• Quality Improvement in Health Care
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• v.1 no.1
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• pp.96-108
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• 1994

Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

• The Journal of the Korea Contents Association
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• v.18 no.1
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• pp.268-276
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• 2018

This study examined the effects of indemnity private health insurance on the medical utilization among the Korean adults. The used data were the 2014 survey data of Korea Health Panel, and the number of subjects was 11,436. Authors employed instrumental variable regression model where the instrument variables for controlling for endogeneity of indemnity were the purchasing of private pension and number of family members. The results showed that the number of outpatient visits and the number of hospitalizations for indemnity private health insurance subscribers were higher than non-subscribers. The number of household members and the private pension variables were proved to be appropriate as instrumental variables. This paper recommends the Korean government to monitor and evaluate the effects of indemnity private health insurance on the medical utilization in order to improve the efficiency of health care finance.

• Journal of Advanced Navigation Technology
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• v.13 no.2
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• pp.224-230
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• 2009

In the latest date, medical body area networks (MBANs) are emerging as a new technology for diagnosis the human body. MBANs in the health care fields are based on short-range and low-power (e.g. ubiquitous computing) among small-sized devices, and have been used by means of medical services. In this paper, we proposed an emergency message transmission protocol using carrier sense multiple access/time division multiple access in MBANs. This scheme focuses on dependability and power-efficiency. In order to increase the reliability of the transmission, this scheme modified a MCTA slot of IEEE 802.15.3 standard to a SR-MCTA slot. SR-MCTA slot is assigned by MBAN coordinator according to requesting terminal nodes. The method, having the priority of transmission, occurs a collision packet randomly. Results from this proposed solution revel that reservation-based TDMA medical body area network(MBAN) protocol for transmitting emergency message was improved in terms of transmission delay.

• Journal of Pharmaceutical Investigation
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• v.13 no.1
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• pp.23-35
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• 1983

Since the national health insurance was introduced in 1978, the increased utilization of hospitals and the growing importance of pharmaceutical services to hospital patients have made the administration of these services a very complex and specialized responsibility. The pharmaceutical services has always been an essential component of comtemporary hospital care. In the hospital, the pharmaceutical services is the professional department which concerns itself with the evaluation, selection, control and utilization of drugs. The director of this service must be a versatile professional person who can work effectively in a heterogenous society of educated persons. However, graduate education in hospital pharmacy has not been introduced yet in Korea. The necessity of graduate education hospital pharmacy has been discussed in this research. Graduate education in hospital pharmacy emphasizes preparation for assumption of responsibility as the senior hospital pharmacist or the director of pharmaceutical services. Graduates should also be prepared as administrators of a department that must operate with great efficiency. They should be prepared serve as a consultant on drugs for the medical and allied health professional staff, organizing and disseminating a large and dynamic body of information in their interest and to establish professional roles that emphasize procurement, storage, manufacturing, packaging, distribution, control and evaluation of drugs. Senior hospital pharmacist is a teacher charged with responsibility fer formal and informal instruction of other hospital personnel in pharmaceutical sciences. In addition, the graduates have the opportunity to be a researcher dealing with aspect of hospital care and are intensively educated in the professional aspects of hospital pharmacy practices. The curriculum of graduate education in hospital pharmacy should be established detailly and carefully to fit the educational objective.

• The Journal of the Korea Contents Association
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• v.11 no.3
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• pp.389-402
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• 2011

Previous research on the management of health care organization has heavily focused on health care quality and operational efficiency, whereas this research deals with flexibility, an important strategic priority in the field of operations management. Particularly, this research analyzes the effects that internal and external resources of volume and product flexibilities have on the organization's financial performance. Survey data from various types of sampled domestic hospitals have been collected using the developed questionnaire and analyzed with a regression model. The results show that volume flexibility based on internal resources has not only main effects but also interaction effects with internal and external resources of product flexibility. However, volume flexibility based on external resources is not shown to have any effect on performance. The explanation and managerial implications from the results are discussed.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.52-61
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• 2015

Objectives: Because recently hospital had to faced with financial hardship, we have to have more effective hospital management. The purpose of this study was to reduce loss costs of the hospital through the systematic management of medical supplies and increase operational efficiency. Methods: The team was composed of outpatient nursing staff, medical record administrator, nurses in medical insurance, medical computer center, dermatologists for this study. We surveyed for 114 people including outpatient nursing staff, nurse aids, medical assistant, physician assistant. Pre-survey period was 2013.03.11 ~ 03.30(2 weeks), and post-survey period was 2013.09.03 ~ 09.17(2 weeks). Result: We improved this way through the computational improvement, conservation campaigns, inventory management, staff training, replaced by low-cost medical supplies. The finding of this study were as follows: Comparing before and after the activity of outpatient nursing staff's degree of knowledge, performance, economic consciousness, the degree of knowledge, performance was increased, but there was no significant change in economic consciousness. Performance of Married person is higher than the unmarried, In addition, the high-position people were more the degree of knowleage, economic consciousness. After activity, correlation of goods and treatment, examinations is increasing, but statistically there was no mean. Conclusion: This study revealed that knowledge in a short period of activity, but also can improve, perform the same change in behavior is not easy. This one shows the intensive training required to sustained and systematic behavioral changes, such as changes in behavior, perform rituals to help the economy. Expensive medical supplies to replace a similar effect as the cost of materials just to have a lot of cost savings. Therefore, more medical supplies change is necessary to develop alternative treatment and cost cutting.

• Korean Journal of Community Nutrition
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• v.8 no.5
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• pp.744-754
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• 2003

At present, health care industries throughout the world are struggling with the challenges to set up financial structures as cost-effective ways and means of satisfying customer needs for health care services. Many hospitals consign foodservice management to foodservice companies for the purpose of efficiency. The companies taking charge of hospital foodservice are also striving to gain an advantage over keen competitions. This study applied Quality Function Deployment(QFD) to one hospital (which will be shown as $\ulcorner$A hospital$\lrcorner$ below) managed by a contract foodservice company for the purpose of strategy planning to provide sustainable competitive advantage. First of all, this study scanned internal and external environment of $\ulcorner$A hospital$\lrcorner$ by means of a Quality Measurement Tool and a fieldwork study. With the result of environment scanning, this study elicited 20 strategies through SWOT analysis, which were categorized by 4 perspectives such as financial, customer, internal process, learning and growth perspectives. Finally, the priorities of 20 strategies were extracted from QFD methodology. According to the results obtained by applying QFD to $\ulcorner$A hospital$\lrcorner$'s foodservice, the strategies which $\ulcorner$A hospital$\lrcorner$ foodservice was obliged to introduce and implement were : the specialization of Children's hospital foodservice, scientific foodservice management through the standardization of foodservice operations, the maintenance of sanitary quality through sanitary system, the remodeling of facilities, the introduction of new equipment, the prompt and accurate response to customer needs, the development of appropriate patient menus, the provision of competitively priced meals for patient selection, the development of a demand forecast model by considering the characteristics of a children's hospital, improvement of productivity and the reduction of labor costs through the employment of experienced employees based on their seniority.

• Quality Improvement in Health Care
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• v.14 no.2
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• pp.125-132
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• 2008

Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

• Journal of Korean society of Dental Hygiene
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• v.19 no.4
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• pp.479-492
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• 2019

Objectives: This study aimed to develop the CAMBRA-kids application for the systematic management of dental caries among preschoolers, activate the dental caries management system, and contribute to the dental caries management of preschoolers. Methods: The collected data were analyzed using R studio 1.2.1335 for Windows (RStudio Inc., Boston, MA, USA, 2018). Algorithm evaluation, heuristic evaluation and usability evaluation were analyzed using descriptive statistics. Results: Both expert evaluations of the application's algorithms were calculated as 100%, for proficiency and efficiency. The application worked well with the designed algorithms, the risk group level of participants was categorized appropriately, and the risk management method was guided properly according to the risk group level. Of the five problems presented in the heuristic evaluation, 'the lack of security' and 'the lack of information on oral health care' received 'high severity' scores. The usability evaluation of the application produces an overall score of 3.27. In the subscales (participation, functionality, aesthetics, and information) of the Mobile App Rating Scale (MARS), the 'participation' domain received the lowest score of 2.56 and the 'functional' domain received the highest score of 3.70. Conclusions: The CAMBRA-kids application is expected to be applied and used in the field of preschoolers' oral health care management, and to contribute to the prevention of dental caries of preschoolers by activating the dental caries management system using the application.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.26 no.9
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• pp.1392-1398
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• 2022

This study was conducted for effective CPR by comparing the quality of chest compressions when using a new chest compression method during pediatric CPR. As an experimental study by Randomized Crossover Design, the depth, speed, compression-to-relaxation ratio, ease, and stability were measured when performing chest compressions for 28 Emergency Medical Technicians who completed the BLS Health Care-Provider qualification. The collected data were analyzed by using the SPSS Ver. 23.0 for Win statistical program. To summarize the results of this study, if the new chest compression method was used for chest compression in pediatric CPR, the qualitative indicators of chest compressions were improved. It is good to stick to the existing method, but through the new chest compression method, it will be necessary to confirm the possibility of clinical use based on additional research on various age groups and environmental factors.