• Title/Summary/Keyword: Out-of-hospital

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Architectural Planning of Out-Patient Clinic Department in Armed Forces Hospital (국군병원 외래진료부의 건축계획)

  • Kim, Jung-Nam;Ham, Wook;Park, Chang-Geun;Lee, Nak-Woon
    • Journal of Industrial Technology
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    • v.24 no.B
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    • pp.47-57
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    • 2004
  • This study is aiming to obtain the pabulum of architectural planning about out-patient clinic department in armed force hospital with search. The discussion was about characteristic problems and differentiated planning characteristics of common general hospital, So the conclusion of research is as follows. In army medical facilities, Because of architectural standard of out-patient clinic department about scale of facilities and characteristic in each examination-part is unprepared, it may have to be readied. Out-patient clinic department was become plan to scale about whole 7~8% in hospital to SB hospital in 95 but was planed about 5% of whole scale from PS hospital in 97. When plan hospital, increase of equipment and increase of module size about bed for the convenience of patient or employees are judged for cause in hospital since 97 years than previous hospital in 95.

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Factors Affecting Patient Moving for Medical Service Using Multi-level Analysis (환자이동에 영향을 미치는 개인 및 병원요인 분석)

  • Kim, Sun Hee;Lee, Hae Jong;Lee, Kwang Soo;Shin, Hyun Woung
    • Korea Journal of Hospital Management
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    • v.19 no.4
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    • pp.9-20
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    • 2014
  • The purpose of this study is to find out factors affecting patient moving to receive medical service. This study is analyzed by multi-level model with patient and hospital level by using SAS 9.3. Total number of patients is 600,000 persons for inpatients and 550,000 patients for outpatients. The degree of the factors, which is combined with personnel factor and hospital factor, can be analyzed by Intra-Class Correlation (ICC). The percentage of group(hospital) level variance of the total variance for out-bound moving case are 30.6% at inpatients, and 28.3% at outpatients. And the percentage of hospital level variance of the total variance for moving distance, are 26.7%, 32,5% respectively. Conclusionally, although the main factor of moving is patient level, hospital is also very important factor to make decision to go out-bound. It contributed to about 1/3 for hospital choice. And, when the one make decision, he will consider the hospital type, number of bed, and training institute in hospital level. Through this study to find out hospital factors affecting patient moving for medical service, it must be continued to find out which factors have more influence to choice the hospital among disease type after this.

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A Study of Resuscitation in Victims in Out-of-hospital Cardiac Arrests (병원전 심정지환자의 심폐소생술 성적)

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.8 no.1
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    • pp.149-160
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    • 2004
  • Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.

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Determinants utilization Behavior and Sttisfaction of oriental and Westerm medical Hospitals in Korea (우리 나라 일부 한.양방병원 이용행태와 민족도에 관한 요인분석)

  • 박상태;이규식;이해종;김춘배;조경숙
    • Health Policy and Management
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    • v.10 no.2
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    • pp.22-40
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    • 2000
  • The purpose of the study was to discuss amrketing strategy for oriental hospital, by making a comparative analysis of how hospital user satifaction was affected by hospi시 choice motivation between oriental hospital users and western hospital. The data usel in this study was the Korea Isititute of oriental medicine(1999)'s study on utilization of oriental medical care. And and interview was hold with outpatients who visited around march to April, 1999, at each an oriental hospital and a westen hospital in Seoul and in Wonju city, Kongwon province. The collected data were analyzed by SPSS program. The factor analysis of hospital choice motivation was made by figuring out facor's mean value, and T-test and ANOVA were employed to find out what difference was made by sociodmographic charcteristics to the factors. Also, the multiple regression analysis was carried out to examine what gave an impact on hospital user satisfaction. The findings of this study were as follows; First as a result of making a factor analysis against hospital choice motivation to find out what kind of differenc there was between oriental hospital user motivation and western hospital and person factors. Among them, the hospital charcteristics, preception, personal and person factors. Among them, the hospital charcteristics appered to have the biggest effect of hospital choice motivation. Second, as a result of making comparison between oriental oriental hospital user satisfaction and werterm hospital user satisfaction, there was a singificant between their satisfaction at treatment time, kindness and relative kiness aginst the pther hospital. The oriental level combining 6 items. The geneal satisfaction level combining 6itmes tured out to have reliability of chronbach $\alpha$=0.7126. As a result of examining how mech the general satifaction level depended on sociodemographic characteristics, ther was found be significantly affected by age, marital status, educational background or hospital type. Those who a spouse or a lower educational background or the oriental hospital users got better score. Third, the multiple regression analysis was made to find out what factors affected western and oriental hospital user satisfaction, As a result, the waiting time, experience of other medical facilities and hospital characteristic variable were identified as a key factor on which westerm hospital user satisfaction depended. In conclusion, the oriental hhspital user expressed more staisfaction than the weshren hospital users. Then the characteristic factor played a singificant role in user satisfaction, which included hospital facilities, kindness of herb doctor and employees, or hospital reputation of credibility. in order to raise hospital user datisfaction, it seemed necessary to pay more attention to hospital characteristic factor rather than to perception factor.

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The Role of Self-Efficacy and Social Support in the Relationship between Emotional Labor and Burn out, Turn over Intention among Hospital Nurses (간호사의 감정노동과 소진, 이직의도와의 관계에서 자기효능감과 사회적 지지의 역할)

  • Kim, In-Soon
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.4
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    • pp.515-526
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    • 2009
  • Purpose: The purpose of this study was to investigate the role of Self-efficacy and Social Support in the emotional labor among hospital nurses. Method: Data was collected from 389 nurses in 3 general hospitals by means of structured questionnaires. Data was analyzed with descriptive statistics, Pearson's correlation coefficient and hierarchial multiple regression using the SPSS 14.0 program. Result: (a) self-efficacy of hospital nurses had no significant moderating and mediating effects between emotional labor and burn out, turn over intention. (b) Social support of hospital nurses had significant mediating effects between emotional labor and burn out, turn over intention. However, social support did not show moderating effects. Conclusion: Social support was a more important predictor of emotional labor than self-efficacy of hospital nurses. This finding suggests the importance of social support to increase hospital nurses psychological well-being and development of organization.

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Study on Out-of-pocket Money among Medical Expenses of an Oriental Medical University Hospital (한방의료의 본인부담금 연구)

  • Shin Sang-Moon;Kang Sung-Wook
    • Journal of Society of Preventive Korean Medicine
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    • v.3 no.1
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    • pp.67-82
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    • 1999
  • This study was performed to investigate out-of-pocket money among medical expenses of an oriental medical university hospital by the use of internal data of an oriental hospital because medical insurance program data could not show us insuree's out-of-pocket money among medical expenses. The purpose of this study was to analyze out-of-pocket money among medical expenses of ambulatory and hospitalized patients. Under this purpose, We analyzed actual medical expenses data of 1389 out-patients and 858 in-patients of the oriental medical university hospital with 90 beds that could be approach to internal data from July 1, 1998 to March 31, 1999. The major findings are as follows : 1. In ambulatory patients, the cost share ratio of insuree & that of insurer was 90 : 10 respectly. 2. In hospitalized patients, the cost share ratio of insuree & that of insurer was 72 : 28 respectly.

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Factors Affecting the Survivals of Out-of-hospital Cardiac Arrests by 119 Fire Service (119구급대원의 심폐소생술 성적 분석 - 병원전 심정지를 중심으로 -)

  • Kang, Byung-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.9 no.2
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    • pp.111-128
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    • 2005
  • Background: Cardiac arrest is one of the most critical diseases which can likely lead to severe cerebral disability or brain death when the cases can not recover their circulation within 10 minutes. Saving out-of-hospital cardiac arrest cases is a recent concern in Korea. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. The best survival can be achieved if all the following links have been optimized : rapid access, and early CPR, defibrillation and ACLS, Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, it is not known how effective resuscitation has become to the patients. In other words, there are no guidelines for reviewing, reporting, and conducting research on resuscitation in Korea. This dissertation aims to provide the basic data for a unified reporting guideline of resuscitation in Korea and evaluating the out-of-hospital factors associated with survival discharge of out-of-hospital cardiac arrest. Methods: As for this study, uses the collected data about Out-of-hospital cardiac arrests at 4 area, from January, 2005 to April. 2005. With a retrospective study, 174 cases were analyzed. The data was recorded based on the Out-of-Hospital Utstein Style. Results: Resuscitation was performed on 174 out-of-hospital cardiac arrest cases at the 4 area 14 patients(8.1%) recovered their spontaneous circulation. Overall, the ROSC of the out-of-hospital cardiac arrest patients was 8.1%, which was poorer than that of western countries. Gender distribution was 50 females(28.7%) and 124 males(71.3%), approximately twice as many males as females. ROSC of witnessed arrests was found out to be 97.7%. The ratio of the witnessed arrest groups showed higher results than that of unwitnessed arrest groups in the above-examined cases. Cardiac etiology consisted of cardiac(33.5%), non-cardiac(45.7%), trauma(20.1%), and unknown(6.0%). Cardiac was the best performance. Initial rhythm showed Ventricular Tachycardia/pulseless Ventricular Fibrillation in 8 patients(6.0%), asystole in 100(75.2%) and unknown in 25(18.8%). The results of the Ventricular Tachycardia/pulseless Ventricular Fibrillation showed higher results than the others cases, The proportion of the cardiogenic cause was 33.5%, which was only half of western countries. Ventricular Tachycardia/pulseless Ventricular Fibrillation is relatively rare. These differences were due to the prevalent pattern of Out-of-hospital cardiac arrest as well as prematurity of the EMSS. Bystander CPR was practiced on 13 patients(7.52%). ROSC was shown in 46.2% cases. CPR by EMT was carried out on 167 cases(96.5%). ACLS by EMf was rare. From collapse, 4 cases(2.6%) arrived to ED within 6 minutes. 13 (8.6%) within 10 minutes, and 49(32.5%) over 31 minutes. The sooner the patients arrived, the greater the ratio of ROSC and discharged alive became, and the same with collapse time to ROSC. As the results of the logistic regression analysis, ROSC was found out to be highly influenced by the time of ED arrival from collapse and Ventricular Tachycardia/pulseless Ventricular Fibrillation. Therefore, the ratio of ROSC depends on not any single factor but various intervention factors. Conclusion: This dissertation presents the following suggestions and directions of the study hereafter. First, the first step for a chain of survival should be taken to activate EMSS early with a phone as soon as cardiac arrests are witnessed. Second, it is keenly needed that emergency medical technicians should be increased through emergency education for living. Third, it is necessary to establish the emergency transportation system. Fourth, most of the Koreans have little understanding of EMT and the present operation systems have many problems, which should be fundamentally changed. Fifth, it is required to have an active medical control over Out-of-hospital CPR, And proper psychological supports should be given not only to patients themselves and their family but also individuals who are engaged in emergency situation. Finally, through studies hereafter on nationwide, comprehensive, and standard forms, it is needed to examine into the biological figures of human body, causes and trends of cardiac arrests, and then, to enhance the survival rate of Out-of-hospital cardiac arrests. Korean guidelines for Cardiopulmonary resuscitation need to be made.

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Impact of Medical Service Quality by Attribute on Overall Satisfaction -Focused on Out-patient and In-patient in High-level general Hospital- (의료서비스 속성에 따른 품질이 전체만족도에 미치는 영향 -일개 상급종합병원의 외래 및 입원환자를 중심으로-)

  • Kim, Jung-Hee;Ji, Kyung-Ja;Park, Chun-Man
    • Korea Journal of Hospital Management
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    • v.18 no.1
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    • pp.18-41
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    • 2013
  • This study was aimed to identify the current status of medical service quality of medical institutes; propose improvements; and find out the impact of medical service quality by its attribute on overall customer satisfaction. The research was conducted on the out-patients and in-patients in a high-level general hospital located in A city. To examine the research, the IPA was utilized to identify the priority requirements for improving the medical service quality. The study also applied an extended theory to the analysis on mismatch between the level of satisfaction and importance recognized by the clients, to examine the impact of the above mentioned factors on the overall satisfaction and intention to revisit and recommend the hospital. For out-patients, the result showed that "hospital hygiene" had a positive and negative impact on the clients' intention to revisit the hospital in priority improvements. In terms of the sustainable improvements, "doctor's skill" had a negative impact on the overall service satisfaction, whereas "state-of-the-art facility" and "nurse's instruction" had a positive impact on the intention to revisit the hospital. In long-term improvements,"complaint remedy" had a positive impact on the intention to recommend the hospital but there were no relevant factors in excessive investment. On the other hand, for in-patients, the result demonstrated that there were no relevant factors in priority improvements and sustainable improvements. The factor of"service procedure speed"had a positive as well as negative impact on the intention to revisit the hospital. In excessive investment,"nurse's empathy"had a positive impact on the intention to recommend the hospital.

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A Study on Factors of Job Satisfaction and Burnout of Hospital Dietitians (병원 영양사의 직무만족도 및 소진에 영향을 미치는 요인)

  • Yun, Hye-Jin;Lee, Joo-Eun;Hong, Wan-Soo
    • Korean Journal of Community Nutrition
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    • v.14 no.1
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    • pp.100-113
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    • 2009
  • This research aims to examine the experiences of hospital dietitians' burnout and the factors of their burnout, such as demographic factors, unique characteristics of hospitals, their self-respect, and organizational factors. In order for this, a questionnaire survey was conducted with hospital dietitians working in general hospitals of over 400 beds in the Seoul Metropolitan area. The average point of self-respect of dietitians is 3.67 out of 5.00. Their experience of burnout turned out to be 3.17 out of 7, the extent of job satisfaction is high, that is 3.35 out of 5.00. The decrease of personal accomplishment is shown to be closely related to the burnout of dietitians. The emotional exhaustion in burnout at the significant level 0.001 is increasing as the annual gross salary is low, their age is young, extra-working hours are long, and is high to the dietitians serving meals and working at entrusted companies. The factors affected by burnout experience vary with individual circumstances. So, to prevent the emotional exhaustion, depersonalization, and reduced personal accomplishment, hospital dietitians' spiritual and physical health needs to be kept up by their self-development and investment.

The Clinical Study on 30 Patients with Neck Pain, Treated by Acupuncture Treatment of Jungja and Jungseon-Hyeol (중자(重子), 중선혈(重仙穴)을 이용한 항통(項痛) 치료(治療)의 임상적 고찰)

  • Han, Hee-Cheol;Lee, Sang-Moo;Hwang, Kyu-Sun;Jung, Hyung-Seob
    • Journal of Acupuncture Research
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    • v.19 no.1
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    • pp.46-53
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    • 2002
  • Objective : The purpose of this study is to find out the effects of Jungja and Jungseon-Hyeol on the patients of neck pain. Methods : A retrospective study has been carried out for 30 cases of neck pain patients who visited Dongseo Oriental Medical Hospital from August 1, 2001 to september 30, 2001. We have treated them with acupuncture treatment of Jungja and Jungseon-Hyeol. Results : We have found out the excellent effects of Jungja and Jungseon-Hyeol on the patients of neck pain. Conclusion : The acupuncture treatment of Jungja and Jungseon-Hyeol is useful on the patients of neck pain.

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