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병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구
이숙자,이진경,유호신,Lee, Sook-Ja,Lee, Jin-Kyung,Ryu, Ho-Sihn 한국가정간호학회 1999 가정간호학회지 Vol.6 No.-
This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health ca
의사, 간호사 국가시험의 문항반응이론에 의한 CAT시스템 개발에 관한 연구
이창규(ChangKyou Lee),이은일(E.I. Lee),이숙자(S.J. Lee),박은숙(E.S. Park),박영주(E.S. Park),박종성(J.S. Park),이승관(SeungGwan Lee),조경진(KyungJin Cho) 고려대학교 보건과학연구소 2005 보건과학논집 Vol.31 No.2
Tests are divided into two major groups by their objectives, a normal referenced test for entrance examinations and a criterion reference test for licenses and certifications. The license examinations for health and medical fields have been developed. The classical item analysis, however, has been used for the test system and most of the tests are paper and pencil test so far. The relative difficulty of the test depends on intellectual levels of candidates and few solutions for the changes of the relative difficulty of the test often lead to various test contingencies.<BR> From the beginning of 21st century, advanced countries have adopted the Computer Adaptive Test (CAT) for license and certification in the field of health and medical specialist as well as in other fields. The Item Response Theory (IRT) was a basic theory for the CAT.<BR> The data for relative difficulty, discrimination, guessing were calculated by IRT and Item Bank was made from the calculated data. Computer Based Test using the item bank was carried into effect and more items are banked and calculated continuously. Computerized Adaptive Test using information communication network, e.g. internet and computer lab, was developed. The CAT system using information communication network is able to use license examination as well as education for the students in medical, nursing, and health sciences.
CAT(Computer Adaptive Test) 시스템 구축을 위한 문항반응이론(IRT)의 문항분석 비교연구(1)
이창규 ( Chang Kyou Lee ),이승관 ( S. G. Lee ),조경진 ( K. J. Cho ),이은일 ( E. I. Lee ),이숙자 ( S. J. Lee ),박은숙 ( E. S. Park ),박영주 ( Y. J. Park ) 대한임상검사과학회 2000 대한임상검사과학회지(KJCLS) Vol.32 No.3
Prior to CAT, the parameter estimation on executed items should be accomplished by IRT.and the item banking must be build up on the basis of the parameter of difficu1ty. A program developed by Korea ETS, Bilog and Bigsteps were all found to be very powerful to understand the attributes of items. Though multiple true-false type K items have some merits, the items should be examined quantitative1y if they are appropriate or not by IRT. Through the study we have fmally confmned that the new program developed by Korea ETS has its abi1ity to check the validities of items from preparing or scoring to item analysis.