• 한국경영과학회지
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• 제37권4호
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• pp.153-160
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• 2012

This study investigates how discrete choice analysis can be applied to health care operations. Discrete choice analysis helps to understand the complex decision-making process of purchasing expensive medical equipments by identifying relative weights that decision makers impose on each attribute through simple virtual choice experiments. We also verified the usefulness of applying discrete choice analysis to the purchase of medical equipments with empirical evidence.

• 대한지역사회영양학회지
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• 제13권2호
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• pp.244-252
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• 2008

The purpose of this study is to investigate the overall operations of National Hospital Food service after it was benefited by National Health Insurance (NHI). The survey was conducted between July and August, 2007. Among questionnaires mailed to 2,558 medical care institutions, 2,090 returned (81%) questionnaires were analyzed by descriptive statistics, $x^2$-test and ANOVA using the SPSS 13.0. The general foodservice characteristic of medical care institutions were as follows. The type of foodservice operations were 'self-operated' (86.9%), 'contracted' (10.5%) and 'Both' (2.6%). Only 6.4% of medical care institutions provided 'hospital food menu not benefited by NHI'. The number of dietitians and cook for medical care institutions were 1.1 and 1.0, respectively. The cost of a general diet meal was 4,205 won and therapeutic diet meal was 4,434 won. The overall operations of hospital foodservice were different depending on the types of medical care institution. After hospital foodservice was benefited by NHI, the overall quality of hospital foodservice including manpower, facilities, and environment was improved. The future direction of hospital foodservice should 1) differentiate the cost of hospital foodservice by the types of medical care institution, 2) increase in co-payment, and 3) provide same service with equal expenses in each party as medical aid or NHS beneficiary.

• 대한간호학회지
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• 제20권2호
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• 한국경영과학회지
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• 제10권1호
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• pp.54-64
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• 1985

This paper deals with analysis on complex and dynamic Primary Health Care (PHC) Systems in rural community to increase understanding of the nature of PHC feedback systems. Because Industrial Dynamics can be very useful for the analysis of such complex and dynamic systems. We used that as a basic tool of Modelling and simulation running. Even If PHC system-models require many assumptions, simulations based on these models can lead decision makers to a better way of problem solving.

• 대한영양사협회학술지
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• 제28권2호
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• pp.67-84
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• 2022

This study aimed to explore the status of food service outsourcing behavior of long-term care institutions (LTCIs) through a cross-sectional survey using a questionnaire administered between July 16th and August 7th, 2020. The survey respondents were either dietitians or facility managers, who worked at 731 nursing homes, 477 group homes, and 673 day-care centers. Approximately 25.9% of nursing homes, 11.7% of group homes, and 33.1% of day-care centers used a managed-services company to operate their food service units. The main reason for outsourcing food service by nursing homes was related to the staffing of dietitians and cooks, whereas group homes and day-care centers outsourced food services due to factors relating to meal costs and the cooking process. Almost all the LTCIs entered into private contracts for outsourced food services. Only a few food service contracts included the types of meals, nutrition standards such as protein and calories per meal, and the parameter or ratio of food cost. Of the respondents, 84.5% from nursing homes, 87.5% from group homes, and 87.1% from day-care centers agreed that the quality of outsourced food services of the LTCIs should be regulated. Meals are essential for maintaining the health and functional status of LTCI users. As more LTCIs outsource their food services, we suggest the following: (1) Increasing the minimum dietitian staffing standards for LTCIs as per the Welfare of Senior Citizens Act and requiring at least one dietitian for every nursing home, (2) Making it mandatory to use a standard food service contract template when drafting food service contract, and (3) Developing realistic standards for food service operations considering the size and operation type of the LTCIs.

• 한국지능정보시스템학회:학술대회논문집
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• 한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
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• pp.373-377
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• 2001

This study is to examine the factors that influence the performances of service quality in university hospitals by investigating systematically the condition of service quality. A synthesis of the health care quality is conducted to identify physical quality, operating process quality, and human resources quality that relate to both the overall satisfaction and intention of revisit. Based on the proposed hypotheses, the relationships between the service quality factors and performance are examined using data collected from 167 patients in three hospitals, Korea. Reliability and validity tests are performed for examining its relationship with service quality in health care systems. Total eight independent variables with respect to three service quality levels and two dependent variables for performance are identified for relationships between service quality and performance in health care systems. The results provide health care managers with a managerial insight to the planning function of performance with service quality in health care systems as well as other operations (business, government, or other service organizations) systems. Implication of the study for theory, future studies, and practices are discussed.

• 가정간호학회지
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• 제14권1호
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• pp.23-30
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• 2007

Purpose: The aim of this study was to establish basic data for developing education program of tailor made visiting home health care. Method: For this study, the subject was recruited in one directorial area among 14 nation-wide areas. The data collection was done using self-report questionnaire developed by Korea Health Industry Development Institute. Ninety one questionnaires were analyzed and response rare was 88.3%. Result: The major results were as follows. Aspect of education operations, the satisfaction of education space was revealed high. However, the satisfaction of education time, hour, and schedule were low. The overall satisfaction of education contents were revealed high. The most useful curriculums were found Chronic disease management, Infant & toddler health management, and Case management of tailor made visiting home health care. However the most unuseful curriculums were Nutritional management according to subject's health problem, Health promotion for poor family, and Understanding of visiting service in community health center. Conclusion: With these results, it was identified that the most needed contents of tailor made visiting home health care education program. So these results will be used to develop the more effective education program to activate tailor made visiting home health care service in community health center.

• 한국통신학회논문지
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• 제37권5C호
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• pp.410-419
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• 2012

본 논문에서는 병원 실내 위치기반 의료정보 푸쉬 서비스를 위한 안전하고 효율적인 익명 인증 스킴을 제안한다. 제안한 스킴은 다음과 같은 장점들을 가진다. (1)안전한 일방향 해쉬 함수(secure one-way hash function)를 사용하여 의료 서비스 사용자와 의료 관리센터 사이에 연산 복잡성을 최소화 하였다. (2)의료 관리센터 측에 삽입공격(insertion attacks) 및 훔친 검증자 공격(stolen-verifier attacks) 등 다양한 암호학적 공격들에 대한 대상이 될 수 있는 민감한 정보를 저장하는 검증 테이블(verification table)을 전혀 필요로 하지 않는다. (3)안전한 상호 인증과 키 설정(secure mutual authentication and key establishment), 기밀 통신(confidential communication), 사용자 프라이버시(user's privacy), 간단한 키 관리(simple key management), 세션 키 독립성 (session key independence)등을 보장하여 높은 보안 수준을 제공한다. 결론적으로 제안한 스킴은 병원 내 실내 위치기반 의료정보 푸쉬 서비스 환경에서 의료 서비스 사용자와 의료 관리센터 사이에서 아주 낮은 연산 오버헤드를 제공하기 때문에 스마트폰과 같은 경량 디바이스를 이용한 다양한 위치기반 의료정보 서비스 환경에 매우 실용적으로 활용될 수 있다.

• 가정간호학회지
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• 제5권
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• 한국농촌생활과학회지
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• 제10권1호
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• pp.21-32
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• 1999

To investigate the status of farmers health management for health promotion, and for checking the effect of village health care center during 1 year, 746 subjects were selected with cluster method in 8 provinces of Korea. The most frequent group was 40th of age (39%) : elementary school graduates (32%) The self-conscious of health status tested with CMI (Cornell Medical Index) questionnaire, the subjects in the village of health care center had lower health status than those of conventional village. The farmers living in the village with health care center had longer agricultural work (p＜0.05) and more frequency of spraying pesticides in the fields. The subjects of living the village of health care center were frequently exercise (34%) with health appliance use methods (30%), but the duration time of exercise was similar, Dietary habits and agricultural work condition were similar between two groups. For the fatigue recovery, steeping and bathing were most favorite methods, but exercise was lowest. It was significantly different between 2 groups the fatigue recovering methods, the subjects of village with health care center were more doing exercise (p＜0.01), less sleeping (p＜0.01) than those of conventional village. The working condition of self-estimated of farmers was not good, only 8.7% was thought pleasant condition. Of the various health factors, exercise, nutrition, and working situation would be more important. Considering on farmers exercise, it was very weak point for health management. The foundation and leading of the Farmers health care center was encouraged to farmers. For more effective operations, the experts education, easy and funny exercise program, and health promotion committee for administrators would be needed. The better systemic and continuous exercise programs should develop for associating livelihood. Funding for this project provided by the ministry of health and welfare of Korea.