• Korea Journal of Hospital Management
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• v.28 no.4
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• pp.73-89
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• 2023

Purposes: The purpose of this study was to empirically analyze the effect of the attitude of medical staff providing medical services on the treatment satisfaction of the patients who experienced outpatient care at the hospitals and clinics. In particular, it was verified whether the courtesy of the medical staff to the outpatients has moderated the effect of the medical staff's explanation on the treatment satisfaction. Methodology: After controlling the socio-demographic factors of the outpatients with their treatment and waiting time, multiple regression analyses were conducted to figure out the effect of the attitude of the medical staff on the treatment satisfaction. And the covariance analyses were adopted to verify the moderating effect of the variables of the medical staff. Findings: At both hospitals and clinics, all attitudes of medical staff such as the way they explain to and communicate with the patients, and their courtesy showed positive effects on treatment satisfaction. Among them, the courtesy of the medical staff was the most influential variable on the satisfaction of the treatment, and it only had the control power over the effect of the way they explain on the treatment satisfaction. Practical Implication: Among the medical staff's attitudes toward patients at hospital or clinic level, the courtesy of doctors and nurses is an important factor in improving treatment satisfaction. In particular, if the level of their courtesy is low among the medical services rendered at the clinics, the satisfaction level will decrease even if the level of explanation of the medical staff is high. Therefore, in terms of hospital management, treatment satisfaction can be improved when doctors and nurses provide medical services to visitors with polite, humble and friendly manner in explaining to and communicating with the patients.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• Korean Journal of Child Studies
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• v.1
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• pp.65-81
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• 1980

This study is aimed at investigating the compensatory education which was already implemented or is being implemented in the U.S.A. and Japan; and at studying the types of programs and their characteristics; and at sounding out the possibilities of the application of such programs in family and social conditions is Korea. In order to achieve the above mentioned objectives, the established items for the study are as follows: (1) Various types of early children's education (2) Programs of compensatory education for the disadvantaged Children (3) Head Start Program, Early Training Project and Montessori School (4) Integrated Preschool Programs (5) Day-Care Center for employed mothers We investigated the various compensatory education programs for the preschool children who are in economically, socially, culturally disadvantaged conditions. Head Start Programs were federally supported programs for preschool children and opened as summer programs in 1965 for the first time. The purpose of Head Start has been to give preschool children the kinds of experiences they need in preparation for school. The Head Start children were found to be significantly better prepared for school than the normal children. However, after six to eight months, their initial advantages had virtually. disappeared and then the simple problem with Head Start and other such programs was that little long-term good could be evidenced unless the high quality educational environment was maintained. Therefore, to solve this problem, three other programs were funded as part of the overall Head Start. These three programs are the Parent-Child Center, Home Start, and the Child and Family Resources Program. The Early Training Project for disadvantaged children was implemented by Klaus and Gray of Peabody College in 1962. The program was a field research study concerned with the development and testing over time of procedures for improving the educability of young children from low income homes. Its major concern was to study whether it was possible to offset the progressive retardation observed in the public schooling careers of children, living in deprived circumstances. Children, who were trained through the Early Training Project were superior to control groups in the test of IQ and vocabulary as well as linguistic abilities, and preparation for reading. This project showed the possibilities which could prevent preschool children from being disadvantaged socially, culturally and mentally. In 1907, Montessori School was established by Maria Montessori in Italy and her school program has been introduced at present to several countries in the world as one compensatory educations. She first began her experimental methods with retarded children, followed by disadvantaged children from the tenements of Rome. The Montessori approach futures a prepared environment and carefully designed, self-correcting materials. The Montessori curriculum presents tastes that feature sequence, order, and regularity, in addition to those that develop motor and sensory skills. She was interested in children's intellectual development and in developing good work habits. One of the latest developed programs for disadvantaged children is "Integrated Preschool Program" which has successfully integrated handicapped and nonhandicapped children. Several studies have showed that handicapped children in integrated school environments are accepted by and interact with their nonhandicapped peers. In fact, this program provides a number of potential, and perhaps opportunities for nonhandicapped children to serve as valuable resources in fostering the development of their handicapped peers. Next we turn to Japanese programs which are divided into two different types. One is Day-Care Center which was established by Child Welfare Law and the other is kindergarten organized by School Education Law. The kindergarten opened in 1876 and it has been part of school systems since 1947 by the implementation of education law, and the Day-Care Center which started in 1890 for the employed mothers. was changed into Day-Nursery by the enactment of child welfare law in 1947. The laws and operational regulations for the Day-Nursery were set up and were put in effect by the establishment standard acts of children welfare facilities, and the Day-Nursery has been operated in various types by the increasing demand, chiefly because of the socio-economical changes of family structures in both urban and suburban areas. Nursery education for physically and mentally disadvantaged children is for those who are blind, deaf and dumb, mentally retarded; physically disadvantaged by accidents or diseases. Montessori education in Japan was started in 1968 and many research groups for studying Montessori were organized. In 1977, Montessori remedial education society was also organized in which they started a number of studies; a study for developing materials; in-service training for the remedial education; and seminars and lectures, etc It is strongly suggested that we study the early educations that are being implemented in Japan and a variety of compensatory educations that were already implemented in the U.S.A. and modify them for the organization of our own model and properly accommodate them to our social needs.

• Neonatal Medicine
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• v.18 no.2
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• pp.345-352
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• 2011

Purpose: Nursing quality influences patient' outcomes in the neonatal intensive care unit (NICU). We compared differences in adverse events (AEs) by differences in the level of nursing experience at the NICU, developed guidelines to prevent AE, and then investigated the change in AE. Methods: AEs related to nursing were investigated from January 1, 2009 to December 31 2009 at the NICU of the newly established A hospital and B hospital that has been operating for 14 years. We also assessed the level of nursing experience. Guidelines to prevent nursing-related AEs were prepared at A hospital, and the change in the incidence of AE was investigated after 1 year. Results: Twenty nurses (80%) had <2 years experience at A hospital, whereas 13 nurses (65%) had 2 years or longer but less than 4 years experience at B hospital (P<0.001). The number of incidences of AE that occurred in 2009 in A hospital was higher (46) than that at B hospital (10). Intravenous (IV) injection-related incidents had the highest share in both hospitals: 24 incidents (52.2%) at hospital A and eight incidents (80%) at hospital B. After the guidelines were instituted in 2009, the number of nursing AEs decreased to 17, of which the number of IV incidents was the highest (6, 35%), athough its share decreased. Conclusion: Supervision and prevention guidelines should be in place to reduce nursing AEs, which would improve the quality of NICU service.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.326-335
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• 2015

Background: Asian dust is known to have harmful effects on the respiratory system. Respiratory conditions are also influenced by environmental conditions regardless of the presence of pollutants. The same pollutant can have different effects on the airway when the air is dry compared with when it is humid. We investigated hospital visits for chronic obstructive pulmonary disease (COPD) and asthma in relation to the environmental conditions. Methods: We conducted a retrospective study using the Korean National Health Insurance Service claims database of patients who visited hospitals in Chuncheon between January 2006 and April 2012. Asian dust, haze, mist, and fog days were determined using reports from the Korea Meteorological Administration. Hospital visits for asthma or COPD on the index days were compared with the comparison days. We used two-way case-crossover techniques with one to two matching. Results: The mean hospital visits for asthma and COPD were $59.37{\pm}34.01$ and $10.04{\pm}6.18$ per day, respectively. Hospital visits for asthma significantly increased at lag0 and lag1 for Asian dust (relative risk [RR], 1.10; 95% confidence interval [CI], 1.01-1.19; p<0.05) and haze (RR, 1.13; 95% CI, 1.06-1.22; p<0.05), but were significantly lower on misty (RR, 0.89; 95% CI, 0.80-0.99; p<0.05) and foggy (RR, 0.89; 95% CI, 0.84-0.93; p<0.05) days than on control days. The hospital visits for COPD also significantly increased on days with Asian dust (RR, 1.29; 95% CI, 1.05-1.59; p<0.05), and were significantly lower at lag4 for foggy days, compared with days without fog (RR, 0.85; 95% CI, 0.75-0.97; p<0.05). Conclusion: Asian dust showed an association with airway diseases and had effects for several days after the exposure. In contrast to Asian dust, mist and fog, which occur in humid air conditions, showed the opposite effects on airway diseases, after adjusting to the pollutants. It would require more research to investigate the effects of various air conditions on airway diseases.

• Journal of agricultural medicine and community health
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• v.15 no.2
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• pp.97-106
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• 1990

1. Background Women's health and their involvement in health care are essential to health for everyone. If they are ignorant, malnourished or over-worked, the health &-their families as well as their own health will suffer. Women's health depends on broad considerations beyond medicine. Among other things, it depends upon their work in farming. their subordination to their families, their accepted roles, and poor hygiene with poorly equipped housing and environmental sanitation. 2. Objectives and Contents a. The health status of rural women : physical and mental complaints, experience of pesticides intoxication, Farmer's syndrome, experiences of reproductive health problems. b. participation in and attitudes towards housework and farming c. accessibility of medical care d. status of maternal health : fertility, family planning practice. induced abortion, and maternal care 3. Research method A nationwide field survey, based on stratified random sampling, was conducted during July, 1986. Revised Cornell Medical index(68 out of 195 items). Kawagai's Farmers Syndrome Scale, and self-developed structured questionnaires were used to rural farming wives(n=2.028). aged between 26-55. 4. Characteristics of the respondents mean age : 40.2 marital status : 90.8% married mean no. of household : 4.9 average years of education : 4.7 yrs. average income of household : \235,000 average years of residence in rural area : 36.4 yrs average Working hours(household and farming) : 11 hrs. 23 min 5. Health Status of rural women a. The average number of physical and mental symptoms were 12.4, 4.7, and the rate of complaints were 22.1%, 38.8% each. revealing complaints of mental symptomes higher than physical ones. b. 65.4% of rural women complained of more than 4 symptoms out of 9, indicating farmer's syndrome. 11.9 % experienced pesticide overdue syndrome c. 57.6% of respondents experienced women-specific health problems. d. Age and education of respondents were the variables which affect on the level of their health 6. Utilization of medical services a. The number of symptoms and complaints of respondents were dependent on the distance to where the health-care service is given b. Drug store was the most commonly utilized due to low price and the distance to reach. while nurse practitioners were well utilized when there were nurse practitioner's office in their villages. c. Rural women were internalized their subordination to husbands and children, revealing they are positive(93%) in health-care demand for-them but negative(30%) for themselves d. 33.0% of respondents were habitual drug users, 4.5% were smokers and 32.3% were alcohol drinkers. and 86.3% experienced induced-abortion. But most of them(77.6%) knew that those had negative effects on health. 7. Maternal Health Care a. Practice rate of contraception was 48.1% : female users were 90.9% in permanent and 89.6% in temporary contraception b. Induced abortions were taken mostly at hospital(86.3%), while health centers(4.7%), midwiferies(4.3%). and others(4.5%) including drug stores were listed a few. The repeated numbers of induced abortion seemed affected on the increasing numbers of symptoms and complaints. c. The first pre-natal check-up during first trimester was 41.8%, safe delivery rate was 15.6%, post-natal check-up during two months after delivery. Rural women had no enough rest after delivery revealing average days of rest from home work and farming 8.3 and 17.2. d. 86.6% practised breast feeding, showing younger and more educated mothers depending on artificial milk 8. Recommendations a. To lessen the multiple role over burden housing and sanitary conditions should be improved, and are needed farming machiner es for women and training on the use of them b. Health education should begin at primary school including health behavior and living environment. c. Women should be encouraged to become policy-makers as well as administrators in the field of women specific health affairs. d. Women's health indicators should be developed and women's health surveillance system too.

• The Journal of Korean Medicine
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• v.37 no.3
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• pp.112-122
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• 2016

Objectives: This study aimed to assess the validity of 'Korean Diagnosis Related Groups-Korean Medicine (KDRG-KM)' which was developed by Health Insurance Review & Assessment Service (HIRA) in 2013 Methods: Among inpatient EDI claim data issued by hospitals and clinics in 2012, the data which included Korean medicine procedures were selected and analyzed. We selected control targets in the Korean medicine hospitals which had longer Episodes-Costliness index (ECI) and Lengthiness index (LI) than average of total Korean medicine hospitals, and compared the results of selection between the major diagnosis-based patient classification system and the KDRG-KM system. Finally, the explanation power (R2) and coefficient of variation (CV) of the KDRG-KM system using practice expenses were calculated. Results: The numbers of control target in Korean medicine hospitals changed from 36 to 32 when patient grouping adjustment method was changed from major diagnosis to KDRG-KM. For expenses of all outpatient claim data on Korean medicine, explanation power of KDRG-KM system was 66.48% after excluding outliers. CVs of expenses of patient groups in Korean medicine hospitals were gathered from under 70% to under 90%, and those in long-term care hospitals mostly belonged under 70%. Conclusions: The validity of KDRG-KM system was assured in terms of explanation power. By adapting KDRG-KM system, fairness of control targets selection for costliness management in Korean medicine hospitals can be enhanced.

• Journal of Family Resource Management and Policy Review
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• v.14 no.3
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• pp.143-163
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• 2010

The purpose of this study is to analyze the trend of research system and contents of thesis which was published with a theme of child tea ceremony education. Under this purpose we have searched the thesis related to the child tea ceremony education which was in the data base of the National Assembly Library, the National Library of Korea, Korea Education & Research Information Service and we have collected total of 22 analyzing subject data. The major results of this study are as followings: First, after analyzing the research system, the release year of child tea ceremony education study which was published from year 2000 to 2009 are shown as followings, 1 unit in year 2000, 2 units in year 2001, 2002 & 2003, 4 units in year 2004, 5 units in year 2005, 2 units in year 2006, 1 unit in year 2007, 2 units in year 2008, 1 unit in year 2009. The publishing type were 14 units of master's degree thesis, 6 units of academic journal, 2 units of doctor's degree thesis. The academic area of researchers are 8 units of propriety and tea culture, 5 units of early childhood education, 5 units of child welfare, 2 units of family culture and consumer, 1 each unit of counseling psychology and korean culture. As per the research method there were 15 units of experimental study, 6 units of reference research, and 1 unit of thesis which adopts both interview and case study. Second, as a result of analyzing the research contents, the goal of child tea ceremony education was shown to be a holistic child growth and development, a formation of basic living habit, a development of pride on traditional culture and an establishment of national identity. The contents of child tea ceremony education has been classified into 57 items. The activity of child tea ceremony education has been classified into 34 items. The vitalizations of child tea ceremony education is shown to be a education for parents and teachers, a development of systematic educational program, durability of child tea ceremony education, and a verification of effectiveness of child tea ceremony education.

• Journal of Korean society of Dental Hygiene
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• v.17 no.6
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• pp.1109-1119
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• 2017

Objectives: The purpose of this study is to evaluate the relationship between socioeconomic characteristics and prevalence of periodontal disease in a representative sample of Korean adults older than age 20. Methods: Data of 3,837 adults were collected by the six Korean National Health and Nutrition Examination Survey, which was conducted in 2015. Socioeconomic, demographic, and oral health-related behavior data were collected as independent variables. We determined frequencies, percentage, and determining statistical significance using multiple regression analysis. Results: Prevalence of periodontal diseases showed statistically significant difference in accordance with sex, age, socioeconomic and demographical characteristics and oral health-related behavior. It was confirmed that the prevalence of periodontal diseases was increased in the lower educational level and income (OR, 1.478 and 1.520) after adjusting for conditions such as age, sex, recent dental check-ups, visiting dental clinic, tooth brushing frequency, use of self-care devices. Conclusions: The prevalence of periodontal disease was related with socioeconomic factors in Korean adults. Therefore, differentiated oral health service policies and dental health education among adults with lower education and income is required in order to reduce the prevalence of periodontal disease.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.74-86
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• 2017

Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.