Critical Pathway 개발 및 적용을 통한 재원일수와 비용의 감소 : 허혈성 뇌졸중의 항응고요법 환자를 대상으로 한 예비 연구

진인선 대한뇌졸중학회 1999 Journal of stroke Vol.1 No.2

Background : Critical pathways have been a strategy for maintain and/or improving patients care quality and controlling health care cost. The aim of this study was to decrease hospitalization costs and length of stay and to increase quality of health care service by developing and implementing a critical pathway to patients who hadbeen treated with anticoagulation therapy in ischemic stroke. Methods : A conceptual framework of our critical pathway was developed through review of the literatures including four critical pathways, which have currently being used in U.S.A. In order to identify the overall service contents required by the patients and to draw up a preliminary critical pathway, thirty cases of medical records of patients who had been treated with anticoagulation therapy in ischemic stroke at Samsung Medical Center were analyzed and reviewed. A validity test was done for the preliminary critical pathway. After these processes, our final critical pathway was developed. This critical pathway was applied to 23 patients who had anticoagulation therapy with ischemic stroke between Aug. 1997 and Oct. 1997. The results after implementation of critical pathway were compared with those before the implementation with regard to the hospitalization cost, the length of stay, and the quality of health care service. Results : After implementation of critical pathway, there was a significant reduction in mean length of stay (22.1 to 11.6 days; P 〈 0.05). During this same period of time, there was a 26% decline in total hospital costs per patient without change of mortality and clinical symptom deterioration. According to a patient survey, they were satisfied with the length of stay (82%) and with explanation made from stroke team (91%). Conclusion : An implementation of critical pathway is valuable to decrease hospitalization costs and length of stay, and to increase quality of health care service. Korean Journal of Stroke 1999;1(2): 201~207

자료포락분석을 활용한 신기술 분야 교육훈련 운영기관의 효율성 분석

진인선,이영민 한국직업교육학회 2023 職業 敎育 硏究 Vol.42 No.3

The purpose of this study was to analyzes the operational efficiency of education and training institutions that operate education and training in the new technology field by using Data Envelopment Analysis(DEA). For this purpose, the researcher analyzed education and training institutions’ operational efficiency through the CCR model, the CCR Super-CCR model, the BCC model, and the Super-SBM model. For the analysis of relative efficiency, the number of training courses, training hours, average training cost per person, total training cost, number of trainees, number of graduates, number of employees, and overall satisfaction were set as variables. As a result of the analysis, 17 institutions, 30.4% of the total 56 institutions, were confirmed to be more efficient than other institutions. It was confirmed that 4 institutions were used as reference institutions more than 10 times when comparing efficiency. Also as a result of the scale efficiency analysis, 32 institutions were found to be related to size as well as technical factors for inefficiency, and it is necessary to consider the scale aspect to improve efficiency. Based on the results of this study, were suggested to need to improve the training supply method, the need for efficiency-oriented training quality management away from the rank-and-file performance management method, and need to sharing of the best practices. 이 연구의 목적은 신기술 분야 교육훈련기관을 대상으로 자료포락분석(Data Envelopment Analysis)를 활용하여 운영 효율성을 분석하는 것으로 자료포락분석 모형 중 CCR 모형, CCR 초효율성(Super-CCR) 모형, BCC 모형, 여유분 초효율성(Super-SBM) 모형을 통해 규모 효율성을 분석하였다. 교육훈련기관의 상대적 효율성 분석을위해 훈련 과정 수, 훈련 시간, 인당 평균 훈련비, 총훈련비, 훈련 인원, 수료 인원, 취업 인원, 전반적 만족도를변수로 설정하였다. 기술효율성 분석 결과, 전체 56개 기관 중 30.4%인 17개 기관이 다른 비교 기관들에 비해운영 효율성이 있는 것으로 나타났고, 이 중 4개 기관은 효율성 분석에서 10회 이상 참조 기관으로 활용되었다. 또한, 규모 효율성 분석 결과, 비효율적 원인이 기술적 요인뿐만 아니라 규모와 연관 있는 기관은 32개 기관으로나타나 효율성 개선을 위해 규모적 측면을 고려할 필요가 있다. 교육훈련기관의 효율성 제고를 위해서는 훈련공급방식을 개선하고, 서열화된 성과관리 방식보다는 효율성 중심의 훈련품질 관리를 실시해야 하며, 상대적으로효율적인 교육훈련기관을 통한 우수사례를 확산하는 방안이 필요하다.

임상현장의 윤리교육 사례2 (종합병원)

진인선 한국간호윤리학회 2019 한국간호윤리학회 학술대회 Vol.2019 No.11

비용절감을 위한 비처방성 진료재료 사용량 관리

윤호순,길현희,진인선,윤수진,윤미선,정복연,황영선,송현숙,이윤미,홍나숙,김은숙,송영득 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3

입원환자의 낙상 실태 및 위험요인 조사연구

윤수진,이천균,진인선,강중구,Yoon, Soo-Jin,Lee, Chun-Kyon,Jin, In-Sun,Kang, Jung-Gu 한국의료질향상학회 2018 한국의료질향상학회지 Vol.24 No.2

Purpose: The objective of this study was to report the incidence of falls in hospitals and analyze the risk factors for falls. Methods: This study used data on 1,216 patients who experienced falls from 2015 to 2017 during their hospitalization. The data was collected from the falls incident reports and patient' electronic medical record of hospital. Data were analyzed with descriptive statistics using Chi-square test, Fisher's exact test and multiple Poisson regression analysis with the SAS 9.4 Results: The incidence of falls was 1.38 per 1,000 patients days (2015), 1.81 per 1,000patients days (2016) and 1.99 per 1,000patients days (2017). The incidence of injury caused by falls (level III~V) was 0.05 per 1,000patients days (2015), 0.04 per 1,000patients days (2016) and 0.06 per 1,000patients days (2017). The largest number of falls occurred during night shift (42.5%), specifically in the patients' room (70.8%), and medical unit (66.0%). Average age of fallers was 69.1 years and 61.7% of them were older than 71 years. CCI and the patient's department have statistically significant differences in injury or injury levels from falls, but the integrated nursing care services had no significant difference in injury or injury levels from falls. Conclusion: The result of this study can be used as a reference for establishing a fall prevention strategy for hospitalized patients by presenting index values such as the fall rate.

발달장애 국가책임제에 관한 발달장애인 부모의 인식 고찰

김성심(Sung-Sim Kim),전인선(In-Sun Jeon),진형식(Hyung-Sik Jin) 한국장애학회 2022 한국장애학 Vol.7 No.1

본 연구는 「발달장애 국가책임제」에 대한 요구가 높아지고 있는 가운데, 발달장애 부모들의 참여를 통해 발달장애 국가책임의 성격을 탐색해 보고자 하였다. 이를 위해 책임은 개인에게 있지만 국가가 주도해야 한다는 복지론, 책임성과 주도성 모두 개인에게 주어지는 윤리론, 책임은 국가에게 있지만 개인이 주도하는 권리중심론에 기초하여 발달장애 부모의 국가책임제에 대한 이해를 살펴보았다. 연구는 4명의 발달장애 부모의 참여로 인터뷰 방식으로 이루어졌고, 질적 연구방법의 자료분석법인 반복적 비교분석법으로 결과를 도출하였다. 연구결과 ‘안 되는 게 많은 아이’, ‘장애는 사회가 알아주지 않는 불편함’, ‘부모가 짊어지고 가야 되는 짐’, ‘국가책임제는 당연’, ‘발달장애인 당사자는 모르는 국가책임제’의 범주로 나타났다. 이는 발달장애의 특성상 가족의 돌봄이 큰 고통에 놓여있고, 무엇보다도 사회가 발달장애인을 배제함으로서 발달장애인과 가족의 고립이 가장 큰 어려움임을 알 수 있었다. 발달장애 부모들은 장애자녀를 부모가 짊어져야 할 ‘십자가’라고 하였으며, 장애자녀의 불안한 삶에 대한 부모의 걱정을 국가가 나눠 짊어지는 의미에서 국가책임제를 긍정적으로 인식하였다. 반면 발달장애 당사자는 국가책임제를 알지 못한다고 하여, 당사자 권리중심의 공적돌봄으로 인식되지 못하고 있음을 알 수 있었다. 이러한 연구결과에 기초하여 진정한 「발달장애 국가책임제」 실현을 위해서는 발달장애인의 시민권적 권리에 대한 인식개선이 필요하며, 발달장애인 당사자의 욕구와 자기결정권 실현을 위한 실천이 강조되어야 함을 제언하였다. This study attempted to explore the nature of state responsibility for developmental disabilities through the participation of parents with developmental disabilities amid the increasing demand for the ‘state responsibility system for developmental disabilities’. To this end, we looked at the understanding of the state responsibility system of parents with developmental disabilities based on the welfare theory that individuals are responsible, the ethics given to individuals, and the individual-led rights-centered theory. The study was conducted in an interview method with the participation of parents with developmental disabilities, and the results were derived using the iterative comparative analysis method, which is a data analysis method of qualitative research method. As a result of the study, the categories were “children with many things that cannot be done,” “disability is inconvenient that society does not recognize,” “the burden that parents should bear,” “the national responsibility system is natural,” and “the national responsibility system that those with developmental disabilities do not know.” Due to the nature of developmental disabilities, family care is in great pain, and above all, society excludes people with developmental disabilities, indicating that isolation of people with developmental disabilities and their families is the biggest difficulty. Parents with developmental disabilities called children with disabilities a “cross” that parents should bear, and positively recognized the national responsibility system in the sense that the state shared their parents’ concerns about the unstable life of children with disabilities. On the other hand, it was found that the parties with developmental disabilities were not aware of the state responsibility system, and were not recognized as public care centered on the rights of the parties. Based on these research results, it was suggested that in order to realize a true ‘state responsibility system for developmental disabilities’, awareness of the citizenship rights of people with developmental disabilities should be improved, and practice for realizing the needs and self-determination rights should be emphasized.

E-O GAS 멸균물품의 효율적인 관리

권말선,유소라,백미영,진인선,진은영,이성순,최재숙,안희자 한국의료QA학회 2009 가을학술대회 Vol.2009 No.3

IT 기업 근로자 숙련도, 교육훈련 적절성, 인재우대, 조직몰입의 인적자원경쟁력 예측 연구

장혜정(Chang, Heajung),진인선(Jin, Insun) 한양대학교 교육공학연구소 2014 학습과학연구 Vol.8 No.1

본 연구는 전문직 근로자들로 구성된 IT 업종에 종사하고 있는 근로자들을 대상으로 한 패널조사 결과를 분석하여 근로자 숙련도, 교육훈련 적절성, 인재우대, 조직몰입, 인적자원경쟁력 간의 관계를 살펴보고 이들 요인이 인적자원경쟁력을 유의미하게 예측하는지를 검증할 목적으로 수행되었다. 이를 위해서 한국직업능력개발원에서 실시하고 있는 인적 자본 기업 패널조사에 참여한 IT업종 64개 기업의 79명의 응답자를 대상으로 중다회귀분석을 실시한 결과, 교육훈련의 적절성(β =.24)과 인재우대(β =.38)는 조직몰입을 유의미하게 예측했으며, 인재우대(β = .34, p<.05), 조직몰입(β = .24, p<.05), 교육훈련의 적절성(β = .23, p<.05)의 순으로 인적자원경쟁력을 유의미하게 예측하였다. 마지막으로 조직몰입은 교육훈련의 적절성 및 인재우대와 인적자원경쟁력을 부분매개하는 변수임을 확인하였다. 이러한 연구결과를 토대로 IT기업 근로자들의 인적자원경쟁력 향상을 위해서는 기업과 근로자들의 현장중심 교육훈련 수요를 정확하게 파악하여 실제업무현장과 가장 유사한 프로그램을 기획, 운영 및 평가하여야 하며, 숙련된 인재에 대한 제도적인 우대와 보상시스템을 마련하여 근로자들의 조직몰입을 촉진함으로써 궁극적으로 인적자원경쟁력 향상이 기업의 성과향상의 결과를 이끌어 낼 수 있음을 시사해 주었다. The purpose of this study is to verify the prediction of proficiency, appropriateness of education/training and top talents management on organizational commitment and HR competitiveness in IT companies. The 79 team leaders of production department in 64 IT companies which responded to HCCP survey were used to assess research hypotheses. The results of this study through multiple regression analysis indicated that appropriateness of education/training and top talents management predicted significantly on organizational commitment. And appropriateness of education/training, top talents management and organizational commitment predicted significantly on HR competitiveness. In addition, organizational commitment partially mediated between appropriateness of education/training and HR competitiveness, and between top talents management and HR competitiveness. The findings show that appropriateness of education/training and top talents management are important variables to encourage HR competitiveness in IT companies. It is also suggested that reward-system for skilled workers would be considered for improving HR competitiveness.

뇌졸중 환자의 절대안정 기간이 골밀도에 미치는 영향

김종국 ( Jong Kook Kim ),송인선 ( In Sun Song ),신혜란 ( Hye Lan Shin ),진광선 ( Kwang Seon Jin ),윤일지 ( Il Ji Yoon ),최승훈 ( Seung Hoon Choi ),오민석 ( Min Suck Oh ) 한방재활의학과학회 2004 한방재활의학과학회지 Vol.14 No.1

Objective: The aim of this study was to investigate the effects of absolute bed resting(ABR) period on bone mineral density(BMD) recovery in acute stroke patients. It is necessary for acute stroke patients to spend a few days-absolute bed resting period-for treatment. During ABR period, bone mineral density have a tendency to decrease. But During exercise period, BMD have a tendency to increase. Therefore this clinical study investigate the change of BMD in acute stroke patients. Methods: This clinical study have been carried out with 50 cases of acute stroke patients that entered Cheongju Oriental Hospital from March to October 2003 and investigates through several items-diagnosis, sex, age, ABR period, smoking, drinking, hypertension, diabetes mellitus(DM) and osteoporosis. Results & Conclusions: The results were as follows; 1. In change of BMD, 31cases(62%) increased and 19cases(38%) decreased. In 43`s infarction patients 26 cases(60%) increased and. in 7`s hemorrhage patients 5 cases(71%) increased. But significant increase was not. 2. In sexual change of BMD, BMD of female patients increased(p<0.05) significantly. 3. In ABR periodic change of BMD, BMD significantly decreased(p<0.01) according as ABR period were long. 4. In change of BMD according to smoking and drinking, BMD of non-smoking group increased(p<0.05) significantly. 5. In change of BMD according to hypertension, DM and osteoporosis, BMD of non-hypertension group increased(p<0.05) significantly. These results indicate that female, non-smoking group, non-hypertension and group that spent short ABR period BMD increased significantly.

효율적연 린넨 관리를 통한 세탁비용 3% 절감

안금희,유소라,유은경,권말선,백미영,진인선,박애희,조지선,윤수진,시혜정,박종효 한국의료QA학회 2008 가을학술대회 Vol.2008 No.2