• 제목/요약/키워드: Public Health Improvement

검색결과 1,039건 처리시간 0.027초

노인환자 특성을 고려한 공공병원 병동부의 치유환경 평가 및 개선방안에 관한 연구 - 영남지역 사례를 중심으로 (A Study on the Evaluation and Improvement of Healing Environment for Public Hospital wards considering Elderly Inpatient Characteristics - Focused on the Public Hospitals in Yeongnam area)

  • 한석범;박재승
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제20권3호
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    • pp.7-15
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    • 2014
  • Purpose: This study is to propose direction for healing environment design in hospital architecture considering the characteristics of elderly patients. The primary goal of a public hospital is providing cheap health care and quality service chance to the underprivileged and elderly in the dead zone. Compared to the rapid increase of the aged population and chronic diseases, Ministry of Health & Welfare is currently planning model of health promotion hospital in development plans of local based public hospital. Due to the increased elderly medical expenses, elderly patients' high utilization is considered. Methods: The literature on the design factors of healing environments were investigated. based on this, analyzed drawings of surveyed hospitals ward in architectural characteristics and observe and evaluate directly healing environment design through field surveys. Results: The design of hospital environment affects patient's therapeutic effect. There is no any official formula for hospital design but environment that architect create could be a big part of the healing process. To increase the quality of the environment, apply the characteristic factors and harmonize well as a human-centered healing environment. Implications: Healing environment design for the elderly is first necessary condition due to high proportion of elderly patients.

한 광역자치도에서 국립대병원과 지방의료원간 협력체계 구축 사례의 성립 요인 및 과정평가 (Process Evaluation and Influencing Factors of Building up a Network System between a National University Hospital and a Public Community Hospital in a Korean Provincial Area)

  • 이원영
    • 보건의료산업학회지
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    • 제6권4호
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    • pp.219-229
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    • 2012
  • This study aimed to explore influencing factors on the establishment of the network system between public hospitals and to make a process evaluation of it. we analyzed the case of a strategic alliance contracted by a National University Hospital(NUH) and a Community Hospital(CH). Main points of the project were regular dispatch of clinical specialists in the NUH such as gastroenterologist and running teleradiology program. The NUH considered the improvement of it's image as a public hospital as a successful element of the network program. The provincial office which have to manage the CH satisfied with these program in terms of helping CH in need of clinical specialists. Staffs in the CH pointed out the problem of discontinuity for patients who visited the CH. Three institutes argued that continuous support of central government in the relevant institution and budget could play the most important role in the advance of the network system between public hospitals.

외국의 성과연동지불제도 현황과 가감지급사업의 발전방향 (Reviews of Pay-for-Performance and Suggestion for Korean Value Incentive Program)

  • 윤효정;박은철
    • 보건행정학회지
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    • 제27권2호
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    • pp.121-127
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    • 2017
  • The effort to measure and improve the quality of healthcare is a common health policy issue worldwide. Korean Value Incentive Programme is one of that effort, but some concerns exist. Compared to pay for performance program in other countries, it measures healthcare quality with relatively narrow performance domain using a small number of clinical indicators. It was designed without involving hospitals and other key stakeholder, and program participation was mandated. Highest and lowest performers get bonus and penalty using relative ranking. As a suggestion for development, the direction for quality management at the national level should be given first. Therefore the philosophy or strategy for quality improvement should be reflected to the program. And various domains and indicators of healthcare quality should be developed with active communication with healthcare providers. The evaluation method is necessary to be changed to provide achievable goal to the healthcare providers and attract quality improvement.

침구치료로 개선된 장애인의 정신건강 증례보고 (A Case Report on Improvement Mental Health of the Disabled by Acupuncture and Moxibustion)

  • 고원준;박상균
    • Korean Journal of Acupuncture
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    • 제39권1호
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    • pp.16-21
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    • 2022
  • The purpose of this study is to report the case mental health of people with disabilities has improved through visit treatment at public health centers. From October 26, 2021 to January 04, 2022, 6 visits were conducted and Patient Health Questionnaire-9 (PHQ-9), Beck Depression Inventory (BDI), Korean version of Center for Epidemiological Studies-Depression Scale (K-CES-D), Visual Analog Scale (VAS), Euro Qol-Visual Analogue Scale (EQ-VAS), Modified Barthel Index (MBI) were used to check changes. After Korean Medicine treatments such as acupuncture, electroacupuncture, electromoxibustion, PHQ-9 decreased from 18 to 8, BDI decreased from 22 to 15, K-CES-D decreased from 42 to 21. And VAS decreased from 85 to 50, EQ-VAS increased from 30 to 50. But There was no change in the MBI. Confirmation of improvement in mental health-related indicators of disabled patients through Korean Medicine treatments.

미생물 간이 검사법 실시에 따른 학교급식소의 위생 및 건강관리 개선 효과 (Effects of Microbe Inspections in School Food Service Systems)

  • 한명숙;윤성태;임준;임정수
    • 보건교육건강증진학회지
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    • 제23권3호
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    • pp.53-63
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    • 2006
  • Objectives: The purpose of this study was to analyze the effects of microbe inspections on the hygienic improvement of school food service systems. Methods: Thirty-three school food service systems in Incheon metropolitan city participated in the study from Sep. 2004 to Apr. 2005. Major items of microbe inspections were cutting boards, knives, kitchen towels, and kitchen staff's hands. The Rodac plate and hand plate were used to measure the surface contamination level of germs such as Staphylococcus aureus, Vibrio species, Salmonella species and E. coli. Results: This study compared the results of the inspections in Sep. 2004 and Apr. 2005. The surface contamination level of Staphylococcus aureus and Vibrio species on the knives and kitchen towels had significantly improved. However, the surface contamination level of E. coli on the hands of the kitchen staff had worsened. Conclusions: This study showed that microbe inspections could control the hygienic level of the school food service systems. In the future, microbe inspections should be actively used to improve sanitary conditions in the school lunch system.

The Effectiveness of a Cultural Competence Training Program for Public Health Nurses using Intervention Mapping

  • Kim, Yune Kyong;Lee, Hyeonkyeong
    • 지역사회간호학회지
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    • 제27권4호
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    • pp.410-422
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    • 2016
  • Purpose: This study evaluated the effects of a cultural competence training program for public health nurses (PHNs) using intervention mapping. Methods: An embedded mixed method design was used. Forty-one PHNs (experimental: 21, control: 20) and forty marriage migrant women (MMW) (20, in each group) who were provided nursing care by PHN participated in the study. The experimental group was provided with a four-week cultural competence program consisting of an eight hour offline and online course, e-mail newsletters and social networking services (BAND). Transcultural Self-efficacy (TSE) of the PHNs, client-nurse trust, and satisfaction with nursing care of MMW were measured. Ten PHNs in the experimental group were interviewed after the experimental study. Results: The experimental group showed a significantly greater improvement in TSE, client-nurse trust, and satisfaction with nursing care than did the control group. Six themes emerged from qualitative data: (a) Recognizing cultural differences, (b) Being interested in the multicultural policy, (c) Trying to communicate in MMW's own language, (d) Providing medical information using internet and smart phone, (e) Embracing culturally diverse people into society, and (f) Requiring ongoing cultural competence training. Conclusion: Cultural competence training enabled PHNs to provide culturally competent care and contribute to MMW's health outcomes.

보건소 뇌졸중 자조관리교실 프로그램이 재가 뇌졸중 환자의 자기효능감, 자아존중감, 질병 관련 지식 및 가족지지에 미치는 효과 (Effects of a Self-help Management Program at Public Health Centers on Self-efficacy, Self-esteem, Knowledge of Stroke, and Family Supports in Stroke Patients)

  • 장경오
    • 지역사회간호학회지
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    • 제24권4호
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    • pp.388-397
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    • 2013
  • Purpose: The purpose of this study is to examine effects of a self-help management program at public health centers on self-efficacy, self-esteem, knowledge of stroke and family supports in stroke patients. Methods: Based on a quasi-experimental design, 44 persons with stroke were assigned to the experimental group (n=21) or the control group (n=23). Data were analyzed through the descriptive statistics, t-test, $x^2$-test and Mann-Whitney test with the SPSS/WIN 18.0 program. Results: The experimental group showed significant improvement in its members' self-efficacy, self-esteem, knowledge of stroke and family supports. Conclusion: The self-help management program can be an effective nursing intervention to help stroke patients improve their self-efficacy, self-esteem, knowledge of stroke and family supports. That program is also meaningful in that it can contribute to more effective implementation of established programs for stroke patients in public health centers.

의약분업(醫藥分業) 실시(實施)에 따른 보건소(保健所)의 내부변화(內部變化)와 업무개선방안(業務改善方案) (Internal Changes and Countermeasure for Performance Improvement by Separation of Prescribing and Dispensing Practice in Health Center)

  • 정명선;감신;김태웅
    • 농촌의학ㆍ지역보건
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    • 제26권1호
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    • pp.19-35
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    • 2001
  • 보건소의 의약분업 시행에 따른 업무변화와 업무 개선방안에 대해 조사 분석하여 보건소의 기능 및 역할 재정립에 필요한 기초자료를 얻고자 2001년 4월과 5월에 경상북도내 25개 보건소와 대구광역시 6개 보건소의 소장 또는 과장에게 의약분업 실시 전후의 보건소 업무 및 진료실적변화 정도를 조사하였고, 이와 함께 보건소 공무원 221명에게 의약분업에 따른 보건소 업무개선방안에 대해 설문 조사하였다. 31개 대상 보건소 가운데 77.4%인 24개 보건소가 주민진료편의 조치를 취하였다고 하였다. 주민 진료편의 조치를 한 보건소의 조치내용으로 약국배치도마련(73.9%), 인테리어 개선(39.1%), 전자처방전달시스템 도입(34.8%) 순이었다. 의약분업 실시 후 의사는 대상 보건소의 3.2%에서 감소하였다. 의약분업에 따라 월평균 진료건수는 대상 보건소의 58.1%에서 감소하였다고 하였고, 조제건수는 96.4%, 총진료비는 80.6%, 본인부담금은 80.6%, 약품구입비는 96.7%의 보건소에서 감소하였다고 하였다. 의약분업 실시 이후 진료부문에 비해 보건사업 부문의 비중은 54.2%의 보건소에서 증가하였다고 하였다. 의약분업 전후이 분기별 진료실적을 분석한 결과 진료실인원은 의약분업이전과 비교하여 의약분업 이후에 감소하였고, 진료연인원은 군보건소와 보건의료원은 감소하였으며, 시화 구보건소는 감소했다가 점차 증가하고 있다. 조제건수 총진료비 본인부담금 약품구입비는 크게 감소하였다. 보건소 공무원들은 의약분업 실시 이후 진료부문의 기능에 대해서는 57.6%가 축소시켜야 한다고 하였고, 보건소에서 우선적으로 개선해야 할 부분으로는 보건사업내용 개발(62.4%), 인력재배치(51.6%), 사업우선순위 결정(48.4%), 조직개편(36.2%), 진료서비스의 질 향상(32.1%), 예산재배치(23.1%) 순으로 응답하였다. 보건소의 이미지를 개선하기 위해서는 지역주민건강정보관리 강화(60.7%)가 가장 시급하다고 하였으며 홍보를 통한 보건소의 이용 확대(15.8%), 보건소 공무원의 친절(15.3%), 건강상담요원 배치(8.2%) 순이었다. 의약분업 실시 이후 바람직한 보건소 역할 설정을 위하여 보건소 전체 업무 영역에 대해 의약분업 이전과 이후에 상대비중을 매기도록 한 결과 25개 세부영역 중 일반진료 및 응급진료 영역만 모두 상대비중이 높아졌다. 의약분업 이후 보건소가 중점을 두어야 할 우선 순위 5위까지의 업무영역은 순서대로 예방접종, 건강증진, 모자보건, 급만성전염병, 지역보건의료계획 이었다. 향후 보건소가 바람직한 공공보건의료조직으로 기능 및 역할을 재정립하기 위해서는 의약분업이라는 중대한 보건의료환경변화를 계기로 진료부문의 기능은 축소하되 노후시설 장비의 개선, 진료방식의 다양화, 건강정보관리 강화 등 진료서비스의 내용과 질에 있어서는 강화하는 방향으로 나아가야 할 것이다. 또한 인력재배치 및 조직개편과 함께 다양한 보건사업의 개발과 지역특성에 맞는 사업우선순위에 의해 예방접조, 건강증진, 모자보건, 급 만성전염병, 지역보건의료계획 수립, 구강보건, 만성퇴행성질환 등 지역주민의 건강증진 질병예방 기능을 강화하되 지역특성(대도시, 중소도시, 농어촌)에 맞게 예방위주의 건강 증진업무와 환자 진료업무의 비중을 차별화 시키는 방향으로 개선해 나가야 할 것이다.

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치과의료 질 향상활동 현황과 개선활동 만족도 (Conditions and Performance of Quality Improvement Activity in Korean Dental Hospitals)

  • 김한나;김호;김혜영
    • 치위생과학회지
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    • 제13권4호
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    • pp.359-368
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    • 2013
  • 본 연구에서는 치과의료 QI 활동이 활발할 가능성이 있는 21개 대표적인 의료기관을 선정하여 QI 활동의 개괄적인 현황을 조사하고, 동시에 그 기관에 근무하는 치과위생사 전체를 대상으로 치과의료 QI 활동의 시행 실태 및 QI 활동시행 후 개선효과에 대한 만족도를 조사하고 QI 활동의 활성화 요인과 저해요인 등을 알아봄으로써 치과의료 QI 활동의 현황을 파악하고 이에 따른 발전 방안을 제시하고자 하였다. 주요 결과는 다음과 같다. 1. QI 활동 주제별 시행률은 외부고객만족 주제가 59.9%로 가장 높았고 비용절감 59.4%, 의료의 질 향상 58.8%, 위험관리 52.8%, 업무효율성 향상 46.5%의 순으로 나타났다. 2. QI 활동 시행 후 개선 효과에 대한 만족도 점수는 비용절감 3.68점, 의료 질 향상 3.66점, 위험관리 3.65점, 외부고객만족 3.61점, 업무 효율성 향상 3.45점 등의 순으로 나타났다. 3. 의료기관 종류별 비교에서는 일반(종합)병원의 QI 활동 시행률이 유의하게 높았고 만족도 점수에서는 치과대학병원이 여러 항목에서 낮은 만족도 점수를 보였다. 4. 가장 많은 응답자가 지적한 QI 활동을 활성화 하는 요인은 병원종사자들의 적극적인 참여도, 저해하는 요인으로는 QI 활동의 인력과 예산 부족이 있다. 결론적으로 치과의료 QI 활동은 외부고객만족도 등 가시적인 효과가 용이하게 나타나는 주제에 집중되는 반면 복잡하고 가시적인 효과가 빠른 시간 내에 나타나기 어려운 주제에 대한 QI 활동은 소홀한 경향이 있으므로 균형 있는 사업 시행을 도모하고 QI 활동을 활성화하기 위해서 노력하여야 할 것으로 생각된다.

여성 결혼이민자의 주관적 건강상태, 건강행위 실천, 결혼만족도 (Perceived Health Status, Health Behavior, and Marital Satisfaction in Married Immigrant Women)

  • 김광숙;문선숙
    • 한국보건간호학회지
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    • 제25권2호
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    • pp.174-186
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    • 2011
  • Purpose: The study examined the correlation of perceived health status, health behaviors, and marital satisfaction in women who have immigrated to Korea through marriage. Method: Data were collected via questionnaires that investigated health status, health behaviors, Korean language ability, characteristics of couple, and marital satisfaction. Three hundred four subjects were selected for a 4-month period. The data of 300 subjects were analyzed using descriptive analysis, t-test, ANOVA, and correlation, after four questionnaires were excluded due to incomplete data. Results: Perceived health status varied significantly according to nationality, existence of religion, and period of immigration. The scores for perceived health status among women who had lived in Korea for more than 5 years were lower than for women who had resided for 1-3 years. There was a significant positive correlation between health status and health behavior, and health status and Korean language ability, but a negative correlation between health status and age. Conclusion: A program for the improvement of health in immigrant women should include communication assistance as their mother language and should provide periodic health screening.