• Title, Summary, Keyword: medical staff

Search Result 724, Processing Time 0.049 seconds

Typology of the medical claims review (의적클레임검토 유형론)

  • Lee, Sin-Hyung
    • Journal of Korean Life Insurance Medical Association
    • /
    • v.26
    • /
    • pp.41-53
    • /
    • 2007
  • In the course of insurance claim administration, medical experts' opinions are called medical claim reviews. They are classified into two main categories: medical verification and counsel for claim staff. Medical verification compare between product coverage and the insured's physical condition. Medical counsel for claim staff is advice for claim staff when they have a question about medical knowledge to make a claim decision. A common example of medical verification is insurance coding of pituitary apoplexy. Some clinicians have insisted that the ICD coding of pituitary apoplexy is l63 of cerebral infarction, but the exclusion criteria of I code show that neoplasm is coded as C00 to D48. Thus, pituitary apoplexy must be coded as D33. An example of medical counsel for claim staff is interpretation of some medical conditions. It is divided into UCR(usual, customary, and reasonable) assessment, assessment of causality, and so on. Disability evaluation is another subject of medical counsel for claim staff. The final claim decision must be made by claim staff because only the claim staff have the authority of claim decision. Medical claims review is only an expert's opinion.

  • PDF

Evaluation of the medical staff effective dose during boron neutron capture therapy using two high resolution voxel-based whole body phantoms

  • Golshanian, Mohadeseh;Rajabi, Ali Akbar;Kasesaz, Yaser
    • Nuclear Engineering and Technology
    • /
    • v.49 no.7
    • /
    • pp.1505-1512
    • /
    • 2017
  • Because accelerator-based boron neutron capture therapy (BNCT) systems are planned for use in hospitals, entry into the medical room should be controlled as hospitals are generally assumed to be public and safe places. In this paper, computational investigation of the medical staff effective dose during BNCT has been performed in different situations using Monte Carlo N-Particle (MCNP4C) code and two voxel based male phantoms. The results show that the medical staff effective dose is highly dependent on the position of the medical staff. The results also show that the maximum medical staff effective dose in an emergency situation in the presence of a patient is ${\sim}25.5{\mu}Sv/s$.

Determinants of Quality in Outpatient Medical Service (외래 의료서비스 질적 수준의 결정요소)

  • Park, Sook-Hee;Kim, Seok-Beom;Kang, Pock-Soo
    • Quality Improvement in Health Care
    • /
    • v.5 no.2
    • /
    • pp.176-189
    • /
    • 1998
  • This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

  • PDF

Prevalence of Sharing Access Credentials in Electronic Medical Records

  • Hassidim, Ayal;Korach, Tzfania;Shreberk-Hassidim, Rony;Thomaidou, Elena;Uzefovsky, Florina;Ayal, Shahar;Ariely, Dan
    • Healthcare Informatics Research
    • /
    • v.23 no.3
    • /
    • pp.176-182
    • /
    • 2017
  • Objectives: Confidentiality of health information is an important aspect of the physician patient relationship. The use of digital medical records has made data much more accessible. To prevent data leakage, many countries have created regulations regarding medical data accessibility. These regulations require a unique user ID for each medical staff member, and this must be protected by a password, which should be kept undisclosed by all means. Methods: We performed a four-question Google Forms-based survey of medical staff. In the survey, each participant was asked if he/she ever obtained the password of another medical staff member. Then, we asked how many times such an episode occurred and the reason for it. Results: A total of 299 surveys were gathered. The responses showed that 220 (73.6%) participants reported that they had obtained the password of another medical staff member. Only 171 (57.2%) estimated how many time it happened, with an average estimation of 4.75 episodes. All the residents that took part in the study (45, 15%) had obtained the password of another medical staff member, while only 57.5% (38/66) of the nurses reported this. Conclusions: The use of unique user IDs and passwords to defend the privacy of medical data is a common requirement in medical organizations. Unfortunately, the use of passwords is doomed because medical staff members share their passwords with one another. Strict regulations requiring each staff member to have it's a unique user ID might lead to password sharing and to a decrease in data safety.

The Study on the Effects of Leadership Types in Hospital Organization on Organization Effectiveness: Focused on Medical and Non-Medical, Middle manager and operator (병원 조직의 상사리더십 유형이 조직 유효성에 미치는 영향에 관한 연구: 직종 및 직급 수준에 따른 차이를 중심으로)

  • Lee, Yeon Sook
    • Journal of Korean Society of Occupational and Environmental Hygiene
    • /
    • v.29 no.1
    • /
    • pp.82-97
    • /
    • 2019
  • Objective: In this study, in order to investigate the relationship between leadership type and job satisfaction, the types of leadership in medical institutions are divided into transformational leadership, servant leadership and authentic leadership. In addition medical staff and non-medical staff are classified according to their job characteristics, and middle managers and operators are classified according to position. Methods: For this purpose, 589 questionnaires were applied to the medical institutions in Seoul and Gyunggi-do, and empirically analyzed with multiple regression. Results: The results of this study are first, among gender, medical or non-medical staff, position and career experience, men, non-medical staffs, and middle managers showed higher leadership, job engagement, and job satisfaction. Second, servant leadership and authentic leadership have significant positive relationships with job engagement. In the case of medical staff, only servant leadership has a positive effect on job engagement, while in the case of non-medical staff, both servant leadership and authentic leadership have significant influence on job engagement. Job satisfaction was found to have a statistically significant effect of servant leadership and authentic leadership in medical staff and non-medical staff. Third, in the case of middle managers, servant leadership showed a statistically significant effect only on job satisfaction, while servant leadership and authentic leadership had statistically significant effects on job engagement and job satisfaction of operators. Conclusions: This study suggests the possibility and applicability of authentic leadership in addition to transformational leadership and servant leadership in hospital organizations. Also, by identifying differences in the effects on organizational effectiveness, it is also suggested the need for research on identifying leadership factors that reflect strictly distinctive job characteristics.

Effects of job satisfaction and patients satisfaction on medical profit at public hospitals (공공병원 직원의 직무만족도 및 환자 만족도가 의료수익에 미치는 영향)

  • Hwang, Eun Jeong
    • Korea Journal of Hospital Management
    • /
    • v.19 no.2
    • /
    • pp.12-21
    • /
    • 2014
  • Purpose: This study was conducted to examine the factors associated with medical profit per bed related job satisfaction and patients satisfaction in public hospitals. Method: A cross-sectional survey was conducted through staff and patients in 39 hospitals (34 local province hospitals, and 5 red-cross hospitals) from September to October in 2011. A questionnaire was designed to collect information on job satisfaction, inpatients and outpatients satisfaction. The data of medical profit per bed was collected in 2011 annual financial reports from each 39 hospitals. Finally, data from 5,521 staff, 1,730 in-patients and 1,730 out-patients were analyzed. Multiple logistic regression analysis was performed to determine factors associated with medical profit per bed related job satisfaction and patients satisfaction in public hospitals. Results: The medical profit was positively correlated with job satisfaction of staff. As the results of multiple logistic regression, the significant variables of medical profit per bed, were communication satisfaction of staff(OR=0.48, 95% CI=0.25-0.91), hospital environment satisfaction of in-patients(OR=1.53, 95% CI=1.05-2.22). Conclusion: The satisfaction of patient and staff were significantly effect to medical profit in public hospitals. The Government and administrators have make an effort to improve satisfaction of staff and patients in public hospitals.

  • PDF

The U. S. Antitrust Law on the Exclusion of Medical Staff Privilege and its Implication (참여의 특권 배제에 관한 미국 독점금지법 법리와 그 시사점)

  • Jeong, Jae-Hun
    • The Korean Society of Law and Medicine
    • /
    • v.12 no.2
    • /
    • pp.295-316
    • /
    • 2011
  • If the medical staff privileges, which mean the eligibility to practice at open hospitals, are excluded in the United States, antitrust claims based on the violation of the Sherman Act have been raised a lot. The proliferation of these lawsuits in the United States, which are characterized as antitrust lawsuits, can be understandable situation. The reason is because doctors who don't belong to specific hospitals are seriously damaged, if the medical staff privileges are excluded and doctors cannot use facilities of open hospitals. In order to decide to allow the privileges of certain doctors, hospitals have to rely on peer review to maintain high quality of medical services, and it is not easy to find alternative of peer review in the professional areas like healthcare. However, there are possibilities that members of the peer review can abuse power to unfairly exclude privileges of potential competitors. In this sense, it is asserted in the U.S. antitrust lawsuits that the restraint of medical staff privilege can be the illegal restraint of trade in violation of section 1 of Sherman Act and can be monopolization or an attempt to monopoly by hospitals in violation of section 2 of Sherman Act. As Korea adopted open hospital system quite recently, there is still no case related with the exclusion of medical staff privileges. However, medical staff privilege system of Korea is not different from that of the United States in principle. Thus, the U.S. jurisprudence on the exclusion of medical staff privileges can be referred in the interpretation of "practice that interferes with or restricts the activities or contents of the business" based on Article 19.1.9 of Monopoly Regulation and Fair Trade Law of Korea.

  • PDF

A Report of Health Status of University Staffs According to the Work Classification

  • Kang Kyounglan;Cho Miran;Kim Byung Sung;Choue Ryowon
    • Journal of Community Nutrition
    • /
    • v.7 no.3
    • /
    • pp.135-140
    • /
    • 2005
  • This study was conducted to evaluate the health status of staff by medical examination data according to the work classification as professional, office worker and laborer in K University in Seoul, Korea. Two thousand four hundred and eighty-four staff (men : 1154, female: 1330) from the university were studied for this report. The anthropometric (height, weight and BMI) and blood pressure (systolic, diastolic) and biochemical parameters (hemoglobin, glucose, cholesterol, AST, ALT) were measured. All groups were calculated using GLM multivariate analysis for three groups after adjustment for age. The average BMI was significantly higher in laborers than professionals and officers after adjustment for age. In blood pressure, especially in SBP, the significant difference was found in females according to the job classification. Blood glucose levels of female laborers were significantly higher than those of officers and professionals. The level of blood total cholesterol of male professionals was significantly higher than those of laborers. The level of blood total cholesterol of female laborers was significantly higher than officers or professionals. Importantly, significant differences were found in BMI, SBP, blood glucose level and cholesterol level of female staff after adjustment for age. These results showed that there were differences in health subjects of staff according to the work classification. This study would provide basic data to prepare the program of health promotion for the college staff according to work classification. Further research is required to discover factors influencing health promotion of staff in colleges.

A Comparison of Patterns of Emergency Care Between Resident and Staff (전공의와 전문의의 응급진료 형태에 대한 비교 연구 - 전공의 파업기간을 전후로 -)

  • Lee, Jeong-Heon;Shin, Im-Hee
    • Quality Improvement in Health Care
    • /
    • v.10 no.1
    • /
    • pp.20-27
    • /
    • 2003
  • Background : The doctors' strike was not only a manmade disaster but also a chance to apply a new pattern of emergency medical service for patients. We hope to propose a new pattern of emergency medical service by comparing the patterns of emergency medical service given by resident and staff during the doctors' strike. Methods : We reviewed the medical records of patients who received emergency medical service in the Emergency Department(ED) of Deagu Catholic University Hospital during 3 days a week prior to the residents' strike (July 21-23, 2000) with those of patients receiving emergency medical service during the first 3 days of the residents' strike (July 28-30, 2000). We evaluated the patient's severity, the cause of the ED visit, the performance on the laboratory study, ECG, and radiological study, the disposition, and the length of ED stay. Also, we compared the collected data by presenting doctor and by patient's severity. Results : The staff performed fewer tests admitted fewer emergent and non-emergent patients than the residents. Also, the length of ED stay was shorter in both the emergent (212.76 vs. 321.40 minutes) and the non-emergent groups (117.68 vs. 171.39 minutes) for patients presenting to staff. Conclusion : It is desirable that emergency medical service is given by staff, not by resident.

  • PDF

Central Line-Associated Bloodstream Infection Prevention by Central Venous Catheter Management Staff in the Surgical Intensive Care Unit

  • Choi, Jin-Uk;Choi, Nak-Jun;Hong, Suk-Kyung;Kim, Tae-Hyun;Keum, Min Ae;Kim, Se Ra;Lee, Sun Ju;Shin, Sung-Dae
    • Journal of Acute Care Surgery
    • /
    • v.8 no.2
    • /
    • pp.65-70
    • /
    • 2018
  • Purpose: Patients in the intensive care unit (ICU) are more susceptible to nosocomial infections, including central line-associated bloodstream infection (CLABSI), surgical site infection, urinary tract infection or ventilator-associated pneumonia. This study is a comparative analysis of how central venous catheter (CVC) management staff affects CLABSI. Methods: We performed a two-phase review of all patients transferred to the surgical ICU (SICU) from January 2013 to June 2014. CVC management staff was introduced in October 2013. Electronic medical records provided the data for a comparative analysis of incidence rates and risks of CLABSI, as well as the subjects' general characteristics. Results: This study included 248 patients before the introduction of a CVC management staff member and 196 patients after the introduction. General patient characteristics before and after the CVC management staff was in place did not differ significantly. The CLABSI rate decreased by 4.61 cases/1,000 device days after the introduction (6.26 vs. 1.65; odds ratio, 4.47; 95% confidence interval, 1.39~14.37; p=0.009). However, the mortality rate and length of ICU stay did not change after CVC management staff was in place (12.9% vs. 10.7%, p=0.480; $16.00{\pm}24.89$ vs. $15.87{\pm}18.80$, p=0.954; respectively). Conclusion: In this study, the introduction of CVC management staff effectively reduced CLABSI rates in current ICU system.