• Title/Summary/Keyword: 환자 분류시설

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Measurement of Ambulatory Patients' Satisfaction and Its Influencing Factors in a Tertiary Hospital (병원 외래 방문 환자의 만족도 평가 및 관련 요인에 대한 연구 - 한 3차 병원 방문 환자를 중심으로 -)

  • Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.27 no.2 s.46
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    • pp.366-376
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    • 1994
  • Patients' evaluation of hospital care is one of the most important aspects of quality assessment. Survey allows patients to judge sujectively the events that occur during their hospital visit if performed properly. This study describes the result of a research effort to develop outpatient questionnaire that has sufficient validity and reliability to be used to measure patients' perception of satisfaction in Korea and to investigate influencing factors on patients' satisfaction. Self-administered questionnaire was developed for outpatient and the survey was conducted covering 827 outpatients in a tertiary hospital. It was confirmed by factor analysis that patients evaluate several components of ambulatory care distinctly ; hospital environment, administration and ancillary services, and medical care. We found strong evidence of construct validity and internal consistency for the above three dimensions of hospital process. On the contrary, reliability of overall outcome measures was low. It suggests that three items concerning overall outcome measures have some different meanings in patients' perception. Using logistic regression analysis it was found that previous health status, cost evaluation, and improvement in health status have significant influences on the level of patients' overall satisfaction and that patient's sex, experience of previous visit, expectation for improvement, cost evaluation, and improvement in health status are strongly related with intention to recommend hospital. In spite of some limitations the results of this study can be used helpfully as baseline informations for developing self-administered questionnaire and for exploring the influencing factors on patients' satisfaction. Further comprehensive research efforts should be made on the measurement of ambulatory patients' satisfaction and its related factors in current Korean situation.

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A Study on Medical Fee System of the convalescent hospital -Focused on the case of patient group adjustment - (요양병원 수가제도에 대한 소고 -환자군 조정 판결을 중심으로 -)

  • Kwon, Hye Ok
    • The Korean Society of Law and Medicine
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    • v.18 no.2
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    • pp.195-218
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    • 2017
  • The increase in medical expenses for convalescent hospitals is increasing abnormally, which puts enormous burden on the National health insurance finances. This is a phenomenon that has been associated with the social phenomenon of rapid aging. The fact that the convalescent hospitals are paid the fixed amount per day for hospitalization became the incentive for some hospitals to use the patients as means of making money. And these hospitals intend to get regular care or take medicines at other hospitals in order to reduce medical expenses, even when the medical fee is paid. In order to prevent such financial leaks, the Health Insurance Review and Assessment Service adjusted the patient group for inpatients in a hospital with the above behavior, and then cut the cost of medical care benefits. However, Above decision was canceled by the court on the grounds that there was no basis rule. However, based on the above case, I think that it can be an opportunity to draw up the problem and to improve of the Medical Fee System of hospital. The modified medical fee system can strengthen the medical function of the convalescent hospital. In addition, it seems reasonable to exclude admission for "physically disabled group". Even if admission is allowed for the physically disabled group due to social needs, it should be excluded from the National health insurance for the fianacial soundness and the sustainability of the system.

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A Chronological Study on the Transformation and the Spatial Characteristics of Emergency department in the United States (미국의료시설 응급부의 시대적 변천과 공간적 특성에 관한 연구)

  • Lee, Sukyung;Choi, Yoonkyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.24 no.3
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    • pp.17-27
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    • 2018
  • Purpose: This study aims to examine spatial characteristics of emergency department Chronologically through case studies; and to consider the social implication of these spatial changes. Methods: In this study, a total of eight emergency departments, one for each period, were selected in order to analyze the spatial characteristics. The spatial maps of Space Syntax were employed for analyzing case studies. Results: The spatial configuration of emergency department has been changed from five or more emergency department specialties to four or less specialties such as psychiatric, pediatrics, emergency, and trauma. In the case of care initiation area, the concentrated arrangement mode was switched from the distributed arrangement mode. The spatial maps indicate that it can be seen that the tree structure changes to an annular structure emphasizing the connection between the spaces in the emergency department. This shows that the space efficiency, safe, visual control and flexibility in the planning of the emergency department are important factors affecting the spatial structure of the emergency department. Implications: In the future, it is expected that Korean emergency department will be more focused on efficiency, safe, visual control, and flexibility in the planning as in the case studies of the United States.

Assessment of Relapsing Urolithiasis from K43 with Erosive Gastritis (미란성 위염 환자 K43에서 재발성 요로 결석에 관한 연구)

  • 김재웅
    • The Korean Journal of Food And Nutrition
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    • v.10 no.1
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    • pp.44-52
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    • 1997
  • Nephrolithiasis is the most common disorder of the urinary tract in hospitalized patients, more frequently increased in 30~50 years of age, more common in males than in females, prior right stone to left side, and than upper ureteral stone is found in cultural country, while lower ureteral stone is increased in uncultural country. Stone components are classified as calcium oxalate, calcium phosphate, magnesium ammonium phosphate, uric acid, cystine, and their mixed stone, respectively. According to the pathophysiology of urinary stones, supersaturation/crystalization of inorganic salt concentration in urine, organic matrix, inhibitor deficiency, and epitaxy theory could be based on the stone formation. Not only hypercalciuria, hyperparathyroidism, hyperoxaluria, hyperuricosuria, and cystinuria, but also renal tubular acidosis, hypervitaminosis D, and peptic ulcer, are significantly associated with nephrolithiasis. In this study upper ureteral stone component were analyzed with chemical analysis, infrared spectrum, and image analyzer from K43 patient wit erosive gastritis. As the results, mixed stone of calcium oxalate dihydrate and calcium phosphate apatite was identified, the values of clinical test in blood and urine maintained normal revels. The relapsing urinary stone from K43 have no correlation between factors for stone formation reported early, also have no evidence for risk from erosive gastritis.

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병원에서의 산업보건관리

  • Jeon, Gyeong-Ja
    • Korean Journal of Occupational Health Nursing
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    • v.2
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    • pp.40-51
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    • 1992
  • 본 연구는 병원에서의 산업보건관리 실태를 파악하기 위하여 전국에 있는 병원을 대상으로 1992년 12월 1일부터 1993년 1월 23일까지 설문조사를 설시하였다. 설문조사에 응당한 병원은 41개병원으로 회수율은 51.9%였다. 조사에 이용된 설문지는 산업안전보건법 내용을 기초로 하여 본 연구자가 작성한 것이며 안전보전에 관한 제반 규정, 안전보건관리체계, 근로자건강관리, 작업환경관리, 보건교육, 보건관련시설, 질병 및 상해에 대한 보상 등에 관한 45개문항으로 구성되어 있다. 분석결과는 다음과 같다. 첫째, 전체 병원 중 68.3%가 안전보건관리 규정이 있다고 답하였으며, 77.5%의 병원이 단체협약 중 근로자의 안전과 보건에 관한 조항을 포함시키고 있는 것으로 나타났다. 단체협약에 포함된 내용 중에는 정기건강진단(23.7%)과 질병 및 상해에 대한 보상(20.9%), 안전보건위원회의 구성(18.1%)등이 많았다. 둘째, 대상 병원중 66.7%가 안전보건관리책임자, 관리감독자, 안전담당자를 두고 있는 것으로 나타났고, 근로자수가 1,000명 이상인 병원은 83.3%가 이들 인력을 선임하고 있다. 그러나, 보건관리자와 안전관리자를 전담으로 두고 있는 경우는 한 곳도 없었으며 50%이내에서 겸직으로 선임하고 있었다. 또한, 안전보건위원회를 운영하고 있거나 노사협의회로 이를 대치하고 있는 병원은 54.2%로 절반 수준에 머물렀고, 그나마 정기적으로 운영을 하고 있다고 답한 병원은 3개 병원 밖에 되지 않았다. 세째, 근로자 건강관리를 위한 건강진단 실시 현황을 보면, 채용시검진 97.6%, 일반건강진단 100.0%, 특수 건강진단 24.4%가 실시하고 있었다. 건강진단에서 주로 실시하고 있는 항목은 흉부 X선검사, 시력, 혈압, 혈청GOT/GPT, 체중, 신장등이었다. 그러나, 병원에서 감염될 수 있는 기회가 높은 간염항원/항체검사의 실시율은 85.7%로 아직도 실시하지 않는 병원이 있음을 알 수 있다. 네째, 작업환경관리를 위하여 정기적으로 환경측정을 실시하는 병원은 21.6%였고 주로 측정하는 항목은 방사선이었다. 특히 소음, 조명, 분진에 대한 측정이 이루어지지 않음은 근로자뿐아니라 환자의 안위에도부정적인 영향을 미칠 수 있다. 다섯째, 안전한 작업과 근로자의 건강을 위하여 정기적인 보건교육을 설시하고 있는 병원은 불과 5.6%였다. 교육내용은 주로 안전에 관한 것이었다. 여섯째, 근로자의 일상적인 건강문제를 해결해주는 의무실을 독립적으로 마련하고 있는 병원은 한 곳도 없었고, 교대근무자나 당직자를 위한 수면시설은 44.7%, 작업 후에 사용할 수 있는 샤워시설은 35.1%의 병원이 마련하고 있었다. 일곱째, 근무중 다치거나 병에 걸렸을 때 치료비에 대한 부담은 대체로 병원이 하고 있으며 치료기간 중 근무는 병가나 휴직으로 처리되고 있다. 이는 병원이 산재보상보험법에 적용을 받지 않은 사업으로 분류되어 있는 현실에 기인된 것으로 보상과 관련된 부담을 병원이나 근로자 모두가 안게 되는 결과를 초래하게 되는 것이다. 이상에서 볼 때 병원근로자를 위한 산업보건관리는 주로 건강진단과 질병 및 상해에 대한 보상제도가 이루어지고 있는 실정이다. 그러므로 질병의 예방이나 악화방지 나아가 건강증진을 도모하기 위한 지속적인 노력을 기울이고 있는 병원은 전무한 상태임을 알 수 있다. 이러한 현실을 병원근로자를 위한 산업보건관리에 대한 인식이 전반적으로 부족함을 드러내는 것으로 이를 개선하기 위한 보다 적극적인 노력이 시급히 요청되고 있다.

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ICT Medical Service Provider's Knowledge and level of recognizing how to cope with fire fighting safety (ICT 의료시설 기반에서 종사자의 소방안전 지식과 대처방법 인식수준)

  • Kim, Ja-Sook;Kim, Ja-Ok;Ahn, Young-Joon
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.1
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    • pp.51-60
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    • 2014
  • In this study, ICT medical service provider's level of knowledge fire fighting safety and methods on coping with fires in the regions of Gwangju and Jeonam Province of Korea were investigated to determine the elements affecting such levels and provide basic information on the manuals for educating how to cope with the fire fighting safety in medical facilities. The data were analyzed using SPSS Win 14.0. The scores of level of knowledge fire fighting safety of ICT medical service provider's were 7.06(10 point scale), and the scores of level of recognizing how to cope with fire fighting safety were 6.61(11 point scale). level of recognizing how to cope with fire fighting safety were significantly different according to gender(t=4.12, p<.001), age(${\chi}^2$=17.24, p<.001), length of career(${\chi}^2$=22.76, p<.001), experience with fire fighting safety education(t=6.10, p<.001), level of subjective knowledge on fire fighting safety(${\chi}^2$=53.83, p<.001). In order to enhance the level of understanding of fire fighting safety and methods of coping by the ICT medical service providers it is found that: self-directed learning through avoiding the education just conveying knowledge by lecture tailored learning for individuals fire fighting education focused on experiencing actual work by developing various contents emphasizing cooperative learning deploying patients by classification systems using simulations and a study on the implementation of digital anti-fire monitoring system with multipoint communication protocol, a design and development of the smoke detection system using infra-red laser for fire detection in the wide space, video based fire detection algorithm using gaussian mixture mode developing an education manual for coping with fire fighting safety through multi learning approach at the medical facilities are required.

A Consideration of Perception on Enforcement of Serious Accident Punishment Act(SAPA) among the Workers in the Nuclear Medicine Department (중대재해처벌법 시행에 따른 핵의학 종사자의 인식 고찰)

  • Lee, Joo-Young
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.477-490
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    • 2022
  • Serious Accident Punishment Act(SAPA) went into effect as of Jan. 27, 2022. The subject of study was the worker of the nuclear medicine department and the investigation was aimed at identifying the present situation of their understanding on the issue in the here and now, which can be utilized as basic research for further study. The survey was conducted on 51 people of the worker in the nuclear medicine department. The general factors were classified by their gender, the scale of the hospitals, the period of career, and the detailed occupational categories. The conclusion was drawn, including 1 missing data in gender and 2 in the type of occupation. The targeted hospitals were tertiary hospital, university hospital, and general hospital which have nuclear medicine department in. The period of subjects' career was categorized by less than 3 years, 3 to 5 years, 5 to 10 years, and more than 10 years. The specific occupation was classified by in-vivo radiological technologist, radiation safety manager and others. The amount of pressure that the job entails was highest in the category of general hospital, the period of 3 to 5 years of job experience, and radiation safety manager each. The system of the code was well constructed in the category of general hospital, the period of less than 3-year career, and radiation safety manager, as they responded. The blood transmissible disease had the largest number of outbreak of accidents related to the serious industrial accident. In addition, the radiopharmaceutical dosing error had the highest number of outbreak of accidents related to the serious civil accident. Therefore, we need to improve SAPA, facility inspection, security of budget, security of professional manpower. It will help the stable use of radiation and ensure patient safety.

Development of a New Terrain Type Classification to be used in Highway Design (도로설계 적정화를 위한 새로운 지형구분에 관한 연구)

  • Kim, Sang-Youp;Choi, Jai-Sung;Lee, Seung-Yong;Han, Hyung-Gwan
    • International Journal of Highway Engineering
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    • v.8 no.4 s.30
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    • pp.49-62
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    • 2006
  • The republic of korea has put a great emphasis on the role of the road as widening a social infra-structural facility. Thus, vast amount of money has been invested on the road establishment. As a result, there has been fruitful outcomes in establishing the road system of the nation especially for the flat road with ease. However, in order to have more systematic and sustainable road system, we should turn our attention to more painful and high-cost regions such as mountainous districts and those are to be developed effectively. The configuration of the road is an important factor to be considered in making a decision for the road planning. Nevertheless, current road planning criterion has no such clarified and objective judging standard for figuring the configuration of the road out and, as a result, speed planning can be decided incorrectly. our research has acknowledged the necessity of estimating the configuration of the road and aimed to make it organized and sorted according to the height, slope, and the vehicle's speed. The results are as follows. First, our research made use of GIS data and classified the road into 9 different areas according to the height and the slope. Also, road classification being matched to the data of vehicle's speed, it has been shown that those characteristics of different areas have made an influence on vehicle's speed. Secondly, based on the results of the similarity between geographical classification and, vehicle's speed of sorted groups according to the height and the slope, conclusively we have classified as flat, rolling region and mountain. Since our research has made use of vehicle's speed for National Highway, it is not applicable to different functional highways. However, for the highway to be established hereafter, it can be a standard for reflection geographical characteristics.

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The Study on the Confidence Building for Evaluation Methods of a Fracture System and Its Hydraulic Conductivity (단열체계 및 수리전도도의 해석신뢰도 향상을 위한 평가방법 연구)

  • Cho Sung-Il;Kim Chun-Soo;Bae Dae-Seok;Kim Kyung-Su;Song Moo-Young
    • The Journal of Engineering Geology
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    • v.15 no.2 s.42
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    • pp.213-227
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    • 2005
  • This study aims to assess the problems with investigation method and to suggest the complementary solutions by comparing the predicted data from surface investigation with the outcome data from underground cavern. In the study area, one(NE-1) of 6 fracture zones predicted during the surface investigation was only confirmed in underground caverns. Therefore, it is necessary to improve the confidence level for prediction. In this study, the fracture classification criteria was quantitatively suggested on the basis of the BHTV images of NE-1 fracture zone. The major orientation of background fractures in rock mass was changed at the depth of the storage cavern, the length and intensity were decreased. These characteristics result in the deviation of predieted predicted fracture properties and generate the investigation bias depending on the bore hole directions and investigated scales. The evaluation of hydraulic connectivity in the surface investigation stage needs to be analyze by the groundwater pressures and hydrochemical properties from the monitoring bore hole(s) equipped with a double completion or multi-packer system during the test bore hole is pumping or injecting. The hydraulic conductivities in geometric mean measured in the underground caverns are 2-3 times lower than those from the surface and furthermore the horizontal hydraulic conductivity in geometric mean is six times lower than the vertical one. To improve confidence level of the hydraulic conductivity, the orientation of test hole should be considered during the analysis of the hydraulic conductivity and the methodology of hydro-testing and interpretation should be based on the characteristics of rock mass and investigation purposes.

The influence of wearing helmet and cervical spine injury in skiers and snowboarders (스키와 스노우 보드에서 헬멧의 착용이 경추부 손상에 미치는 영향)

  • Kim, Sung Hun;Kim, Tae Kyun;Chun, Keun Churl;Hwang, Jae Sun
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.94-99
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    • 2011
  • Purpose: As the number of people enjoying skiing and snowboarding which are two popular winter sports has been increasing, wearing helmet during doing these sports has been needed for safety. The rates of head or face injury have decreased after using helmet. However the effect that wearing helmet has on cervical damage is not yet to be known. So through this research we intend to be helpful in developing effective program and safety equipment. Materials and Methods: During two seasons from December 2009 to march 2011, cased 658 cervical injuries within 14538 admittance in medical center of major resort due to skiing and snow-boarding injuries. For survey and research model, one year before the research year conducted a pilot study. Admittance were 432 male and 226 female, advanced 273 and 385 novice. We divided them into two groups depending on wearing helmet, measured cervical damage ratio and injury mechanism, and researched the severity of damage and diagnosed injury. Each group used SPSS 12.0 (SPSS Inc., Chicago, IL, USA) to process data statistically. Results: The number of patients was 312 in skier and 346 in snow boarder. Patients wearing helmet were 146 in skier and 127 in snow boarder. Classification of each injuries were confirmed as 292 cases of simple sprain, 359 bruising, 6 cervical fractures and 1 case of dislocation. Classification of injury mechanisms were 287 of human collision, 212 material collision, 108 of slip down by oneself, 39 of falling and 12 cases of etc. In cases wearing helmet ski 78/ snow board 70 were simple sprain, ski 64/ snowboard 68 were shown as bruising, ski 1/ snow board 2 had cervical fracture or dislocation. The ratio of cervical sprain increased in cases of wearing helmet compared to non-wearing cases and there was a statistical significance (p<0.001). The ratio of cervical contusion increased significantly in non-wearing helmet user (p<0.05). However, there was no significant increase in fracture and dislocation compared between helmet user and non-user (p> 0.05). Conclusion: In this study, wearing helmet had no relation to additional cervical injury occurrence or severity among skiers and snow boarders. The ratio of cervical sprain increased significantly in helmet user with person to person accident. However, the cervical contusion decreased. On this ground, further biomechanical studies are required and modified helmet will be necessary.

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