• 제목/요약/키워드: service quality of life insurance

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노인 장기요양보험급여 이용자들의 삶의 질과 신체적 및 정신적 기능과의 관련성 (Quality of Life and Its Association with Physical and Mental Function in the Elderly People Affiliated with Long-term Care Insurance Services)

  • 김형선;박재영;권인선;조영채
    • 한국산학기술학회논문지
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    • 제11권10호
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    • pp.3808-3819
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    • 2010
  • 본 연구는 장기요양보험 인정자로 판정받은 노인들의 삶의 질 수준을 알아보고, 삶의 질에 영향을 미치는 관련요인들을 규명해 보고자 시도하였다. 조사대상은 65세 이상 노인 중 2008년 7월부터 실시된 노인장기요양보험제도에 의해 장기요양인정자로 판정받은 노인 958명(1등급 305명, 2등급 323명, 3등급 330명)으로 하였으며, 조사는 2009년 3월 1일부터 5월 31일까지의 기간 동안에 표준화된 무기명식 면접조사용 설문지를 사용하여 면접조사를 실시하였다. 연구결과, 전체 조사대상자의 삶의 질 평균점수는 $55.4{\pm}15.62$점이었으며, 장기요양등급별로는 1등급이 $49.7{\pm}14.17$점, 2등급이 $56.8{\pm}14.62$점, 3등급이 $59.4{\pm}16.36$점으로 등급이 높을수록 삶의 질 점수는 유의하게 낮은 것으로 나타났다. 노인들의 장기요양등급별 삶의 질에 영향을 미치는 변수를 알아보기 위해 다중 회귀분석을 실시 한 결과에서는 교육정도, 월수입, 주관적 건강상태, 우울 및 인지기능장애가 1, 2, 3등급에서 공통으로 유의하게 영향을 미치는 것으로 나타났으며 45~62%로 비교적 높은 설명력을 보였다.

독립형 호스피스 센터 모델 개발에 관한 연구 (A Study on the Development of an Independent Hospice Center Model)

  • 노유자;한성숙;김명자;유양숙;용진선;전경자
    • 대한간호학회지
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    • 제30권5호
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    • pp.1156-1169
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    • 2000
  • The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

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새터민(탈북자)의 삶의 질 (Quality of Life of North Korean Defectors in Korea)

  • 신기수;조갑출;양선희;이옥철;백희정;이규영;이숙정
    • 한국보건간호학회지
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    • 제25권2호
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    • pp.221-232
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    • 2011
  • Purpose: The study sought to provide basic information for North Korean defectors (Sae-Tu-Min) by studying the quality of life(QoL) based on their general characteristics and health problems. Methods: The targeted subjects were 1400 North Korean settlers who were receiving settlement service by Korean National Red Cross after finishing their training at Hanawon in 2005. The data was collected from August to October in 2007. The QoL was assessed by Medical Outcomes Study Short Form-36. Collected data were analyzed by ANOVA and t-test with SPSS win 15.0 program. Result: The majority of the 466 subjects were female(77.9%). The average age was 36.8 years, 52.8% lived alone, and 64.0% were unemployed. The average QoL score of the group was $62.4{\pm}18.4$, which was markedly lower in terms of social, physical and mental health compared to the scores of immigrants to South Korea from other countries. The score was the highest for physical ability and the lowest for general health. Influential socio-demographic factors to QoL were gender, age, education, religion, annual salary, occupation, and life insurance. Employed in the subject group showed higher level of QoL on eight categories than unemployed. Concerning health problems that detracted from QoL, 18.5% of the subjects were aware they suffered from anemia and 8.8% of them recognized they suffered from attention deficits. Conclusion: The health conditions of the North Korean settlers had improved since they settled in South Korea, but their QoL was lower than other immigrants. Various programs to maintain and promote the health of North Korean settlers would be useful.

제조업 근로자의 건강행태에 따른 만성질환 유병률 (Prevalence of Chronic Diseases according to Health Behavior of Manufacturing Workers)

  • 김정영;이은주;서순림
    • 보건의료산업학회지
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    • 제11권1호
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    • pp.107-115
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    • 2017
  • Objectives : The purpose of this study was to examine the relationship between the health behavior and prevalence of chronic diseases among manufacturing workers. It would provide fundamental data in the development of health promotion programs for manufacturing workers. Methods : Data on 3,171 employees who underwent health check-ups by the National Health Insurance Service in L company, G City from March to December 2014 were analyzed. The statistical analysis of frequency, chi-square test, and multiple logistic regressions were performed using SPSS 18 program. Results : The results of this study show that obesity and over-weight are the health behaviors that influence the prevalence of chronic diseases in manufacturing employees. Conclusions : The implementation of public health projects to improve the voluntary participation of the employees can enhance their health, improve the productivity, and influence their quality of life positively by changing the health behaviors.

내시경 점막하 박리법을 시술 받은 위종양 환자에서 심리적 요인이 시술 후 통증에 미치는 영향 (The Effect of Psychological Factors on Postoperative Pain in Gastric Tumor Patients after Endoscopic Submucosal Dissection)

  • 이준협;전한호;이산;이혁;오승택;장진구;임우영;박재섭;최원정
    • 정신신체의학
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    • 제26권1호
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    • pp.68-75
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    • 2018
  • 연구목적 암 환자에게 있어 통증은 삶의 질과 예후에 큰 영향을 주는 중요한 요소로 통증을 줄이기 위한 시도가 활발히 이루어지고 있다. 이러한 관점에서 위종양 환자에게 많이 시행되는 내시경 점막하 박리법 후 통증을 줄이기 위한 노력이 계속되고 있는데, 시술 후 통증에 영향을 미치는 생물학적 요인이 많이 알려진 것에 비해 심리적 요인에 대해서는 연구가 거의 이루어지지 않았다. 본 연구의 목적은 내시경 점막하 박리법을 시술 받은 위종양 환자가 시술 후 겪는 통증에 영향을 미치는 심리적 요인을 알아보고자 하였다. 방 법 본 연구는 2015년 5월부터 2016년 6월까지 국민건강보험 일산병원에 내원하여 내시경 점막하 박리법을 시술 받은 91명의 위종양 환자를 대상으로 시행되었다. 내시경 점막하 박리법을 시술 받기 전에 사회인구학적 요인과, 불안, 우울, 회복탄력성을 평가하였다. 환자들이 호소하는 통증의 정도가 시각적 유추척도 3점 이상인 군(고통증군)과 3점 미만인 군(저통증군)으로 나누었고, 시술 후 통증에 영향을 주는 요인에 대해 독립표본 T검정 및 카이제곱 검정을 시행 후 유의한 차이를 보인 요인에 대해 로지스틱 회귀분석을 시행하였다. 결 과 고통증군이 저통증군에 비해 음주량이 낮았고 우울 점수가 높게 나타났다. 또한 고통증군이 저통증군에 비해 회복탄력성 점수가 낮았으며, 회복탄력성의 하위 항목 중 자기조절능력, 긍정성 항목에서 점수가 낮았다. 다변량 로지스틱 회귀분석 결과 회복탄력성 중 자기조절능력(OR, 0.911 ; 95% CI, 0.854-0.971, p=0.004)이 낮을수록 내시경 점막하 박리법 시술 후 겪는 통증이 큰 것으로 나타났다. 결 론 본 연구 결과 내시경 점막하 박리법을 시술 받는 환자의 회복탄력성 하위 항목인 자기조절능력이 낮을수록 시술 후 더 큰 통증을 호소하는 것을 확인하였다. 따라서 본 연구에서 대상으로 한 심리적 요인 중 개인의 회복 탄력성이 통증에 영향을 주는 것을 확인하였다.

만성 관절통증이 있는 취약계층 재가 여성노인의 삶의 질에 영향을 미치는 요인 (Factors Influencing Quality of Life in the Community Dwelling Vulnerable Older women with Chronic Joint Pain)

  • 유재순;함인숙
    • 한국산학기술학회논문지
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    • 제19권1호
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    • pp.355-367
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    • 2018
  • 본 연구는 C시에 소재한 보건소의 방문건강관리 대상 노인 중 만성 관절통증이 있는 65세이상 취약계층 재가 여성노인 234명을 대상으로 삶의 질에 영향을 미치는 주요 요인을 파악하기 위한 서술적 상관관계 연구이다. 본 연구의 자료는 일반적 특성, 통증양상, 통증정도, 지각된 건강상태, 일상생활능력, 수면양상, 우울, 삶의 질로 구성된 구조화된 설문지를 통해 2017년 2월 16일부터 3월 13일에 걸쳐 수집되었으며, t-test, ANOVA, 상관분석, 위계적 다중 회귀분석으로 분석하였다. 연구결과, 대상자의 일반적 특성을 포함하여 대상자의 삶의 질에 영향을 미친 변수는 우울(${\beta}=-.60$, p<.001), 통증정도(${\beta}=-.15$, p=.007), 의료보장 유형(${\beta}=.15$, p=.001), 지각된 건강상태(${\beta}=.14$, p=.007), 통증지속기간(${\beta}=-.10$, p=.019), 결혼상태(${\beta}=.10$, p=.024), 일상생활능력(${\beta}=.09$, p=.036)순으로 나타났으며, 모형의 총 설명력은 63.1%였다. 본 연구를 통해 만성 관절통증이 있는 재가 여성노인의 삶의 질을 향상시키기 위해서는 지역사회 중심의 체계적인 우울 예방 및 관리 프로그램 운영이 우선 실시되어야 하며, 특히 경제적으로 취약한 공적부조 대상 노인의 삶의 질에 관심을 기울여야 하고, 통증 발현 초기부터 통증에 대한 정확한 사정을 토대로 통증완화중재 개입을 시행해야 한다.

Hypofractionated whole breast irradiation: new standard in early breast cancer after breast-conserving surgery

  • Kim, Kyung Su;Shin, Kyung Hwan;Choi, Noorie;Lee, Sea-Won
    • Radiation Oncology Journal
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    • 제34권2호
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    • pp.81-87
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    • 2016
  • Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

Cost-Effectiveness Analysis of Home-Based Hospice-Palliative Care for Terminal Cancer Patients

  • Kim, Ye-seul;Han, Euna;Lee, Jae-woo;Kang, Hee-Taik
    • Journal of Hospice and Palliative Care
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    • 제25권2호
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    • pp.76-84
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    • 2022
  • Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

Analysis of Temporomandibular Joint Disorders in Children and Adolescents: Diagnosis and Treatment Pattern by Age

  • Heemin Kim;Jaegon Kim;Daewoo Lee;Yeonmi Yang
    • 대한소아치과학회지
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    • 제51권2호
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    • pp.185-196
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    • 2024
  • Temporomandibular joint disorders (TMDs) can occur at any age, including childhood and adolescence, and pain-related TMDs can affect growth and quality of life. In the present study, recent trends in the diagnosis and treatment of TMDs in children and adolescents were analyzed over a 10-year period. Using 10 years of data from the Health Insurance Review and Assessment Service (HIRA) and Jeonbuk National University (JBNU) Dental Hospital, patients between 0 and 19 years of age diagnosed with K07.6 (temporomandibular joint disorders) were analyzed by 5-year bins. Both datasets indicated a higher prevalence in females (1.2-fold in HIRA, 1.5-fold in JBNU) and in ages 15 to 19 years (72.1% in HIRA, 74.7% in JBNU). HIRA reported a 42.3% increase in prevalence per 100,000 people, from 651.4 in 2011 to 927.0 in 2020. JBNU reported K07.66 (masticatory muscle disorders) as the most common diagnosis in subjects under 10 years of age and K07.60 (internal derangement of temporomandibular joint) in those over 10 years of age. In addition, both were treated mainly by a combination of physical therapy and medication, and the treatment rate increased in accordance with age. Because TMDs can affect various structures in the orofacial region and cause pain that tends to differ with age, an early and specific diagnosis appropriate for age is important for treatment. Therefore, pediatric dentists need to promptly recognize TMDs in children and adolescents and consult with specialists as the prevalence increases.

장기요양기관(시설급여) 평가의 효과성 검증 (Verification of effectiveness of evaluation of long-term care institution)

  • 김윤정;김영재;이상진
    • 예술인문사회 융합 멀티미디어 논문지
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    • 제9권5호
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    • pp.781-791
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    • 2019
  • 본 연구에서는 장기요양기관 관리자, 요양보호사, 입소노인을 대상으로 하여 2015년도 장기요양기관의 평가(평가등급, 평가등급의 변화, 평가지표의 적합성), 요양보호사의 서비스의 질, 입소노인의 서비스 질 만족도, 삶의 만족도, 시설 선택에 미치는 영향을 파악하고자 하였다. 이를 위해 IRB를 받은 뒤 2018년 1월과 2월에 장기요양기관 관리자 79명, 요양보호사 381명 및 입소 노인 381명을 대상으로 설문조사를 완료하였다. 설문조사는 2015년도 장기요양(시설급여) 평가결과를 반영한 할당표본을 실시하였다. 연구결과 장기요양기관 평가의 주된 목적이라 할 수 있는 입소노인의 삶의 질 향상에는 요양보호사의 서비스 질 보다 기관평가(평가등급, 평가등급의 변화, 자표의 적합성 인식)가 더 큰 영향을 미치는 것으로 나타났다. 그러나 퇴소 후 시설재선택의향은 요양보호사의 서비스의 질에 더 큰 영향을 받았다. 따라서 시설재선택의향을 제외하고 보면, 국민건강보험공단의 평가의 호과성이 부분적으로나마 검증되었다고 볼 수 있다.