. As the result of this study, the fees for self treatment & herb drug are two times as much as those of regural medical treatment. Within the direct cost, there are the mean cost of regural medical treatment 59,630 won/mon., self-treatment 42,790 won/mon., and herb drug 78,380won/mon. therefore total mean direct cost is 180,800won per month. Moreover patients intermittently pay the cost of prostheses If folk remedies, these are added to the direct cost as above mentioned. Attributes of folk remedies are various from cure & analgesics to nutrients and their virtues as medicine are not clear in view of scientific knowledge. But 56% of arthritis patients have ever been experienced folk remedies. the cost for these remedies has wide ranges from 40,000 won to 1,000,000won. Total mean indirect cost including the transfortation fee, lodging charge & labor-losing-time cost has the range from 82,825won/month to 106,150won/month. Among these cost, labor-losing-time cost has a mojority because the waiting times are too long for seeing a doctor. In conclusion those patients having arthritis have a large burden against the treatment cost for continuous care. Therefore health professional should make effort to guide the patient to determine themselves informed choice about the treatment process.

• Journal of Korean Academy of Nursing
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• v.38 no.4
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• pp.612-619
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• 2008

Purpose: The purpose of this study was to examine health problems and to estimate economic impact based on health problems of workers. Methods: The subjects of this study consisted of 301 workers who received a group occupational health service. Data was collected from February 1 to March 30, 2006. The questionnaire contained questions based on general characteristics and the Stanford Presenteeism Scale. Data was analyzed with descriptive statistics, t-test using SPSS program. Results: The primary health conditions as reported by workers were ranked in order as stomach or bowel disorders, back or neck disorders, or liver function disorders. The reason of absenteeism per worker was ranked in order as asthma, or a breathing disorder. The reason of presenteeism was ranked in order as asthma, insomnia or a sleep disorder. The cost of the total economic impact on the workplace in this study was 8,851,838 won. The cost of absenteeism per worker was 8,390 won. The cost of presenteeism per worker was 941,732 won. Conclusion: Presenteeism had a strong correlation to health conditions of the workers. Therefore, improving the work conditions of the workers is very important. If employers improve the health condition of workers, they will benefit from improved productivity in their business.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.1
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• pp.113-120
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• 2005

Purpose: To identify risk factors for surgical site infections in patients undergoing general surgery, to analyze the prolonged hospital stay and extra cost for antibiotics, and to provide basic data for control of surgical site infections. Method: Surgical site infection was defined using the definition of the CDC and the data were analyzed by $x^2$-test and unpaired t-test. Results: The prevalence of surgical site infections was 9.7%, and it was related to wound class, duration of operation, number of operations, whether the operation was an emergency, trauma, drains, preoperative stays, presence of remote infection during operative period, and previous history of recent surgery. The mean duration for post-operative stay when a surgical site infection occurred was 9.5 days and in 56.9 % of the patients the surgical site infection appeared 7 days after the operation. Post-operative stays for infected patients were 20.3 days longer than that of uninfected patients. The mean cost of antibiotics for infected patients was higher than that for uninfected patients by 561,067 won per person. Conclusion: Surgical site infection results in an increased length of stay and extra-cost, thus, hospitals need to create strategies to reduce nosocomial infections through effective infection surveillance and by considering factors related to surgical site infections.

• Journal of Korean Academy of Nursing
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• v.43 no.4
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• pp.507-516
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• 2013

Purpose: The purpose of this study was to use cost-benefit analysis of activity to clarify the economic effect of prepared nurses versus atmospheric environment managing engineers as healthcare managers. Methods: For the study 111 workplaces were surveyed, workplaces in which nurses or atmospheric environment managing engineers were employed as healthcare managers. The survey content included annual gross salaries, participation in external job training, costs in joining association covered by the company, location and year of construction of the healthcare office, various kinds of healthcare expenditures, costs in operating healthcare office, health education, and activity performance in the work of environment management. Results: In the case of the healthcare manager being a nurse, benefit was larger than input costs at a ratio of 2.31. On the other hand, in the case of healthcare manager being an atmospheric environment managing engineer, input costs were larger than benefits (benefit-cost ratio 0.88). Conclusion: Results indicate that nurses are an effective healthcare human resource and can offer good quality healthcare service. Therefore companies should hire nurses and actively promote the economic efficiency of nurses in workplace.

• Perspectives in Nursing Science
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• v.6 no.1
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• pp.55-65
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• 2009

The Korean government introduced Home Care Services System to cut medical cost and make efficient use of limited medical resources because of increasing chronic diseases and the growing population of the elderly. The Korean government established measures to control the use of insurance services by restricting the number of nurse's visits to patient's home and by asking the patients to shoulder the transportation fee of nurses during the visit. Factors such as oversupply of hospital facilities, low price of home care services, high insurance coverage for hospital services and increased nuclear family set up resulted in the limited use of home care nursing services. The introduction of long-term care insurance in 2007 brought the decrease in the number of home care agencies and these agencies are facing a crisis today. The increase in chronic diseases and growing population of the elderly recently resulted in the need to control the high medical cost. Home care services for early discharge patients and chronic-severe disease patients will contribute in the reduction of medical cost at the same time improves the quality of patient's life. To catch up with the demands of the nation, accessibility to home care services should be improved and policies such as the expansion of home care services insurance coverage and promotion of establishing home care agencies should be considered.

• Women's Health Nursing
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• v.24 no.1
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• pp.24-32
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• 2018

Purpose: To determine traits related to pregnancy and delivery, length of stay, health care cost, postpartum discomfort, and satisfaction with medical service of puerperas giving birth in midwifery clinic and hospitals. Methods: This study used a comparative survey design. Data were collected from a total of 140 postpartum mothers composed of 70 mothers who gave births in two hospitals and another 70 mothers who delivered in one midwifery clinic. Results: Delivery in midwifery clinic had higher Apgar score at 1 minute and 5 minutes after birth than hospital. Those who delivered in midwifery clinic had shorter stay in the clinic, fewer health care cost, less postpartum discomfort in physical, environmental, social, and cultural areas, higher satisfaction with medical services than those who delivered in hospitals. Conclusion: Results of this study can be used as a basis for studies on giving birth in midwifery clinic and hospitals. They might increase the autonomy of women in giving birth with positive effect on the delivery experience of the mother and her spouse.