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RISS 인기검색어
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- 저자 : 신숙연 ( Suk Youn Shin ) (검색결과 4 건)
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신숙연 ( Suk Youn Shin ),박춘선 ( Choon Seon Park ),김선민 ( Sun Min Kim ),김남순 ( Nam Soon Kim ),이상일 ( Sang Il Lee ) 한국보건행정학회 2009 보건행정학회지 Vol.19 No.3
Objectives: To identify target areas and set priorities among those areas identified for national quality evaluation. Methods: Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories: short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.
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박춘선 ( Choon Seon Park ),김묘정 ( Myo Jeong Kim ),임지혜 ( Jee Hye Im ),김태현 ( Tae Hyun Kim ),신숙연 ( Suk Youn Shin ),이남석 ( Nam Suk Lee ),장진희 ( Jin Hee Chang ) 한국보건경제정책학회(구 한국보건경제학회) 2016 보건경제와 정책연구 Vol.22 No.3
슬관절치환술은 무릎 관절염 환자에게 있어 효과적인 수술방법으로 알려져 있으며, 선진국에서 가장 일반적으로 시행되는 수술 중 하나이다. 한국에서는 2011년부터 특정 질환 및 진료 과목에 대해 난이도가 높은 의료행위를 하는 병원을 대상으로 전문병원 지정제도가 운영되고 있다. 이 연구의 목적은 관절전문병원과 비교병원에서 슬관절치환술 환자의 진료결과를 비교하는 것이다. 분석자료는 건강보험심사평가원의 건강보험청구자료를 이용하여 구축하였으며, 2012년에 일차 슬관절치환술로 종합병원 및 병원에 입원한 36,934명의 환자가 포함되었다. 계획되지 않은 재입원과 위해사건 발생을 진료결과로 고려하였다. 연령, 성별, 의료보장유형, 찰슨동반질환지수를 이용하여 환자특성을 보정하였다. 통계방법은 GEE (Generalized Estimating Equation)을 이용하였다. 퇴원 후 30일 이내 계획되지 않은 재입원율은 전문병원이 12.1%, 비교병원이 10.1%였고, 입원 후 90일 이내 위해사건 발생률은 전문병원이 1.3%, 비교병원이 1.9%였다. 그러나 환자특성을 보정하면 관절질환 전문병원과 비교병원의 진료결과 간에 유의한 차이는 보이지 않았다. 추후 전문병원 지정제도의 효과를 확인하기 위해서는 임상자료를 포함한 다년도 자료를 이용하여 전문병원의 진료결과가 비전문병원의 진료결과보다 우수한지 규명하는 연구가 필요하다. Total knee arthroplasty (TKA) is a common and effective surgical procedure for severe knee arthritis and is one of the most increasingly popular procedures in developed countries. In 2011, the Korean Government designated hospitals that had been focusing on specific diseases or procedures as specialty hospitals. The aim of this study was to compare outcomes of TKA specialty hospitals and non-specialty hospitals. Observational data collected from the National Health Insurance Claims Data of the Health Insurance Review and Assessment Service included 36,934 patients who underwent primary TKA at hospitals during 2012. Outcomes of TKA were unplanned readmission and adverse events. Age, sex, health insurance status, and comorbidity using Charlson`s Index were used to adjust for covariates. A generalized estimating equation (GEE) was used to compare outcomes of specialty hospitals and non-specialty hospitals. The unplanned readmission rates within 30 days of discharge of specialty and non-specialty hospitals were 12.1% and 10.1%, respectively. Patients who underwent TKA in specialty hospitals experienced fewer adverse events within 90 days of surgery compared to those who underwent the procedure in non-specialty hospitals (1.3% vs. 1.9%). However, the outcomes were not significantly different after adjusting for covariates. Further studies are needed to determine whether the outcomes of specialty hospitals become better than those of non-specialty hospitals in order to examine the effect of the designation policy.
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김은경,황정해,신숙연 대한간호행정학회 2006 간호행정학회지 Vol.12 No.2
Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simp1e dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.
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