• Title/Summary/Keyword: 환자 중심적 병원

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Effect of Patient-centered Communication of Doctor on Patient Participation : Focusing on Moderating Effect of Trust (의사의 환자중심 커뮤니케이션이 환자참여에 미치는 영향 : 신뢰의 조절효과를 중심으로)

  • Lee, Jong-Hak;Kim, Chan-Jung
    • The Journal of the Korea Contents Association
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    • v.13 no.3
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    • pp.278-286
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    • 2013
  • The main purpose of this study is to examine the effect of patient-centered communication of doctor(facilitating factor, inhibition factor) on patient participation(behavioral participation, emotional participation, informational participation). Concretely, it is confirmed where there are effects of patient-centered communication of doctor to patient participation and whether there are moderating effects of trust between patient-centered communication of doctor and patient participation. In domestic general hospital, 301 samples were for this analysis collected and tested by factor analysis and moderating regression analysis. As a result of this study is as followings. First, it is confirmed that communication facilitating factor have influences on patient participation positively and communication inhibition factor have no influences on patient participation. Second, there are moderating effects of trust between facilitating factor and emotional participation, between facilitating factor and informational participation. Especially, in higher level group of trust, it is confirmed that facilitating factor more influence on emotional participation and informational participation. On the basis of these study results, I suggested theoretical and practical implication for the patient-centered communication and successful medical service.

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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The Approaches to Postoperative Pain Management (술후 통증관리의 접근)

  • Song, Sun-Ok
    • The Korean Journal of Pain
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    • v.8 no.1
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    • pp.1-7
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    • 1995
  • 효율적인 술후 통증치료를 위해서는 통증치료의 방법과 환자관리면을 동시에 고려하여야 한다. 방법은 상술한 바와 갈이 술후 통증기전에 부합되는 방법들이 예방적으로 적용되어야 하고 아울러 환자 개개인에 맞는 지속적인 균형제통이 시행되어야 한다. 그리고 환자관리면에서는 환자의 통증을 자주 평가하고 그에 동반된 처치 및 간호업무가 수반되어야 한다. 그러므로 술후 통증관리는 진통제에 대한 전문지식을 갖춘 의료인이 적합한 제통방법을 지속적으로 시행하여야 하는데 그러기 위해서는 효율적인 조직체제가 필요하다. 구미각국에서는 여러해 전부터 술후 통증관리가 통증관리센터란 체제하에서 효과적인 급성 통증치료실로 운영되어져 왔으며 현재는 병원의 중심센타로 확립된 실정이다. 우리나라도 국민의료보험이 도입된지 17년이 지났고 환자 위주의 병원환경이 마련되어야 한다는 데에는 대다수의 국민들로부터 공감대가 형성된 현시점에서 이제는 통증관리센터가 설립되어야 한다고 생각된다. 이러한 제안이 기정사실화 되기까지는 많은 논의와 임상결과에 대한 자료들이 있어야 하겠지만 무엇보다도 마취과 의사들의 술후통증관리에 대한 지속적인 관심과 연구가 뒷바침되어야 할 것으로 생각된다.

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Resolved Cerebral Venous Hypertension after Angioplasty of Central Venous Stenosis in a Hemodialysis Patient: A Case Report (혈액투석 환자에서 발생한 중심 정맥 협착의 혈관성형술 후 호전된 대뇌 정맥 고혈압: 증례 보고)

  • Heemin Kang;Sung-Tae Park
    • Journal of the Korean Society of Radiology
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    • v.83 no.1
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    • pp.206-211
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    • 2022
  • Stenosis of the central veins is a common complication in hemodialysis patients. However, cerebral venous hypertension and neurological symptoms caused by central vein stenosis are relatively rare. We present a rare case of cerebral venous hypertension in a 63-year-old male who showed venous reflux into the dural sinuses due to central venous stenosis on time-of-flight MR angiography. After management for central venous stenosis, the venous reflux disappeared.

Change in patient safety, quality of medical care, organization culture and hospital management performance after healthcare accreditation system for convalescent hospital (요양병원 의료기관인증제 시행 후 환자안전, 의료의 질, 조직문화 및 병원경영성과의 변화)

  • Seo, Young-Ho;Kim, Keon-Yeop;Kim, Myeong-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.9
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    • pp.391-401
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    • 2018
  • This study was conducted to investigate the effects of implementation of the healthcare accreditation system on patient safety, quality of medical care, organization culture and management performance of convalescent hospitals. Ten hospitals were selected at random from among 36 convalescent hospitals in Daegu that had obtained accreditation until September 2015. To accomplish this, hospital staff were surveyed from 15 February to 25 March, 2016 using a questionnaire with 253 objects. We investigated how the healthcare accreditation system has influenced patient safety, service quality, organization culture and performance of hospital management. The change in the treatment support system showed the highest score of 3.93 among quality change and medical service items, while that of personnel source culture showed the highest score of 3.78 points among organization culture items, and that of internal process view, study and growth view showed the highest score of 3.71 among management performance items. Multiple regression analysis revealed that factors positively changing hospital management performance were nurses, employees and managers, basic value systems, organization culture, personnel source culture, open system culture, hierarchical culture, and production oriented culture. The quality of patient safety and medical care was positively influenced by changes in the quality of convalescent hospitals after implementation of the healthcare accreditation system. However, among the four types of organizational culture, the financial perspective was relatively low compared to other perspectives.

A Study of Patient Centered Navigation Model for Care Convenience of Large Hospitals Based on Indoor Positioning Technology (실내 측위 기술 기반의 대형병원 진료 편의를 위한 환자 중심형 네비게이션 모델 연구)

  • Park, Chang Min;Yang, Yu Mi;Ryu, Ki Dong;Churn, Jin Hyuk;Cho, Sang Wook;Kim, Woo Je
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2014.01a
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    • pp.409-412
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    • 2014
  • 본 논문에서는 환자가 실내 측위 기술과 스마트폰을 이용하여 대형 병원의 내부에서 진료 동선을 스스로 찾아갈 수 있도록 하는데 도움을 주는 네비게이션 모델을 제안한다. 정보기술의 비약적인 발전과 함께 실내 측위 기술을 결합한 스마트폰의 위치기반 어플리케이션들이 각광 받게 되었다. 또한, 실내 측위와 관련된 응용 서비스도 새로이 창출되어 점차 이에 대한 관심과 그 정확성을 높이기 위한 연구들이 활발하게 이루어지고 있다. 기존의 실내측위 기법들 중 가장 보편적인 것은 Wi-Fi 신호를 이용 하는 삼각측량 기법으로 초기 구축비용이 저렴하며 서비스 제공 가능 범위가 넓어 본 논문에서 다루고자 하는 장소인 병원의 특성에 알맞다. 따라서 본 모델은 Wi-Fi를 이용하여 사용자의 정확한 위치를 추정하고 진료 프로세스에 따라 경로를 안내를 해주는 네비게이션 서비스를 제공한다. 이를 통하여 환자에게는 진료를 위한 효율적인 동선을 제공함과 동시에 대형 병원에서는 인적, 물적 낭비를 줄이는데 도움이 되고자 한다.

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The Lived Experiences of Clinical Nurses Who working at the Women's Hospital Caring for Foreign Wives in Korea: A Narrative Study Approach (여성전문병원 간호사들의 다문화 환자 돌봄 경험)

  • Yih, Bongsook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.1
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    • pp.188-198
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    • 2016
  • This study explored the experience of clinical nurses caring for foreign wives in Korea. A narrative study approach within the qualitative research paradigm was applied in this study. The data were collected using individual in-depth interviews with 10 clinical nurses who had at least 5 years working experiences caring for foreign wives and their children in the Women and Children's clinical setting. The narrative stories of the clinical nurses were analyzed in the frame of culture-bounded nursing care. In the culture-bounded nursing care, ethnocentric viewpoints, acceptable viewpoints, and culture-based viewpoints were identified within the time frame. Significantly, the narrator identified herself as a therapeutic caregiver in the culture-based viewpoints providing tailored caregiving for foreign wives. This study requires cultural sensitivity of nurses who care for the people with different cultural backgrounds. Self-awareness would be the starting point to reach culturally competent nursing care.

A Study on Dynamic Clinical Process Generation based on Clinical Decision Support System (의사결정시스템을 이용한 진료 프로세스 동적 생성에 관한 연구)

  • Min Yeong-Bin;O Je-Yeon;Gang Seok-Ho
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 2006.05a
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    • pp.1227-1234
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    • 2006
  • 최근 의료 서비스의 질적 향상을 위해 지식 기반의 의사결정지원 시스템 (Decision Support System)의 도입이 지속적으로 이루어지고 있으며, 이의 대표적 예로 임상실행지침(CPG : Clinical Practice Guideline) 중심의 진료 시스템이 있다. 임상실행지침은 환자가 병원에서 거치는 프로세스를 표현한 것으로, 질환에 대한 환자의 표준화된 진료 프로세스 지식이다. 본 연구에서는 임상실행지침, 의료 지식, 환자의 실시간 데이터를 연결시켜 환자가 병원에서 받아야할 진료 과정을 동적으로 생성하는 의사결정지원 시스템을 제시한다. 본 시스템은 임상실행지침과 의료지식을 바탕으로 추상화된 진료 프로세스 템플릿을 생성하고, 이 템플릿의 인스턴스에 해당하는 환자의 실시간 데이터를 반영하여 이후의 진료 프로세스를 동적으로 생성한다.

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Analysis of Arrival Information and Status of the Patients in Emergency Department (응급의료센터 환자의 내원 정보 및 실태 분석)

  • Lee, Sam-Beom;Do, Byung-Soo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.277-282
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    • 1999
  • Background: For effective and systematic management of patients in the emergency department(ED), the data on patient arrival and status in ED of Yeungnam University Hospital were evaluated. Materials and Methods: During the seven days from Apr. 1 to Apr. 7, 1998, the general patient information such as onset time and place, factors associated with transportation, causes of admission, cared department and patient disposition were recorded. Results: Total of 464 patients visited the ED during the seven days, and the mean number of patients per day was 66.3. Male to female ratio was 1:0.71. Daily staying patients were 17.3, and 83.6 patients were cared totally each day. The methods of transportation and distribution of patients according to region and event were as follows: visit by walk(57.3%). transportation by car(58.0%), place of event in residence(85.3%), regional distribution in Taegu(81.5%), and direct visit(97.4%). Cause of admission due to diseases was 74.6%. The percentages of departments which cared the patients were internal medicine 26.6%, pediatrics 16.8%, orthopedics 8.6%, neurology 8.2%, neurosurgery 7.8% and other department including emergency medicine 8.2%, respectively. Patient dispositions were admission 38.4%, discharge 61.0% and death on arrival(DOA) 0.6%, but referred patient-to-another-hospital was zero. Conclusion: Improvements in several aspects of ED's caring system such as "fast tracking" system and reinforcement of disease and trauma caring system, would be helpful for effective management of emergency patients.

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A study on the development of hospital rounds information system utilizing NFC (NFC를 활용한 병원 회진 안내 시스템 개발에 관한 연구)

  • Lee, Hyo Seung;Oh, Jae Chul
    • Smart Media Journal
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    • v.5 no.3
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    • pp.67-73
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    • 2016
  • Now, Korean health technology and health service is proud to be world class one at a level of not falling behind anywhere in the world. However, this health service has been provided, centering on hospital or medical staff, not patient so far. And there is a tendency to gradually change into patient-centered health service. According to the results of survey performed by Korea Institute for Health and Social Affairs, it was reported that, as of 2016, 30% or more of inpatients were not sufficiently given information relating to hospital rounds, and in particular, 50% or more of inpatients in their twenties to thirties expressed discontent, and approximately 17% of inpatients in their seventies and beyond expressed discontent. In the light of these data, especially inpatients in their twenties to thirties want information relating to hospital rounds and the like. And taking into consideration that they are characterized by being accustomed to using a smartphone, it is intended to design and implement a hospital rounds information smartphone application. Now, in some of medium and large hospitals, information about hospital is provided through smartphone application. However, the main purpose is hospital information or outpatient's appointment to see a doctor and so on. Even in case of providing information about hospital rounds, only information about approximate time to make rounds is provided. This paper is intended to design and implement hospital rounds information system making it possible to check their turn when rounds are made by utilizing NFC function in smart phone.