• 보건교육건강증진학회지
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• 제22권1호
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• pp.147-160
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• 2005

The purpose of this study is to identify the nature of the patient service quality of health center, and based on that, to examine the relationship of health center visitor's perceived quality and overall satisfaction. Data were collected on the basis of 'the 3rd Regional Health Care Planning' operated by Rural Health Care Service Technology Aid Task-force Team(RHCSTAT), Ministry of Health and Welfare. Basically, the Manual of 3rd Regional Health Care Planning is composed of structure, process, and outcome measurement indicators. Of these indicators, 21 patient satisfaction questions as outcome indicators are used in this study. The samples are 3,530 patients who visited 80 health centers all of the nation. First, the reliability and validity of patient service quality items was evaluated. Second, the descriptive statistics of health service quality are calculated. Third, through the T-test and ANOVA, the differences of patient satisfaction by responder's general characteristics are compared. In final, to explore the relationship of service quality and overall satisfaction, multiple regression analysis was used. This study shows firstly, the dimension of patient service quality was categorized into 3 dimensions, that is, facilities and environment, staff kindness, and access convenience. Secondly, the reliability and validity of patient service quality items was satisfied. Thirdly, the mean score of staff kindness factors are high in contrast to the facilities and environment. And in regard to the overall satisfaction, the mean score is more higher in Daegu region, County type health center, male group, and upper 65 age group than comparison groups. Lastly, as a result of multiple regression analysis, the effect of patient's perceived service quality, especially, appropriateness of billing time(Beta=0.190) and of reservation time(Beta=0.132) are statistically significant(P<0.01). In conclusion, to satisfy the health need of community people and improve the service quality of the health center, the efforts for the access convenience might be needed. Additionally, the enlargement on health center space and supply of new medical equipment is urgent for the patient satisfaction.

• 보건행정학회지
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• 제3권1호
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• pp.25-52
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• 1993

Variation in the utilization of medical services is a very important issue in cost containment and quality assurance of health care. Practice variation directly affects health care expenditure especially in fee-for-service system, which is the payment system of health insurance in Korea. In addition to cost issue it is generally accepted that variations in medical practice and the cost of inpatient care suggest the possibility of inappropriate quality of care. This study is to closely examine the patterne and degrees of variation in cost structure of inpatient care among types of hospital and individual hospitals in some tracer diseases, and also to inquire into the service items which contribute much to the variation of total medical care cost. Foru common diseases, i.e. Cesarean Section, appendectomy, cataract extraction and pediatric pneumonia, were selected as tracer diseases. In most tracer diseases there were statistically significant differences in total medical care cost among hospitals in same type of hospital as well as among types of hospital(p<0.01). When total medical care cost were subdivided into the types of service, cost of medication and diagnostic examination varied the most prominenly. When the cost of medication were subdivided again, cost of parenteral antibiotics showed the most prominent variation. Of total medical care cost, medication was most contributory to the variation of total medical care cost(58.1~82.3%), and cost of antibiotics was most contributory to the variation of medication cost(63.9~92.2%). The results of study implicated that reducing the variation of medication may plays a significant role in containing the cost of inpatient care. In order to sort out the factors affecting practice variations including drug prescription pattes further researches are required.

• 보건의료산업학회지
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• 제7권4호
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• pp.191-204
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• 2013

This study is intended to identify relationship between stress, self-esteem and mental health in nursing students. The data were collected from 448 nursing students using self-report questionnaire. The data were analyzed by frequencies, t-test, ANOVA, Pearson's correlation coefficients and Stepwise multiple regression using the SPSS 19.0 program. The result are as followed; First, the average of stress, self-esteem, and mental health was $1.25{\pm}0.55$, $3.33{\pm}0.42$, and $2.79{\pm}1.20$ point. Second, mental health was correlated with stress positively and self-esteem negatively. Third, the influencing factor in mental health of the participant were interpersonal relationship and clinical based stress, $R^2=.561$. Thus, development of guidance program to improve mental health of nursing students is recommended.

• 보건의료산업학회지
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• 제6권4호
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• pp.83-98
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• 2012

The objective of this study is to analyze the utilization patterns of national health insurance and medical aid inpatients in tertiary hospitals. For the analysis, the study utilize the nationwide data on '2010 Survey of Patients' of Ministry of Health & Welfare. The statistical methodology used in the study is the logistic regression model. This study has three major findings. First, utilization rate of national health insurance inpatients was higher than medical aid inpatients in tertiary hospitals. Second, the significant affecting demographic factors in utilizing tertiary hospitals were sex, age, surgery case, treatment result, inpatients residence region and short length of stay. Third, compared to other disease groups, the inpatients on 'congenital malformation, deformity and chromosomal abnormalities', 'factors influencing health status and contact with health services' and 'neoplasm' groups are more likely to utilize tertiary hospitals. Finally, according to residence region, Seoul residence inpatients in both of national health insurance and medical aid more likely to utilize tertiary hospitals than other region inpatients.

• 보건의료산업학회지
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• 제11권3호
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• pp.65-78
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• 2017

Objectives : Obesity is a worldwide health concern due to an increasing obese population. This study proposed to analyze the differences in medical costs and care utilization between obese and normal group using propensity score matching. Methods : Data were collected from the sample cohort database by the Korea National Health Insurance Corporation. Propensity score matching(PSM) was applied to control selection bias, and factors affecting obesity were used as covariates in PSM. Results : The results showed higher medical costs and care utilization in the obese group than the normal group. According to gender and medical type, there were differences in the relationships between obesity and medical charges and utilization. In particular, the differences in the female population were larger in both outpatients and inpatients than the male population. Conclusions : It is important to manage obesity, because obesity has a negative effect on national health insurance costs. These findings suggest directions for future research.

• 보건행정학회지
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• 제21권4호
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• pp.599-616
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• 2011

This research was performed to investigate the determination factors of medical service to cover the fee for selecting a doctor which is one of the most important causes of debilitating national health insurance in Korea. Data was from Korea Health Panel and analyzed by Dutton(1986)'s medical service model which was an extended Anderson Model and was widely used in the researches on determination factors of medical service. The results were as follows; In the determinants of selecting a doctor in specialized medical institutions and general hospitals, patients with serious diseases selected doctors more often than other patients. By industrial accident compensation insurance law and enforcement ordinances, insurance covers the fee of selecting a doctor in the hospitals appointed by Labor Welfare Corporation for the patients in critical conditions under industrial accident compensation insurance, while health insurance patients pay the fee themselves for selecting a doctor in all cases. It is suggested that patients with serious diseases proved by medical opinion be provided with health care insurance in selecting a doctor and that the health insurance benefit coverage be enhanced by staged lowering of patient's cost-sharing.

• 보건의료산업학회지
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• 제6권4호
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• pp.255-265
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• 2012

The purpose of this study was to analyze the service needs and role awareness of military hospital coordinator to provide basic data for establishing the role of military hospital coordinator and facilitating efficient, systematic work performance. Questionnaires were used to survey military hospital out patients for 25 days from July 13 to August 11. 2011. The subjects were 616 outpatients. Research results, the recognition of higher awareness of the military hospital coordinator to perform the work to know if the work performed was low awareness of the present in the generally. High service needs was generally presented among outpatients that perceived the work performed by the military hospital coordinator, and most of the work preformed in the service needs was higher, showed a high needs. The results of this study showed that military hospital outpatients presented low role awareness but high level of service needs for military hospital coordinator. Establish roles of military hospital coordinator and provide for systematic performance if so can military hospital will contribute to improving service satisfaction.

• 한국학교ㆍ지역보건교육학회지
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• 제1권1호
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• pp.61-82
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• 2000

The purpose of this study was to find out the general problems of school food service and to explore a way to improve it, by examining elementary school teacher's consciousness and attitude toward it that gave a big impact on children's development of food habit. For attaining the purpose, the following research questions were posed : 1) What's elementary school teacher attitude toward school food service management? 2) What's elementary school teacher attitude toward school food service effect on children? 3) What's elementary school teacher opinion about how to develop school food service? The subjects of study were 328 male or female teachers who served at elementary school in urban and rural area, including eup, myon, or farming and fishing villages, Kyonggi province. A questionnaire survey was conducted over them. The conclusions were as follows: 1) Teacher Attitude Toward School Food Service Management Concerning food service place, the subjects were more satisfied at food service room(73.3%) than at classroom(23.0%). They responded that food service room was more effective, than classroom, for food transportation, distribution and post-arrangement. Their satisfaction at food service place was significantly different. The older teachers considered personnel management and cooking room's sanitary management to be more efficient, and their age made a significant difference to their consciousness of these things. Many teachers(63.1%) thought the measures to prevent and manage group food poisoning were relatively efficient. The male teachers expressed more affirmative view on the efficiency of school food expense management and menu preparation than female teachers, and there was a significant disparity between male and female teachers. 2) Elementary School Food Service Effect School food service was thought to be very effective for physical growth(74.1%) and physical strength improvement(70.1%). Teachers at smaller school revealed more affirmative response toward school food service effect on correcting an unbalanced diet, and older teachers considered its effect on nutrition knowledge acquisition and learning outcome to be more great. Teachers at larger school put less value on its effect on table manners, and school size produced a significant difference. The number of teachers who thought school food service generally raised parent concern and support for school(36.6%) was a little more than that of teachers who didn't think so(15.2%). And the number of teachers who didn't consider its effect on improving parent food life to be good(29.3%) was slightly more than that of teachers who did. 3) School Food Service Reform Measure What's most urgently needed for better school food service management appeared to be an expansion of facilities concerned, followed by more effective food distribution and transport, cooking room's better sanitary management, more successful food poisoning prevention and management, more effective food expense management, and an increase of food service personnel in the order named. The most effective means of school food service education was found to be a creation of link system to family, followed by a development of school food service education program, a development of teaching materials, an insertion of school food service in curriculum, and teacher education in the order named.

• 한국병원경영학회지
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• 제17권3호
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• pp.37-56
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• 2012

The purpose of this study is to analyze effects of medical service quality on the customer satisfaction and intention of revisit in long-term care hospitals. To achieve purpose of the research, the data was collected from 321 patients in 8 long-term care hospitals using a standardized questionnaires. Using the structural equation modeling(SEM), this study examines the relationship among medical service quality, customer satisfaction and intention of revisit. The results show that the medical service quality factors such as convenience and accessibility have positive effects on the customer satisfaction which positively relates to intention of revisit. Medical expertise of the service quality factors has positive influence upon intention of revisit in long-term care hospitals. Therefore, the results of this study show that the medical service quality factors which are convenience and accessibility leading to customer satisfaction are important factors to select long-term care hospitals.

• 보건행정학회지
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• 제19권3호
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• pp.109-124
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• 2009

Background: This study aimed to examine whether cases of punishing false claimants threat general physicians to check their medical cost claims with care to avoid being suspected, and identify empirically general deterrence effects of the on-site investigation system in the Korean National Health Insurance. Methods: 800 clinics were selected among a total of 15,443 clinics that had no experience of on-site investigation until June 2007 using a stratified proportional systematic sampling method. We conducted logistic multiple regression to examine the association between factors related to provider's perception of on-site investigation and high level of perceived deterrence referring to fear of punishment after adjusting provider's service experiences and general characteristics. Results: The probability of high perceived deterrence was higher 1.7 times (CI: 1.13-2.56), 2.73 times (CI: 1.68-4.45) each among clinics exchanging the information once or more per year or once or more for 2-3 months than among clinics no exchanging the information about on-site investigation. Also, the probability of high perceived deterrence was higher 2.27 times (CI: 1.28-4.45) among clinics that knows more than 3 health care institutions having experienced an on-site investigation than among clinics knowing no case. Conclusion: A clinic knowing more punishment cases by onsite investigation and exchanging more frequently information about on-site investigation is likely to present high perceived deterrence. This result will provide important information to enlarge preventive effects of on-site investigation on fraud and abuse claims.