• Journal of Korean Society for Quality Management
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• v.46 no.4
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• pp.1029-1042
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• 2018

Purpose: The purpose of this study is to explore the health care decision making of Ethiopian women at household level. Moreover it is to understand the factors that influence to potential customers in healthcare industry from the social quality level perspective. Methods: We used Ethiopia Demographic Health Survey (EDHS) 2005 & 2016, which provided data about currently married women aged 15-49 years (N=2003, N=2017, respectively). We performed a chi-square test, and a Pearson correlation and a logistic regression. Andersen model is considered as well. Results: This study revealed that the mobility decision making has an association with health care decision making of women. Furthermore, there is a moderate effect of an economic decision making of women. Lastly, the women's decision making empowerment level increase year by year. Conclusion: Health care industry has to consider potential costumers among women like in Ethiopia, whose decision making empowerment will enhance on their own healthcare in future. It is very important to figure out factors from the social quality management domain. It helps finding a new market from downstream approach. From this point, the impact of decision making of women empowerment has a significant implication from the holistic perspective.

• Journal of muscle and joint health
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• v.20 no.3
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• pp.197-206
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• 2013

Purpose: The purpose of this study was to investigate end-of-life care preferences of employees working in a university hospital. Methods: Of 650 eligible employees that were approached, 607 employees (386 nurses, 93 physicians, and 128 general staff) completed the Korean version of Preferences for Care Near the End of Life (PCEOL-K). Results: Among 5 dimensions of the PECOL-K, "Pain" was the most preferred care dimension and "Decision making by health care professional" was the least preferred care dimension. The item that received the highest mean score was "I want to let nature guide my dying and I do not want my life to be artificially prolonged in any way", and the lowest item was "I want health care providers to make all decisions about my care". As preferred care near the end of life, nurses gave lower scores to the life sustaining treatment and decision making by health care profession than physicians and general staff. Compared to physicians and nurses, general staff preferred the decision making by health care professional and by family. Conclusion: The results show that adequate pain relief is the most preferred care at the end of life among hospital employees and non-medical personnel preferred decision making by others.

• Quality Improvement in Health Care
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• v.24 no.1
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• pp.40-52
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• 2018

Purpose: This study aimed to identify the factors influencing on patients' participation in their treatment decision making, and influences of patients' experience on their health status. Methods: Data from the 2015 Korea National Health and Nutrition Examination Survey were used for the analysis. Multivariate logistic regression analysis was conducted to identify the factors influencing on patients' participation in their treatment decision making. The influences of patients' experience on their health status were analyzed using multiple linear regression analysis. Results: Of the 4,497 respondents, 3,698 (82.2%) respondents mostly participated in their treatment decision making. Those who experienced enough visit duration, physicians' explanation easy enough to understand, or more opportunities to ask were more likely to participate in their treatment decision making. After controlling for their sociodemographic factors and health status, those who had better experience during the outpatient visits were more likely to have better self-rated health or quality of life. Conclusion: To improve patients' health outcomes and satisfaction of health care uses, it is necessary to provide better experiences and expand the opportunities for participation in treatment decision making during their hospital visits.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.21 no.2
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• pp.147-155
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• 2014

Purpose: Clinical decision-making carried out by nurses is a complex process that influences the quality of care provided and various patient outcomes. This study examined the relationship between critical thinking disposition and clinical decision-making abilities in home health advanced practice nurses. Method: The study had a non-experimental correlational design. Data were collected from 100 home health advanced practice nurses in 20 hospitals. Results: The mean critical thinking disposition score was $3.69{\pm}.39$ out of 5 and the mean score for clinical decision-making abilities was $3.48{\pm}.22$ out of 5. In this correlation analysis, a significant positive correlation (r=.58, p<.001) was found between critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses. Conclusion: In order to improve the clinical decision-making ability of home health advanced practice nurses, we need to improve their critical thinking disposition. In order to make this change, appropriate training program are needed to increase the critical thinking disposition and clinical decision-making abilities of home health advanced practice nurses.

• The Korean Journal of Applied Statistics
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• v.27 no.5
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• pp.667-679
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• 2014

National Health Insurance Service(NHIS) provide care-plans for beneficiaries in the long-term care insurance(LTCI) systems that help them use LTC services appropriately. The care-plan includes recommendations for the most adequate type of care (gold standard) for beneficiaries. This study develops a decision-support system to determine the appropriate type of care plan. To develop a model, we used a data set that well-trained assessors in the NHIS investigated as a gold standard for beneficiaries: nursing home care, home-visit care, home-visit bathing, home-visit nursing, or day and night care. The decision-support system was established through a decision-tree model, because it may be easy to explain the algorithm of a decision-support system to working groups and policy makers. Our results might be useful in evidence-based care planning in an LTCI system and contribute to the efficient use of LTC services.

• The Korean Society of Law and Medicine
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• v.14 no.1
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• pp.355-401
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• 2013

The first legislation for terminal health-care decision was California's Natural Death Act (NDA) of 1976 that permitted any adult person to execute a directive directing the withholding or withdrawal of life-sustaining procedures. Advance directive legislation has subsequently progressed on a state-by-state basis. By 1992, all 50 states, as well as the District of Columbia, had passed legislation to legalize some form of advance directive. This state legislation, however, has resulted in an often fragmented, incomplete, and sometimes inconsistent set of rules. Statutes enacted within a state often conflict and conflicts between statutes of different states are common. In an increasingly mobile society where an advance health-care directive given in one state must frequently be implemented in another, there is a need for greater uniformity. In 1993, the Uniform Law Commissioners approved the Uniform Health-Care Decisions Act (UHCDA) in order to bring order to the existing chaos. Unfortunately, the Commissioners waited too long to act. By the time the UHCDA was approved, nearly all states had passed legislation governing advance directives. Consequently, the UHCDA has achieved only a limited success, picking up but one or two enactments a year. The UHCDA is currently in effect in around 10 states: Alabama, Alaska, California, Delaware, Hawaii, Kansas, Maine, Mississippi, New Mexico, Tennessee, Wyoming. In these states the previous laws related to the subjects have been all repealed. The overall objective of the UHCDA is to encourage the making and enforcement of advance health care directives including living will or individual instruction, power of health-care attorney and to provide a means for making health care decisions for those who have failed to plan. The U. S. House of Representatives in 1991 enacted the Patient Self-Determination Act (PSDA). The Act stipulates that all hospitals receiving Medicaid or Medicare reimbursement must ascertain whether patients have or wish to have advance directives. The Patient Self- Determination Act does not create or legalize advance directives; rather it validates their existence in each of the states. Now in America, terminal health-care decision or advance directive for health care is common and universal system. The problem, however, is how to let more people use these good tools to make their lives more beautiful and honorable.

• Journal of Korean Public Health Nursing
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• v.24 no.2
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• pp.237-248
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• 2010

Purpose: The study assessed the effects of a 12-session empowering program to promote health quality of life, decision making self-efficacy, self-care competency, and reasonable medical care utilization among low income women households in one rural area. Methods: A quasi-experimental, one-group pre-posttest design was employed. A total of 28 women enrolled as medicaid recipients in the Public Health Center of W city agreed to participate. The empowering program consisted of 12 sessions addressing health education for self-care of disease, medication management, and counseling for psycho-social support. The intervention was delivered by five nurses and one social worker. Women completed a structured questionnaire measuring the study variables with demographic characteristic before and after the intervention. Data were analyzed by PAWS Statistics 17 utilizing descriptive statistics and paired t-test. Results: After the intervention, significant increases were evident in participant health quality of life (t=-5.83, p<.001), decision making self-efficacy (t=-4.86, p<.001), self-care competency (t=-8.16, p<.001), and reasonable medical care utilization (t=-3.97, p<.001). Conclusion: The 12-session empowering program on health quality of life as well as self-care competency was effective when delivered to low income women households. Further studies with larger numbers of participants and a control group are necessary to validate the results.

• The Korean Society of Law and Medicine
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• v.14 no.1
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• pp.275-302
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• 2013

The Unites States has been plagued with soaring health care costs and an alarmingly large number of uninsured population. The Patient Protection and Affordable Care Act of 2010 ushered in the most sweeping health care reform in the United States since the introduction of Medicare and Medicaid in 1965 to address these issues. The law's requirement for individuals to purchase health insurance (the so-called "individual mandate"), however, not only caused a political stir but also prompted constitutional challenges. Some questioned whether the federal government, lacking general police power, could require its citizens to buy unwanted insurance based on its enumerated powers under the U.S. Constitution. This paper summarizes the decision of the U.S. Supreme Court on the constitutionality of individual mandate, and explores how the decision relates to Korea's own universal health care.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.18 no.2
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• pp.284-310
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• 2024

Identifying clinical pathways for disease diagnosis and treatment process recommendations are seriously decision-intensive tasks for health care practitioners. It requires them to rely on their expertise and experience to analyze various categories of health parameters from a health record to arrive at a decision in order to provide an accurate diagnosis and treatment recommendations to the end user (patient). Technological adaptation in the area of medical diagnosis using AI is dispensable; using expert systems to assist health care practitioners in decision-making is becoming increasingly popular. Our work architects a novel knowledge-based recommender system model, an expert system that can bring adaptability and transparency in usage, provide in-depth analysis of a patient's medical record, and prescribe diagnostic results and treatment process recommendations to them. The proposed system uses a set of parallel discrete fuzzy rule-based classifier systems, with each of them providing recommended sub-outcomes of discrete medical conditions. A novel knowledge-based combiner unit extracts significant relationships between the sub-outcomes of discrete fuzzy rule-based classifier systems to provide holistic outcomes and solutions for clinical decision support. The work establishes a model to address disease diagnosis and treatment recommendations for primary lung disease issues. In this paper, we provide some samples to demonstrate the usage of the system, and the results from the system show excellent correlation with expert assessments.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.26-34
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• 2010

Objectives: The purpose of this research is to analyze the impact of shared-decision making on patient satisfaction. The study is significant since it focuses on developing appropriate methodologies and analyzing data to identify patient preferences, with the goals of optimizing treatment selection, and substantiating the relationship between such preferences and their impact on outcomes. Methods: A thorough literature review that developed the framework illustrating key dimensions of shared decision making was followed by a quantitative assessment and regression analysis of patient-perceived satisfaction, and the degree of shared-decision making. Results: A positive association was evident between shared-decision making and patient satisfaction. The impact of shared decision making on patient satisfaction was greater than other variable including gender, education, and number of visits. Conclusions: Patients who participate in care-related decisions and who are given an explanation of their health problems are more likely to be satisfied with their care. It would benefit health care organizations to train their medical professionals in this communication method, and to include it in their practice guidelines.