• Journal of Society of Preventive Korean Medicine
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• v.17 no.3
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• pp.1-18
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• 2013

Objectives: Korea has a dual medical system where traditional Korean Medicine (KM) and Western Medicine (WM) exist au equal terms with exclusive practice boundaries. The aim of this study was to identify complementary and substitute relationships between KM and WM in Korea. Methods: The data of 19,413 respondents were collected from the 2009 Korea Health Panel dataset. General characteristics and the medical utilization of respondents were analyzed descriptively. the Univariable Analysis was used to compare the factors that affected KM and WM utilization, and the Multivariable Analysis was applied to identify complementary or substitute relationships between the respondents' choices for KM and WM. The data were analyzed by the seven disease groups; diseases of nervous system, circulatory system, respiratory system, digestive system, skin and subcutaneous tissue, musculoskeletal system, and connective tissue, injury, poisoning and others. Results: 13.6% and 76.9% of respondents used KM and WM respectively last 12 mouths. 12.7% used both, and 0.9% used KM only. In overall, respondents who visited KM institutions used also WM. However, according to the analysis of choices of medical institutions, non-pharmacological KM treatment and WM has been used as a substitute for another in the diseases of the skin and subcutaneous tissue, diseases of the musculoskeletal system, and connective tissue, injury, poisoning and others. Conclusions: Despite some exceptional disease areas, Korean people use KM complementarily to WM, and this result can rationalize the recent Korean government policies encouraging the cooperation of KM and WM. This study can he used for the future policies development for KM service delivery.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.92-106
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• 1999

Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.12
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• pp.167-175
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• 2019

Recently, health examination centers have been changing from auxiliary medical facilities to key and independent medical facilities. However, it is not easy to improve medical facilities, including health examination centers, due to the variable characteristics of the relationship between humans and space. Therefore, this study was done to develop a pedestrian-based discrete event simulation analysis program to examine the problems and develop methods for improvement. The program was developed to analyze five evaluation indices and the density of examinees. The problems were derived by analyzing the required time, capacity, and queue size for each examination through simulations. We reduced the examination time and moving distance, increased the capacity, and distributed the queues by adjusting the medical services and relocating the examination rooms. The results were then quantitatively verified by simulations.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of agricultural medicine and community health
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• v.45 no.4
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• pp.208-220
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• 2020

Objectives: The purpose of this study was to identify factors influencing the posttraumatic growth of maritime police officers. Methods: The subjects include 293 maritime police officers that received basic and professional education at the Korea Coast Guard Academy on June 17~July 31, 2019. Data was analyzed in frequency, percentage, mean, standard deviation, t-test, variance analysis, Pearson's correlation analysis, and multiple regression analysis with the SPSS Version 21.0 program. Results: The findings show that the maritime police officers scored mean 39.72±16.56 points in posttraumatic growth. marital status(β=.194, p=.002), smoking(β=.152, p=.010), regular exercise(β=-.185, p<.001), total duration of service(β=-.154, p=.033), resilience(β=.310, p<.001), social support (β=.250, p<.001), and collective culture(β=.158, p=.004) had impacts on their posttraumatic growth. Conclusion: The findings of the study demonstrate that the posttraumatic growth of maritime police officers was under the influence of supports from families and peers, working environment, and culture as well as their individual characteristics.

• Journal of Korean Public Health Nursing
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• v.1 no.1
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• pp.32-44
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• 1987

The purpose of this survey was to find out the knowledge and the disease management of the Tuberculosis patients by themselves among the first grade middle and high school students in Seoul city during the period of June 15-July 19, 1986. Questionaires were used to collect the data and were analysed from answers of 188 students at the 113 schools. The results were as follows: 1. The ages of the students were distributed as follows: in middle school, 13 years old was $70.0\%$. 14 years old, $20.0\%$, and 15 years old, $6.7\%$. In high school, 16 years old was $66.5\%$, 17 years old, $18.4\%$, and 15 years old, $10.1\%$. 2. In X-ray mass examination by school, the rate of execution was $50.4\%$ in middle school and $96.7\%$ in high school, and in X-ray mass examination by student, it was $50.1\%$ in middle school and $97.3\%$ in high school. 3. The prevalence of Tuberculosis among the middle school students was $00.3\%$and high school students, $0.15\%$. 4. Of the total, $77.1\%$ of the respondents did not realized Tuberculosis bdore X-ray mass examination 5. The perfect cure rate of the respondents was $52.7\%$. 6. General characteristics of the respondents: a. The educational background was varied as follows: of the total $47.9\%$ of the fathers had the level of high school education and $37.2\%$ of the mothers had the level of middle school education. The educational background of the parents had no statistical significant to the medical cure rate of Tuberculosis. (P>0.05). b. The average monthly income of the family was as follows : above five hundred thousand won was $21.8\%$, three or four hundred thousand won was $22.9\%$, and below two hundred thousand won was $10.6\%$. The most frequent family size was 5-6 persons. $(59.6)\%$. 7. The actual situation of Tuberculosis control and the variables related to the treatment: a. $69.1\%$ of the respondents wanted mental support from their surroundings. $48.7\%$ of the respondents answered that their parents or the other family helped treatment as mental supporter, b. As a medical service, $53.2\%$ of the respondents were treated at Health Center, $38.8\%$ were treated at a hospital. A medical service was statistically significant to the medical cure (P<0.01). c. Family members of $61.7\%$ of the respondents had checked chest X-ray. A X-ray examination of family was statistically significant to the medical cure (P<0.005). d. $73.9\%$ of the respondents had taken the Anti-Tuberculosis-drugs regularly. Regular taking of Anti-Tuberculosis drugs was statistically significant to the medical cure (P<0.005). e. $89.4\%$ of the respondents had received a regular examination during the treatment. A regular examination was statistically significant to the medical cure (P<0.05). f. The period of perfect cure was that $50.0\%$ of the respondents took from half a year to one year, $25.2\%$ took below half a year and $16.2\%$ took from one year to one year and a half. g. The rate of the respondents who abhored to let anyone know their disease was $93.1\%$. 8. Knowledge related with Tuberculosis: a .$63.3\%$ of the respondents answered that Tuberculosis is a communiable disease. b. $89.9\%$ of the respondents answered that there is a preventive method of Tuberculosis. Among them, $28.4\%$ answered that it is B.C.G. vacination. c. $96.8\%$ of the respondents belived they can be cured perfectly. d. $42.4\%$ of the perfect curer answered that they had have permanent immunity of Tuberculosis. According to the results of above study, it is desired to be practiced X-ray mass examination to the total middle school students. Nurse teachers and the responsible persons who participated to the helping of disease management to the Tuberculosis patients must make an offer knowledge of Tuberculosis to the Tuberculosis patients. And also, it will be very helpful to the cure of Tuberculosis patients if they do their best and to have a mental supporter.

• Journal of Digital Policy
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• v.1 no.2
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• pp.71-77
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• 2022

The purpose of this study is to analyze the job satisfaction of hospital workers according to the type of hospital and to provide basic data for successful hospital management. For data analysis, frequency analysis and chi-square analysis are performed for general characteristics, and Kendall's tau correlation analysis is performed to see the correlation between statistically significant factors among job environment, value realization, organizational characteristics, and individual ability factors. did A total of 241 people working at primary, secondary, and tertiary medical institutions were surveyed. Among the value realization factors in the research results, self-esteem and rewarding (p<0.05), autonomy and creativity (p<0.05), and among personal competencies factors, workload (p<0.05) were statistically A significant difference was seen. Value realization and personal competence factors were found to influence job satisfaction (p<0.001). In conclusion, the most basic for the qualitative and quantitative growth of the hospital should be the job satisfaction of the internal members, on the basis of which positive medical services should be provided to the patients.

• The Korean Journal of Health Service Management
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• v.8 no.3
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• pp.27-38
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• 2014

The purpose of this study is proving the effects of the internal customer satisfaction management on worker's job satisfaction at general hospital. In the relationship between the management and the satisfaction, the study also finds the moderating effect of the organizational support awareness and the organizational justice. For this study, it was surveyed targeting 270 employees who work in seven general hospitals in Busan. As the result, 246 questionnaires returned. All of these questionnaires were used in the final analysis. The method of analysis is descriptive statistics using SPSS VER. 18.0, correlation analysis, regression analysis, factor analysis and reliability analysis. The main results of empirical analysis were as follows: First, in the effect of the internal customer satisfaction management to worker's job satisfaction, it has positive effect to internal communication and the commission of authority and it has positive effect to worker's job satisfaction. Second, the organizational support awareness & the organizational justice have moderating effect on the relationship between the internal customer satisfaction management and worker's job satisfaction. Third, the study proves that supporting management hierarchy shows positive effects for all socio-demographic characteristics in the organizational support awareness and the organizational justice.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.2
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• pp.211-225
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• 2000

With the drastically changing healthcare market, the adoption of DRG system and the use of Critical Pathway will be increased gradually in order to care hospitalized patients qualitatively and manage cost-effectively in Korea. The purpose of this quasi-experimental research is to apply and analyze the developed critical pathway to the patients with Cesarean section. 35 eligible subjects for the control group were chosen from postpartum patients who has delivered at H-hospital in Kwang-ju, and were questioned after appling previous care plan from May to December, 1998. For the experimental group, 37 subjects were chosen and questioned after applying Critical Pathway service from January to June, 1999. The instruments are a critical pathway for the patients with Cesarean section developed by chung(1998) and a questionnaire that evaluate patients and family members' satisfaction level. Also, educational materials were used to inform them in the process of Critical Pathway application. As a result of chi-square test on general characteristics, there is significant difference between control group and experimental group only in terms of room size(p= .010). There are no significant differences in the average length of stay in the hospital between control group and experimental group(t=.078). Also, the average medical consult fee has no difference significantly between two groups(t= .105). The findings showed that the experimental group with critical pathway service scored significantly higher than control group on the satisfaction level toward care services(p=.000). The items are post-operative care, postpartum exercise technique, breast feeding and breast manage through educational materials. In conclusion, the research indicates that the application of planned Critical Pathway can have a positive impact on satisfaction level of inpatients with Cesarian section.

• Quality Improvement in Health Care
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• v.12 no.2
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• pp.75-83
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• 2006

Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.