The purpose of this study is to investigate the overall operations of National Hospital Food service after it was benefited by National Health Insurance (NHI). The survey was conducted between July and August, 2007. Among questionnaires mailed to 2,558 medical care institutions, 2,090 returned (81%) questionnaires were analyzed by descriptive statistics, $x^2$-test and ANOVA using the SPSS 13.0. The general foodservice characteristic of medical care institutions were as follows. The type of foodservice operations were 'self-operated' (86.9%), 'contracted' (10.5%) and 'Both' (2.6%). Only 6.4% of medical care institutions provided 'hospital food menu not benefited by NHI'. The number of dietitians and cook for medical care institutions were 1.1 and 1.0, respectively. The cost of a general diet meal was 4,205 won and therapeutic diet meal was 4,434 won. The overall operations of hospital foodservice were different depending on the types of medical care institution. After hospital foodservice was benefited by NHI, the overall quality of hospital foodservice including manpower, facilities, and environment was improved. The future direction of hospital foodservice should 1) differentiate the cost of hospital foodservice by the types of medical care institution, 2) increase in co-payment, and 3) provide same service with equal expenses in each party as medical aid or NHS beneficiary.
Um, Mi Hyang;Park, Yoo Kyung;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
Journal of the Korean Dietetic Association
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v.20
no.3
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pp.183-198
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2014
The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.
Objectives: This study was conducted to examine the status of foodservice management, with special interest on sanitary and nutritional food service in elderly day care centers. Methods: A total of 79 employees who managed foodservice facilities in elderly day care centers were included in the survey. The contents of the questionnaire consisted of general characteristics, importance and performance of sanitary and nutrition management, the reasons for poor performance, factors necessary for improvement, and the employee's demand for support. Data analysis was conducted using the SPSS v25.0. Results: Sanitary management showed an average importance score of 4.84 ± 0.40 and a performance score of 4.70 ± 0.61 (t-value: 8.260). The item with the lowest performance score was personal sanitary management (4.58 ± 0.71). In nutrition management, the average importance score was 4.52 ± 0.68, and the performance score was 4.20 ± 1.00 (t-value: 9.609). There were significant differences between the average score of importance and performance in both areas. As a result of an Importance-Performance Analysis, items that were recognized as important but had relatively low performance was "personal hygiene", "ventilation" and "food storage". Also in the nutritional management area, "menu planning for disease management" and "checking the saltiness in the soup" etc. had very low performance with low importance recognition. The items shown in the "low priority" quadrant were those that required professional management skills. In the areas that demanded support in foodservice management, education about sanitary and safe institutional food service had the highest score (4.42 ± 0.74), and all other items showed a demand of 4 points or more. Conclusions: Foodservice managers recognize the importance of foodservice facility management but performance is relatively low. Institutional support is, therefore, needed to improve performance. For items with low importance, it seems necessary to improve awareness of the necessity of these items and to provide education in this regard. To gradually improve foodservice management, continuous provision of education and training in these areas are of great importance.
Journal of the Korea Society of Computer and Information
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v.26
no.11
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pp.201-208
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2021
The purpose of this study is to investigate factors affecting unmet medical care in elderly hypertensive patients. The purpose of this study was to understand the reasons for unmet medical care in elderly hypertensive patients over 65 years of age and to identify the characteristics of each type to improve the medical use system and to contribute to policy making so that unmet medical care does not occur. Using data from the 7th period of the National Health and Nutrition Examination Survey (2016, 2017), 23 sample households were selected using the phylogenetic extraction method among appropriate households and analyzed using the SPSS 18.0 Program. As a result of the study, the unmet medical care of those who had suicidal thoughts compared to those who had not had suicidal thoughts in the past year, when females were higher than males, had worse subjective health status, those who did not subscribe than those who had private insurance, and those who had smoked in the past year. The experience rate was high. This is considered to be able to contribute to improving the medical service system and making policy decisions so that unmet medical care does not occur in the future.
Purpose: It was to identify the relationship with the health beliefs, self-efficacy and medical care utilization in nurses in order to provide basic data for program development to actively help nurses' health practice. Methods: The subjects were 360 hospital nurses in P city, K Province. Instruments were health belief developed by Walker, Sechrist & Pender (1987), self-efficacy by Sherer, Maddux & Mercandante(1982), and medical care utilization by Korean National Health & Nutrition Examination Survey(2006). The data were analyzed as descriptive statistics, Chi-square, t-test, and ANOVA using SPSS 11.5. Results: There were significant differences in medical care utilization depending on age(p=.008), marital status(p=.019), education level(p=.005), types of work(p=.017), nursing units(p=.018), and period of work(p=.001). Use of outpatient clinic was significantly different depending on perceived susceptibility(F=2.463, p=.045). Nurses who consulted to doctor in other hospital had higher perceived severity(F=2.759, p=.028). Nurses who used complementary medicine had higher perceived barrier(F=2.278, p=.047). The score of self-efficacy was significantly different in medical care service frequency (F=3.030, p=.018) and to whom their health problems consulted(F=3.092, p=.010). Conclusion: Medical service utilization was different depending on the demographic characteristics, perceived susceptibility, severity, and barrier, and self efficacy. It is needed to give health promotion program considering these factors for nurses.
The present study was conducted to provide the basis for improvement of clinical nutrition services through development of job standards of clinical dietitian for the clinical nutrition therapy to cancer patients in hospitals. Developing A Curriculum (DACUM) method was used for job analysis and development of job standards for clinical dietitians for cancer care. Based on DACUM analysis, information about duties, tasks, and task elements of clinical dietitians for cancer care was collected. Developed job standards were applied to clinical nutrition care for cancer patients in hospitals for evaluation. Based on DACUM analysis, consultations from professionals, and field application tests, the final job standards were composed of four duties, 18 tasks, and 56 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring evaluation. For cancer nutrition care, 109 work activities were developed. They were composed of 75 basic and 34 recommended work activities. The application of developed job standards for clinical dietitians for cancer care at 10 hospitals showed a performance rate of 72.3%. In conclusion, job standards for clinical dietitians for cancer care developed in this study might be effectively used as guidelines for providing clinical nutrition services for cancer patients in hospitals.
Objective: The study evaluated the impact of pharmacist inventions with the implementation of pharmacistinvolved nutritional support service at neonate intensive care unit in a tertiary teaching hospital. Method: A retrospective and observational study was carried out. The total of 58 infants in neonate intensive care unit was enrolled between January 2011 and October 2012. The pharmacist-involved total parenteral nutritional program was initiated in June of 2012. During the program, pharmacist actively participated in the multidisciplinary round with performing the interventions from reviewing the amount of combined total parenteral nutrition and enteral fluid intakes, the amount of total calories, the glucose infusion rate, and the amounts of proteins per weight in kilogram. The outcome was compared with the results from the control group which reflected the prior period of the program initiation. Result: The number of days of regaining birth weight was significantly shorter (14.5 vs. 19 days, p=0.049) and the percentage of total calorie days with >90 kcal/kg/day was increased significantly (40 vs. 13%, p=0.008) in intervention group compared to the values in control group. In addition, the total mean daily caloric intakes ($84.78{\pm}13.8$ vs. $74.86{\pm}15.36$ kcal/kg/day, p=0.018) was significantly higher in intervention group than those results in control group. There were no significant differences in safety parameters between two groups related to nutritional services of necrotizing enterocolitis, intraventricular hemorrhage, proven sepsis, and also parenteral nutrition-induced hepatotoxicity. Conclusion: Pharmacist-involved total parenteral nutrition managed program was successfully implemented. The outcome showed the improved effectiveness of total parenteral nutrition with pharmacist interventions and no differences in adverse reactions. This could prove the positive effects of pharmacist involvement on nutritional therapy for neonate population.
Purpose: This study aimed to investigate the current status of food service management in elementary care classes. Methods: A focus group interview with seven care class managers and a survey with 101 care class managers using a self-administered questionnaire in Gyeonggi province were conducted. Results: In the focus group interview, purchased meals and snacks were evaluated as low quality by the care class managers. Frequent use of frozen or processed food and products with low prices were also reported as problems. Care class managers were in charge of meal and snack planning without any guidelines or expert advices. The results of the survey show that most schools serve purchased snacks and meals. The average unit costs of one meal and snack were 4,062 and 1,463 Won, respectively. The average unit costs of snacks during semester (p = 0.015) and vacation (p = 0.039) were significantly lower in rural than urban areas. The percentages of schools that prepared nutrition standards for meal and snack planning in elementary care classes were only 7.4% and 10.9%, respectively. The meal menus were mostly provided by catering service companies, and the snack menus were planned mostly by the care class managers. Menu planning by the care class managers was more usual in rural than urban areas (p = 0.054 for meal planning and p = 0.008 for snack planning). Just 33.7% of schools introduced safety standards for food service in elementary care classes, and more than half of the respondents (56.4%) did not do a regular medical check-up. Only 33.7% of the respondents received education for food safety. Conclusion: These results show the necessity for establishment of detailed guidelines for food service in elementary care classes and for the introduction of a food safety and nutrition education program customized for care class managers.
The purpose of this study was to investigate the need for a nutritional care service in silver town and identify awareness of the role of a dietitian in silver town using a structured questionnaire. The subjects consisted of 466 adults (216 males, 250 females), aged 20~59 years, in the Gyeongnam area. Although most of the subjects were aware of silver town and felt a necessity for it, only 24.9% of the subjects intended to live in silver town, whereas 55.6% of the respondents replied that they did not know whether they lived in silver town. Results on the importance of services offered in silver town indicated that medical service facilities, the interior and mood of silver town, the reliability of management, and meal service prepared by a dietitian were prioritized. Healthy food was the most valuable part of the meal service followed by taste. In total, 88.3% of the subjects answered that the meal service in silver town should be supervised by a dietitian. Clinical nutrition management was chosen as the most important job of the dietitian followed by sanitation management. These results could provide a better understanding of the personal needs of silver town, focusing on the meal service and the role of a dietitian.
Kim, Bong Joo;Kang, Hyung Won;Kim, Nam-Kwen;Seo, Eun-Sung
Journal of Oriental Neuropsychiatry
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v.29
no.3
/
pp.135-144
/
2018
Objectives: The purpose of this study was to analyze the medical cost for patients with vertigo and to examine associations between chronic vertigo and mental disorder using 2014 Health Insurance Review & Assessment Service-National Patients Sample (HIRA-NPS). Methods: We analyzed sociodemographic characteristics, medical cost and medical care use pattern for vertigo patients. We used hierarchical multiple logistic regression analysis to examine odds ratio between chronic vertigo and mental disorder. Results: A total of 46,502 people and 118,504 claims data were identified for vertigo cases. Characteristics of vertigo patients have significant differences on proportion of female patients (68.36%), patients' average age (54.98) and proportion of medical assistance (5.76%) compared with non-vertigo patients. Results revealed that Korean medicine are one of frequent methods among total treatments for vertigo patients. Total days of medical care and total costs are 2.78 days and 111,362 won, respectively, and days for outpatients in Korean medical care (mean: 2.26 days) are more than those (mean: 5.05 days) in Western medical care. There is significant difference relative to sex between acute vertigo and chronic vertigo. The odds ratio between chronic vertigo and mental disorder is estimated as 1.34, that means risk of becoming chronic is 34% higher for vertigo patients with mental disorder. Conclusions: This study assessed socio-demographic characteristics, medical care use and expenses related to vertigo, and estimated associations between chronic vertigo and mental disorder. Findings provide a basis for economic evaluation studies on vertigo patients and development of clinical practice guidelines for vertigo patients with mental disorder.
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