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김종인(Jong-In Kim),고민석(Min-Seok Ko),오평자(Pyeung-Ja Oh) 한국보건복지학회 2008 보건과 복지 Vol.10 No.-
Objectives. The purpose of this study was to make a case analysis of psychiatric patients in their 20s to find out their lives and physical and mental state. It's basically meant to lay the foundation for health and welfare policy setting for psychiatric patients and suggest some of the right directions for mental health care projects. Methods. The subjects in this study were five psychiatric patients who were in their 20s and hospitalized at the department of psychiatry in a general hospital in North Jeolla Province. A survey was conducted from May 1 to Jun 30, 2008. The findings of the study were as follows: Result. As for general characteristics including gender, two of the five patients investigated were male, and the other three were female. By marital status, many were unmarried, and most of them benefitted from the health insurance. They weren't ordinarily engaged in social activities, and most of them were unemployed. Every patient complained of economic difficulties. Concerning their diseases, three got 55 on the GAF scale, and two got 65. Every patient had no family history of mental disease except one, and the duration of illness ranged from four to eleven years, which showed that they suffered from chronic mental disease. And they were repeatedly hospitalized. Regarding their state, they didn't find themselves to be properly supported. Their state upon hospitalization was marked by self-injury, anxiety, insecurity, hostile behavior, unstable mood and difficulties in controlling aggressiveness, which indicated that they were in a similar state. Some of them showed little intelligence. As to mental state, they were irritated, nervous and suffered from visual and auditory hallucinations, and they were depressed and felt an impulse to commit suicide. In regard to physical state, they suffered from chronic or acute diseases in addition to mental illness. In terms of nursing diagnosis, they were lost in wild fancies, and they were consequently likely to use violence or respond to others in a defensive manner. Besides, they were left out from others. Conclusions. In order to prevent mental illness, it's required to take measures to help people in general to get rid of stress and stay away from depression. The government should take legal actions to gather and share information on psychiatric patients to facilitate their treatment, and build a inpatient change system in view of inpatients change rate for different types of psychiatric patients to promote more energetic mental health care projects. Public mental health care projects should be enlarged to provide psychiatric patients with better treatment and expedite the rehabilitation of the mentally disabled in order to create a healthy society. In health and welfare projects, a separate budget should be earmarked for patients who suffer from severe illness and need long-term hospitalization so that they and their families could be relieved of the economic burden. Every local community should provide the mentally disabled with job rehabilitation training to guarantee their job security, and the government should prepare efficient policies and budget to facilitate their job rehabilitation.
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고민석,김수열,오평자 원광대학교 대학원 2007 論文集 Vol.39 No.-
The purpose of this study was to find the present condition and improvement of health care service utilization for the elderly. The data for the analysis of the present condition of health care service utilization came from National Health Insurance Statistical Yearbook for 1992~2000 by National Health Insurance Corporation and Health Insurance Review and Evaluation Statistical Yearbook for 2001~2006 by Health Insurance Review Agency. The result of the investigation shows that health problems of the elderly are still serious and their health care expenditures and utilization of health care service they need to get are continuing to rise. There are even signs of moral hazards that may eventually lead to deteriorating health of the elderly, as it is revealed that payment has been requested with more recipients documented than the number of patients who have been actually treated at hospitals together with more days of treatment than actual ones. I would like to suggest measures for improvement as follows: firstly, the primary health care system for the elderly should be intensified; secondly, the clinical practice guideline for treating the elderly should be developed; thirdly, efforts should be made to finance the health care expenditures for the elderly on the national level; and fourthly, a construct surveillance system for moral hazards in diagnosis and treatment of the elderly.
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