Journal of Digital Convergence (디지털융복합연구)

The Society of Digital Policy and Management (한국디지털정책학회)
권호 표지
DOI QR코드

DOI QR Code

Patients' Perception of Quality of Health Service and Utilization considering convergence factors: A Survey of Elderly Patients of Public Health Centers, Seoul, Republic of Korea

융합적 요소를 고려한 의료서비스 질 인식도와 의료이용의 관련성: 서울시 보건소를 이용하는 노인을 대상으로

  • Sohn, Minsung (Dept. of Public Health Science, Graduate School.BK21Plus Program in Public Health Science, Korea Univ.) ;
  • Kim, Mi Sun (Dept. of Public Health Science, Graduate School.BK21Plus Program in Public Health Science, Korea Univ.) ;
  • Kim, Joonsik (Dept. of Public Health Science, Graduate School.BK21Plus Program in Public Health Science, Korea Univ.) ;
  • Moon, Sangsik (Dept. of Health Administration, Hanyang women's Univ.) ;
  • Choi, Mankyu (School of Health Policy and Management Korea Univ.)
  • 손민성 (고려대학교 대학원 보건과학과.BK21PLUS 인간생명-사회환경 상호작용 융합사업단) ;
  • 김미선 (고려대학교 대학원 보건과학과.BK21PLUS 인간생명-사회환경 상호작용 융합사업단) ;
  • 김준식 (고려대학교 대학원 보건과학과.BK21PLUS 인간생명-사회환경 상호작용 융합사업단) ;
  • 문상식 (한양여자대학교 보건행정과) ;
  • 최만규 (고려대학교 보건정책관리학부)
  • Received : 2015.06.09
  • Accepted : 2015.08.20
  • Published : 2015.08.28
Download PDF
⟨ Previous Next ⟩

Abstract

Health service quality is increasingly emphasized, and primary care service is no exception in this. This study identified patients' perception of quality considering convergence factors associated with increased utilization among patients over the age of 65 using community health centers. A total of 307 respondents were included in the analysis. The results showed that positive perceptions on facility and environment, patient-centered care, technical knowledge and skills of physicians, and emotional support with nurses and non-medical workers were statistically and significantly associated with higher utilization. In order to increase utilization of primary care service at community health centers, they need to manage and improve these factors.

오늘날 의료가 단지 치료라는 개념을 넘어 서비스라는 인식이 확대되면서 의료서비스 소비 주체인 이용자들이 인식하는 의료서비스 질의 중요성은 날로 강조되고 있으며, 일차의료라고 해서 예외는 아니다. 이 연구는 65세이상 노인들이 보건소에서 제공하는 의료서비스의 질을 어떻게 인식하고 있는지 파악하고, 어떠한 요인들이 의료서비스 이용량과 관련성이 있는지를 탐색하고자 하였다. 이 연구는 서울시 보건소를 이용하는 노인들을 대상으로 연구원이 면접조사를 통하여 자료를 수집하였고, 총 307명의 설문자료를 분석하였다. 의료서비스 질은 융합적 요소를 고려하여 접근하였으며, 분석 결과, 이들의 구성항목 중에서 이용시설 및 환경, 환자중심진료, 의사의 전문적 지식 및 기술수준, 그리고 직원 및 간호사의 정서적 지지에 대하여 노인들이 긍정적으로 인식할수록 보건소의 의료이용이 증가하였다. 따라서 보건소가 쾌적하고 편리한 시설환경을 갖추고, 직원 및 간호사들은 이용자들과 원활한 의사소통을 위해 노력하며, 동시에 의사가 환자중심의 전문적인 의료서비스를 제공한다면 보건소의 의료서비스 질과 가치 향상에 도움이 될 것이다.

Keywords

References

  1. G. Cathcart, Primary care in the driver's seat? Organizational reform in European primary care. International Journal of Dental Hygiene, Vol. 5, No. 4, pp.250-252, 2007. https://doi.org/10.1111/j.1601-5037.2007.00273.x
  2. J. S. Kim, H. J. Park, K. H. Kim, B. S. Kim. A, Study on the Functions of Urban Health Centers under the Local Autonomy system. Health Policy and Mangemnet, Vol. 4, No. 1, pp.1-24, 1994.
  3. S. H. Yeem, A Study on the Operation System of Local Healthcare Services and Their Development Plans. Ph.D. dissertation, Paichai University, 2009.
  4. Korea Institute for Health and Social Affairs, Ntional Health Insurance Service, Korea Health Panel, https://www.khp.re.kr:444/
  5. WHO, Quality of care: a process for making strategic choices in health systems. Geneva: World Health Organization, 2006, http://www.who.int/management/quality/assurance/QualityCare_B.Def.pdf, march 25, 2015.
  6. Raleigh V, Foot C, Getting the measure of quality: opportunities and challenges. London: The King's Fund, 2010, http://www.kingsfund.org.uk/sites/files/kf/Getting-the-measure-of-quality-Veena-Raleigh-Catherine-Foot-The-Kings-Fund-January-2010.Pdf, march 25, 2015.
  7. Y. Kim, Changes in patient-centered medical services: focused on improvements on communication between doctors and patients. Journal of science and technology studies, Vol. 13, No. 2, pp.71-110, 2013.
  8. R. T. Anderson, A. M. Barbara, C. Weisman, S. H. Scholle, J. Binko, T. Schneider, K. Freund, V. Gwinner, A qualitative analysis of women's satisfaction with primary care from a panel of focus groups in the National Centers of Excellence in Women's Health. J Womens Health Gend Based Med, Vol. 10, No. 7, pp.637-647, 2001. https://doi.org/10.1089/15246090152563515
  9. M. Attree, Patients' and relatives' experiences and perspectives of 'Good' and 'Not so Good' quality care. J Adv Nurs, Vol. 33, No. 4, pp.456-466, 2001. https://doi.org/10.1046/j.1365-2648.2001.01689.x
  10. J. H. Larrabee, L. V. Bolden, Defining patientperceived quality of nursing care. J Nurs Care Qual, Vol. 16, No. 1, pp.34-60, 2001. https://doi.org/10.1097/00001786-200110000-00005
  11. S. Sofaer, K. Firminger, Patient perceptions of the quality of health services. Annu Rev Public Health, Vol. 26, pp.513-559, 2005. https://doi.org/10.1146/annurev.publhealth.25.050503.153958
  12. J. Sweeney, A. M. Brooks, A. Leahy, Development of the Irish National Perception of Quality of Care Survey. Int J Qual Health Care, Vol. 15, No. 2, pp.163-168, 2003. https://doi.org/10.1093/intqhc/mzg022
  13. L. A. Giordano, M. N. Elliott, E. Goldstein, W. G. Lehrman, P. A. Spencer, Development, implementation, and public reporting of the HCAHPS survey. Medical Care Research and Review, 2009.
  14. A. K. Jha, E. J. Orav, J. Zheng, A. M. Epstein, Patients' perception of hospital care in the United States. New England Journal of Medicine, Vol. 359, No. 18, pp.1921-1931, 2008. https://doi.org/10.1056/NEJMsa0804116
  15. G. Bukh, A. M. M. Tommerup, O. R. Madsen, Impact of healthcare design on patients' perception of a rheumatology outpatient infusion room: an interventional pilot study. Clinical rheumatology, pp.1-6, 2014.
  16. A. M. Dozier, H. J. Kitzman, G. L. Ingersoll, S. Holmberg, A. W. Schultz, A. W, Development of an instrument to measure patient perception of the quality of nursing care. Research in nursing & health, Vol. 24, No. 6, pp.506-517, 2001. https://doi.org/10.1002/nur.10007
  17. J. J. Fenton, A. F. Jerant, K. D. Bertakis, P. Franks, The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Arch Intern Med, Vol. 172, No. 5, pp.405-411, 2012. https://doi.org/10.1001/archinternmed.2011.1662
  18. C. Pileggi, V. Carbone, M. Pavia, I. F. Angelillo. "Patients' perceptions and related behaviours on role of primary care physician in Italy. Eur J Public Health, Vol.14, No.3, pp.258-260, 2004. https://doi.org/10.1093/eurpub/14.3.258
  19. Y. H. Cho, S. Y. Lee, D. W. Jeong, E. J. Choi, Y. J. Kim, J. G. Lee, Y. Y. Go, Y. H. Lee, M. J. Bae, C. H. Kim, A Survey of Role Perception and Function Performance Related to Public Health Service among the Medical Staff in a National Hospital. J Agric Med Community Health, Vol. 37, No. 2, pp.67-75, 2012. https://doi.org/10.5393/JAMCH.2012.37.2.067
  20. E. Babbie, The Basics of Social Research. California: Cengage Learning, p. 221, 2013.
  21. F. A. Infante, J. G. Proudfoot, G. P. Davies, T. K. Bubner, C. H. Holton, J. J. Beilby, M. F. Harris, How people with chronic illnesses view their care in general practice: a qualitative study. Medical Journal of Australia, Vol. 181, pp.70-73, 2004.
  22. X. Dong, L. Liu, S. Cao, H. Yang, F. Song, C. Yang, Y. Gong, Y. Wang, X. Yin, X. Xu, J. Xie, Y. Sun, Z. Lu, Focus on vulnerable populations and promoting equity in health service utilization - an analysis of visitor characteristics and service utilization of the Chinese community health service. BMC Public Health, Vol. 14, pp.503, 2014. https://doi.org/10.1186/1471-2458-14-503
  23. S. Park, H. Jeon, J. Kim, S. Kim, S. Roh, Sociodemographic factors associated with the use of mental health services in depressed adults: results from the Korea national health and nutrition examination survey (KNHANES). BMC Health Serv Res, Vol. 14, No. 1, pp.645, 2014. https://doi.org/10.1186/s12913-014-0645-7
  24. R. Wong, J. J. Diaz, Health care utilization among older Mexicans: health and socioeconomic inequalities. Salud Publica Mex, Vol. 49, Suppl. 4, pp.505-514, 2007.
  25. D. L. Blackwell, M. E. Martinez, J. F. Gentleman, C. Sanmartin, J. M. Berthelot, Socioeconomic status and utilization of health care services in Canada and the United States: findings from a binational health survey. Med Care, Vol. 47, No. 11, pp.1136-1146, 2009. https://doi.org/10.1097/MLR.0b013e3181adcbe9
  26. U.S. National Center for Health Statistics. Health, United States, 2011: With special feature on socioeconomic status and health. (DHHS Publication No. 2012-1232). Hyattsville, MD: Edward J. S, 2012.
  27. R. Ionescu-Ittu, J. McCusker, A. Ciampi, A. M. Vadeboncoeur, D. Roberge, D. Larouche, J. Verdon, R. Pineault, Continuity of primary care and emergency department utilization among elderly people. Cmaj, Vol. 177, No. 11, pp.1362-1368, 2007. https://doi.org/10.1503/cmaj.061615
  28. K. Vegda, J. X. Nie, L. Wang, C. S. Tracy, R. Moineddin, R. E. Upshur, Trends in health services utilization, medication use, and health conditions among older adults: a 2-year retrospective chart review in a primary care practice. BMC Health Serv Res, Vol. 9, pp. 217, 2009. https://doi.org/10.1186/1472-6963-9-217
  29. K. Ranstad, P. Midlov, A. Halling, Importance of healthcare utilization and multimorbidity level in choosing a primary care provider in Sweden. Scand J Prim Health Care, Vol. 32, No. 2, pp.99-105, 2014. https://doi.org/10.3109/02813432.2014.929819
  30. National Health Insurance Service, 2013 National Health Insurance Service Statistics, Seoul, 2014.
  31. J. K. Vederhus, C. Timko, O. Kristensen, T. Clausen, The courage to change: patient perceptions of 12-Step fellowships. BMC Health Serv Res, Vol. 11, pp.339, 2001.
  32. J. F. Stichler, M. E. Weiss, Through the eye of the beholder: multiple perspectives on quality in women's health care. Journal of Nursing Care Quality, Vol. 15, No. 3, pp.59-74, 2001. https://doi.org/10.1097/00001786-200104000-00009
  33. S. Whitehouse, J. W. Varni, M. Seid, C. Cooper-Marcus, M. J. Ensberg, J. R. Jacobs, R. S. Mehlenbeck, Evaluating a children's hospital garden environment: Utilization and consumer satisfaction. Journal of environmental psychology, Vol. 21, No. 3, pp.301-314, 2001. https://doi.org/10.1006/jevp.2001.0224
  34. J. B. Perlin, R. M. Kolodner, R. H. Roswell. The Veterans Health Administration: quality, value, accountability, and information as transforming strategies for patient-centered care. Am J Manag Care, 10(Part 2), pp.828-836, 2004.
  35. T. D. Nuss, Patient-centered care. Achieving STEEEP health care: Baylor health care system's quality improvement journey, p.137, 2013.
  36. A. G. Pallis, P. A. Kostagioloas, J. A. Mouzas, Niakas D, Patients' perceptions as an indicator of quality of care, in Greek patients with inflammatory bowel disease. Scandinavian Journal of Caring Sciences. Vol. 23, pp.93-99, 2009. https://doi.org/10.1111/j.1471-6712.2007.00594.x
  37. J. W. Lee, K. H. Kim, A Study on the Relationship between the Name Awareness of Public Medical Institutions and Patients' Intent to Revisit. Journal of Digital Convergence, Vol. 11, No. 7, pp.271-279, 2013. https://doi.org/10.14400/JDPM.2013.11.7.271
  38. Roberts, S., Schofield, P., Freeman, J., Hill, D., Akkerman, D., Rodger, A, Bridging the information and support gap: evaluation of a hospital-based cancer support nurse service. Patient education and counseling, Vol. 47, No. 1, pp.47-55, 2002 https://doi.org/10.1016/S0738-3991(01)00174-4
  39. K. D. Rao, D. H. Peters, K. Bandeen-Roche, Towards patient-centered health services in India-a scale to measure patient perceptions of quality. International journal for Quality in Health care, Vol. 18, No. 6, pp.414-421, 2006. https://doi.org/10.1093/intqhc/mzl049