• Title/Summary/Keyword: threatened assessment

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An Analysis of Nursing Behavior and Unit of Treatment Cost of Non- Insurance Patients (종합병원의 비보험환자 처치행위 양상과 수가분석에 관한 연구)

  • 오세영
    • Journal of Korean Academy of Nursing
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    • v.10 no.1
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    • pp.41-55
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    • 1980
  • The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 %. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ₩22,650 while its daily average was ₩2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(₩10,880) and next in neurologic cases(₩ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (₩5,200) and integrated (₩5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

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Status of Birds using Rice Fields in Mid-western Part of Korean Peninsula (한반도 중서부 지역 논습지를 이용하는 조류 현황)

  • Nam, Hyung-Kyu;Kim, Miran;Choi, Green;Jang, Dooly;Choi, Seung-Hye;Cho, Kwang-Jin;Choe, Lak-Jung;Choi, Soon-Kun;Bang, Hea-Son;Na, Young-Eun;Kim, Myung-Hyun
    • Korean Journal of Environmental Agriculture
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    • v.35 no.2
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    • pp.143-147
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    • 2016
  • BACKGROUND: Rice fields are one of the most important habitats for various bird species. The list of bird species occurred in rice fields in Korean peninsula have been documented. However, information of listed bird species is included not only rice fields but also other wetland habitats such as lakes, tidal flats and rivers. Therefore, the study was conducted to clarify the status of bird observed in rice fields of Korea.METHODS AND RESULTS: Birds using rice fields defined as birds which forage or rest on rice paddies, levees, ditches and farming roads. Birds using rice fields recorded as total 124 species belonging to 40 families. Anatidae and Scolopacidae were the best represented family, followed by Ardeidae, Accipitridae, Motacillidae and Emberizidae; 50% of species belonged to these six families. 18 of 124 endangered wild species, which designated threatened at the national scale, found in this study regions.CONCLUSION: Despite interest in birds using rice fields of Korean peninsula, knowledge of birds and rice fields there is extremely limited. We need more studies to understand and conserve for birds in rice fields of Korea.

Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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User-specific Agrometeorological Service to Local Farming Community: A Case Study (농가맞춤형 기상서비스 시범사업)

  • Yun, Jin I.;Kim, Soo-Ock;Kim, Jin-Hee;Kim, Dae-Jun
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.15 no.4
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    • pp.320-331
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    • 2013
  • The National Center for AgroMeteorology (NCAM) has designed a risk management solution for individual farms threatened by the climate change and variability. The new service produces weather risk indices tailored to the crop species and phenology by using site-specific weather forecasts and analysis derived from digital products of the Korea Meteorological Administration (KMA). If the risk is high enough to cause any damage to the crops, agrometeorological warnings or watches are delivered to the growers' cellular phones with relevant countermeasures to help protect their crops against the potential damage. Core techniques such as scaling down of weather data to individual farm level and the crop specific risk assessment for operational service were developed and integrated into a cloud based service system. The system was employed and implemented in a rural catchment of 50 $km^2$ with diverse agricultural activities and 230 volunteer farmers are participating in this project to get the user-specific weather information from and to feed their evaluations back to NCAM. The experience obtained through this project will be useful in planning and developing the nation-wide early warning service in agricultural sector exposed to the climate and weather extremes under climate change and climate variability.

The Development of Vulnerable Elements and Assessment of Vulnerability of Maeul-soop Ecosystem in Korea (한국 마을숲 생태계 취약요소 발굴 및 취약성 평가)

  • Lim, Jeong-Cheol;Ryu, Tae-Bok;Ahn, Kyeong-Hwan;Choi, Byoung-Ki
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.34 no.4
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    • pp.57-65
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    • 2016
  • Maeul-soop(Village forest) is a key element of Korean traditional village landscape historically and culturally. However, a number of Maeul-soops have been lost or declined due to various influences since the modern age. For this Maeul-soop that has a variety of conservation values including historical, cultural and ecological ones, attention and efforts for a systematic conservation and restoration of Maeul-soop are needed. The purpose of the present study is to provide information on ecological restoration and sustainable use and management of Maeul-soops based on component plant species, habitat and location characteristics of 499 Maeul-soops spread throughout Korea. Major six categories of threat factors to Maeul-soop ecosystem were identified and the influence of each factor was evaluated. For the evaluation of weight by threat factors for the influence on the vulnerability of Maeul-soop ecosystem, more three-dimensional analysis was conducted using Analytic Hierarchy Process (AHP) analysis method. In the results of evaluation using AHP analysis method, reduction of area, among six categories, was spotted as the biggest threat to existence of Maeul-soops. Next, changes in topography and soil environment were considered as a threat factor of qualitative changes in Maeul-soop ecosystem. Influence of vegetation structure and its qualitative changes on the loss or decline of Masul-soop was evaluated to be lower than that of changes in habitat. Based on weight of each factor, the figures were converted with 100 points being the highest score and the evaluation of vulnerability of Maeul-soop was conducted with the converted figures. In the result of evaluation of vulnerability of Maeul-soops, grade III showed the highest frequency and a normal distribution was formed from low grade to high grade. 38 Maeul-soops were evaluated as grade I which showed high naturality and 10 Maeul-soops were evaluated as grade V as their maintenance was threatened. Also in the results of evaluation of vulnerability of each Maeul-soop, restoration of Maeul-soop's own area was found as top priority to guarantee the sustainability of Maeul-soops. It was confirmed that there was a need to prepare a national level ecological response strategy for each vulnerability factor of Maeul-soop, which was important national ecological resources.