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한국보건행정학회> 보건행정학회지> 외국인 환자 간호에 대한 간호사의 문화역량 영향요인

KCI등재

외국인 환자 간호에 대한 간호사의 문화역량 영향요인

Factors Affecting Cultural Competence of Nurses Caring for Foreign Patients

안정원 ( Jung-won Ahn ) , 장혜영 ( Hye-young Jang )
  • : 한국보건행정학회
  • : 보건행정학회지 29권1호
  • : 연속간행물
  • : 2019년 03월
  • : 49-57(9pages)
보건행정학회지

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서 론
방 법
결 과
고 찰
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Background: The purpose of this study was to examine the cultural competence of nurses caring for foreign patients in general hospitals.
Methods: The subjects are 308 nurses who work in general hospitals in Seoul and Gyeonggi-do. The data, collected using a structured questionnaire on cultural competence, coping strategy, multicultural experience, intercultural uncertainty, and intercultural anxiety, were analyzed using descriptive statistics, t-test, analysis of variance, Pearson’s correlation analysis, and hierarchical multiple regression.
Results: Cultural competence was significantly associated with marital status, level of education, type of ward, and number of cared foreign patients. In hierarchical multiple regression analysis, the level of cultural competence was significantly associated with married, master degree qualified, high level of coping strategy and multicultural experience, and low level of cultural uncertainty.
Conclusion: The findings revealed the need for educational programs which can contribute to lower the intercultural uncertainty and to enhance coping strategies dealing with foreign patients. In addition, individual and organization efforts to provide opportunities to expand nurses’ multicultural experience will affect nurses’ cultural competence development.

UCI(KEPA)

I410-ECN-0102-2019-500-001552427

간행물정보

  • : 의약학분야  > 예방의학및보건학
  • : KCI등재
  • :
  • : 계간
  • : 1225-4266
  • : 2289-0149
  • : 학술지
  • : 연속간행물
  • : 1991-2022
  • : 1001


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32권2호(2022년 06월) 수록논문
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KCI등재

1새정부 보건의료정책 개선을 기대한다

저자 : 이선희 ( Sun-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 123-124 (2 pages)

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With the inauguration of a new government, expectations for policy changes are also rising. In the hope that this will serve as an opportunity to improve health care policy, I would like to outline the principles strategies. First, considering the growing socioeconomic impact of the health care sector, the government's policy priorities should be notably increased compared to the past. Second, policy improvement measures based on evidence should be sought instead of dwelling on presidential pledges. While easing regulations, we should improve the quality of regulatory approaches. Therefore, it is a time when efforts are needed to strengthen the stability of policies in response to economic crises.

KCI등재

2미국의 혁신의료기술 지불보상제도: 인공지능 의료기기를 중심으로

저자 : 이보람 ( Boram Lee ) , 임재준 ( Jaejun Yim ) , 양장미 ( Jangmi Yang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 125-136 (12 pages)

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The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

KCI등재

3공공 및 민영의료보험의 비급여 관리정책에 대한 국가별 비교

저자 : 김하윤 ( Ha Yun Kim ) , 장종원 ( Chong Won Chang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 137-153 (17 pages)

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In the process of promoting policies to strengthen health insurance coverage, the relationship between public health insurance and private health insurance, along with the management of non-benefit, is also emphasized as a policy issue. First, the concept and scope of non-benefit were comparatively analyzed by country. Second, the interaction between the public and private health insurance was classified as 'large or small,' and the government's regulation and management policy on private health insurance was classified as 'strong or weak.' Korea has relatively smaller benefits covered by public health insurance, higher copayment expenses, and more areas and scope of non-benefits. In countries where the interaction between public and private health insurance is small, private health insurance-related policies are weak. And in countries with large interactions had public-private partnerships and the government's management policies were also strong. On the other hand, Korea has a large interaction, but the actual structure of cooperation between public and private insurance and management policies were weak. Because the non-benefit sector in Korea is relatively wide, it is difficult to manage compared to other countries where the concept of non-benefit is limited. In addition, the health authorities rarely perform the role of supervision over private health insurance, and they have so few linkages and cooperation for public-private insurance. Therefore, practical policy enforcement is necessary to achieve the easing of the burden of national medical expenses through linkage and cooperation of public-private health insurance with reference to relevant other countries' cases.

KCI등재

4진료비 고가도 지표의 한계와 개선 방향

저자 : 장호연 ( Ho Yeon Jang ) , 강민석 ( Min Seok Kang ) , 정서현 ( Seo Hyun Jeong ) , 이상아 ( Sang Ah Lee ) , 강길원 ( Gil Won Kang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 154-163 (10 pages)

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Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit.
Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method.
Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated.
Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

KCI등재

5코로나19 전·후 응급실로 내원한 소아청소년 호흡기계 환자의 유사점과 차이점

저자 : 허영진 ( Young-jin Huh ) , 박윤숙 ( Yun-suk Pak ) , 김은아 ( Eun-ah Kim ) , 오미라 ( Mi-ra Oh )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 164-172 (9 pages)

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Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak.
Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model.
Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020.
Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.

KCI등재

6요양병원에서 응급실로 전입된 노인환자의 경향분석, 2014-2019

저자 : 고성근 ( Sung-keun Ko ) , 김선지 ( Seonji Kim ) , 이태영 ( Tae Young Lee ) , 이진희 ( Jin-hee Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 173-179 (7 pages)

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Background: This study aimed to identify patterns of elderly patients who transferred from long-term care hospitals to emergency rooms and provide the evidence of emergency medical systems to prepare for a super-aged society.
Methods: The data source was the National Emergency Department Information System database from January 2014 to December 2019 in Korea. We performed a cross-sectional study among elderly patients (≥65 years) who transferred from a long-term care hospital to an emergency room. Trend analysis was conducted by year.
Results: We identified 225,765 elderly patients who were transferred from long-term care hospitals to emergency rooms between January 1, 2014 and December 31, 2019. The proportion of the study population and their mean age were recently increased (p<0.001, respectively). The proportion of elderly patients being re-transferred (p=0.049) and the patients re-transferred to long-term care hospitals is significantly increased (p=0.005).
Conclusion: The establishment of efficient emergency medical services for an aging society is important. It is necessary to develop a healthcare network with the government, long-term care hospitals, and medical institutions in the community suitable for preventing disease deterioration.

KCI등재

7산업재해 근로자의 사회적 지지가 주관적 건강에 미치는 영향

저자 : 김지은 ( Ji Eun Kim ) , 함명일 ( Myung-il Hahm )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 180-189 (10 pages)

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Background: Social support contributes directly and indirectly to maintaining physical, mental, and social well-being. The aim of the study was to identify the impact of social support on self-rated health among Korean industrial accident workers.
Methods: This study used data from the panel study of workers' compensation insurance (PSWCI). The final subjects were 2,759 workers who responded to a 2018 to 2020 PSWCI. Social support was defined as social contact with friends, neighbors, family, and social participation activities like religious activity, social activity, and club activity. Multivariate logistic regression analysis was performed to investigate causal relationships between social support and self-rated health using a generalized estimating equation model.
Results: Proportion of workers' good self-rated health steadily increased (2018: n=1,447, 63.2%; 2019: n=1,542, 66.2%; 2020: n=1,653, 67.3%). Higher levels of social contacts with friend (worse: reference; same: β=0.442) and higher levels of social activity (yes: reference; no: β=-0.173) were especially associated with good self-rated health.
Conclusion: This study confirmed social support positively influenced self-rated health among the self-rated health of industrial injured workers. The results of this study suggested that recovery policies that the government served should include programs enhancing social support for improving health among industrial injured workers.

KCI등재

8우리나라 노인의 가구형태와 주관적 건강상태의 관련성: 2017년 노인실태조사 자료를 이용하여

저자 : 최민지 ( Minji Choi ) , 주혜진 ( Hye Jin Joo ) , 김태현 ( Taehyun Kim ) , 백상숙 ( Sang Sook Beck ) , 정우진 ( Woojin Chung )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 190-204 (15 pages)

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Background: In Korea, the population is rapidly aging, and the types of households for the elderly are also diversifying. The self-rated health of the elderly is a valuable health indicator that can comprehensively represent the overall quality of life along with physical, mental, and functional health. On the other hand, studies on the association between household type and self-rated health of the elderly are still insufficient. Thus, this study analyzed the association between household type and self-rated health by gender in Korean older adults.
Methods: Using data from the analysis of the National Survey of Older Koreans 2017, 10,299 elderly people aged 65 and over were targeted. For the accuracy of the analysis data, 9,910 people were selected as the study sample by excluding proxy responses, those diagnosed with dementia, and non-response. And technical analysis, univariate analysis using the Rao-Scott chi-square test, and logical regression analysis involving survey characteristics were conducted by gender.
Results: According to the adjusted model with all variables, in both men and women, the odds ratio of self-rated health 'bad' in 'couple (with ill spouse)' was significantly higher than 'couple (with spouse)'. It was 2.54 (95% confidence interval [CI], 2.05-3.15) for men and 2.11 (95% CI, 1.70-2.62) for women. In addition, the odds ratio of self-rated health 'bad' in 'living with adult children' was 1.43 (95% CI, 1.09-1.87) for men and 1.42 (95% CI, 1.15-1.75) for women, which was more significant in women than men.
Conclusion: This study states that there is an association between gender, household type, and self-rated health of the elderly, and the health of a spouse and cohabitation with children have a significant effect on self-rated health. As a result, in order to improve the health status of the elderly, health promotion and health care policies involving the characteristics of the elderly's gender and household type are needed.

KCI등재

9지역쇠퇴 유형별 의료이용행태 영향요인: 도시쇠퇴 지표와 의료취약지 지표를 활용하여

저자 : 정지윤 ( Ji Yun Jeong ) , 정재연 ( Jae Yeon Jeong ) , 윤인혜 ( In Hye Yoon ) , 최화영 ( Hwa Young Choi ) , 이해종 ( Hae Jong Lee )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 205-215 (11 pages)

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Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators.
Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables.
Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect.
Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

KCI등재

10가구 식품불안정 상태와 정신건강 및 건강 관련 삶의 질과의 연관성

저자 : 김유진 ( Yu-jin Kim ) , 박종은 ( Jong Eun Park ) , 김소영 ( So Young Kim ) , 박종혁 ( Jong-hyock Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 32권 2호 발행 연도 : 2022 페이지 : pp. 216-227 (12 pages)

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Background: Food insecurity may contribute to mental health indicators such as stress, anxiety, or depression. We investigated whether food insecurity was associated with mental health indicators and health-related quality of life (HRQoL) in a representative sample of the Korean population.
Methods: This study enrolled 12,987 adults without a history of medically serious disease from the 2012, 2013, and 2015 Korea National Health and Nutrition Examination Survey. Household food security status was categorized as “food security,” “mild food insecurity,” and “moderate/severe food insecurity.” The association between mental health and HRQoL was evaluated using a multivariate logistic regression model with food security as the reference group.
Results: The adjusted odds ratio of adverse mental health or low HRQoL increased significantly in mild or moderate/severe food insecurity compared to food security. In the moderate/severe food insecurity group, it was 1.98% (95% confidence interval [CI], 1.31- 2.99) higher for perceived stress, 3.58% (95% CI, 2.44-5.26) higher for depression symptoms, 4.16% (95% CI, 2.68-6.45) higher for suicidal ideation, and 2.81% (95% CI, 1.91-4.15) higher for quality of life.
Conclusion: Food insecurity was strongly associated with negative mental health status and poor HRQoL. There is a need for a dietary support program that provides psychosocial support to those experiencing food insecurity.

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KCI등재

1자살예방을 위한 통합적 접근의 필요성

저자 : 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 1-3 (3 pages)

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Suicide is a major problem in Korean health care and a serious social problem. In Korea, 12,463 people (24.3 per 100,000) lost their lives due to suicide in 2017. Although the government has established three National Comprehensive Plan of Suicide Prevention (2004, 2009, 2016), and National Action Plan of Suicide Prevention (2018), the suicide rate is still high. The suicide rate of the elderly is especially high. This is due to the economic vulnerability of the elderly in Korea. Therefore, in order to prevent suicide in Korea, mental health care approach and social welfare approach should be integrated. The intervention of preventing suicide of suicide attempters should include social welfare services as well as mental health program and should be based on community. There are many health problems, including prevention of suicide, which can not be solved only by the efforts of health care. Many health problems are social problems and the integrated approach is needed to solve them. In order to solve many health care problems and improve health, integrated approach of health, social science, and humanities is needed.

KCI등재

2신종담배의 출현과 정책방향: 전자담배 및 가열담배에 대한 전략

저자 : 박명배 ( Myung-bae Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 4-10 (7 pages)

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The term new tobacco products (NTPs) refers to the new alternatives to conventional cigarettes. There are several kinds of NTPs in South Korea. The present study discusses the most widely used NTPs namely electronic cigarette (ECs) and heated tobacco products (HTPs). The aims of this study are to evaluate the risk related to the use of ECs and HTPs, introduce policy examples across different countries of management of this issue, and finally, present some policy implications of the problem and our response strategies. Since the advent of ECs, there has been a lot of debate about its risk. Some studies have reported that ECs are less harmful than conventional cigarettes and that they are effective in aiding smoking cessation. Nevertheless, the efficacy of ECs in smoking cessation and its potential health risks are still unclear. However, the obvious fact is that it is not harmless. Regulations on ECs differ from country to country. In many countries, they are strictly regulated as tobacco or toxic substances; however, in the United Kingdom, the use of ECs are included as part of their smoking cessation policy, and in Japan, they are treated as a form of medication. On the other hand, HTPs are the most recently introduced NTPs and they have attained sensational popularity because of the wrongly held belief that they are less harmful to health. So, what about our policy response to these two tobacco products? The research on ECs requires more systematic statistical monitoring, such as monitoring the ratio of dual-users. Further, the new EC smokers should be identified taking into account that the arguments for the use of ECs often emphasize smoking cessation or less risks to health, the government should further strengthen its policy to prevent those claims. The HTPs market experienced a very sharp growth and continues to grow because the government policy is too passive. Taking this as a lesson, it is necessary to approach NTPs, such as HTPs, proactively and increase their contribution to the National Health Promotion Fund by imposing greater taxes on them. Finally, considering the likelihood of NTPs being promoted as a less harmful tobacco product, it is essential to strictly regulate tobacco companies' publicity from the very beginning to ensure that potential consumer s are not mislead.

KCI등재

3일본 인지증 정책 종합 추진전략의 실천 사례: 쿠마모토현의 쿠마모토 모델

저자 : 주정민 ( Jungmin Joo ) , 권용진 ( Yong-jin Kwon )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 11-18 (8 pages)

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The purpose of this research is to introduce the best practice of the Japanese national dementia strategy and explore implications to the Korean national de-mentia strategy. Interview was conducted among professions those who is in charge of Kumamoto dementia care practice in Kumamoto province, upon review of related literature and public documents. The Kumamoto model is im-plemented by the department of neuropsychiatry in public university hospitals, which can offer dementia-specialized medical ser-vices. Medical centers for dementia in public university hospitals play a leading role for managing practice and training local demen-tia centers specialist, coordinating medical services among medical institutions and community welfare facilities. In reference to the Kumamoto model, the Korean national dementia strategy can find implications in the direction of current system, specifically its ap-proaches toward policy governance.

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4서울시 보건소 대사증후군관리사업의 효과와 자가관리 지원수준 평가

저자 : 김동옥 ( Dong-ok Kim )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 19-26 (8 pages)

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Background: The purpose of this study was to evaluate the effectiveness and the level of self-management support on the Metabolic Syndrome Management Program at public health centers in Seoul metropolitan city.
Methods: The effectiveness on the Metabolic Syndrome Management Program were analyzed using secondary data from 1,312 community residents who were receiving program. The level of self-management support on Metabolic Syndrome Management Program was evaluated using an 'Assessment of Primary Care Resources and Supports for Chronic Disease Self-Management' from four public health centers.
Results: The effectiveness on the Metabolic Syndrome Management Program was showed that decreased smoking (p=0.044) and drinking (p<0.001), and increased healthy dietary habit (p<0.001) in health behaviors. It was showed that decreased triglyceride (p=0.002) and increased high-density lipoprotein cholesterol (p<0.001) in clinical indicators. The level of self-management support on Metabolic Syndrome Management Program was 98.1 points and it meaned that implementation is done in an organized and consistent manner using a team approach. There was difference in the level of self-management support by public health centers (p=0.003).
Conclusion: The Metabolic Syndrome Management Program in public health centers was effective, and level of self-management support was done as organizational level, but patient input and mental health were insufficient.

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5지방의료원의 성과에 영향을 미치는 요인

저자 : 이해종 ( Hae Jong Lee ) , 이동원 ( Dong Won Lee ) , 정지윤 ( Ji Yun Jeong )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 27-39 (13 pages)

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Background: This study is designed to estimate the factors that affect the level of three different performance (publicity, efficiency, profitability) among regional public hospitals.
Methods: The units of analysis are the regional 30 hospitals, which have the operating data during 22 years (from 1933 to 2014). The research method is used by fixed panel analysis. The publicity is measured by medicaid outpatient proportion and medicaid inpatient proportion. The efficiency is measured by two types of efficient score by DEA (data envelopment analysis). The profitability is measured by medical income to medical revenue and ROA (return on total asset).
Results: At first, the increase of bed gives negative affect to the publicity but give positive effect to the efficiency and profitability. Because it means the increase of the region population, it gives more profitability compare to hospital with small number of beds. The more the operating period is the higher effect to the publicity and efficiency because of it's refutation. The debt ratio gives negative effect to publicity, but positive effect to profitability. It is the normal belief that there is inverse relationship between publicity and profitability. The turnover rate of bed gives the negative affect to the publicity, but positive affect to the efficiency and profitability. That give us the implication that type of the inpatient make different effect the hospital performance. The ratio of labor cost give negative effect to all kind of performance. That means that the higher labor cost don't mean the higher publicity and labor cost control is very important factors to hospital performance. So the region hospital have to focus the labor factors more to make higher performance.
Conclusion: As the conclusion, the independent variables give similar effect to the efficiency and the profitability, but give inverse effect to the publicity. That means that if an region hospital want to make the more publicity, it loss the higher efficiency and profitability. Specially publicity is higher negative relation with the profitability.

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6완화의료 일당정액수가제 시행에 따른 진료비와 진료행태의 변화

저자 : 임문남 ( Mun Nam Lim ) , 최성우 ( Seong Woo Choi ) , 류소연 ( So Yeon Ryu ) , 한미아 ( Mi Ah Han )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 40-48 (9 pages)

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Background: As of July 2015, per diem payment was changed from fee for service Therefore, this study aims to analyse changes in medical charges and medical services before and after enforcement of the palliative care, targeting palliative care wards in a general hospital, and provide basic data needed for development of per diem payment.
Methods: The subjects of the study were a total of 610 cases consisting of 351 patients of service fee who left hospital (died) from July 2014 to June 2016 and 259 ones of per diem payment at Chosun University Hospital in Gwangju Metropolitan City.
Results: The results are summarized as follows. First, after the palliative care system was applied, benefit medical service charges and insurance increased significantly (p<0.001). As benefit medical service charges increased, benefit private insurance payment increased significantly (p<0.001). Second, after the per diem payment was applied, total private insurance payment to medical institutes decreased significantly (p=0.050) and non-benefit also decreased significantly (p=0.001).
Conclusion: It is suggested that additional rewards in the obligatory palliative care items should be continuously remedied and monitored to provide good quality hospice palliative care.

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7외국인 환자 간호에 대한 간호사의 문화역량 영향요인

저자 : 안정원 ( Jung-won Ahn ) , 장혜영 ( Hye-young Jang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 49-57 (9 pages)

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Background: The purpose of this study was to examine the cultural competence of nurses caring for foreign patients in general hospitals.
Methods: The subjects are 308 nurses who work in general hospitals in Seoul and Gyeonggi-do. The data, collected using a structured questionnaire on cultural competence, coping strategy, multicultural experience, intercultural uncertainty, and intercultural anxiety, were analyzed using descriptive statistics, t-test, analysis of variance, Pearson's correlation analysis, and hierarchical multiple regression.
Results: Cultural competence was significantly associated with marital status, level of education, type of ward, and number of cared foreign patients. In hierarchical multiple regression analysis, the level of cultural competence was significantly associated with married, master degree qualified, high level of coping strategy and multicultural experience, and low level of cultural uncertainty.
Conclusion: The findings revealed the need for educational programs which can contribute to lower the intercultural uncertainty and to enhance coping strategies dealing with foreign patients. In addition, individual and organization efforts to provide opportunities to expand nurses' multicultural experience will affect nurses' cultural competence development.

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8우리나라 대학생의 음주행태 심층조사

저자 : 영준 ( Yeong Jun Ju ) , 오소연 ( Sarah Soyeon Oh ) , 박상익 ( Sang Ick Park ) , 이혜자 ( Hye-ja Lee ) , 유민규 ( Min-gyu Yoo ) , 박은철 ( Eun-cheol Park )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 58-67 (10 pages)

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Background: In this study, we aimed to investigate the drinking behaviors and drinking-related problems of college students in South Korea to produce national alcohol statistics.
Methods: We carefully examined the questionnaires and previous research developed in the previous research project and selected questions that reflect the special environment and culture of college students. In order to stratify a nationally representative sample of college students, the distribution of students around the country were found through the educational statistics database of the Korea Educational Development Institute. Based on this information, we conducted a survey in collaboration with Gallup (Korea) to survey and analyze the drinking behaviors of 5,024 Korean students.
Results: A nationwide cross-sectional survey was conducted in 2017, for Korean college students. A total of 5,024 students were recruited and analyzed. The monthly drinking rate was 78.0% for male students and 72.9% for female students. The high-risk drinking rate was 23.3% for male students and 17.2% for female students. The most popular category for number of drinks per drinking session was 'more than 10 glasses' per drinking session for both male (44.1%) and female (32.8%). On the alcohol use disorders identification test, the greatest proportion of male students were in the high-risk drinking category (score 8 to 15) 43.8%, followed by the 'low-risk drinking' (score 0 to 7) in 43.6%, 'alcohol abuse' (score 16 to 19) 7.2%, and 'alcohol dependence' (greater than 20) 5.4% categories, respectively. For female students, the greatest proportion of female students were in the 'low-risk drinking' in 49.6%, followed by 'high-risk drinking' 37.1%, 'alcohol abuse' 8.4%, and 'alcohol dependence' 4.9% categories, respectively.
Conclusion: The results of the study showed that the drinking behavior of Korean college students was excessive. Overall, it was found that the college population has a greater high-risk drinking behaviors than general adult population. Furthermore, these problem drinking behaviors were prominent among female college students. Results from the present study suggest that it is necessary to monitor the drinking behavior of college students with constant interest and to prepare policies and strategies suitable for these circumstances.

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9Association between Self-Reported Sleep Duration and Diabetes Mellitus: Data from a 7-Year Aggregated Analysis

저자 : Jae-hyun Kim , Eun-cheol Park

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 68-76 (9 pages)

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Background: This study investigates the association between sleep duration and diabetes mellitus (DM) in a large representative population-based survey in South Korea.
Methods: The fourth (2007-2009), fifth (2010-2012), and sixth (2013) Korea National Health and Nutrition Examination Survey data sets were used. A total of 37,989 individuals were selected for the study. Chi-square tests and multivariate logistic regression analyses were used to analyze whether general characteristics, health status, and health risk behaviors were associated with DM.
Results: After adjusting for confounders, the odds of DM in short sleepers (≤5 hr/day) and long sleepers (≥9 hr/day) were 1.033-times higher (95% confidence interval [CI], 0.913-1.169) and 1.334-times higher (95% CI, 1.140-1.562), respectively, compared with individuals who slept 7 hr/day. Subgroup analysis according to gender showed a U-shaped association for both genders, although it appeared stronger in men.
Conclusion: This study identified a U-shaped association between sleep duration and the risk for DM. Additional studies should help clarify the important information in this study.

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102017년 자살 관련 지표들과 추이

저자 : 권준현 ( Junhyun Kwon ) , 양지은 ( Jieun Yang ) , 주영준 ( Yeong Jun Ju ) , 박은철 ( Eun-cheol Park ) , 장성인 ( Sung-in Jang )

발행기관 : 한국보건행정학회 간행물 : 보건행정학회지 29권 1호 발행 연도 : 2019 페이지 : pp. 77-81 (5 pages)

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Suicide is a major public health issue that causes over 800,000 deaths each year globally. Korea ranks high in suicide rates, in which around 24.3 per 100,000 individuals are reported to have died by intentional self-harm in 2017 according to Statistics Korea. The aim of this study was to examine the current status and trend of suicide ideation and attempt using data from the following five sources: Korean National Health and Nutrition Examination (KNHANES, '07-13, '15-17), Korean Community Health Survey (KCHS, '08-09, '13, '17), Korean Wealth Panel Study (KOWEPS, '12-17), Korea Health Panel Survey (KHP, '10-13), and Statistics Korea (1983-2017). Suicide ideation and attempts were also further examined based on equalized household income levels. Data published by Statistics Korea were used to show the updated suicide rate and number of deaths by intentional self-harm. The rate of suicide ideation at the recent year was 4.73% (KNHANES, '17), 6.96% (KCHS, '17), 1.63% (KOWEPS, '17), and 5.39% (KHP, '13). That of suicide attempts as recent year was 0.71% (KNHANES, '17), 0.32% (KCHS, '17), and 0.09% (KOWEPS, '17). Annual percentage change of suicidal ideation was -15.4% (KNHANES, '07-17), -2.5% (KCHS, '08-17), -8.6% (KOWEPS, '12-17), and -10.9% (KHP, '10-13). Annual percentage change of suicide attempts was -4.0% (KNHANES, '07-17), -4.4% (KCHS, '08-17), and -14.9% (KOWEPS, '12-17). Individuals with lower income levels were more likely to experience suicide ideation and attempts. Considering that Korea still shows a high suicide rate despite the continuously decreasing trend of suicide ideation and attempt, continuous observation and appropriate policy implementation regarding suicide related problems are necessary.

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