• Title/Summary/Keyword: Quasi-state

Search Result 504, Processing Time 0.024 seconds

A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)

  • 박경숙;정연강
    • Journal of Korean Academy of Nursing
    • /
    • v.24 no.4
    • /
    • pp.545-556
    • /
    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

  • PDF

The Politics of Scale: The Social and Political Construction of Geographical Scale in Korean Housing Politics (스케일의 정치: 한국 주택 정치에서의 지리적 스케일의 사회적.정치적 구성)

  • Ryu, Yeon-Taek
    • Journal of the Korean Geographical Society
    • /
    • v.42 no.5
    • /
    • pp.691-709
    • /
    • 2007
  • This paper investigates the social and political construction of geographical scale in conjunction with Korean housing politics. Recently, attention has been drawn to the issue of the social and political construction of geographical scale. Spatial scales have increasingly been regarded as socially constructed and politically contested rather than ontologically pregiven or fixed. The scale literature has paid attention to how different spatial scales can be used or articulated in social movements, with an emphasis on 'up-scaling' and 'scales of activism' rather than 'down-scaling' and 'scales of regulation.' Furthermore, the scale literature has focused on the aspect of empowerment. However, it is worthwhile to examine how scale-especially 'down-scaling' and 'scales of regulation'-can be used not only for marginalizing or excluding unprivileged social groups, but also for controlling the (re)production of space, including housing space. Under a regulatory regime, the Korean central government gained more control over the (re)production of housing space at geographical multi-scales by means of 'jumping scales,' specifically 'down-scaling.' The Korean central government has increasingly obtained the capacity to 'jump scales' by using not only multiscalar strategies for housing developments, but also taking advantage of various scales of institutional networking among the central and local governments, quasi-governmental institutions, and Chaebols, across the state. Traditionally, scale has been regarded as an analytical spatial unit or category. However, scale can be seen as means of inclusion(and exclusion) and legitimation. Choosing institutions to include or exclude cannot be separated from the choices and range of spatial scale, and is closely connected to 'scale spatiality of politics.' Facilitating different forms of 'scales of regulation,' the Korean central government included Chaebols and upper- and middle-income groups for the legitimization of housing projects, but excluded local-scale grassroots organizations and unprivileged social groups as decision-makers.

Intercomparison of Satellite Data with Model Reanalyses on Lower- Stratospheric Temperature (하부 성층권 온도에 대한 위성자료와 모델 재분석들과의 비교)

  • Yoo, Jung-Moon;Kim, Jin-Nam
    • Journal of the Korean earth science society
    • /
    • v.21 no.2
    • /
    • pp.137-158
    • /
    • 2000
  • The correlation and Empirical Orthogonal Function (EOF) analyses over the globe have been applied to intercompare lower-stratospheric (${\sim}$70hPa) temperature obtained from satellite data and two model reanalyses. The data is the19 years (1980-98) Microwave Sounding Unit (MSU) channel 4 (Ch4) brightness temperature, and the reanalyses are GCM (NCEP, 1980-97; GEOS, 1981-94) outputs. In MSU monthly climatological anomaly, the temperature substantially decreases by ${\sim}$21k in winter over southern polar regions, and its annual cycle over tropics is weak. In October the temperature and total ozone over the area south of Australia remarkably increase together. High correlations (r${\ge}$0.95) between MSU and reanalyses occur in most global areas, but they are lower (r${\sim}$O.75) over the 20-3ON latitudes, northern America and southern Andes mountains. The first mode of MSU and reanalyses for monthly-mean Ch4 temperature shows annual cycle, and the lower-stratospheric warming due to volcanic eruptions. The analyses near the Korean peninsula show that lower-stratospheric temperature, out of phase with that for troposphere, increases in winter and decreases in summer. In the first mode for anomaly over the tropical Pacific, MSU and reanalyses indicate lower-stratospheric warming due to volcanic eruptions. In the second mode MSU and GEOS present Quasi-Biennial Oscillation (QBO) while NCEP, El Ni${\tilde{n}}$o. Volcanic eruption and QBO have more impact on lower-stratospheric thermal state than El Ni${\tilde{n}}$o. The EOF over the tropical Atlantic is similar to that over the Pacific, except a negligible effect of El Ni${\tilde{n}}$o. This study suggests that intercomparison of satellite data with model reanalyses may estimate relative accuracy of both data.

  • PDF

The Effect of Home Rehabilitation Exercise Program of Home Stayed Chronic Hemiplegic Stroke Patients (재가 만성 뇌졸중 편마비 환자의 가정 재활운동 프로그램의 효과)

  • Roh Kook Hee
    • Journal of Korean Public Health Nursing
    • /
    • v.16 no.1
    • /
    • pp.77-94
    • /
    • 2002
  • This study was a quasi-experimental study of nonequivalent control group pretest- posttest design to investigate the effect of home rehabilitation exercise program on the physical and psychological functions of home stayed chronic hemiplegic stroke patients. The data were collected during the period of May 20th to August 15th, 200l. The subjects for this study were 40 hemiplegic stroke patients with the experimental group consisting of 19 patients and the control group being composed of 21 patients. The patients selected for this study were: (a)living in J city who had been diagnosed with stroke and at home after being discharged from the hospital, (b) suffering from stroke for 6 months to 5 years, (c) without recognition disorder with the MMSE-K(Mini-Mental State Examination-K)score above 25, (d) below 2 on the modified Ashworth scale, (e)free from heart and pulmonary disease, (f)able to walk beyond 15 minutes for themselves, (g) not taking regular exercises. The program for the experimental group provided 8 weeks' home rehabilitation exercise, two times of group education during the first week and individual education and supportive care after the second week through home visiting and telephoning more than once a week. The amount of time spent on rehabilitation exercise by the experimental group was 35 to 50 minutes a day, three times a week. In order to understand the effects of experiment the two groups were compared and verified by measuring the physical and psychological functions of both groups. The data were analysed by $\chi^{2}-test$, paired t-test and unpaired t-test and ANCOVA through SAS/PC program. The results of the study were as follows: 1. In terms of physical variables: grip strength. lower extremity muscle strength, walking time, ADL and serum lipid levels 1) There was no significant difference in the unaffected and affected grip strength between the two groups, even though the unaffected and affected grip strength was more improved in the experimental group than in the control group. 2) There was no significant difference in the unaffected lower extremity muscle strength between the two groups, even though the unaffected lower extremity muscle strength was more improved in the experimental group than in the control group. There was no significant difference either in the affected lower extremity muscle strength between the two groups, even though the affected lower extremity muscle strength was more improved in the experimental group than in the control group. 3) There was significant difference in walking time between the two groups. Walking time was significantly reduced in the experimental group whereas it increased in the control group. 4) There was significant difference in ADL score between the two groups. ADL score was significantly increased in the experimental group, but it significantly decreased in the control group. 5) There was significant difference in serum total cholesterol level between the two groups. After experiment the serum T-C level became lower in the experimental group whereas it became sigficantly higher in the control group. 2. In terms of psychological variables: depression and self-esteem 1) There was no significant difference in the depression between the two groups, even though the depression showed constant in the experimental group, but it showed a significant increase in the control group. 2) There was no significant difference in the self-esteem between the two groups, even though the self-esteem showed some increase in the experimental group, but it significant decrease in the control group. As shown above, the results of 8 weeks' home rehabilitation exercise program for chronic hemiplegic stroke patients produced positive effects on walking time, ADL score and serum T-C level, shortening walking time, improving activities of daily living(ADL) and lowering serum total cholesterol level.

  • PDF