• 제목/요약/키워드: Primary medical care

검색결과 640건 처리시간 0.031초

진폐환자 가족의 특성 (The Characteristics of the Families with Pneumoconiosis Patients)

  • 박영미;이성은
    • 한국직업건강간호학회지
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    • 제8권1호
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    • pp.84-91
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    • 1999
  • Pneumoconiosis is a pathological change which is caused by coal dusts. It is a chronic disease that is not cured thoroughly but need treatment and nursing care through all lifetime of the patient. The family of the patient will be suffered from the physical and mental difficulties in the consequence of pneumoconiosis. The study is to find out the characteristics of the families with pneumoconiosis patients. The subjects of the study were 300 families with pneumoconiosis patients who were under medical treatment in Taeback, Donghae, Jeongsun Occupational Medical Center. The period of the study was from the 8th to the 31st of August, 1998. The data were collected by the structured questionnaires included the family intensity measurement which was translated by "Oh". The general properties of the subjects were calculated by frequency and percentage with SAS program. The followings are the summaries of the study. 1) The mean age of the pneumoconiosis patients was 62.3 years. The mean duration of diseases was 11 years and 7 months and the mean duration of hospital stay was 6 years and 4 months. 2) The mean age of the primary care giver was 55.7 years. The proportion of highschool education was 9.6% and it was quite low level compared to other primary care giver groups. 3) The average number of family members were 1.76 person(2.76 persons included patient). The economic status was somewhat high compared to other families with chronic patients. 4) The mean score of family intensity was 41.2(item mean=3.4). With the result, it is recommended to develop a program to improve the quality of family life. For example, there will be social support program for pneumoconiosis patients family sponsored by Social Insurance for Occupational Diseases.

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Implementation of a care coordination system for chronic diseases

  • Lee, Jung Jeung;Bae, Sang Geun
    • Journal of Yeungnam Medical Science
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    • 제36권1호
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    • pp.1-7
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    • 2019
  • The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

SWOT Analysis and Expert Assessment of the Effectiveness of the Introduction of Healthcare Information Systems in Polyclinics in Aktobe, Kazakhstan

  • Lyudmila, Yermukhanova;Zhanar, Buribayeva;Indira, Abdikadirova;Anar, Tursynbekova;Meruyert, Kurganbekova
    • Journal of Preventive Medicine and Public Health
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    • 제55권6호
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    • pp.539-548
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    • 2022
  • Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

병원 포괄 수가제 도입에 대비한 산욕부 및 신생아 가정간호 기록지 개발 (Development of a Recording System for Home Health Care for Postpartum Women adn Their Newborns)

  • 김혜숙
    • 여성건강간호학회지
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    • 제2권1호
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    • pp.25-39
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    • 1996
  • The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.

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농촌주부(農村主婦)들의 의료(醫療)와 항생제(抗生劑)에 대(對)한 지식(知識)과 태도(態度)에 관(關)한 조사(調査) (A Study on Knowledge and Attitude of Housewives toward Health Care and Antibiotics in a Rural Area)

  • 김순기
    • Journal of Preventive Medicine and Public Health
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    • 제9권1호
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    • pp.147-151
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    • 1976
  • A study was conducted during the period of August 13 to August 18, 1974 to obtain information on knowledge and attitude of the rural area housewife toward health care and antibiotics using. Interviewed 242 housewives dwelling in Soodong and Hwado Myun, Yangju Gun, Kyunggi Do, a typical rural area in Korea and the following results are obtained: 1. Of 242 housewives interviewed, 20.2% were illiteracy, 68.2% was graduated from primary school, 9.1% from middle school and 2.5% from high school. 2. Of those interviewed, 8.7% were Christian, 5.0% Bueldist, 2.9% Confucianism, and 83.4% of those were no religious preference. 3. Utility rate according with the kind of mass media in home was 85.1% of respondants possessed radio, 16.1% of magazine, 12.8% of newspaper, and 4.1% of television. 4. In the case of patients occure in a family, 13.0% out of 242 respondants had chosen physician's clinics for inicial medical care place, 58.4% drug stores, 0.9% herb medicine and 27.7% of those had chosen folk medicine at home. 5. Antibiotics effective complaints listed by the respondants were skin diseases with 43.8%, suppurated wound 30.0%, URI like symptoms 18.2%, diarrhea 14.5%, low back pain 12.9%, fever 6.2%, loss of appetite 3.3%, all kind of diseases 2.5%, urethral discharge 2.1% and tuberculosis 0.8% respectively. 6. Only 14.7% of respondants had obtained antibiotics for medical care from physician's clinics and 85.3% of the respondants had obtained antibioties from drug store (70.7%), village shop (10.4%), and salesmen in street market without any physician's prescription. 7. Eighty-nine percent of the respondants were understanding on patient care activity as the local health subcenter but only 11.0% of those on M.C.H., 29.0% of those on family planning, 21% on vaccination, and only 6.6% on tuberculosis control activity. 8. Utility rate of the local health subcenter was 71.9% out of the patients indicated medical care of medical facilities.

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건강보험자료를 이용한 12세 미만 소아에서 코데인 처방양상평가 (Prescribing Patterns of Codeine among Children under Aged 12 in Korea)

  • 박효주;신한나;신주영
    • 한국임상약학회지
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    • 제25권4호
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    • pp.273-279
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    • 2015
  • Objective: Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. Method: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were subclassified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12. Results: Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%). Conclusion: This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.

대만 의료보장개혁과 교훈 (Tawian's Health Care Reform and Its Lessons)

  • 이규식
    • 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.

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요양병원 근무 한의사의 지위와 역할에 관한 연구 (A Study on the Position and Role of Korean Medicine Doctors Working at Long-Term Care Hospitals)

  • 강태리;이상룡
    • 대한예방한의학회지
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    • 제19권3호
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    • pp.77-90
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    • 2015
  • Objective : The purpose of this study is to discuss the role and ways to improve the position and rights of Korean Medicine Doctors (KMDs) working at long-term care hospitals (LTCHs) through survey analysis. Method : (1) The legal and institutional position of KMDs is studied using current law and related papers. (2) The online survey was conducted through KMD community websites, targeted at KMDs working at LTCHs. Results : (1) Whereas there is perceived added benefit for the eight specializations for a specialist of Western medicine at LTCHs, in the case of a specialist of Korean Medicine, their value is not institutionally recognized at all. (2) A Western inpatient's medical fee is more than a Korean inpatient's medical fee, and the individual fee for the same medical treatment is also higher in Western hospitalization. So, Korean medical hospitalization actually cannot be made. Because of that, Korean Medicine Doctors find it difficult to be primary care physicians. (3) Musculoskeletal diseases and the aftereffects of cerebrovascular diseases were the most common chief complaints addressed in Korean medical consultations. Conclusion : This study shows that KMDs working at LTCHs have suffered many kinds of inequality. That is because of the limited medical scope of the current medical system and real constraints from the gap in Korean-Western medical fees by the National Health Insurance Corporation. Therefore, it is necessary to eliminate these variations along with revising the statute with continuous research.

Adult Primary Myelodysplastic Syndrome: Experience from a Tertiary Care Center in Pakistan

  • Sultan, Sadia;Irfan, Syed Mohammed
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권3호
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    • pp.1535-1537
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    • 2016
  • Background: Primary myelodysplastic syndrome (MDS) is an acquired clonal disorder of myeloid progenitor cells, characterized by peripheral cytopenias in the presence of hypercellular marrow with dysplastic features. Our aim was to study the demographical and clinicopathological features of adult Pakistani patients with MDS at disease presentation. Materials and Methods: This single centre study was conducted at Liaquat National Hospital and Medical College, extending from January 2010 to December 2014. Data were retrieved from the patient archives. Results: Overall 45 patients were diagnosed at our institution with de novo MDS during the study period. There were 28 males and 17 females. Age ranged between 18 and 95 years with a mean age of $57.6{\pm}17.4years$ and median of 64 years. The male to female ratio was 1.7:1. The main presenting complaints were generalized fatigue (60%), fever (33.3%), dyspnea (15.5%), bleeding (13.3%) and weight loss (11.1%). Examination was unremarkable in 42.2% of patients. Physical examination revealed pallor in 37.7%, followed by petechial and purpuric rashes in 20%. The commonest laboratory finding was anemia (hemoglobin < 10 g/dl in 41 (91.1%) patients. Out of these, 27 (60%) patients had normocytic anemia, followed by macrocytic (22.2%) and microcytic (8.8%). Conclusions: Primary MDS in Pakistani patients demonstrates a male preponderance. The proportion of anemic patients was high in our series with predominance of normocytic anemia. However, other clinico-hematological features appear comparable to published data.

취약계층의 재가 거주자를 대상으로 수행한 방문구강건강교육 경험에 관한 질적연구 (A qualitative study of home-visiting oral health care experience in vulnerable populations)

  • 문상은;이보람;정민숙;이재라;김선영;하명옥;김일신;임형석;이미라;윤영애;홍선화
    • 한국치위생학회지
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    • 제24권3호
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    • pp.229-242
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    • 2024
  • Objectives: The purpose of this study was to explore and analyze experiences with home-visiting oral health education in vulnerable populations and to provide foundational data necessary for the development of preventive strategies for oral health promotion among these patients. Methods: Using a phenomenological research, in-depth interviews were conducted between August 29 and October 31, 2023 with 20 vulnerable individuals participating in the Home Visit Oral Health Education Program under the Gwangju+ Gwangsan Integrated Care Service project spearheaded by the Gwangju Medical Welfare Cooperative. Results: After analyzing the contents of the participants' experiences, 130 meaningful words and 14 subcategories were identified and categorized into five major themes. Participants expressed discomfort when chewing or swallowing food and felt burdened by visits to the dentist. Although they experienced considerable loneliness because they spent a significant amount of time alone, they enjoyed communicating through visitation care and expressed gratitude for receiving oral health education. Conclusions: Oral health education through home visits cam increase awareness of oral health management among vulnerable populations and serve as an important means of improving their quality of life.