• 한국직업건강간호학회지
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• 제17권1호
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• pp.5-13
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• 2008

Purpose: The purpose of this study is to identify Activities of Daily Living(ADL) of industrial accident disabled with a caregiver and to evaluate the degree of satisfaction with services according to kinds of caregiver, professional or non-professional. Method: Data was collected from 178 patients in three workers' accident medical corporations of H, A and D cities from July to August, 2006. Five inspectors interviewed with the disabled by visiting the hospital. Collected data was analyzed for the frequency, percentages, t-test, etc. Results: The average score of ADL which ranged from 1 to 7 was 3.6. The 51.5 percent of caregivers for industrial accident disabled were non-professional and the 48.5 percent of caregivers were professional. 50.9 percent of the reason for the family caregivers was because of economical one. The caregiver satisfaction degree was 3.7 out of 4. The satisfaction degree with the professional caregivers was significantly higher than that with non-professional family caregivers for their excellent knowledge and techniques. Conclusion: A nursing expenses for the industrial accident disabled was intended to provide appropriate nursing services for the patient and so, it should not be a kind of income. So, the system for caring services should be investigated and the qualification of caregivers should be classified according to the health condition of the patient or ADL.

• 한국융합학회논문지
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• 제8권5호
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• pp.61-68
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• 2017

이 연구는 2015년 1월부터 12월까지 1년간의 자동차보험으로 진료 받은 치과와 한방을 제외한 의과 8,589,602건에 대해 자동차보험회사별로 진료특성과 진료비 차이를 분석한 것으로 그 결과는 다음과 같다. 첫째, 일반적 특성 중, 연령에서는 손해보험과 공제조합 모두 50-59세가 22.8%로 가장 높은 것으로 나타났다(p<0.001). 둘째, 진료과별 입원 건당진료비는 손해보험과 공제조합 모두 내과계가 외과계보다 높은 것으로 나타났으며, 외과계 세부과목별로는 손해보험회사와 공제조합 모두 흉부외과가 가장 높게 나타났다. 이상의 연구결과를 볼 때, 심사평가원에서는 자동차보험 청구요양기관에 대한 적정성평가를 실시하여 불필요한 진료비를 증가시키는 문제와 환자의 재활 및 일상생활의 복귀가 지연되어 발생하는 사회적 비용 문제를 해결하여야 할 것으로 사료된다.

• 농촌의학ㆍ지역보건
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• 제33권2호
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• pp.204-220
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• 2008

Objectives: This study was performed to determine the levels of depression symptoms among the community elderlies and to reveal its related factors, specifically aimed at revealing psycho-social factors such as social support net-work, sense of self-esteem, state anxiety, interpersonal behavior trait and locus of control. Methods: The interviews were performed during the period from April 1st to June 30th, 2007 to the 790 elderlies in urban and rural areas. Results: The mean scores of depression (CES-D) among all subjects were 16.65±10.97(urban: 18.81±10.31, rural: 14.49±11.20) and they were higher in urban than rural. The level of depression symptoms was influenced by the variables of educational level, with or without spouse, bear for living expenses, sense of satisfaction in daily life. As for health related behaviors, they were influenced by the variables of with or without regular exercise. As for health status, they were influenced by the subjective health status, with or without disability of body, visual acuity, hearing ability, ability of food mastication, urinary incontinence, with or without help in activity of daily living (ADL) and instrumental activity of daily living (IADL). As for social support net-work and social activities, they were influenced by number of offspring, frequency of offspring contents, frequency of going out and activity of hobbies. As for psycho-social factors, they were influenced by sense of self-esteem, state anxiety and social support, especially, the level of depression symptoms was higher influenced by the variables of psycho-social factors than other variables. Conclusions: Lower of the level of depression symptoms among the community elderlies would require development and application of programs to keep under management psycho-social factors as well as looking for ways to promoting the present health status.

• Journal of Nutrition and Health
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• 제15권2호
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• pp.98-106
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• 1982

This study was carried out to investigate the nutritional status of physically handicapped children with cerebral palsy in order to contribute to their welfare by studying their healthy status, nutrient intake, daily energy expenditure, and living environment. The survey was conducted at two rehabilitation institutions from May 25 to June 30, 1981. A special questionnaire was designed to investigate the living environment. The 24 hr. recall method was used in evaluation the nutrient intake of 67 children. Anthropometric measurement was made of height, weight, chestgirth, upper-arm circumference, and triceps skinfold thickness. The biochemical status of the children with cerebral palsy was assessed with measurement of hemoglobin and hematocrit. The results may be summarized as follows : 1. The children with cerebral palsy, the intakes of all nutrients except vitamin A, thiamin, and ascorbic acid were lower than Korean recommend dietary allowances (1980). They had significantly higher intakes of vitamin A and calcium than the normal children, but the calcium intake was low as 62% of the Korea RDA. 2. All the children with cerebral palsy were very short and low weight in comparison with the accepted standards, but chestgirth was above the accepted standards for Korean school children. 3. The average hemoglobin value was 12.2gm%, hematocrit 39.3%, and mean corpuscular hemoglobin concentration (MCHC) 31.1%. 4. The possible etiological factors of cerebral palsy were, prenatal factors 16%, natal 44.9%, postnatal 27.5%, and unknown 11.6%. Eighty four percent of the children showed their first symptoms within the first year after birth. 5. Thirty percent of the parents said that the handicapped children lead to marital problems, and 84.1% of the parents mentioned that medical expenses for the children influenced their family finances.

• 한국건설관리학회논문집
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• 제19권1호
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• pp.21-31
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• 2018

고령자 가구의 급격한 증가는 전 세계적 추세이며 의료비 등 사회적 비용 또한 급격히 증가할 것으로 예상된다. 치매와 같은 노인성 기능 질환의 경우 고령자의 일상생활 활동 (ADL) 패턴을 상시적으로 모니터링하고 평소와 다르거나 비정상적인 패턴이 발생하는 경우 이를 치매 조기진단의 근거로 활용할 수 있다. 그러나 사생활 침해의 우려가 큰 기존의 직접적 센싱 방식과 달리 간접적 센싱 방식 (Non-intrusive approach)을 활용하여 재실자의 최소한의 정보 (Coarse-grained data)만을 수집하고, 이를 통해 활동 정보를 추출하는 연구는 거의 이루어지지 않았다. 또한 추출된 활동 및 활동패턴을 이해하기 위해 활동의 맥락적 정보를 시각화하는 방법 또한 추가적인 연구가 필요하다. 이를 위해 본 연구에서는 재실자의 정보 중 시 공간 데이터 로그만을 활용하여 재실자의 수행 활동을 추출하고 컨텍스트화 된 행동 정보를 공간-활동 지도 (Space-Activity Map)로 시각화한다. 본 연구는 재실자의 일상생활 활동 패턴을 추출하는 데 기반이 되는 연구로서, 향후 고령자를 위한 상시적인 건강 모니터링 기술의 도입에 기여할 수 있다.

• 대한간호학회지
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• 제24권4호
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• pp.545-556
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• 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.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.741-750
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• 2022

Objective : In March 2020, World Health Organization declared a global pandemic caused by a novel coronavirus (SARS-CoV-2). The disease caused by this virus is called COVID-19. Due to its high contagiousness, many changes have occurred in overall areas of our daily life including hospital use by patients. The aim of this study was to investigate the impact of COVID-19 on volume of spine surgery in South Korea using the National Health Insurance database and compare it with the volume of a homologous period before the pandemic. Methods : Data of related to spine surgery from January 2019 to April 2021 were obtained from the National Health Insurance and Health Insurance Review and Assessment Service database. Primary outcomes were total number of patients, rate of patients per 100000 population, and total number of procedures. The number of patients by hospital size was also analyzed. Results : COVID-19 outbreaks occurred in South Korea in March, August, and December of 2020. Compared to the previous year, the total number of patients who underwent spinal surgery showed a decrease for 2-3 months after the first and second outbreaks. However, it showed an increasing trend after the third outbreak. The same pattern was observed in terms of the ratio of the number of patients per 100000 population. Between 2019 and 2021, the mean number of spine surgeries per month tended to increase. Mean annual medical expenses increased over the years (p=0.001). When the number of spine surgeries was analyzed by hospital size, proportion of tertiary general hospital in 2021 increased compared to those in 2019 and 2020 (vs. 2019, p=0.012; vs. 2020, p=0.016). The proportion of general hospital was significantly decreased in 2020 compared to that in 2019 (p=0.037). Conclusion : After the COVID-19 outbreak, patients tended to postpone spinal surgery temporarily. The number of spinal surgeries decreased for 2-3 months after the first and second outbreaks. However, as the ability to respond to the COVID-19 pandemic at the hospital and society-wide level gradually increased, the number of spine surgeries did not decrease after the third outbreak in December 2020. In addition, the annual number of spine surgeries continued to increase. However, it should be noted that patients tend to be increasingly concentrated in tertiary hospitals for spinal surgery.