• Journal of Information Science Theory and Practice
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• 제11권2호
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• pp.82-103
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• 2023

The Zimbabwean healthcare sector faces huge challenges due to increased demands for improved services for a growing number of patients with fewer resources. The use of information and communications technologies, prevalent in many industries, but lacking in Zimbabwean healthcare, could increase productivity and innovation. The adoption of health management information systems (HMISs) can lead to improved patient safety and high-level patient care. These technologies can change delivery methods to be more patient focused by utilising integrated models and allowing for a continuum of care across healthcare providers. However, implementation of these technologies in the health care sector remains low. The purpose of this study is to demonstrate the advantages to be attained by using HMISs in healthcare delivery and to ascertain the factors that influence the uptake of such systems in the public healthcare sector. A conceptual model, extending the technology, organization, and environment framework by means of other adoption models, underpins the study of adoption behavior. A mixed method methodology was used to conduct the study. For the quantitative approach, questionnaires were used to allow for regression analysis. For the qualitative approach, thematic analysis was used to analyse interview data. The results showed that the critical success factors (namely, relative advantage, availability, complexity, compatibility, trialability, observability, management support, information and communication technology expertise, communication processes, government regulation, infrastructure support, organizational readiness, industry and competitive support, external support, perceived ease of use, perceived usefulness, attitude, and intention to use) influenced adoption of HMISs in public hospitals in Zimbabwe.

• 보건행정학회지
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• 제23권4호
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• pp.326-342
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• 2013

Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

• 디지털융복합연구
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• 제14권12호
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• pp.283-292
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• 2016

본 연구는 당뇨병 환자를 대상으로 인슐린 치료에 대한 문화적 관점과 경험을 탐색하기 위해 19명의 제1형과 2형 당뇨병 환자를 대상으로 포커스 그룹 인터뷰를 실시하였다. 인터뷰 내용을 기록하고 녹취한 후 내용분석을 통해 당뇨병 환자들이 경험하는 인슐린 치료에 대한 사전인식요인과 장애요인 및 촉진요인을 목록화하였으며 이들 3가지 목록에 포함되는 주요어를 도출하였다. 그 결과 인슐린에 대한 막연한 두려움이 사전인식요인의 주요어로 확인되었고 장애요인으로는 인슐린과 관련된 걱정(통증, 낮은 지식과 문해력, 자가 주사에 대한 낮은 자신감, 경제적 부담, 저혈당에 대한 두려움)과 의료진에 대한 양가감정, 의지하게 된 삶, 친구, 친척과 가족에 대한 감정, 불편감, 과거에 대한 후회, 부끄러움이 주요어로 도출되었다. 촉진요인으로는 깨달음과 신체적 회복 및 혈당조절에 대한 자신감이 확인되었다. 본 연구결과를 토대로 국내 당뇨병 환자의 인슐린 치료에 대한 경험과 지각에 대한 의료인의 이해가 필요하며 당뇨병 환자의 이러한 경험은 존중되어야 할 것으로 사료된다.

• 대한한의학회지
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• 제43권1호
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• pp.73-86
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• 2022

Objectives: In the health care industry, the influence of online reviews is growing. As medical services are provided mainly by providers, those services have been managed by hospitals and clinics. However, direct promotions of medical services by providers are legally forbidden. Due to this reason, consumers, like patients and clients, search a lot of reviews on the Internet to get any information about hospitals, treatments, prices, etc. It can be determined that online reviews indicate the quality of hospitals, and that analysis should be done for sustainable hospital marketing. Method: Using a Python-based crawler, we collected reviews, written by real patients, who had experienced Korean medicine, about more than 14,000 reviews. To extract the most representative words, reviews were divided by positive and negative; after that reviews were pre-processed to get only nouns and adjectives to get TF(Term Frequency), DF(Document Frequency), and TF-IDF(Term Frequency - Inverse Document Frequency). Finally, to get some topics about reviews, aggregations of extracted words were analyzed by using LDA(Latent Dirichlet Allocation) methods. To avoid overlap, the number of topics is set by Davis visualization. Results and Conclusions: 6 and 3 topics extracted in each positive/negative review, analyzed by LDA Topic Model. The main factors, consisting of topics were 1) Response to patients and customers. 2) Customized treatment (consultation) and management. 3) Hospital/Clinic's environments.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권5호
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• pp.277-283
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• 2023

Purpose: Cow's milk protein allergy (CMPA) is a common condition in infants, but little is known about healthcare providers' clinical experience treating infants with CMPA. To address this gap, we analyzed prospectively collected data from healthcare providers (HCPs) who treated infants under six months old with suspected CMPA using hypoallergenic formulas. The study focused on a commercial extensively hydrolyzed formula containing Lactobacillus rhamnosus GG (ATCC53103) (eHF-LGG) or a commercial amino acid formula (AAF). Methods: In this secondary analysis of prospectively collected survey data, 52 HCPs treated 329 infants under six months old with suspected CMPA using hypoallergenic formulas. A series of two de-identified surveys per patient were collected by HCPs to assess short-term symptom relief in the patients and HCP's satisfaction with the management strategies. The initial survey was completed at the initiation of treatment of CMPA, and the second survey was completed at a follow-up visit. Results: The majority of HCPs (87%) in the study were general pediatricians, and most saw 2 to 10 CMPA patients weekly. Results showed that clinicians reported satisfaction with treatment in 95% of patients in the EHF cohort and 97% of patients in the AAF cohort and achieved expected clinical results in 93% and 97% of patients using eHF and AAF, respectively. Furthermore, few patients were switched from the hypoallergenic formula once initiated. Conclusion: The study provides new insights into HCP perspectives on treating infants with CMPA and supports using hypoallergenic formulas to manage this condition. However, additional prospective controlled studies are needed to confirm these initial findings.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.85-97
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• 2022

Purpose: This study aimed to describe nurses' perceived needs and barriers to pediatric palliative care (PPC). Methods: Mixed methods with an embedded design were applied. An online survey was conducted for nurses who participated in the End-of-Life Nursing Education Consortium- Pediatric Palliative Care (ELNEC-PPC) train-the-trainer program, of whom 63 responded. Quantitative data were collected with a survey questionnaire developed through the Delphi method. The 47 items for needs and 15 items for barriers to PPC were analyzed with descriptive statistics. Qualitative data were collected through open-ended questions and analyzed with topic modeling techniques. Results: The mean scores of most subdomains of the PPC needs were 3.5 or higher out of 4, and those of PPC barriers ranged from 3.22 to 3.56, indicating the items in the questionnaire developed in this study properly reflect each factor. The needs for PPC were divided into 4 categories: "children and adolescents," "families," "PPC management system," and "community-based PPC." Meanwhile, PPC barriers were divided into 3 categories: "healthcare delivery system," "healthcare provider," and "client." The keywords derived from the topic modeling were perception, palliative, children, and education for necessities and lack, perception, medical care, professional care providers, service, and system for barriers to PPC. Conclusion: In this study, by using mixed-methods, items of nurses' perceived needs and barriers to PPC were identified, categorized, and weighted, and their meanings were explored. For the stable establishment of PPC, the priority should be given to improving perceptions of PPC, establishing an appropriate system, and training professional care providers.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.27-37
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• 2021

Purpose: The purpose of this study is to compare the changes in hospital accreditation evaluations, the changes in hospital building design guidelines, and the development of design indicators for reducing medical accidents in the state-of-the-art healthcare providers. Methods: The changes and tools were carefully investigated and compared that had been taken place and used in the building certification standards, design guidelines, and patient safety design standards to reduce accidents in the United States and the United Kingdom. Results: First, medical accidents are recognized as multiple defense layers rather than personal ones, and a public reporting and learning system is created, reporting the accidents in question publicly and suggesting ways to improve them based on the data at a time. Second, for the accreditation institute that secures the service quality of medical institutions, detailed standards for patient safety are continuously updated with focus on clinical trials. The United States is in charge of the private sector, but on the other hand the United Kingdom is in charge of the public sector. Third, the design guidelines are provided as web-based tools that complement various guidelines for patient safety, and are improved and developed as well. Fourth, detailed approaches are continuously developed and provided to secure patient safety and reduce medical accidents through appropriate research, evidence-based design and strict evaluations. Implications: When medical institutions make efforts to strength patient safety methods through valid design standards, accidents are expected to decrease, whereby hospital finances are also to be improved. A higher level of medical quality service will sure be secured through comprehensive certification evaluation.

• 노인간호학회지
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• 제20권sup1호
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• pp.137-143
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• 2018

Purpose: The purpose of this study was to examine effectiveness and usefulness of Information Communication Technology (ICT) in communication between physician and visiting nurses who provide visiting nursing services under long-term care insurance. Methods: Structured questionnaires were used to measure usefulness and satisfaction of the system, both accessibility and convenience to visiting nurses (31 people) and users (182 people). Results: From the user perspective, accessibility and convenience in terms of service users were both satisfactory as shown by users' percentage. No statistically significant difference was found for satisfaction between before and after using the system. The usefulness of the system for visiting nurses was satisfactory for most the nurses. Also most nurses answered that the system is needed and is very useful. Most of the participants (both visiting nurse and service users) were satisfied with use of the ICT system. However, there was no statistically significant difference in satisfaction between the pre and post service because the service provision period was too short (three months). Conclusion: The consensus from both users and service providers is that an ICT based visiting nursing system needs to be introduced but a more user - friendly environment for system development will be needed.

• 한국임상약학회지
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• 제31권2호
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• pp.104-114
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• 2021

Objective: To explore the perception of drug utilization review (DUR) system and DUR modernization pilot project among healthcare professionals and patients. Methods: We conducted 8 times of focus group interviews (FGI) between August 1, 2019 to December 31, 2019. The healthcare professionals and patients who participated in the DUR modernization pilot project were included in the present study. Based on the type of project participation or medical institution, the participants were divided into the following four groups: group 1, hospital; group 2, clinic; group 3, pharmacy; and group 4, patient. Within each group, interviews were conducted under a pre-defined agenda to identify the implicit perceptions of the participants; the contents of the interviews were, then, categorized. Results: Healthcare professionals established a consensus on the positive aspects of the DUR system and DUR modernization pilot project. However, substantial concerns remain, such as additional workload associated with monitoring adverse events or acquiring consents from patients. Furthermore, a difference of opinion over the DUR convenience system was observed. Among 3 DUR convenience system, the personal medication history review service was highly utilized, but pop-up hold function and communication system was rarely used. Conclusion: We observed that systematic intervention using the DUR system is effective for both healthcare providers and consumers. Adverse events caused by inappropriate drug use can be prevented by continuous patient monitoring. Therefore, the role of DUR system needs to be expanded to establish a safe drug management system.

• Journal of Hospice and Palliative Care
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• 제27권1호
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• pp.1-10
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• 2024

This article underscores the importance of integrating comprehensive palliative care for noncancer patients who are undergoing hemodialysis, with an emphasis on the aging populations in Asian nations such as Taiwan, Japan, the Republic of Korea, and China. As the global demographic landscape shifts towards an aging society and healthcare continues to advance, a marked increase has been observed in patients undergoing hemodialysis who require palliative care. This necessitates an immediate paradigm shift to incorporate this care, addressing the intricate physical, psychosocial, and spiritual challenges faced by these individuals and their families. Numerous challenges impede the provision of effective palliative care, including difficulties in prognosis, delayed referrals, cultural misconceptions, lack of clinician confidence, and insufficient collaboration among healthcare professionals. The article proposes potential solutions, such as targeted training for clinicians, the use of telemedicine to facilitate shared decision-making, and the introduction of time-limited trials for dialysis to overcome these obstacles. The integration of palliative care into routine renal treatment and the promotion of transparent communication among healthcare professionals represent key strategies to enhance the quality of life and end-of-life care for people on hemodialysis. By embracing innovative strategies and fostering collaboration, healthcare providers can deliver more patient-centered, holistic care that meets the complex needs of seriously ill patients within an aging population undergoing hemodialysis.