• Genomics & Informatics
• /
• 제9권2호
• /
• pp.52-58
• /
• 2011

Osteoporotic fracture (OF), along with bone mineral density (BMD), is an important diagnostic parameter and a clinical predictive risk factor in the assessment of osteoporosis in the elderly population. However, a genome-wide association study (GWAS) on OF has not yet been clarified sufficiently. To identify OF-associated genetic variants and candidate genes, we conducted a GWAS in a population-based cohort (Korean Association Resource [KARE], n=1,427 [case: 288 and control: 1139]) and performed a de novo replication study in hospital-based individuals (Asan and Catholic Medical Center [ACMC], n=1,082 [case: 272 and control: 810]). In a combined meta-analysis, a newly identified genetic locus in an intergenic region at 10p11.2 (near genes FZD8 and ANKRD30A ) showed the most significant association (odd ratio [OR] = 2.00, 95% confidence interval [CI] = 1.47~2.74, p=$1.27{\times}10^{-6}$) in the same direction. We provide the first evidence for a common genetic variant influencing OF and genetic information for further investigation in bone metabolism.

• 한국산학기술학회논문지
• /
• 제18권6호
• /
• pp.290-301
• /
• 2017

본 연구는 리더십유형과 조직몰입 및 직무성과의 인과관계를 연구하여 병원조직의 조직성과 향상 및 효과적인 인적자원관리 방법을 제시하는데 그 목적이 있다. 조사기간은 2016년 10월 6일부터 10월 20까지 이며, 병원에 근무하고 있는 직원 375명을 최종 조사대상으로 선정하였다. 분석방법은 측정변수의 타당도를 분석하고자 신뢰도 및 확인적 요인분석을 실시하였으며, 리더십과 조직몰입 및 직무성과의 인과관계를 파악하고자 공분산 구조방정식 분석을 실시하여 결론을 도출하였다. 결과를 보면 리더십, 조직몰입 및 직무성과는 직종(p<0.05), 연령(p<0.05), 근무기간(p<0.05)별로 유의한 차이가 나타났으며, 개별적 배려(p<0.001), 조건적 보상(p<0.001)이 조직몰입과 직무성과에 높은 인과관계를 나타냈다. 앞으로 조직 구성원의 개별적인 특성을 고려한 배려와 능력을 발휘할 수 있는 리더십과 업무달성도를 측정한 후 합리적인 보상체계의 구축이 필요하다. 또한 직종별 뿐만 아니라 성별, 연령, 근무기간 등을 감안하여 조직의 성과를 촉진시킬 수 있는 상황에 맞는 리더십이 필요하다. 그리고 관리자는 구성원들이 조직에 대한 충성심과 애착을 가질 수 있도록 조직문화 형성과 관련교육프로그램 제공 등의 노력이 요구된다.

• 한국의료질향상학회지
• /
• 제7권1호
• /
• pp.118-131
• /
• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

• 한국병원경영학회지
• /
• 제8권4호
• /
• pp.59-75
• /
• 2003

This study was conducted to investigate the degree of utilization of outsourcing in large hospitals in Korea. We also investigated the outcome and the level of satisfaction for adopting outsourcing in these hospitals. Types of work areas that were currently operated by outsourcing and were planned to adopt outsourcing in the future were identified. A total of 83 hospitals were eligible for this study, which had more than 500 beds, and were identified from the 2003 National Hospital List published by the Korean Hospital Association. A self-administered Questionnaire survey was conducted between April 25th and May 20th in 2003 with a personnel being charged of arrangement of outsourcing in each hospital. Among the 58 hospitals responding the survey(response rate=69.9%), 49 hospitals(84.5%) utilized outsourcing in at least one work field in their organizations. The largest proportion of the hospitals(85.7%) using outsourcing responded that the biggest outcome after introducing outsourcing were cost reduction(49.0%), followed by improved efficiency in operating the organization or human resources(34.7%) and the improved quality of the work(6.1%). The degree of satisfaction for outsourcing among the hospital managers(3.43) was significantly higher than that among the employees(3.l4) on a S-point Likert-type scale(p<0.05). Among the 7 work areas, the hospitals used outsourcing most frequently in facility management(housekeeping, building maintenance, hospital security and parking management), followed by non-medical profit business(funeral, convenient store, and cafeteria), logistics(provision of patient meal, in-house delivery, and purchasing), and information and computing system(hospital information system, maintenance of personal computers and printers). The work areas that the hospitals planned to adopt or expand the outsourcing in the future most frequently were facility management, non-medical profit business, logistics, and information and computing systems. In conclusion, outsourcing was highly diffused in large Korean hospitals, particularly in the work field of facility management and non-medical profit business. The satisfaction for outsourcing was not high yet in Korean hospitals.

• 한국임상보건과학회지
• /
• 제2권1호
• /
• pp.1-16
• /
• 2014

Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

• 한국산학기술학회논문지
• /
• 제17권1호
• /
• pp.622-628
• /
• 2016

본 연구의 목적은 의료기관 행정직 종사자의 역할 스트레스가 소진과 직무만족, 조직몰입에 미치는 영향을 실증적으로 규명하고자 실시되었다. 본 연구는 200병상 이상의 종합병원 중 10곳의 행정직원을 대상으로 2015년 7월 13일부터 8월 14일 까지 한 달 동안 설문조사를 실시하였다. 조사된 설문은 AMOS 18.0을 이용하여 확인적 요인분석, 평균분산추출, 연구모형의 적합도 지수, 연구모형의 경로계수 추정치 분석 등을 실시하였다. 본 연구의 주요결과로는 의료기관 행정직 종사자의 역할갈등과 역할과다는 소진에 정(+)적인 영향을, 소진은 직무만족에 부(-)적인 영향을 미치는 것으로 나타났고, 조직몰입과의 관계는 유의하지 않은 것으로 나타났다. 본 연구결과는 부서간의 연계 업무 등에 있어 역할갈등을 줄이기 위해서는 업무에 대한 명확한 지침과 업무지시의 통일성 등이 필요하고, 정확한 업무 측정과 계량으로 구성원의 역할을 적정화할 때 조직에 대한 애착과 헌신도도 높아지고 궁극적으로 개인의 직무성과도 향상될 수 있음을 시사하고 있다.

• 한국산학기술학회논문지
• /
• 제19권2호
• /
• pp.405-412
• /
• 2018

예산은 조직성과의 체계적 관리와 조직상황을 진단하는데 중요한 관리도구이다. 병원은 비영리 조직으로서, 효율적인 예산집행이 중요하지만 현재 국내에는 병원의 예산슬랙에 관한 연구가 부족한 실정이다. 이에 본 연구가 수행되었다. 본 연구의 목적은 병원 예산시스템의 특성이 예산슬랙에 미치는 영향을 규명하는 것이다. 본 연구의 자료는 서울 소재 일개 대학병원의 예산 담당자 118명을 대상으로 자기기입식 설문조사를 시행하였다. 본 자료수집 기간은 2015년 7월 14일부터 7월 22일까지이다. 설문에 응답한 데이터는 STATA 14.0을 이용하여 빈도분석, 상관분석 및 회귀분석을 시행하였다. 연구결과 예산시스템의 특성 중 정보비대칭은 예산슬랙을 유의하게 증가시켰다. 반면에 예산 피드백과 예산 동기부여는 예산슬랙을 유의하게 감소시키는 것으로 나타났다. 본 연구결과 병원 직원 간 예산관련 정보의 원활한 공유가 효율적인 병원경영을 위해 중요하며, 예산슬랙을 체계적으로 관리하기 위해 예산행위에 있어서 예산피드백과 동기부여를 강화하는 것이 필요한 것으로 나타났다. 본 연구는 병원 예산슬랙 영향요인에 관한 연구가 부족한 상황에서, 예산슬랙 연구에 대한 관심을 환기시키고 국내 의료기관들의 경영 효율성을 향상시키는데 실증적인 기초자료를 제공해 줄 수 있을 것으로 사료된다.

• 간호행정학회지
• /
• 제1권2호
• /
• pp.372-387
• /
• 1995

One-hundred eighty four medical doctors and 349 nurses out of 6 university hospitals and 1 general hospital were surveyed from Mar. 3, to Mar. 31, 1995, in order to appreciate the extent of their understandings on the clinical nurse specialist system. The difference was analyzed by the subjects' age, their position and department, the expected benefits of the system. the assigned department, the position and qualification, the required special educational organization and program, and the extent of autonomy of the function of clinical nurse specialists and the special nursing field. The results were as follows ; 1. The perception about the expected benefits of the introduction of clinical nurse specialist system was significantly different among the age groups of medical doctors, and the age group of 40s among them showed the most positive perception. 2. The extent of acquaintance with clinical nurse specialist was the higher in the older age groups of respondent nurses. Meanwhile, the experience of participation with clinical nurse specialists was the more in the older age group of medical doctors. 3. The opinion about the required position of clinical nurse specialists was significantly different by the age and position of the respondent nurses. The rank of head nurse was suggested by the respondent nurses of older age and higher positon, while the level of in-charge nurse was suggested by the staff nurses. Also, the duration of clinical experience required of clinical nurse specialists was the most frequently responded as 6 to 10 years by nurses, as 2 to 5 years by medical doctors. 4. The degree of educational background required of clinical nurse specialists was differently responded by the various position of medical doctors and nurses. Of the medical doctors, professors frequently responded bachelor degree and medical residents frequently responded master degree as the required educational background. Of the nurses, nursing administrators more frequently responded that master degree was required of clinical nurse specialists than staff nurses and clinical nurse specialists did. 5. The extent of acquaintance with clinical nurse specialist system was different among the various department of medical doctors, which was the highest in the doctors of psychiatry, internal medicine and pediatrics, respectively. The doctors of surgery were the least acquainted of clinical nurse specialist. 6. The nurses of special parts, of surgery and of obstetrics & pediatrics responded more frequently that clinical nurse specialists should belong to the nursing department than the nurses of internal medicine and of others did. 7. The Special parts that necessitate clinical nurse specialists were responded to be the more important by nurses than by medical doctors. Clinical nurse specialists were responded to be the more necessary in the parts of diabetics, oncology, pyschiatry, dialysis, organ transplantation, intensive care, and in cardiovascular part. They were responded to be the less important in the parts of intravenous therapy, computer informatics, nursing administration, the improvement of nursing quality.

• 성인간호학회지
• /
• 제28권4호
• /
• pp.399-414
• /
• 2016

Purpose: The purpose of this study was to review and identify factors relevant to workplace bullying in nursing. Methods: Twenty-three studies that met the criteria were selected from a sample of twenty-six studies. These articles were retrieved from a central literature databases (N=13,241). The total correlational effect size (ESr) for each related factor was calculated from Fisher's Zr. A funnel plot inspection (similar to scatter plot) with a trim-and-fill method was used to assess the publication bias of the meta-analyzed studies. Results: From the systematic review, fifty-one factors were identified as having an influencing effect. Fourteen factors (five individual and nine organizational factors) were eligible for meta-analysis. The individual factors included, self-esteem (ESr=-.31), psychological capital (ESr=-.26), and marital status (ESr=-.06) which were significantly correlated with workplace bullying. Organizational factors included, organizational tolerance (ESr=.48), supervisor incivility (ESr=.47), job stress (ESr=.46), group morale (ESr=-.36), group support (ESr=-.35), supervisor leadership (ESr=-.35), group identity (ESr=-.33), and structural empowerment (ESr=-.27). These factors were significantly correlated with workplace bullying. There were no publication biases except for both individual and organizational factors. Conclusion: Organizational factors have more of an greater impact than individual factors on workplace bullying. The results of this study support the need for intervention at the organizational level.

• 한국직업건강간호학회지
• /
• 제25권3호
• /
• pp.177-187
• /
• 2016

Purpose: This cross-sectional descriptive study was to explore the relationship among practice environment, organizational justice, and job satisfaction of male nurses. Methods: Subjects were 115 male nurses who were the member of the Korean man nurses association, and they were asked to complete self-administration questionnaires via internet site for this survey which included nurse's practice environment, organizational justice, and job satisfaction. Collected data were analyzed using SPSS/WIN version 21.0 software. Results: The mean scores of the nurse's practice environment, organizational justice, and job satisfaction were 2.9, 3.0, 3.1 out of 5 Likert scale respectively. The job satisfaction was positively correlated with the nurse's practice environment (r=.70, p<.001) and organizational justice (r=.78, p<.001). The job satisfaction was affected by procedure-related justice, interpersonal justice, adequacy of staffing and resources in nursing work environment, compensation justice, and good healthy status. These variables explained 68.6% of male nurse's job satisfaction. Conclusion: This finding suggest that suitable organization management for male nurses are necessary through improvement of practice environment and organizational justice in hospital.