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Association between Bone Mineral Density and Bone Nutrition Indicators in Elderly Residing in Low Income Area of the City (도시거주 저소득층 노인들의 골지표 및 영양소섭취와 골밀도와의 상관관계에 관한 연구)

  • 손숙미;전예나
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.1
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    • pp.107-113
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    • 2004
  • This study explored the association between the bone nutrition indicators and the bone mineral density (BMD) in 138 apparently healthy elderly (male: 38, female: 100) dwelling in a low income area of the city. Dietary intakes were estimated from two meals (breakfast & dinner) and snack using 24 hr-recall method and lunch with weighing over 3 consecutive days. Female elderly showed significant lower intakes (p<0.001∼p<0-05) for most of the nutrients except calcium and vitamin C than the elderly male. Calcium and vitamin D intakes for both male and female were 331.0 mg, 1.89 $\mu\textrm{g}$ and 308.6 mg, 1.21 $\mu\textrm{g}$, respectively and they were below the 50% of the RDA. Both the BMDs at lumbar spine (LS) and femoral neck (FN) were positively correlated with the energy intake, calcium intake and vitamin D intake (p<0.05, respectively) for male. In female BMDs of the both sites were positively correlated with the intakes of carbohydrates, protein, lipid, calcium and vitamin D (p<0.01∼p<0.05). Female showed higher serum osteocalcin (p<0.01) and urinary deoxypyridinoline/creatinine (DPYR/CR) (p<0.001), meaning that female had elevated rate in bone turn over and bone resorption. The proportion of subjects with vitamin D deficiency assessed with serum 25(OH)VitD$_3$<10 mg/mL was 35.0% for female and 23.7% for male, respectively Both the BMDs at lumbar spine and trochanter were positively correlated with serum 25(OH)VitD$_3$ but BMDs in most of the sites were negatively associated with urinary DPYR/CR, phosphate/CR. Stepwise multiple regression showed physical activity, serum alkaline phosphatase, weight, vitamin D explained 47.6% of the variation of the LS BMD. The indicator variable for serum alkaline phosphatase was negatively associated with LS BMD. However, the indicator variable for weight and vitamin D intake were positive and significant (p=0.0087, p=0.0007, respectively). For FN BMD, the indicator variable for age and serum alkaline phosphatase were negative and significant (p<0.0075, p<0.0015, respectively) and the weight was positively associated with the FN BMD.

A Verification on the Effectiveness of Middle Managers' Emotional Leadership in Food Service Management Companies (위탁급식업체 중간관리자의 감성리더십 효과성 검증)

  • Kim, Hyun-Ah;Jung, Hyun-Young
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.36 no.4
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    • pp.488-498
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    • 2007
  • The purposes of this study were to: a) provide evidences concerning the effects of emotional leadership b) examine the impacts of emotional leadership on employee-related variables, 'job satisfaction', 'organizational commitment', 'organizational performance' and 'turnover intention', and c) identify a conceptual framework underlying emotional leadership. A survey was conducted from August 23 to November 3, 2005 to collect data from mid-level managers in food service company headquarters (N=219). Statistical analyses were completed using SPSS Win (12.0) for descriptive, reliability, factor and correlation analyses and AMOS (5.0) for confirmatory factor analysis and structural equation modeling. The main results of this study were as follows. First, the managers gave the highest point to their leaders in the emotional leadership competence 'organizational awareness : reading the currents, decision networks, and politics at the organizational level' and gave the lowest point in the emotional leadership competence 'influence: wielding effective tactics for persuasion'. Second, the means of job satisfaction was above the midpoint (3 points). Employees' job satisfaction with 'coworkers' was relatively high. However, the extents of satisfaction with 'payroll' 'promotion', and 'work environment' were relatively low. Third, the organizational commitment was above the midpoint (3 points). In the organizational commitment, 'loyalty' factor was higher than 'commitment' factor. Fourth, the means of organizational performance was above the midpoint. The highest organizational performance variable was 'internal efficiency; trying to reduce cost' and the lowest organizational performance variable was 'internal fairness ; equitable treatment and all are treated with respect with no regard to status and grade'. Fifth, most respondents intended on 'thinking of quitting ; towards turnover process'. Sixth, the test of hypothesis using structural equation modeling found that emotional leadership produced p[Isitive effects on job attitude and job performance. Emotional leadership enhanced job satisfaction and organizational commitment, and in turn, employees' attitude positive effects on organizational performance; emotional leadership also had a direct impact on organizational performance

A Study on Psychological Rehabilitation to Decrease Powerlessness in the Elderly Population (노인의 무력감 완화를 위한 심리 재활에 관한 연구)

  • 김조자;임종락;박지원
    • Journal of Korean Academy of Nursing
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    • v.22 no.4
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    • pp.506-525
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    • 1992
  • Older people, because of the psychological and physiological changes related to the aging process are more vulnerable to experiencing powerlessness than any other age group. This self destructive cycle of depression in older people related to the experience of continued and long term powerlessness can lead even to death. The purpose of this study was to measure powerlessness and resources to increase power in older people, and to measure the effectiveness of a psychological rehabilitation program for reducing powerlessness. The research methodology used was a two step process. In the first step, a survey was done of perceived powerlessness and power resources comparing four groups of elderly people ; those living at home, those in hospital, those living in nursing homes and those attending educational programs for the elderly. The total sample size was 236. In the second step, a psychological rehabilitation program was carried out, pre and post measurements were taken related to this program. The sample consisted of 29 residents in a nursing home. The results of the study are as follows : 1. Powerlessness was classified as cognitive, emotional, activity and learning. The lowest score for powerlessness was in the area of activity, that is the people in the sample felt more power concerning their activities. The highest score was in the area of cognition where they felt they had less power. 2. When the different groups of elderly were compared, it was found that the residents of the nursing home had the highest score on perceived powerlessness and the group who were living at home had the lowest score. 3. Among the general characteristics, the factors influencing the powerlessness score were age, sex, level of education, financial resources and health status. In the interaction effects among these factors, it was found that level of education and health status were factors influencing perceived powerlessness. The elderly with lower education and poorer health status had the higher scores for perceived powerlessness. 4. The power resources could be classified into the following areas : physical strength, emotional strength, positive self-image, energy, knowledge, motivation and belief system. Belief system was given the highest score among the power resources and energy, knowledge and motivation were given low scores. 5. The group participating in an educational program for the elderly had the highest score for power resources while the group made up of residents of a nursing home had the lowest score as well as the highest score for perceived powerlessness. 6. The factors influencing the power resource scores were sex, level of education, financial resources and health status. In the analysis of the interaction effect among the factors, it was found that sex, level of education and financial resources were the factors that influenced the power resource score, that is, women, those with a low level of education and those with poor financial resources reported a lower level of power resources. 7. There was a negative correlation between perceived powerlessness and power resources in the elderly in this study. Since power resources explainded 49% of the variance for powerlessness, it can be concluded that the power resources can be used to reduce powerlessness. 8. The psychological rehabilitation program was carried out with the nursing home residents over a period of five weeks. No statistically significant difference was found in the scores on powerlessness between the pre and post tests, but there was a slight decrease in the raw scores on the post test for emotional, activity and learning powerlessness. There was a statistically significant increase in the power resource scores for emotional strength, positive self-image, energy, knowledge and motivation in the post test as compared to the pre test. In conclusion, the study indicates that a psychological rehabilitation program for the elderly could be effective in increasing power resources and this in turn could lead to a decrease in perceived powerlessness.

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A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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Changes in midpalatal suture area and adjacent periodontal tissues of individual tooth following rapid palatal expansion in young adult dogs ; Histomorphologic and immunohistochemical study (유성견 급속 구개확장시 정중구개봉합부 및 치아주위 조직 변화에 관한 조직형태학적 및 면역조직화학적 연구)

  • Lee, Ju-Young;Lee, Jin-Woo;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.30 no.3 s.80
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    • pp.317-333
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    • 2000
  • The purpose of this study was to determine the proliferative activity of the osteoblasts and fibroblasts in the midpalatal area and to investigate the adjacent periodontal tissues of individual tooth following rapid expansion of the palate. Ten young adult dogs, aged approximately ten months, were used in the experiment. The experimental design was consisted of 1 week expansion group(Group E1, 3 dogs), 2 week expansion group(Group E2, 3 dogs), 2 week expansion and 2 week retention group(Group E3, 3 dogs), and control group(Group C, 1 dog). For each group, expansion screw was activated one time per day(1/4 turn;$90^{\circ}$) following Hyrax-screw application. The experimental animals in each group were sacrificed at 1, 2 and 4 weeks following palatal expansion. Maxillary tissue blocks were obtained and prepared ior the histomorphologic and immunohistochemical studies. Light mcroscope, polarizing microscope, and soft X-ray apparatus were used in this study, and following results were obtained. 1. In polarizing microscopic study, the expansion groups(E1 & E2) showed blue color representing bone resorption and new bone formation in midpalatal suture area. E3 groups skewed less blue color compared to the E1 and E2 group. But yellow color increased by calcification in the E3 groups. 2. Immunohistochemical study revealed that positive responses of the osteoblasts to PCNA and undifferentiated fibroblasts to EGF in E1 group were somewhat increased. Positive response to PCNA and EGF were increased in fibroblasts and the osteoblasts forming new bone in E2 group. In E3 group, the positive response cell concentrated the periphery of edge of palatal process in both PCNA and EGF. 3. Throughout the expansion period(E1 & E2), light microscopic study showed the edges of the extensive resorption and new palatal processes, indicating bone remodeling within the suture. E3 group exhibited less remodeling of midpalatal suture area. E2 group and E3 group showed cementum formation and resorption at the apex of 3rd premolar and 1st molar E3 group exhibited extensive hyalinized zone on the cervical portion of buccal side of 1st molar. 4. Soft X-ray analysis of E1 group showed hypomineralized defect and microfractures in various parts of the suture areas when compared with control animals. There was no significant difference in the degree of mineralization in the midpalatal suture region between the C and E3 groups. Tooth axis showed tipping of 3rd premolar and 1st molar in the E2 group and E3 group. Based upon these experimental results, it is concluded that the undifferentiated mesenchymal cells always presented in midpalatal suture area following RPE. Differentiated osteoblasts and fibroblasts possess proliferating cellular activity until the 2 week retention period. The posterior teeth are tend to tip buccally as RPE force applied. Retention group exhibited irreversible response with severe hyalinized zone on the buccal surface of the first molar.

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A Study on the Shinmoongo System: Issues of the Origin and Changes of Function and Institution (신문고 제도에 대한 몇 가지 쟁점: 기원과 운영, 기능.제도의 변천을 중심으로)

  • Kim, Young-Ju
    • Korean journal of communication and information
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    • v.39
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    • pp.250-283
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    • 2007
  • The Shinmoongo (Shinmoon-drum) system is known as the last means of petition, appeal, and, denunciation during the Chosun dynasty. The purpose of this study is first to examine the system's origin and changes of its function and operation. The study further looks at several issues around the striking gong system, an alternative appealing method, and its background and transition. Introduced by King Taejong, the Shinmoongo was a kind of the press (or communication) system which was intended to deliver various cases of personal appeal, social petition, national denunciation, etc. Since the 2nd year of King Sejong, the system had been changed into the legal system which mainly to settle personal mortifying problem. Originally, the system was institutionalized for the common people who were hard to appeal their mortifying affairs to the supervisory administration. This reporting system to a superior was utilized as an institutional device to remedy abuses from 'complaint to the King near his sedan chair' and 'direct complaint out of order' during the early disordered years of Chosun dynasty. The system was often abused for the devices of private interest by illustrious officials. Meanwhile, it carried out a role of checking power abuses of provincial governors and magistrates. There were many obstacles for the common people and lowly people to turn to the means. The drum was located at the palace of capitol, less accessible for most people at the time. The petition had to be processed through several steps in written forms. The punishment on a false drummer was heavy. It inhibited any appeal concerning the superior under the rigorous caste system. The Shinmoongo system is regarded as a legitimate press system. Also, it is taken as informal or semi-official press system such as 'document to send around', 'document for agitation', 'joint petition', 'striking gong to complain', 'complaint to the King near his sedan chair', 'scream to complain', etc. Connecting together, the tools resulted in the increase of regal power and decrease of divine authority.

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A study on the traditional salt-making of the Joolpo inlet area during the 18th and 19th century (18~19世紀 茁浦灣의 煮鹽 - 鹽場의 分布와 煮鹽法을 중심으로 -)

  • ;Hong, Keum-Soo
    • Journal of the Korean Geographical Society
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    • v.29 no.1
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    • pp.46-64
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    • 1994
  • Among every civilized people salt has been recognized as an essential foodstuff to the human society without which even man's survivor is unthinkable. The cultural-anthropological meaning of salt is estimated highly as well, and in geographical perspective salt itself symbolize regional interrelationship. Playing a decisive role in freeing innermost settlement from isolation, salt aiso made a contribution to expanding human habitats. This study tries to reconstruct historica geography of 18th and 19th century surrounding traditional salt-roasting (chayeom). The Joolpo Inlet area which is located on the mid-western coast in Honem Region is selected for study area. Established on the basis of optimum physical geographical conditions such as topography, climate and vegetation, salt-making of Joolpo Inlet area was run dynamically with the sudden turn of events in the 18-19th century which was chacterized as an age of transition from medieval society to modern one. In this paper the writer attempts to clarify mainly following three points: physical conditions and socio-economic background leading to the initiation and later development of roasting of salt in Joolpo Bay; distribution of saltworks; methods of saltmaking. Main points drawn from these analyses can be summarized as follows: of iron pan and cow-drawn tools rendered labour-saving and output growth. 1, Saltworks of Joolpo Inlet area in the 18-19th century were distributed evenly over Kobu, Puan, Mujang and Heungduck counties among which Kobu's was located in Puanmyon - a sort of exclave. All saltworks belonging to above four counties were clasified as most lucrative ones in Honam Region on government archives. In particular, Gumdang saltwork which belongs to Mujang county is noteworthy in that it was first introduced by one Paekje priest in 6th century and therefore it provides a clue to examine the history of salt-roasting of Joolpo Inlet area. In light of the fact that temple or monastery economy, regardless of East and West, has been closely connected with traditional industry, the case of Gumdang is not unusual. 2. The process of saltmaking follows this order: harrowing of salt field exposed to solar heat; construction of saltern mound with saline earth; acquiring of brine by leaching saline earth; roasting of salt. Salterns (saltworks) are consisted with various salt making facilities such as roasting shed, saltern mound, salt field, salt well) salt pit or brine pit) and seawater reservoir. Among them roasting shed which is constructed chiefly with hundreds of pieces of pine tree as a frame and with straw as roof and wall is customarily considered as an unit of saltwork. And inside it is saltpan made of two kinds of materials, that is iron pan or plaster pan. The area attached to one unit of roasting shed is approximately 1 ha, and that of saltern mound is a tenth of it.

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Spatial problems of Korea -A delphi survey- (國土管理의 方向定立을 위한 國土診斷 -專門家 集團의 問題意識을 中心으로-)

  • Kim, Inn;Yu, Woo-Ik;Huh, Woo-Kung;Park, Young-Han;Park, Sam-Ock;Yu, Keun-bae;Choi, Byung-Seon
    • Journal of the Korean Geographical Society
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    • v.29 no.1
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    • pp.16-38
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    • 1994
  • The spatial structure of Korea has been changed drastically during the second half of this century. The events such as the Korean War and the resultant division of the Korean Peninsular into two Koreas, rapid industrialization and urbanization are the major causes among others for the spatial changes of the nation. The changes in turn have spawned a number of spatial problems. It is time, we argue, to diagnose how much the nation is now ill-structured, and to discuss of which directions the long-term spatial management be reoriented. A delphi survey was conducted during the early 1993 to fulfill such research needs. Questionnaires were distributed among geographers, planners, and high governmental officials throughout the nation. These 'experts of spatial problems' were requested to evaluate the past spatial policies and strategies, and to identify spatial and environmental problems at the national, regional and local levels. The survey included questions with regard to the spatial problems in North Korea too. A complementary literature survey in the fields of spatial sciences was accomplished as well in order to identify the major research interests and issues with regard to the nations's spatial structure. The delphi survey results indicatee that the present spatial structure: in relation to consumption, housing and economic activities is satisfactory in overall, while rather poor in terms of education, leisure and community activities. Most of the experts consider infrastructural improvements are urgent in the areas of roads, waste disposal facilitles, railroads, harbors, water supply and drainage systems. The over-concentration of economic, social and political function in the Seoul Metropolitan Region is perceived to be the most serious spatial problem in Korea. The long-term solutions suggested are strategies toward a more balanced regional development as well as toward a cleaner environment. The concensus among the experts for the short-term solution is the redistribution of population and industries from the Seoul Metropolitan Region to the intermediate and small cities. The land use policies and concurrent large-scale infrastructural projects are evaluated largely pertinent and desirable in general. It is, however, suggested that development projects be conducted in a more harmonious way with environment. The survey respondents suggest that the present environmental management policies should be reexamined critically. With regard to regional and local problems, transportation and pollutions are thought to be most serious in the Seoul Metropolitan Region, while employment opportunities, and information, education and health care services are most deprived in small cities and rural areas. The majority of the experts consider a city size of 250, 000-500, 000 population is desirable to live within. Respondents beileve that North Korea's physical environment is still not aggravated much whereas its infrastructural provisions are largely pool. The co-authors of this research figure a "environmentaly sound and spatially balanced Korean Penninsular" as the ideal type of spatial structure in Korea. The basic guidelines toward this ideal prototype are suggested: the recovery of spetial integrity, progressive restructuring of the nation, land uses geared to public welfare rather than private interests, and eco-humanistic approach in spatial policies.

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Gender Roles, Accessibility, and Gendered Spatiality (성역할, 접근성, 그리고 젠더화된 공간성)

  • Kim, Hyun-Mi
    • Journal of the Korean Geographical Society
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    • v.42 no.5
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    • pp.808-834
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    • 2007
  • This study attempts to elucidate manifold dimensions of gendered accessibility experiences. How gender roles(household responsibilities) differentiate accessibility experiences between women and men is explored through the comparison of married dual-earner couples' parental status, using the US Portland activity-travel diary dataset with GIS-based geocomputation results of(time-geography based) space-time accessibility. First, this study shows how gender division of labor within the household still permeates current society, despite the widespread belief of the social change toward a gender-egalitarian society. Then, the study pays special attention to the way gender roles structure individual accessibility experiences of women and men differently, and, in turn, the way such accessibility experiences take a form of gendered spatiality. Gendered spatiality is examined through the analysis of accessibility space as well as activity space in order to ascertain women's home-attached and spatially entrapped characteristics. More household responsibilities throughout a day and, even more, the time constraint of picking up children at the daycare centers after work lead women's possible activity space to be more home-centered. The analysis of the spatio-temporal context of accessibility space makes gendered spatiality visible. However, the findings suggest that behavioral outcomes should be understood with an explicit awareness of constraints individuals face. It is because the revealed activity spaces can be not only an outcome of constraint but also an outcome of choice. Behavioral outcomes should not be treated as a straightforward expression of the level of constraints. It is problematic to expect that behavioral outcomes directly mirror the level of constraints. It is also problematic to suppose that the level of constraints can be straightforwardly elicited from revealed behavioral outcomes.

A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance - (병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구)

  • Lee, Sook-Ja;Lee, Jin-Kyung;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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