• 가정∙방문간호학회지
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• 제19권1호
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• pp.11-18
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• 2012

Purpose: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.

• 대한소아치과학회지
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• 제47권1호
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• pp.44-52
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• 2020

1956년 한국에 처음 소아치과학교실이 창설되었고, 1992년 한국 최초의 소아전문 치과의원이 등장하였다. 치의학의 발전과 소아치과에 대한 대중의 인식 변화로 인해 소아전문 치과의원은 점점 더 증가하고 있다. 이 연구의 목적은 지역 분포를 포함한 여러 측면에서 한국의 소아전문 치과의원의 현황을 조사하는 것이다. 한국에 17,917개의 치과의원 중 소아전문 치과의원은 343개이고, 1.91%를 차지하였다. 343명의 소아전문 치과의원 개원의 중 248명이 소아치과 전문의였다. 소아치과 전문의 248명 중 25명이 전문의를 표방하여 개원하고 있었다. 16개의 시도 중 경기도에 소아전문 치과의원이 가장 많았고, 33.5%를 차지하였다. 서울과 부산이 그 뒤를 이었다. 서울의 25개 구 중에서는 강남구에 소아전문 치과의원이 가장 많았고, 유소년 10만명당 소아전문 치과의원 수도 강남구에서 제일 높았다. 소아전문 치과의원의 90.9%는 평일 야간진료를 하지 않았고, 26.5%는 토요일에 15시 이후에 문을 닫았다.

• 치위생과학회지
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• 제15권1호
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• pp.18-23
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• 2015

2013년 9월 9일부터 11월 2일까지 편의추출법에 의해 전라북도 군산시 소재의 학교구강보건실을 운영 중인 5개 초등학교 교사 133명과 설치 운영하지 않는 5개 초등학교 교사 144명을 대상으로 학교구강보건실 및 예방사업 인지에 대해 설문지를 이용하여 조사한 후 IBM SPSS Statistics 21.0 프로그램으로 빈도분석과 교차분석을 실시하였다. 중요하다고 생각하는 구강건강사업의 우선순위에 대해 학교구강보건실 운영 학교에서는 불소도포와 구강보건교육(71.1%)을, 비 운영 학교 교사들은 구강보건교육(76.5%)을 가장 중요하게 생각하고 있었다. 학교구강보건실 운영 학교 교사 87.0%는 학생들의 구강건강상태가 개선되었다고 하였다. 학교구강보건실 비 운영 학교 교사 74.4%는 학교구강보건사업에 대해 들어본 적이 없다고 하였으나 85.8%의 교사들이 학교구강보건사업이 실시된다면 학생의 구강건강상태가 나아질 것으로 기대하고 있었다. 학교구강보건실 운영학교의 57.7%는 예방사업인력이 충분치 않다고 하였다. 이상으로 학교구강보건실의 원활한 사업수행은 학교 구성원들의 구강건강증진과 나아가 지역사회 구성원들에게도 많은 영향을 끼치게 되므로 구강보건실 비 운영 학교를 대상으로 학교구강보건실 설치의 필요성에 대한 국가적 차원의 적극적인 홍보가 필요하다.

• 한국의료질향상학회지
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• 제26권2호
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• pp.86-94
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• 2020

Purpose: This study aimed to identify current quality control (QC) practices of primary care clinics participating in the National Cancer Screening Program (NCSP) in Korea. Methods: A nationwide survey using a structured questionnaire was conducted among the primary care clinics participating in the NCSP, which were selected by a proportionate stratified sampling. The questionnaire consisted of general information about the responding clinics and the scope of QC activities undertaken. A total of 360 clinics responded and the set of data was then analyzed with Chi-square test and multivariable logistic regression analysis. Results: Among 360 respondents, 332 (92%) reported that they were involved in the QC activities. Most frequently performed QC activities were 'maintenance of facility and instruments' (89%) and 'staff training' (85%). The analysis revealed, with statistical significance (p<.05), that there was an association between certain characteristics of the clinics and the scope of QC activities. These findings also indicated that the diversity of QC practices varies according to the size of the clinics. The clinics screening more types of cancer, those with more screenees, and those with more employees were more likely to implement various QC activities including 'maintenance of facility and instruments', 'external quality control', and 'management of screening data'. Conclusion: To our knowledge, this is the first study to investigate the current status of QC activities conducted among primary care clinics participating in the NCSP. The results of this survey can be used as a basis for further development of policies on quality management of small- and medium-sized primary care clinics in Korea. However, further studies encompassing various aspects of QC activities and management of primary care clinics are needed to assess the current situation in a concise manner.

• 한국임상수의학회지
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• 제1권1호
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• pp.1-9
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• 1984

• 한국임상수의학회지
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• 제4권1호
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• pp.439-444
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• 1987

• Asian Pacific Journal of Cancer Prevention
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• 제14권1호
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• pp.75-80
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• 2013

Background: Breast cancer is the most common cancer diagnosed in females in Sri Lanka and early detection can lead to reduction in morbidity and mortality. Aim: To evaluate selected aspects of breast cancer early detection services implemented through well woman clinics (WWCs) in the Gampaha District. Methods: The study consisted of two components. A retrospective descriptive arm assessed clinical breast examination (CBE) coverage of target age group women (TGW) of 35-59 years in all the WWCs in Gampaha district over 2003-2007. A cross sectional descriptive study additionally assessed quality of breast cancer early detection services. The Lot Quality Assurance Sampling (LQAS) technique was used to decide on the lot size and threshold values, which were computed as twenty and six clinics. Checklists were employed in assessing coverage, physical facilities and clinic activities. Client satisfaction on WWC services was assessed among 200 TGW attending 20 WWCs using an interviewer-administered questionnaire. Results: CBE coverage in the Gampaha district increased only from 1.1-2.2% over 2003-2007. With regard to physical facilities, the number of clinics that were rated substandard varied between 7-18 (35-90%). The items that were lacking included dust bins, notice boards, stationary, furniture and linen, and cleanliness of outside premises and toilets. With regard to clinic activities, punctuality of staff, late commencement of clinics, provision of health education, supervision, CBE and breast self-examination (BSE) were substandard in 7-20 clinics (35-100%). Client satisfaction for WWC services was 45.2% (IQR: 38.7-54.8%) and only 11% had a score of ${\geq}70%$, the cut off set for satisfaction. Conclusions: Breast cancer early detection service coverage in the Gampaha district remained low (2.2%) in 2007, 11 years after commencing WWCs. All 20 clinics were substandard for overall CBE and BSE.

• 한국임상약학회지
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• 제20권3호
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• pp.205-212
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• 2010

The prescription sheets for outpatients from July 2008 to June 2009 from 7 community pharmacies in Ulsan City were surveyed for the anti-inflammatory drug (AID) prescription pattern. The AID prescription rate of pediatricians and ENT physicians were 30.0% and 34.8%, respectively. The oral steroidal anti-inflammatory drugs (SAIDs) were prescribed as much as 3.9% by pediatricians and 10.3% by ENT physicians. The chiefly prescribed oral SAID was prednisolone in pediatric clinics and methylprednisolone in ENT clinics. Meanwhile the prescription rate of oral non-steroidal anti-inflammatory drug (NSAID) was 22.5% by pediatricians and 21.4% in ENT physicians. The most favorable NSAIDs were propionate derivatives in both clinics. In case of externally-applied SAIDs, the prescription rate of pediatricians was 3.6% and that of ENT physicians was 2.8%. Among them, nasal spray, inhalant and gargle formulations for upper respiratory infection (URI) treatment occupied 35.8% of externally-applied SAIDs in pediatric clinics and 59.7% in ENT clinics. Further, it was observed that ENT physicians favored much stronger SAIDs in Group III of ATC classification (75.4% of externally-applied SAIDs) than pediatricians (49.2%). In the survey of AID combination rate, pediatric clinics showed much lower rate (1.4% of total AID prescriptions) than ENT clinics (7.5%). Among them, the combination rate of oral SAID and oral NSAID by ENT physicians (52.2% of total AID combinations) was much higher than pediatricians (36.6%), which might be over-prescription of AID agents. In conclusion, the AID prescription rate as well as AID combination rate, especially in SAID prescriptions, was much higher in ENT than pediatric clinics, which implies the higher confidency on AID drugs of ENT physicians even though the severity of patient's symptom could be considered.

• 대한한의학회지
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• 제32권4호
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• pp.25-36
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• 2011

Objective: To check the status of traditional Korean medical doctors' medical services amid the continual increase in the number of traditional Korean medicine clinics. Methods: A survey of traditional Korean medicine clinics based on questionnaire sheets mailed to 4,200 out of 10,895 clinics, of which 465, or 11.0%, responded, in the June 1, 2008 to December 9, 2008 period. Results: 1. 65.6% of the traditional Korean responding clinics are doing business in a rented space; 92.1%of them are one-person institutions; 24.4% of them, i.e., the largest group of those surveyed, operate in a space sized 41 (123 $m^2$)~50 pyeong (150$m^2$). The number of sick beds installed in their facilities comes to 7.9 on average. 2. Concerning support staff, 190 of them (or 40.9%), i.e., the largest group of those surveyed, employ two people in this capacity. They generally comprise assistant nurses (48.7%) and others (47.6%). 3. The size of the space used by the clinics is showing a tendency to increase. The number of sick beds and support staff, including assistant nurses, reached a peak in 2006, and has been on the decrease since then. 4. The average number of on-days comes to six days a week among 92.6% of those surveyed. Their average daily service hours come to 9 hours and 33 minutes (from 9:17 am to 6:50 pm). 5. Per-patient service time: 14 minutes on average; per-patient acupuncture time: 18.8 minutes; per-patient moxa cautery time: 10.1 minutes per-patient; boil-cupping time: 5.7 minutes; per-patient physical treatment: 28 minutes. Conclusion: Periodical studies should be carried out concerning desirable ways of developing traditional Korean medicine clinics with the focus on the facilities, doctors' service hours, and types of service.

• 보건행정학회지
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• 제27권3호
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• pp.247-255
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• 2017

Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.