DOI QR코드

DOI QR Code

상급종합병원의 4대 중증질환 의료 서비스 품질과 보호받을 권리 및 존엄성 유지에 관한 연구

A Study on the Quality of Healthcare Services for Four Critical Illnesses and the Maintenance of Right to Protection and Dignity in a Senior General Hospital

  • 이우진 (건국대학교 일반대학원 국제무역학과) ;
  • 신민석 (건국대학교 일반대학원 국제무역학과)
  • Woojin Lee (Department of International Trade, Konkuk University) ;
  • Minsuk Shin (Department of International Trade, Konkuk University)
  • 투고 : 2023.10.11
  • 심사 : 2023.11.20
  • 발행 : 2023.12.31

초록

Purpose: The unique nature of life-and-death healthcare services sets them apart from other service industries. While many studies exist on the relationship between healthcare services and customer satisfaction, most of them focus on mildly ill patients, ignoring the differences between critically ill and non-seriously ill patients. This study discusses the actual quality of healthcare services for patients who are facing life-threatening illnesses and are on life support, as well as their right to protection and dignity. Methods: The survey conducted to 149 patients with the four major illnesses: cancer, heart disease, brain disease and rare and incurable disease, those who have experiences with senior general hospitals. Results: The basic statistics of this study are adequate to represent the four major critical illnesses, and the reliability and validity of this study's hypotheses, which were measured by multiple items, were analyzed, and the internal consistency was judged to be high. In addition, it was found that the convergent validity was good and the discriminant validity was also secured. When examining the goodness of fit of the hypotheses, the SRMR, which is the standardized root mean square of residuals that measures the difference between the covariance matrix of the data variables and the theoretical covariance matrix structure of the model, met the optimal criteria. Conclusion: The academic implications of this study are differentiated from other studies by moving away from evaluating the quality of healthcare services for mildly ill patients and focusing on the rights and dignity of patients with life-threatening illnesses in four senior general hospitals. In terms of academic implications, this study enriches the depth of related studies by demonstrating the right to protection and dignity as a factor of patient-centeredness based on physical environment quality, interaction quality, and outcome quality, which are presented as sub-factors of healthcare quality. We found that the three quality factors classified by Brady and Cronin (2001) are optimized for healthcare quality assessment and management, and that the results of patients' interaction quality assessment can be used to provide a comprehensive quality rating for hospitals. Health and human rights are inextricably linked, so assessing the degree to which rights and dignity are protected can be a superior and more comprehensive measurement tool than traditional health level measures for healthcare organizations. Practical implications: Improving the quality of the physical environment and the quality of outcomes is an important challenge for hospital managers who attract patients with life and death conditions, but given the scale and economics of time, money, and human inputs, improving the quality of interactions and defining them as performance indicators in hospital quality management is an efficient way to create maximum value in the short term.

키워드

참고문헌

  1. Bagnasco, A., Zanini, M., Dasso, N., Rossi, S., Timmins, F., Galanti, MC., and Sasso, L. 2020. Dignity, Privacy, Respect and Choice-A Scoping Review of Measurement of These Concepts within Acute Healthcare Practice. Journal of Clinical Nursing 29(11-2):1832-1857. https://doi.org/10.1111/jocn.15245
  2. Bopp, K. 1990. How Patients Evaluate The Quality Of Ambulatory Medical Encounters: A Marketing Perspective. Journal of Health Care Marketing 10(1).
  3. Bovero, A., Tosi, C., Botto, R., Cito, A., Malerba, V., Molfetta, V., and Torta R. 2020. The Health Care Providers' Perspectives on End-of-Life Patients' Sense of Dignity. A Comparison among Four Different Professionals' Categories. Journal of Cancer Education 35:1184-1192. https://doi.org/10.1007/s13187-019-01577-4
  4. Brady, M. K., and Cronin, J. J. 2001. Some New Thoughts On Conceptualizing Perceived Service Quality: A Hierarchical Approach. Journal of Marketing 65(3):34-49. https://doi.org/10.1509/jmkg.65.3.34.18334
  5. Burm, E.A., Chun, Y., Choi, A. S., and Gu, J.A. 2020. Effectiveness in The Converged Relationship between Human Rights Sensitivity and Patient Rights Awareness through Nursing Students' Human Rights Sensitivity Improvement Education. Journal of The Korea Convergence Society 11(11):81-88. https://doi.org/10.15207/JKCS.2020.11.11.081
  6. Cho, C.H. 2013. Image Improvement and Trust Building of Traditional Medical Service Considered Emotional Attachment. Journal of Korean Society Quality Management 41(2):261-276. https://doi.org/10.7469/JKSQM.2013.41.2.261
  7. Cho, C.H. 2022. The Effect of Work Environment Quality and LMX of Physical Therapist in Small and Medium-sized Hospitals on Turnover Intention. Journal of Korean Society Quality Management 51(3):445-459.
  8. Choi, E.J. 2022. Medical Support Policies for Rare Diseases in the United States. Global Social Security Review 21:55-66.
  9. Choi, H.C., Seo, S.K., Kwon, J.Y., Park, S., and Chang, H. 2023. Medical Staff's Awareness of Infected Patient Transfer Robots: Using SERVQUAL and AHP. Journal of Korean Society for Quality Management 51(3):381-401. https://doi.org/10.7469/JKSQM.2023.51.3.381
  10. Choi, J.Y., and Suh, S.K. 2020. Hospital-Level Factors Associated with Patients' Experience with Inpatient Care. Health and Social Welfare Review 40(4):584-610. https://doi.org/10.15709/HSWR.2020.40.4.584
  11. Han, I.Y., and Lee, I.J. 2011. Posttraumatic Growth In Patients With Cancer. Korean Journal of Social Welfare Studies 42(2):419-441. https://doi.org/10.16999/kasws.2011.42.2.419
  12. Han, S.K., and Kim, T.H. 2019. What Hospital Characteristics Influence the Patient Experiences. Public Health Affairs 3(1):121-132. https://doi.org/10.29339/pha.3.1.121
  13. Hong, S.J. 2015. Disruptive Innovations of Group Practice Model Hospital -A Case Study of a Cleveland Clinic-. Korean Journal of Hospital Management 20(4):78-88.
  14. Huh, E.J., Oh, J.S., and Jang, H.I. 2017. The Structural Relationship between Trust, Customer Satisfaction, and Loyalty of the Medical Service Quality and Empathy Ability. Korean Business Education Review 32(6):1-22. https://doi.org/10.23839/kabe.2017.32.6.1
  15. Hwang, B.D., and Kim, Y.J. 2018. Evaluation of Patient-Centered Healthcare Provision in Hospitals and General Hospitals-Based on Patient Experience Assessment. The Korean Journal of Health Service Management 12(3):1-11. https://doi.org/10.12811/kshsm.2018.12.3.001
  16. Jang, W., Kim, K.A., and LEE, K.H. 2011. Success Factors and Marketing Strategies of Bumrungrad Hospital. The Korean Journal of Health Service Management 5(2):209-226. https://doi.org/10.12811/kshsm.2011.5.2.209
  17. Jeon, K.I., Lee, H.W., and Lee, K.T. 2014. The Relationship Between Medical Service Quality, Customer Satisfaction And Customer Loyalty, Korean Business Education Review 29(4):416-438.
  18. Jeong, Y.H. 2017. Compare Patient Right and Consumer Right in Medical Field. Health Policy and Management 27(1):3-17. https://doi.org/10.4332/KJHPA.2017.27.1.3
  19. Jung, M.S., and Park, E.J. 2013. The Intersectionality of Human Rights and Health: Dignity as Seen from the Perspective of Health Care. Korean Journal of Medicine and Law 21(2):7-28.
  20. Jung, O.K., Shin, H.S., and Park, C. 2017. The Effect of Customer Orientation on Relationship Quality and Customer Loyalty in the Medical Services Context. Health Service Management Review 11(3):1-15. https://doi.org/10.18014/HSMR.2017.11.3.1
  21. Jung, S.H., and Ahn, H.S. 2023. Trends and Prospects of Digital Healthcare Service. The Journal of the Korea Society of Art & Design 26(3):113-130.
  22. Kim, C.G. 2019. The History of Hospice and Palliative Care in Korea. Korean Journal of Hospice and Palliative Care 22(1):1-7. https://doi.org/10.14475/kjhpc.2019.22.1.1
  23. Kim, C.W. 2023. The Effect of O2O Platform Food Service Quality on Behavior Intention : Focusing on the Sequential Mediating Effect of the Review Acceptance and Customer Satisfaction. The Korea Tourism Enhancement Society 1-27.
  24. Kim, C.Y. 2020. Public Health Care and Health Justice. Yellow Sea Culture 109:62-79.
  25. Kim, G.J., and Park, G.Y. 2022. The Effect of Medical Tourism Service Quality on Medical Service Value and Customer Satisfaction. Korean Journal of Hospitality and Tourism 31(4):109-126. https://doi.org/10.24992/KJHT.2022.6.31.04.109
  26. Kim, H.A., and Park, S.H. 2019. Validate the Validity and Reliability of The Patient Rights Awareness Tool. Journal of The Korean Data Analysis Society 21(4):2119-2130. https://doi.org/10.37727/jkdas.2019.21.4.2119
  27. Kim, H.K., Jang, Y.I., and Jung, Y.S. 2013. A Study on Revisiting Intentions of Medical Institution Customers and Service Quality Factors Influencing Word-of-Mouth Effect. Journal of Korean Society Quality Management 39(1):15-23.
  28. Kim, H.W. 2009. A Study on the Relationship of Process Quality, Outcome Quality, and Management Performance -Combination of Service Quality and BSC Concept for Insurance Industry. Journal of Korean Society Quality Management 37(4):43-51.
  29. Kim, J.H., Kim, T.H., Lee, S.G., and Jang, S.Y. 2022. Association between Score Change by Patient Experience Score and Overall Satisfaction. Health Insurance Review & Assessment Service Research 2(2):235-244. https://doi.org/10.52937/hira.22.2.2.e4
  30. Kim, J.W,, Je, N.J., and Hwa, J.S. 2023. The Impact of Human Rights Sensitivity and Patient Rights Awareness on First-Year Clinical Students' on Clinical Practice Adaptation. Korean Journal of Hospital Management 28(2):1.
  31. Kim, T.M., Kim, S.H., and Kang, S.M. 2012. The Mediating Effects of Customer Satisfaction on the Relationship between Interactional Quality and Loyalty - Focused on the Customers of Deluxe Hotels in Seoul -. Tourism Research 34:99-113.
  32. Kline, R. B., and Santor, D. A. 1999. Principles & Practice of Structural Equation Modelling. Canadian Psychology 40(4):381.
  33. Ko, H.J. 2022. The Mediating Effects of Sufficient Explanation for Treatment Outcome on the Relationship Between Doctor's Understanding of Deafness and Deaf People' Satisfaction with Medical Care. Disability & Social Welfare 13(2):159-181.
  34. Kook, S.P., Kang, J.K., and Lee, K.S. 2022. A Study on the Relationship between Patient Safety and Patient-Centeredness in Hospitals. Korean Journal of Hospital Management 27(3):39-49.
  35. Korean Statistical Office. 2023. Cause of Death Statistics 2022. Retrieved from https://www.kostat.go.kr/
  36. Lee, B.R. 2022. A Framework for Evaluating The Quality of User Interaction in Augmented Reality Content. Journal of Korea Telecommunications Technology Association 203:80-87.
  37. Lee, H.J., Lee, S.E., Sang, S.M., and Lee, S.H. 2023. Hospital Characteristics Associated with Patients' Experience of Care in Korean Hospitals. The Korean Society of Health Service Management 17(2):1-12. https://doi.org/10.12811/kshsm.2023.17.2.001
  38. Lee, H.O. 2018. Effect of Four Major Severe Diseases Benefit Expansion Policies on the Health Care Utilization and Catastrophic Health Expenditure. Korean Journal of Social Welfare 70(1):89-116. https://doi.org/10.20970/KASW.2018.70.1.004
  39. Lee, J.Y., Lee, S., and Oh, E.G. 2020. Conceptualization of person-centered care in Korean nursing literature: A scoping review. Korean Journal of Adult Nursing 32(4):354-363. https://doi.org/10.7475/kjan.2020.32.4.354
  40. Lee, S.K., and Lee, S. H. 2020. Effects of Healthcare Service Experience Factors on Satisfaction and Behavioral Intention: Focus On Patient Experience Evaluation. Journal of Korea Service Management Society 21(2):1-21. https://doi.org/10.15706/jksms.2020.21.2.001
  41. Lee, T.K., and Yang, W.J. 2022. A Study on the Relationship between Medical Service Quality, Customer Satisfaction, and Customer Citizenship Behavior: Focusing on Cosmetic Surgery Hospitals. Journal of Tourism and Leisure Research 34(7):91-106.
  42. Lee, Y.H., Park, J.S., Kim, J.H., and Lee, B.M. 2010. Personalized Diet Recommendation Service for management of coronary heart disease, Journal of KIIT 8(5):189-197.
  43. Lee, Y.J. 2009. A Study on The Influences of Changes to The Co-Payment of Cancer Patients of Their Uses of Medical Services. The Journal of Korean Public Policy 11(1):3-25.
  44. Mitchell, R. J. 1993. Path Analysis: Pollination in Design and Analysis of Ecological Experiments. NY: Chapman and Hall, 211-231
  45. Najafizada, M., Rahman, A., and Oxford, K. 2021. Analyzing Models of Patient-Centered Care in Canada Through a Scoping Review and Environmental Scan. Journal Of Public Health 1-13.
  46. Nam, I.W. 2022. A Study on the Relationship among Innovation Orientation, e-business factor of Korean Export SMEs on Cultural Marketing Use and Corporate Performance. The e-Business Studies 23(4):63-80. https://doi.org/10.20462/tebs.2022.8.23.4.63
  47. Nunnally, J. C. 1978. Psychometric Theory: 2d Ed. McGraw-Hill.
  48. Parasuraman, A.B.L.L., Zeithaml, V.A., and Berry, L. 1988. SERVQUAL: A Multiple-item Scale for Measuring Consumer Perceptions of Service Quality 64(1):12-40.
  49. Park, E.S., and Lee J.S. 2011. Effects of Medical Tourism Service Quality on Satiafaction and Behavioral Intention among Japanese Medical Tourists. Journal of Tourism Management Research 26(4):487-502.
  50. Park, H.Y. 2009. Desirable Policy Directions for Supporting People with Rare Diseases. Korean Journal of Insurance Medicine 6(1):19-27.
  51. Park, J.K., Kang, M.K., Kim, C.B., Kim, K.S., and Ji, S.H. 1998. Meta-analysis on the Blood Lipids as Risk Factors of Coronary Heart Diseases in Koreans. Korean Journal of Preventive Medicine 34(4):491-498.
  52. Park, J.K., Kim, K.S., Lee, T.Y., Lee, D.H., Ko, K.U., and Lee, K.S. 2001. Risk Factors for Cerebrovascular Disorders in Koreans. Korean Journal of Preventive Medicine 34(2):157-165.
  53. Shin, M.M. S., and Joo, J. H. 2015. Relationships between Customer Socialization, Customer Participation, and Loyalty of On-Line Service Providers. Journal of Distribution Science 13(11):15-22. https://doi.org/10.15722/JDS.13.11.201511.15
  54. Song, Y.H., and Shin, J.B. 2006. The Performance of Service and Relationship Quality. Korean management Review 35(4):1261-1280.
  55. Sung, H.J., and Kim, Y.S. 2015. A Study on Sustainable Service Improvement -Case of Seoul National University Hospital, Korea-. KOREA SCIENCE & ART FORUM 19:417-424. https://doi.org/10.17548/ksaf.2015.03.19.417
  56. Tomaselli, G., Buttigieg, S. C., Rosano, A., Cassar, M., and Grima, G. 2020. Person-Centered Care from a Relational Ethics Perspective for The Delivery of High Quality and Safe Healthcare: A Scoping Review. Frontiers In Public Health 8, 44.
  57. UGLI, A.N.B., and Um, K.H. 2023. The Effect of Social Media Marketing Capability on International Patient Satisfaction through Perceived Risk in the Medical Tourism Context. Journal of Korean Society for Quality Management 51(2):203-221. https://doi.org/10.7469/JKSQM.2023.51.2.203
  58. Wi, H.S., Park, S.H., and Park, J.E. 2019. Empirical Study on How the Quality of Medical Service Influences the Value of Medical Service and Customer Satisfaction. Journal of Industrial Economics and Business 32(6):2491-2511. https://doi.org/10.22558/jieb.2019.12.32.6.2491
  59. Woo, J.P. 2023. A Study on the Effect of Sample Size and Normality on the Fit Index and Path Coefficient of the Research in Structural Equation Modeling. Journal of Product Research 41(1):1-6.
  60. Yang, J.H., Song, T.G., and Jang, D.M. 2012. Effects of Medical Service Quality on the Customer Satisfaction and Intention of Revisit in Cancer Patients. The Journal of the Korea Contents Association 12(12):269-281. https://doi.org/10.5392/JKCA.2012.12.12.269
  61. Yang, J.Y. 2017. The Effect of the Physical Environment on Service Quality and Relational Continuance Intention: Focus on Business Hotels. Journal of Tourism Studies 41(7):101-114.
  62. Yoo, M.R. 2003. Concept Development Using Hybrid Model For The Concept, Patient Respect. Korean Journal of Adult Nursing 15(1):137-145.
  63. Yoo, M.R., Hyeon, J. S., and Choi, Y. J. 2007. Instrument Development for Patient Respect. The Journal of Korean Academic Society of Nursing Education 13(2):162-168.
  64. Yoon, S.J. 2021. A Study on the Relationships Between Airlines' Service Quality, Relationship Quality and Relationship Persistence Intention. Journal of Tourism and Leisure Research 33(7):313-332. https://doi.org/10.31336/JTLR.2021.7.33.7.313