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융복합시대에 의료기관 정보가 일당진료비와 삭감율에 미치는 영향에 관한 연구 (A study of the impacts of medical institution information on daily medical expenses and medical expense reduction rate in convergence age)

  • 양유정;이혜승
    • 디지털융복합연구
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    • 제13권7호
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    • pp.259-268
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    • 2015
  • 본 연구는 일당진료비와 삭감율의 차이와 변동요인을 파악하고 이를 중심으로 요양급여비 관리대책 수립에 필요한 기초자료를 제공할 목적으로 수행되었다. 전국 종합병원 50개소의 감염성 장염(A09.0) 질환의 1년 동안 평균 일당진료비와 평균 삭감율을 입원과 외래로 구분 조사하였고 결과는 다음과 같다. 입원 일당진료비는 의료기관의 총인원, 외래 일당진료비는 병상수, 입원 삭감율은 병상수와 총인원에 상관이 있는 것으로 나타났다. 의료기관 정보가 일당진료비에 미치는 영향은 입원과 외래 동일하게 의료기관의 총인원에 정적(+) 영향을 미치는 것으로 나타났다. 이러한 삭감율과 일당진료비에 대한 연구는 의료기관의 효율적이고 합리적인 의사결정을 돕고, 요양급여비 정책의 우선순위를 결정하는데 중요한 근거가 될 것이다.

간호사의 코칭행동수준과 감성지능이 조직유효성에 미치는 영향에 대한 융합연구 (A Convergence Study about Influences of Coaching Behavior Level and Emotional Intelligence on Organizational Effectiveness of Nurse)

  • 권정옥;임선영
    • 한국융합학회논문지
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    • 제8권7호
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    • pp.63-73
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    • 2017
  • 본 융합연구의 목적은 간호사의 코칭행동수준과 감성지능이 조직유효성에 미치는 영향을 확인하기 위한 서술적 조사연구이다. 연구대상자는 B, U광역시 4개의 종합병원 간호사이며, 2017년 3월 2일부터 2017년 3월 23일까지 자기기입식 설문지로 조사 후 최종 182부를 IBM SPSS 21.0프로그램을 이용하여 분석하였다. 연구결과 코칭행동수준 $3.28{\pm}0.42$점, 감성지능 $3.27{\pm}0.45$점, 조직유효성 중 조직몰입 $2.89{\pm}0.52$점, 직무만족도 $2.94{\pm}0.53$점, 이직의도 $3.24{\pm}0.56$점이었다. 조직몰입은 코칭행동수준, 감성지능과 정적상관관계가 있었고, 조직유효성에 영향을 미치는 융합요인은 프리셉터 경험(${\beta}=.25$, p=.001), 간호직 만족도(${\beta}=.26$, p<.001), 코칭행동수준(${\beta}=.26$, p<.001)이었고 설명력은 25%이었다. 따라서 간호사의 조직몰입을 높이기 위해서 직무의 특성을 만족시키고, 코칭행동수준을 향상시키는 중재프로그램이 마련되어 적용된다면 조직유효성을 높일 수 있을 것으로 기대한다.

여성근로자의 월경시 불편감과 대처방법에 따른 완화정도 -의료기관 종사자를 대상으로- (Female worker′s menstrual discomforts and coping -focus on hospital workers-)

  • 임윤미
    • 한국융합학회논문지
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    • 제9권2호
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    • pp.259-266
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    • 2018
  • 본 연구는 여성근로자의 월경시 불편감의 양상과 대처방법 및 그에 따른 완화정도를 파악하자 시도된 서술적 조사연구이다. 연구대상은 S시에 위치한 3개 종합병원에 근무하는 여성으로 본 연구의 목적에 동의한 394명이다. 2010년 4월 20일부터 4월 30일까지 자료수집을 하였으며 SAS 9.2를 사용하여 기술통계, independent t-test, one way ANOVA, Pearson's correlation을 실시하였다. 연구 결과 월경시 불편감은 연령, 결혼유무, 임신경험, 출산경험과 유의한 차이를 보였고 근로특성은 차이가 없었다. 월경시 불편감의 정도는 최대 5점 중 평균 $2.46{\pm}0.68$으로 보통 수준이었으며, 양상은 통증, 수분 축적, 행동변화 순이었다. 대처방법에 따른 완화정도는 행동적 대처가 $3.55{\pm}0.58$로 가장 효과적이었고 월경시 불편감과 대처행동 간에는 회피적 대처에서만 상관관계가 있어 불편감이 높은 사람일수록 회피적인 대처를 하고 있었다(r=.178, p=.001). 이상의 결과를 통해 여성근로자의 월경시 불편감을 완화하기 위하여 회피적 대처방법보다는 스스로 극복하도록 바람직한 대처방법을 모색해야하며 앞으로 월경시 불편감을 해소할 수 있는 교육프로그램 개발을 제언한다.

임부의 강인성과 산전간호이행과의 관계연구 (A Correlation Study on the Relationship between Hardiness and Compliance with Prenatal Care in Pregnant Woman)

  • 박명희
    • 대한간호학회지
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    • 제23권3호
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    • pp.339-355
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    • 1993
  • The purpose of this correlational study was to offer strategies for nursing intervention to improve compliance with prenatal care. This study was designed to investigate degree of tardiness, correlation between hardiness and compliance with prenatal care. In research, the characteristic of hardiness has 1 teen demonstrated in resolving stressful situaltions and in adapting to overcome physical and psycho-logical tension. pregnancy is normal crisis process. Therefore, it is necessary to investigate degree of hardiness in normal pregnant woman and I think that concept of hardiness is able to become a new, important concept for prenatal care imtervention. The subjects were 388 normal pregnant woman over five months, who were selected from five university hospitals and two health centers in Taegu. Data were obtained using a convenience sample technique. Data collection was done from March 6 to June 18, 1992. The instruments used for this study were the Health Related Hardiness Scale developed by Pollock(1984) and compliance with a prenatal care scale developed by the author on the basis of results of a literature review. Data were analyzed using the SAS program for t - test, ANOVA, Scheffe test, Pearson correlation and stepwise multiple regression. The results are as follows : 1. The scores on the hardiness scale ranged from 35 to 210 with mean of 88.89. 2. The scores on the compliance with prenatal care scale ranged from 28 to 140 with a mean of 111.49. 3. There were significant differences between hardiness and obstetrical characteristic factors, duration of pregnancy, frequency of pregnancy, frequency of abortion(P .05). 4. There were significant differences between compliance with prenatal care and general and obstetircal characteristic factors, education and frequency of pregnancy(P .05). 5. Correlations between hardiness and compliance with prenatal care were all negative and significant(r=-.2276~ -.2930, P .000). Challenge of hardiness components was the low est (r= -.2814). 6. Significant differences between hardiness and compliance with prenatal care by group were as follows : Group 1 was the high est, whereas Group 8 was the lowest(F=5.47, P .0000). 7. Factors influencing compliance with prenatal care were : 1) Challenge was the main variable and accounted for 7.92% of the total variance. 2) Education and frequency of pregnancy accounted for an additional 2.74% of the total variance. From the above findings, this study suggests the following : 1) Considering the lack of empirical support, the theroy of hardiness needs to be evaluated. 2) A valid, reliable and culturally appropriate instrument needs to be developed for Health Related Hardiness Scale. 3) There is a need for further study of hardiness in a broad variety of populations. 4) There is a need for comparative study correlation between hardiness and compliance with prenatal care in woman with normal and abnormal pregnancies

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영아의 수유 및 보충식에 대한 조사연구 (A Survey Of Infant Feeding Practices In Seoul, 1991.)

  • 김효진;박영숙
    • 대한간호학회지
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    • 제23권3호
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    • pp.377-398
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    • 1993
  • A survey of infant practices was conducted to provide information on which to base planned nursing interventions. The subjects were a convenience sample of 168 mothers visiting out - patients departments of five general hospitals and one public health center in Seoul for immunizations or treatment for common colds for their infants from two to 12 months of age. Data collection was carried out from July 8th to September 30th, 1991 using a questionnaire of 84 questions, 31 on the type of feeding, 22 on supplementary feeding and 21 on demographic infer mation. The results are summarized as follows : 1) The type of feeding was primarily artificial feed-ing (63.1%), followed by mixed feeding (22%) and breast feeding (14.9%) of the 59 mothers expecting during pregnancy to breast feed, 54. 2% changed artificial feeding and 30.5% went on to breast feed as they had expected. For mothers expecting to continue breast feeding over seven months. only one infant was being breast fed for over seven months. 2) For the 106 mothers using artificial feeding, 70. 8% hed attempted breast feeding, 64% of them for less than a month. Breast milk had been suppressed by for medication (38.7%) : 34.9% had used no specia] means. 3) The major reasons for replacing breast feeding with artificial feeding were the infants' demand for more milk (47.2% ) and insufficient supply of breast milk (49.3%). 4) Most mixed feeding was started at the age of one to three months (59.5%). Only 34.4% gave an artificial feeding after breast feeding : most (46%) alternated breast feeding with artificial feeding. On the whole, the motive for mixed feeding was the lack of breast milk (70.3%). 5) Many mothers (81.8%) were adding vitamin or mineral supplements to artificial milk and 51.5% were adding something to faciliate digestion. As for the method of sterilizing milk bottles and nipples, 56% had sterilized them together in boiling water from the beginning : 27% were just washing the bottles after boiling only once initially when measuring artificial milk powder, 31. 5% of the mothers over filled the measuring spoon rather than to the level. 6) The mother's occupation was related to her way of feeding. Mothers at home full time did more breast feeding than mothers employed outside the home. (x²=5.72, p=〈0.05). 7) Most mothers began supplementary food, from three to four months (48.8%) : 11.2% began later than seven months. Supplementary food was given between milk feedings by 67.2% of the mothers : 19.2% gave it before a milk feeding. Some mothers(26.4%) made their own supplementary food : 19.2% used ready - made supplementary food products for convenience. Recommendations for nursing interventions included : 1. Prenatal education about the advantages of breast feeding and breast care, and home visits after delivery for counselling related to breast feeding. Correct preparation of artificial feeding methods need to be taught in both pre & postnatal periods. In addition, specific education about supplementary feeding needed. 2. Further research is indicated about the Perceived lack of supply of breast milk and about the effectiveness of nursing interventions to Promote breast feeding.

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간호학적 지식/권력과 실무: 아동중환자실을 중심으로 (Nursing Knowledge/Power and Practice in Pediatric Intensive Care Unit)

  • 이은주;홍경자
    • Child Health Nursing Research
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    • 제7권1호
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    • pp.85-95
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    • 2001
  • The purpose of this study was to reveal what influences the divergent methodological researches have brought the nursing practice in during the past 3 decades. The nursing record sheets ie, the nursing discourses were analyzed to know the knowledges that were recorded, accepted and communicated in nursing practice at pediatric intensive care units, and unclosed the philosophical and methodological position of that knowledges. The texts were 13 sheets, 3 kinds of nursing record(7 24hours flow charts, 4 nursing information record sheets and 2 transfer record sheets) used at 4 hospitals. The unit of analysis was 'word'. First, all words of the sheets were listed up, clustered into categories based on their contents. And then, the larger conceptual themes were drawn to elucidate the effect of the knowledge/power and the philosophical and methodological position of that knowledges. To enhanced the validity of the analysis, the data were analyzed by two researchers. The 'words' were classified into 3 categories; 'general information', 'assessment' and 'inter-vention'. The conceptual themes of the texts were 'the gaze for quantification and objectification' and 'technical/assimilated caring'. This themes reflected the logic positivistic and biomedical view that had dominated at clinical practice. Nursing has endeavored to resist the logic-positivistic knowledge/power and to established the nursing knowledge/power based on multiple philosophies and methodologies, especially phenomenological-interpretative. But the results of this study revealed that such efforts in nursing theory and research couldn't influenced the knowledge of practice. Logic positivism was yet so strong and the biomedical model yet dominated in the clinical practice. It identified that the borrowed theory and the knowledge from the received view gave nursing the power. But they were modalities that reinforced the dominant, medical power. Nursing has investigate the other positions (feminism, Habermas' critical social theory and Foucault's discourse theory). This positions suggest different assumptions but share the common concepts; equality, emancipation and freedom. The important point is how make these concepts the practical for nursing knowledge/power in practice. We must recognize that the praxis at clinical setting take place at the field unlike theoretical praxis. The change of clinical practice is the social, economic and political change.

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대학부속 한방병원 교직원의 안전활동에 영향을 미치는 요인 (Factors that Impact on Safety Activities of Personnels in Oriental Medicine Hospital of University)

  • 이정우
    • 한국병원경영학회지
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    • 제22권3호
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    • pp.61-73
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    • 2017
  • Purposes : The purpose of this study is to identify factors that have effects on safety activities of hospital personnels by investigating causality between patient safety culture, job stress, safety system and safety activities of faculty and staff member who are working for oriental medicine hospital of university. Methodology : The subjects were 246 employees working in 4 oriental medicine hospitals of university in Daejeon and Chungcheongnam-do. The data were collected from January 16 to January 25, 2017 using a structured questionnaire. For data analysis, descriptive statistics, Pearson correlation coefficient, t-test, ANOVA and Duncan test with SPSS 22.0 were used. Findings : The activity score for patient safety of faculty and staff member, who were experienced at job training program after joining a company and regular training course for qualification or license, was meaningfully higher than that of group who had no job training experience. The result indicated that the higher there is level of safety culture and safety system and the lower there is work stress, the more the activity has positive effect on patient safety. The level score of awareness for safety culture of faculty and staff member in C hospital, which is facing financial crisis in business circumstances recently, showed average value of 3.29. It was significantly lower than that of the other three hospital. Also, The activity score for patient safety was markedly lower than that of the other three hospital. This result become interested in the process of linking non-financial performance and financial performance. The level score of safety activity in A hospital which obtained healthcare accreditation was remarkably higher than that of the other three hospital which didn't certify healthcare accreditation. Pratical Implications : Subjects about Q.I or patient's experience management must be included in curriculum of Oriental medicine. It is necessary to get the effect of job training program for faculty and staff member through the process of preparation for obtaining healthcare accreditation. When the hospital director is appointed, it must be considered that he/she has the ability to attach importance to analysis and management of the factors creating safety accident, and has business mindset for healthcare delivery of customer- centricity. This research showed that financial performance of hospital, which of business environment is favorable; located in metropolitan city and having large scale of hospital and quality of residence rating but low-level of safety culture and safety activity, was lower than that of general hospital situated in small and medium-sized cities. More research needs to be done for answering this result.

일부 병원 종사자들의 치과위생사에 대한 이미지 선호 경향 (Trend in Preference for Dental Hygienist Image among Health Care Workers)

  • 윤현서;김정술;이미옥;김현대
    • 치위생과학회지
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    • 제10권4호
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    • pp.211-218
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    • 2010
  • 부산지역 치과를 포함하는 종합병원에 근무하는 병원종사자 228명을 대상으로 치과위생사의 주된 업무, 선호하는 내적인 이미지, 선호하는 외적이미지, 사회적 수준 등에 대하여 조사한 본 연구의 결론은 다음과 같다. 1. 치과위생사의 주된 업무는 1순위는 치의사의 진료보조 28.2%, 2순위 치석제거 23.2%, 3순위 예방업무 20.6%로 나타났다. 2. 선호하는 이미지는 밝은 표정이 61.4%로 가장 많았으며, 단정함 32.9%, 세련됨 3.5%, 지적 임 2.2% 순으로 나타났다. 기혼에서 밝은 표정을 많이 선호하였으며 유의미한 차이를 보였다(${\chi}^2=8.11$, p<.05). 3. 유니폼은 투피스 바지 형을 76.3%로 가장 선호하였으며, 여자에서 투피스 바지 형을 많이 선호하는 유의미한 차이를 보였다(${\chi}^2=41.09$, p<.001). 4. 치과위생사가 갖추어야 할 중요한 자질은 전문적 지식이 49.1%로 가장 많았으며, 성실함과 책임감 23.2%, 친절성 22.4%, 인격과 교양 5.3% 순으로 나타났다. 40세 이상인 종사자가 성 실함과 책임감으로 인식하는 경우가 많았으며 유의미한 차이를 보였다(${\chi}^2=20.62$, p<.01) 5. 사회적 수준이 높다고 인식할수록 치과위생사의 외형적 모습이 신뢰감 또는 안정감에 영향 을 줄 수 있으며 유의미한 차이를 보였다(F=9.98, p<.001) 6. 사회적 수준이 높다고 인식하는 경우 밝은 표정을 선호하였으며(${\chi}^2=31.54$, p<.001), 사회적 수준이 낮다고 인식할수록 경우 친절성 및 성실함과 책임감이라고 인식하였으며, 유의미한 차이를 보였다(${\chi}^2=14.03$, p<.05). 이상의 연구결과를 볼 때 치과위생사의 사회적 수준과 이미지 향상을 위해서는 치과위생사에게 적합한 업무를 수행할 수 있는 실무능력향상 프로그램 마련되어야 할 것으로 사료된다.

병원 간호조직문화와 조직성과에 관한 연구 (A Study on the relationship between nursing organizational culture and organizational performance)

  • 한수정
    • 간호행정학회지
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    • 제8권3호
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    • pp.441-456
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    • 2002
  • Purpose : This research is, by investigating the relations between the cultural types of a nursing organization in a hospital and performance, to ascertain the cultural types to be able to improve performance. Method : The data were gathered from 487 nurses and 328 patients who were in eight general hospitals by using the self-report type of questionnaires. The period of data collection was from August 10, 2000 to September 10, 2000. For this research, the following tools were used; the tools for measuring the organizational characteristics, organizational culture, and job satisfaction, the tool for measuring organizational commitment, and the tool for measuring patients' satisfaction. For data analysis the SPSS Win 7.5 program was used. Result : 1) There was a significant difference in the organizational culture type according to the establishment type of hospital. 2) In the relationship between organization characteristics and organizational culture of a hospital were correlated with the type of each culture(p=0.00). 3) In the relation between the organizational culture type of hospital and its performance, there was a strong positive correlation between innovation-oriented culture and job satisfaction. And relation-oriented culture and task-oriented culture showed that they had a weak positive correlation with job satisfaction(p=0.00). There were a positive correlation between affective commitment and relation-oriented, innovation-oriented cultures(p=0.00), and there were no culture type significantly related to continuance commitment and there was a weak positive correlation among normative commitment and innovation-oriented culture, relation-oriented culture(p=0.00). 4) The types to have an influence upon nurses' job satisfaction were innovation-oriented culture and relation-oriented culture. These had 34.5% of influence with job satisfaction.. The type of organizational culture did not influence continuance commitment, but it had an influence on affective commitment and normative commitment. And relation-oriented culture and innovation-oriented culture had 21% of an influence with affective commitment, and they had 9.5% of an influence with normative commitment. Conclusion : As the above mentioned research results, the organizational culture type was found which had an influence upon nurses' job satisfaction and organizational commitment and patients' satisfaction in nursing service. These results are very significant in having showed the persons in charge of nursing administration a basic data for creation of an effective organizational culture.

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병원행정직의 직무만족도와 관련된 융복합적 요인 분석 (Analysis of Convergent Factors Related to Job Satisfaction among Hospital Administrative Staff)

  • 김승희;배상윤
    • 디지털융복합연구
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    • 제15권4호
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    • pp.365-375
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    • 2017
  • 본 연구는 병원행정직의 직무만족도와 관련된 융복합적 요인들을 조사하고자 수행되었다. 조사대상은 임의로 선정된 전라북도 지역 11개 종합병원의 재직자 221명으로 하였으며, 자료수집은 2016년 11월 1일부터 2017년 1월 31일까지 무기명 자기기입식 설문지를 통해 이루어졌다. 위계적 다중회귀분석 결과, 비교대근무 군이, 병원직원수가 많을수록, 자기효능감이 높을수록, 직무특성의 직무다양성이 높을수록, 직무스트레스의 관계갈등 및 보상부적절이 낮을수록, 직무만족도가 높았으며 이들의 설명력은 61.0%이었다. 이상의 연구결과를 볼 때, 병원행정직의 직무만족도를 높이기 위해서는 자기효능감을 높이고 직무특성 및 직무스트레스를 관리하는 노력이 필요하다. 이러한 결과는 병원행정직의 직무만족도를 높이는 프로그램 및 인적자원관리에 활용이 기대된다. 향후연구에서는 병원행정직의 직무만족도에 영향을 미치는 추가요인에 대한 구조방정식 모형의 분석이 필요하다.