• Quality Improvement in Health Care
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• v.21 no.1
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• pp.12-31
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• 2015

Objectives : The purpose of this study was to develop the qualification system for training of Quality improvement professionals who work for improving patients' safety and healthcare quality. Methods : Based on the various laws and regulations, and the operational status of other professionals' qualification systems, a basic plan of professional qualification system of QI was drawn. And through meetings with QI experts, the final scheme of the concrete qualification system was developed. Results : For management of professionals's certification or qualification, fairness and reliability are important. To do this, setting the official standard, providing a standardized training program and having appropriate qualification test are required. In order to operate the qualification system strategically, 1) the introduction step, 2) dissemination and expansion step, and 3) fusing step should be considered. As a governing body for QI specialists' qualification, 'QI professionals' qualification Center (tentative)' must have the committee to assure fairness, professionalism, and reliability. In addition, 'QI Experts Certification Department (tentative)" to develop standards for the qualification tests and conduct the tests program,' QI experts Education Department (tentative name)" must be able to operate and maintain the QI training for professional qualifications. QI professional qualification exam must be taken by everyone regardless of age, gender, race, occupation, education, and work experience. The examination should include management, leadership, strategic planning and design, quality management, health care information, patient safety culture. Practical training courses can have three step programs; beginning, intermediate and special level. Conclusion : The QI qualification system need strategic approaches for the experts working for healthcare quality improvement and patient safety. It should include the program of standardized contents and test, and operating protocol of the qualificaton system.

• Health Policy and Management
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• v.30 no.1
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Quality Improvement in Health Care
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• v.22 no.1
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• pp.11-26
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• 2016

The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.

• Journal of The Korea Institute of Healthcare Architecture
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• v.13 no.2
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• pp.27-36
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• 2007

Recently, hospital patients experience anxiety, confusion, and stress about wayfinding as the spacial layout and treatment circulatory system of hospitals have become complicated due to their oversized and complex structure. As part of finding a solution to the problem, this study seeks to examine what are the essential elements of the wayfinding planning of O.P.D. in general hospitals, to develop the model of wayfinding, and to suggest the methods of improving the wayfinding system. The research methods of this study adopted were literature review in wayfinding cognition, plan analysis of ten general hospitals, space analysis of these hospitals through space syntax, analysis of the system of visual-perceptual information through a field study, and analysis of surveys and follow-up surveys conducted to support the results. Based on these results, the proposals for finding decision points, providing the information, and developing a model planning are listed as follows. 1) The comprehensive understanding of O.P.D. spacial layout and the visual-perceptual information system is necessary to find the essential elements of wayfinding. 2) The decision points are found through the full understanding of spacial functions, circulation systems, and facility configuration, considering the spacial layout, the bound of the visual-perceptual information system, and the circulatory system. Furthermore, the information decision points could be confined by space syntax. 3) The checklist and color compound & color codes, developed through the planning of signage system and color system could be applied to the methods of providing the information. 4) The planning of wayfinding system according to the whole process of practices for outpatients was mentioned above. The system of visual-perceptual information developed through the process of this study should be integrated in the spacial layout of the whole O.P.D.

• Journal of Convergence for Information Technology
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• v.7 no.4
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• pp.27-38
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• 2017

The purpose of this study was to ascertain new policies fo the development of the Korean Hospital Accreditation Program (HAP) by comparing and reviewing the domestic HAP of Korea, the U. S. and Australia as well as the International Accreditation Program of the International Society for Health Care Quality. The results of this study are as follows. First, it is necessary to improve the standards of the HAP such as 'patient and community centered standards' and 'staffing related standards'. Second, it is necessary to strengthen patient safety through the HAP. Third, the linkage among the HAP, clinical indicators and patient experience evaluation should be strengthened. Fourth, the competencies of surveyors should be improved. Fifth, the HAP of small and medium hospitals also needs to be vitalized. Sixth, it is necessary to improve the disclosure of the healthcare quality evaluation results. The findings of this study can be used as a basis to improve the Korean HAP.

• Journal of Society of Preventive Korean Medicine
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• v.6 no.2
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• pp.36-47
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• 2002

Over thousands of years oriental traditional medicine has developed a theoretical and practical approach to treat and prevent diseases and to promote people's health in China and Korea. In China, the integration of traditional Chinese medicine into the national healthcare system began in the late 1950s. This was in response to national planning needs to provide comprehensive healthcare services. On contrary to China, South Korea established the parallel operation of two independent medical systems in 1952. Hence there has been a political conflict between oriental and modern medicine over issues of fee, the ability to sell and prescribe herbal medicines, and the licensing of practitioners in traditional medicines. Given this background. This study is to compare peoples' attitudes and opinions for oriental traditional medicine by ethnicity (Chinese, Korean-Chinese and Korean). Chinese and Korean-Chinese were more used and satisfied with traditional medicine treatment and traditional practitioners compared with Koreans. The proportion of Koreans who reported the cost of traditional treatments was expensive was higher than those of Chinese and Korean Chinese. Most of Chinese, Korean-Chinese, and Koreans reported that they would use traditional medicine: 1) when they would have some disease to be treated best through traditional medicine; and 2) when traditional practitioner had a reputation and lots of experiences for those diseases. Most Korean people reported that oriental and western practitioners should cooperate each other to improve the quality of care. Therefore, policy framework including integration of traditional and western medicine, regulation, etc. is needed. In addition, research is needed to determine which diseases is treated best through traditional medicine.

• Journal of Information Technology Services
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• v.20 no.5
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• pp.119-136
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• 2021

Since the global spread of COVID-19, social distancing and untact service implementation have spread rapidly. With the transition to a non-face-to-face environment such as telework and remote classes, cyber security threats have increased, and a lot of cyber compromises have also occurred. In this study, cyber-attacks and response cases related to COVID-19 are summarized in four aspects: cyber fraud, cyber-attacks on companies related to COVID-19 and healthcare sector, cyber-attacks on untact services such as telework, and preparation of untact services security for post-covid 19. After the outbreak of the COVID-19 pandemic, related events such as vaccination information and payment of national disaster aid continued to be used as bait for smishing and phishing. In the aspect of cyber-attacks on companies related to COVID-19 and healthcare sector, we can see that the damage was rapidly increasing as state-supported hackers attack those companies to obtain research results related to the COVID-19, and hackers chose medical institutions as targets with an efficient ransomware attack approach by changing 'spray and pray' strategy to 'big-game hunting'. Companies using untact services such as telework are experiencing cyber breaches due to insufficient security settings, non-installation of security patches, and vulnerabilities in systems constituting untact services such as VPN. In response to these cyber incidents, as a case of cyber fraud countermeasures, security notices to preventing cyber fraud damage to the public was announced, and security guidelines and ransomware countermeasures were provided to organizations related to COVID-19 and medical institutions. In addition, for companies that use and provide untact services, security vulnerability finding and system development environment security inspection service were provided by Government funding programs. We also looked at the differences in the role of the government and the target of security notices between domestic and overseas response cases. Lastly, considering the development of untact services by industry in preparation for post-COVID-19, supply chain security, cloud security, development security, and IoT security were suggested as common security reinforcement measures.

• Korean Journal of Clinical Pharmacy
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• v.28 no.4
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• pp.308-319
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• 2018

Background: Some mental illnesses such as depression are known to be one of the risk factors of suicide and proper antidepressant therapy can reduce suicidal behavior. Objectives: This study aimed to analyze regional variations in antidepressant consumption and adherence, suicide rate, prevalence of suicide related mental disorders, and access to relevant healthcare services. Methods: Cross-sectional analyses were conducted using National Patients Sample data compiled by the Health Insurance Review and Assessment Service between 2014 and 2016. We included patients who had a diagnosis record of suicide related mental disorders during the study period. Cause of death statistics and National health and medical statistics were used to identify suicide rate and distribution of healthcare service. We conducted visual analyses, chi-squared tests, independent t-tests and correlation analyses to demonstrate regional variations. Results: Between 2014 and 2016, the average prevalence of suicide related mental disorders was 5.4 per cent. Suicide rate and prevalence of suicide related mental disorders were higher in Gangwon, Chungcheong, and Jeolla (p < 0.001), and lower in Seoul (p < 0.001) than the national average. Unexpectedly, regional variations in antidepressant consumption were seen in the limited area including Daejeon, Chungnam and Gyeongnam (p < 0.05). The number of mild patient-centered clinics was associated positively with antidepressant consumption (p < 0.01) and associated negatively with suicide rate (p < 0.01). Conclusion: There were some regional variations in prevalence of suicide related mental disorders, antidepressant adherence and suicide rate. The higher level of antidepressant therapy and the lower level of suicide rates were seen in regions with easy access to mild patient-centered clinics.

• Quality Improvement in Health Care
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• v.26 no.2
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• pp.104-112
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• 2020

This study was done to investigate the independent organizations established for patient safety, related policies, and the duties of experts in other countries. Australia established an organization called the Commission in 2006, the United Kingdom established the National Patients Safety Agency in 2001, and the United States assigned its work to the Agency for Healthcare Research and Quality in 2005. This was done by law in all three countries. The experts for patient safety were mainly called the "patent safety and quality coordinator", and although there was no qualification system for carrying out patient safety work, all three countries had licenses in the health care field or required more than 4-5 years of practical experience. The main duties were planning on patient safety and quality of healthcare service, data collection and analysis, and education, etc. and for this, competencies such as communication, leadership, and teamwork were required.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.2
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.