• 한국의료질향상학회지
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• 제2권2호
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• pp.56-71
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• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.

• 간호행정학회지
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• 제19권4호
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• pp.437-448
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• 2013

Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.

• 간호행정학회지
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• 제9권3호
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• pp.353-366
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• 2003

Purpose: This study was to define the care time of elderly in long-term care facilities and to compare and analysis the care time by staff and facility types. Method: The data were collected from 530 elderly over sixty, residing in two long-term care hospitals for dementia, three long-term care hospitals for the elderly and two skilled nursing facilities. Care time for individual residents was measured the total time spent by nurses, aides. Result: The average care time measured by nursing staff was 158.6 minutes a day. The average care time for one resident by nurse was 40.4 minutes, and by aides, 118.2 minutes. The difference of the care time showed statistical significance between long-term care facility types(p<0.001) : average care time for dementia hospital(199.1min) was twice as long as that of skilled nursing facility(94.1min). Conclusion: The results of the study showed that the care time differentiates care time provided to elderly in long-term care facilities in Korea. The study suggests the need to emphasize the importance of standardization of level of staff and service programs by the long-term facilities.

• 한국의료질향상학회지
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• 제19권2호
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• pp.36-46
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• 2013

Objectives: The purpose of this study is to find a way to effectively introduce accreditation for ambulatory health care organization by identifying the physicians' attitude for accreditation and characteristics that affect thei r attitude. Methods: A web survey was conducted from February 15 to March 4, 2011 for 183 physicians who work in ambulatory health care organizations throughout the nation. Self-reported questionnaire was used for this study. SPSS WIN(version 12.0) was utilized for statistical analysis. Results: Physician's attitude towards accreditation for ambulatory health care organization was positive(25.7%), moderate(39.3%), and negative(35.0%). Clinics that practice as a group or which treat more patients per day showed more positive attitude(p<0.05). The result of ordinal regression analysis indicates the groups with daily patients over 100 showed 36.3 times more positive attitude than the one under 75(p<0.05). Conclusion: The accreditation for ambulatory health care organization has not been throughly discussed yet. Many physicians did not have knowledge about accreditation. Clinics that see more patients per day had more positive attitude for accreditation. It indicates the cost may play important role in voluntary participation in accreditation.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제12권1호
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• pp.17-26
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• 2006

The demand for long-term care is continuously on the rise as number of elders among the population increases. Due to the rapid growing demand for long-term care in Korea, there have been discussions for the introduction of new long-term care system into Korean society. The purpose of this study in to analyze changes of elderly care facilities in Japan after the beginning of long-term care system in 2000. The functional and architectural changes of Japanese facilities were researched to be used as references for predicting changes in Korean facilities. In Japan, after the execution of long term care system, the alterative aspect of facilities is divided into some categories; in sum, the change of environment for long term care, the effort to spread specialized facilities in a whole community, and the tendency to complex a variety of function of facilities such as an facility for home care service, and the like.

• Child Health Nursing Research
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• 제28권2호
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• pp.142-153
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• 2022

Purpose: Preventing missed care is important in neonatal intensive care units (NICUs) due to neonates' vulnerabilities. This study examined missed care and its influencing factors among NICU nurses. Methods: Missed care among 120 Korean NICU nurses was measured using a cross-culturally adapted online questionnaire. The frequency of missed care for 32 nursing activities and the significance of 23 reasons for missed care were collected. Results: All participants had missed at least 1 activity, missing on average 19.35 activities during a typical work-day. The most common missed item was "provide developmental care for the baby". The most common reason for missed care was "emergency within the unit or deterioration of one of the assigned patients". The final regression model explained 9.6% of variance in missed care. The average daily number of assigned patients receiving inotropes or sedation over the last month influenced the total number of missed care items. Conclusion: Missed care was affected by nurses' workload related to the number of patients taking medication. Frequently missed activities, especially those related to developmental care, require patience and time, conflicting with safety prioritization and inadequate working conditions. NICU nurses' working conditions should be improved to ensure adequate time for nursing activities.

• 대한간호학회지
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• 제22권4호
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• pp.589-603
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• 1992

This study investigated a process to estimate the need for nursing staff on the basis of a patient elassification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I (mildly ill), class II (mederately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hourse and personal time of the nursing staff. Step 3. Calculation of he total nursing workload in a nursing unit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours every other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical (N.S.), the distribution was class I, 22 patient, 3, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit(0.5.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the 0.5. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communiontion(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatmemt(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the 0.5. nursing unit of the same number of beds, 19 nursing staff would be indicated.

• 한국산학기술학회논문지
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• 제18권2호
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• pp.524-531
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• 2017

본 연구의 목적은 어린이집 교사들의 역할놀이에 대한 은유의 경향과 은유의 의미를 알아보는 것이다. 이를 위하여 A지역 대학 보수교육에 참여한 어린이집 교사 166명을 대상으로 문장 완성형 은유 방법을 활용하여 자료를 수집하였다. 수집한 자료는 은유분석에 관한 선행연구에 기초하여 유아교육전문가 2인이 질적 연구의 방법을 활용한 범주화의 과정을 거쳐 분석하였다. 연구결과 첫째, 역할놀이 은유의 경향은 3개 범주, 8개의 내용으로 분류되었으며, 3개 범주는 '사회성 발달', '정서발달', '발달'의 순서로 빈도가 높게 나타났다. 8개의 내용 중 '사회성 발달' 범주에서는 '모방'이 가장 빈도가 높게 나타났고 '정서발달' 범주에서는 '정서표현'이 가장 높은 빈도를 나타냈다. '발달' 범주에서는 '발달의 필수요인'이 단독내용으로 나타났다. 둘째, 역할놀이 은유의 의미는 먼저 '사회성 발달' 범주에서는 '사회적 기술', '역할체험', '모방', '사회이해'의 의미, '정서발달' 범주에서는 '상상력', '정화작용', '정서표현'의 의미, '발달' 범주에서는 '발달의 필수요인'으로 인식하고 있었다. 연구결과를 기초로 하여 유아교육기관에서 이루어지는 역할놀이의 가치와 교사의 역할에 대한 재조명이 필요함을 논의하였다.

• 농촌의학ㆍ지역보건
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• 제27권2호
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• pp.127-136
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• 2002

공공기관에서도 재가노인복지사업의 제공을 확대한다는 정책대안의 관점에서 보건진료소에서 주간보호실을 2001년 6월 21일부터 다음해 6월 30일까지 1년동안 이용한 노인 119명을 대상으로 이용노인의 일반적 특성, 건강특성 및 프로그램의 실태와 더불어 이용의 효율성을 분석, 검증하고자 방문간호대장, 치매체크 리스트지 및 일상생활동작능력일지를 분석하였다. 연구대상 보건진료소 주간보호실을 이용노인은 119명으로 관내 노인인구의 26.9%, 약 1/4이상이었으며, 이용횟수는 1회-10회까지 범위로 1인당 1.5회 이용으로 나타났는데, 성별로는 여자노인의 이용이 88.9%로 남자노인보다 훨씬 많았다. 일반노인집단은 94명, 장애 노인집단은 25명으로 이용자의 각각 79.0%, 21.0%를 차지하였다. 일상생활동작은 1점(완전의존)에서 4점(자립)의 범위로 기록조사한 결과, 장애노인집단이 $2.18{\pm}0.55$점, 일반노인집단이 $2.78{\pm}0.30$점이었고, 수단적 일상생활동작은 장애노인집단이 $1.78{\pm}0.51$점, 일반노인집단이 $2.47{\pm}0.60$점으로 통계적으로 유의한 차이가 있었다 만성질환을 가진 노인은 이용노인의 39.5%였는데, 관절염이 가장 많았고, 그 다음이 고혈압환자의 순이었다. 사망률은 장애노인집단에서 16.0%로 일반노인집단의 2.1%보다 훨씬 높았고, 통계적으로도 p<0.05수준에서 유의한 차이가 있었다. 치매점수를 분석한 결과에서는 20점 이상의 치매의심노인은 41.2%이었고, 치매점수는 장애노인집단이 $17.39{\pm}7.17$점, 일반노인집단이 $18.43{\pm}7.36$점이었으나 통계적으로 유의한 차이가 없었다. 노인들에게 일상생황능력을 높이고 삶의 질에 도움이 되는 프로그램을 제공한 후, 신체적 일상생활동작능력은 장애노인집단이 $2.58{\pm}0.32$점, 일반노인집단이 $2.70{\pm}0.35$점으로 점수가 변경되었고, 수단적 일상생활 동작은 장애노인집단이 $2.06{\pm}0.48$점, 일반노인집단이 $2.32{\pm}0.59$점으로 장애노인집단에서 통계적으로 p=0.01 수준에서 유의한 차이가 있었다. 필요한 서비스는 물리치료(22.2%), 말벗서비스(20.6%), 목욕서비스(12.7%), 부엌일(9.5%) 등으로 나타났다. 주간보호실 이용노인들의 건강상태, ADL과 치매정도를 보다 증진시키기 위해서는 보다 개개인에 알맞은 접근 가능하고 비용 효과적인 주간보호프로그램의 개발과 더불어 재가노인보건의료복지서비스의 지침이 요구된다.

• 디지털융복합연구
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• 제20권5호
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• pp.909-918
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• 2022

본 연구는 어린이집 원장을 대상으로 감염병 예방 교육요구도, 자기효능감을 파악하고 감염병 예방 자기효능감에 영향을 미치는 요인을 파악하고자 시행되었다. 연구는 G, J, S시 소재 어린이집 원장 172명을 대상으로 설문지를 이용하여 진행하였다. 수집된 자료는 SPSS 24.0 프로그램을 이용하여 기술통계, t-test, ANOVA, Pearson's correlation coefficient, Multiple regression analysis로 분석하였다. 연구 결과, 감염병 예방 교육요구도는 손 씻기 방법 및 시기, 세척과 소독 방법이 높았고, 감염병 예방 자기효능감은 영유아 손 씻기 교육과 시기가 가장 높았다. 감염병 예방 교육요구도와 자기효능감(r=.528, p<.001) 간에는 양의 상관관계가 있는 것으로 나타났다. 감염병 예방 자기효능감에 영향을 미치는 유의한 요인은 감염병 예방 교육요구도(β=.53, p<.001), 감염병 예방 교육의 경험(β=.25, p<.001)로 나타났다. 이러한 연구 결과는 어린이집 원장에 대한 감염병 예방에 대한 교육 요구를 충족시킬 수 있는 프로그램 개발이 필요하다는 것을 보여준다. 이러한 교육을 통해 어린이집 원장의 감염병 예방에 대한 자기효능감이 향상될 것이다.