• Korea Journal of Hospital Management
• /
• v.22 no.3
• /
• pp.1-17
• /
• 2017

Purposes: Diabetes is a metabolic disorder that requires continuous care in order to prevent complications, as it can impose a critical burden on families and society due to various complications, including terminal renal failure, non-traumatic lower extremity amputation, and adult blindness. The usual sources of care are "specified private clinics, public health centers, or other facilities to visit when ill or when health-related advice is needed". These usual sources of care offer preventative services, have a high overall satisfaction rate in terms of public health care, and decrease the inpatient rates and medical costs of medical aid recipients. This study analyzed the current status of diabetic patients over 20 years of age based on their possession of a usual source of care, and the effects of this possession on the frequency of their medical service usage and its costs. Methodology: Based on data from the 7th Korea Health Panel, a Tobit analysis was used to analyze the different factors that can affect the frequency of medical service usage and its costs for diabetic patients with and without a usual source of care. Findings: The medical costs of diabetic patients with a usual source of care decreased in terms of inpatient, and the outpatient visits and inpatient costs of the group with a usual source of care in the form of a mainly-visiting doctor decreased more than those of the group with a mainly-visiting medical institution only. Practical Implications: Having a usual source of care can increase the treatment continuity, leading to reduced inpatient, and having a mainly-visiting doctor as the usual source of care further increases the treatment continuity. Based on these results, a new policy is needed to increase and strengthen diabetic patients? possession of a usual source of care.

• Journal of Nutrition and Health
• /
• v.46 no.2
• /
• pp.137-146
• /
• 2013

The purpose of this study was to evaluate diet-related Quality of Life (QOL) and to analyze the relationship among diet-related QOL, dietary regimen practice, health-related QOL, and gastrointestinal symptoms in hemodialysis patients. Subjects were recruited from an artificial kidney center in Seoul. The self-report questionnaire consisted of socio-demographic characteristics, diet-related QOL, compliance with dietary regimen practice, health-related QOL, and gastrointestinal symptoms was distributed. Diet-related QOL includes a 'Quality of Life and Related to Dietary Change Questionnaire', 'Satisfaction Survey', and 'Dietary Impact Survey'. According to their responses, participants had experienced the greatest difficulty with 'Dietary Impact'. In particular, the mean score for general health was low. Association of dietary regimen practice showed a positive association with 'Cost' and 'Self-care' score. In addition, diet-related QOL showed positive correlation with health-related QOL, particularly in 'taste'. Scores for 'Taste', 'Convenience', and 'Dietary Impact' were lower for subjects with constipation compared to those of subjects without constipation. Scores for 'Taste' and 'Dietary Impact' were lower in subjects with irritable bowel syndrome compared to those of subjects without the syndrome (p < 0.05). Diet-related QOL showed a positive association with health-related QOL (p < 0.05), whereas it showed a negative association with constipation (p < 0.01). In conclusion, hemodialysis patients in Korea suffer from burden of dietary regimen practice and most scores for diet-related QOL and health-related QOL from patients with gastrointestinal symptoms were low. Therefore, appropriate nutrition education considering gastrointestinal symptoms is necessary for improvement of patients' QOL during dietary regimen practice.

• Journal of the Korean Orthopaedic Association
• /
• v.55 no.2
• /
• pp.154-161
• /
• 2020

Purpose: To describe the clinical and radiology results of a surgical treatment for clinodactyly due to a longitudinal epiphyseal bracket. Materials and Methods: This study analyzed the records of 11 patients (27 case) with clinodactyly due to a longitudinal epiphyseal bracket who underwent an osteotomy or physiolysis between March 1999 and April 2017. The preoperative range of motion of the proximal and distal interphalangeal joints, the subjective satisfaction of the patient, and the degree of angulation to the ulnar side were examined. The patients were classified into two groups: osteotomy and physiolysis. The results were reviewed retrospectively and compared according to the surgical method. Results: The mean age of the patients who underwent osteotomy was 10.3 years. The average preoperative angle was 25.7° and the average postoperative angle was 13.5° the mean correction rate was 47.4%. The mean age of the patients who underwent physiolysis was 6.0 years the mean preoperative angle was 24.5° and the postoperative angle was 10.7°. The average correction rate was 59.4%. No significant difference in the correction angles was observed between the group who underwent the correction osteotomy and the group who underwent the osteotomy. In each group, the postoperative correction was statistically significant. The range of motion at the last follow-up was not significantly different from the preoperative range of motion. Conclusion: In patients with clinodactyly due to longitudinal epiphyseal bracket, osteotomy or physiolysis may be performed selectively according to age, bone age, and radiological progression. Both surgical methods showed good clinical results and deformity correction.

• Journal of Korean society of Dental Hygiene
• /
• v.10 no.4
• /
• pp.635-644
• /
• 2010

Objectives : The purpose of this study was to analyze and investigate the effecting factors on the actual condition of dental clinic use of the out patient. Methods : In oder to achieve this purpose, A survey for 302 patients in 6 participating dental clinics located in Daejeon metropolitan city from May 01 to May 30, 2010. The result of this study was as follows. Results : 1. The duration of dental clinic use was reflected in 36.1% of the under 1 year, 34.1% of over 2 years, and 29.8% of over 1 ~ under 2 years in order. Especially, the higher the duration of over 2 years the higher the age was, on married group had a significance. 2. The type of medical examination for samples was 27.6% of periodontal, 26.5% of conservative, 17.2% of prosthodontics, 10.9% of implant, and 7.9% of preventive in order. Especially, the male group the more the prosthodontics, implant had a significance. the higher the monthly income, on married group, the more the periodontal, prosthodontics and implant had a significance. 3. The motive of dental clinic selection was 38.4% of acquaintances' inducement, 33.4% of the superb treatment, 15.6% of easy convenience, and 7.0% of friendliness staff in order. Especially, male group the more the easy convenience, superb treatment, friendliness staff had a significance. 4. The mean of transportation in order to visit a dental clinic was 38.7% of public transportation, 37.5% of the own car, 23.8% of others in order. Especially, there was a highly significant difference on the public transportation in female, the lower education level, lower monthly income, and medical protection group. 5. The duration of time required of dental clinic reflected in 80.1% of the under 30 minute, 16.3% of over 30 minute~under 1 hour, and 3.6% of over 1 hour in order. Especially, the higher the treatment satisfaction, the dissatisfaction the higher the duration of time required under 30 minute had a significance. Conclusions : These results indicate that as medical services upgrade and get more varied, the expectation of medical quality also increases. It is thus considered that the revitalization of this hospital's management strategy can be achieved by providing highly developed medical services, and, more importantly, by better understanding the actual conditions of dental clinic use by the patients themselves.

• Journal of Korean Academy of Nursing Administration
• /
• v.7 no.1
• /
• pp.97-110
• /
• 2001

An image exists in the thought of every subjective person and it exercises its influence over everything, having a great power in the real world. An positive image of the nurse has an influence on her faith, value and confidence, therefore increasing her job satisfaction, helping to upgrade her level of profession of nursing through qualitative nursing service as a result, considering the necessity of such an image when it comes to improvement of the profession, the confirmation of the image is indispensable to its evaluation of a speciality in nursing. This study is intended to help that improvement of the nursing profession in the present so that the total effort in every field of nursing is made and to offer basic material for developing a strategy to improve the image of nurses. This study is designed to investigate such an image descriptively. The subjects include 105 nurses, 60 doctors, 68 office workers, 88 medical engineers, 127 patients and there protectors with a total of 448 adapted with accidental sampling, who work at Y and W general hospital in Chonju. The measuring instrument consists of 40 question, with the researcher amended and made from on of Inja Song(1993), Donsoon Lee(1995), Ilsim yang(1998), and its Cronbach's alpha coefficient is .95. Data were collected from March 1 2000 to March 20, 2000 using self-reported questionnairs, analyzed with SPSS WIN 7.5 after encoding. The results are as follows: 1. Most of the subjects thinks the nursing as a hard, stressful, always busy job(more than 75%), and consider nurses as good-looking, supportive and responsible to co-workers to above average degree($50.0{\sim}74.9%$), especially it shows the idea that nursing is independently academic job and has come to fasten itself upon the public. But it shows below the everage($25.0%{\sim}49.9%$) in regard to self development as a specialist, affection for there job, an association activity, service to the community, high intelligence level and direct given patient nursing service. It also rated low as a recommendable job, independently nursing accomplishment, social position. 2. The nurses, patients and there protectors expressed more positive opinions than doctors, medical engineers, office workers about the image of the nurse(F=18.80, p=.00). This fact indicates that the former group evaluated the image similarly contrary to lowness of the latter. 3. In the study on what influenced upon the image, it defines to 79.8% by direct contact in the hospital or acquaintance with nurses, and 16.3% by mass media. 67.3% answered that they saw the image in a new light through hospitalization, which suggests an important source for the image management originates from caring for the quality of nursing service. Considering the evaluation of the image above, we need strategies to lead a unique professional knowledge and technological development, insurance of professional self-determination, high social position, participation in group activities, dedication to lifetime job, in order that nursing comes to expand as a professional occupation. Also, as for generating more positive images, we must take the quality of nursing service into account and offer and monitor correct information about the expanded role and function of the nurse continuously so that mass media reflect a more accurate image of nurses in general.

• Sleep Medicine and Psychophysiology
• /
• v.23 no.2
• /
• pp.77-83
• /
• 2016

Objectives: The present study investigated current practices of insomnia treatment among Korean doctors in clinical settings. Methods: A total of 100 doctors participated in the present study and filled out a series of survey questions regarding their treatment of insomnia patients. Results: The results revealed that the primary type of insomnia treatment was pharmacological and that the most popular medication was zolpidem. The majority of doctors reported that they also utilized non-pharmacological treatments such as sleep hygiene education and cognitive-behavioral therapy. However, these treatments tended to result in low satisfaction. In addition, the doctors perceived that patients largely preferred pharmacological treatments to non-pharmacological ones and did not have sufficient knowledge of non-pharmacological treatments. Conclusion: Many doctors believed that non-pharmacological treatments for insomnia were important, but reported that they were difficult to implement in practice. The results of this study suggest that improved medical conditions for non-pharmacological treatments and education of physicians are necessary to appropriately treat insomnia.

• Clinics in Shoulder and Elbow
• /
• v.1 no.1
• /
• pp.109-117
• /
• 1998

We evaluated the results of the surgery for impingement syndromes and partial thickness tears of the rotator cuff with an average follow-up period of 15 months. One group(group I) of 43 patients, 46 cases underwent arthroscopic subacromial decompression. The other comparable group(group Ⅱ) of 10 patients, II cases underwent open acromioplasty. The average age at operation was 48 years, old. Arthroscopic subacromial decompression achieved slightly better pain relief, the range of the acti ve forward flexion, function, strength and the overall score with improvement from the preoperative condition than open acromioplasty. The patient's satisfaction was better in group I as well. Using the UCLA Shoulder Rating Scale, 89% of group I and 82% of group n had good or excellent results. Preservation of the origin of the deltoid during an arthroscopic acromioplasty reduced the postoperative morbidity and made it possible to start rehabilitation sooner and to achieve the better and more predictable results.

• The Journal of the Korea Contents Association
• /
• v.18 no.9
• /
• pp.399-410
• /
• 2018

This study is a methodological approach to the study of a customer experience-based Tuberculosis(TB) management service design for a local public medical institution, with the application of the service design process by the Design Council in the UK. This study designed a TB management service for a local public medical institution using the service design method which identifies and resolves TB management-related problems based on experiences of medical personnel of TB facilities as well as of TB patients. To design a TB management service for the whole process from hospitalization to discharge and then to cooperation with local communities, a team was formed with 12 TB management-related personnel. The team went through the four phases of service design process: Discover, Define, Develop and Deliver. In addition, the TB management service based on customer experience was developed that included eight services related to processes from hospitalization to discharge and cooperation with local communities. According to the study results, a service design methodology was found to be considerably effective in developing a service program that takes into account an overall circumstance of various relevant personnel as well as patients. It is suggested that further studies use a service design methodology in developing various health management service programs in need of improvement of work efficiency among relevant personnel as well as providing the best satisfaction for customers by identifying hidden needs based on their experiences.

• Quality Improvement in Health Care
• /
• v.20 no.1
• /
• pp.28-40
• /
• 2014

Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

• Journal of Korean Foot and Ankle Society
• /
• v.21 no.4
• /
• pp.135-138
• /
• 2017

Purpose: The purpose of this study is to determine the correlation between the correction loss of hallux valgus angle and the severity of valgus angle of the second toe. Materials and Methods: We selected 312 cases from 268 surgical patients with hallux valgus deformity receiving distal chevron osteotomy. For a radiological evaluation, we analyzed the changes in the hallux valgus angles, first to second intermetatarsal angles, and valgus angle of the second toe post index operations. All patients were women; the mean age was 46 years. The mean follow-up period was 17 months. Results: The mean hallux valgus angle was $33.6^{\circ}$ preoperatively (range, $25.7^{\circ}{\sim}44.8^{\circ}$), $13.1^{\circ}$ (range, $8.4^{\circ}{\sim}16.4^{\circ}$) after 4 weeks of postoperative period, and $17.1^{\circ}$ (range, $9.4^{\circ}{\sim}28.5^{\circ}$) at their final follow-up. The mean valgus angle of the second toe was $8.4^{\circ}$ preoperatively (range, $2.0^{\circ}{\sim}25.8^{\circ}$) and $8.3^{\circ}$ (range, $1.7^{\circ}{\sim}24.9^{\circ}$) at the final follow-up. Preoperatively, there was a positive correlation between the valgus angle of the second toe and hallux valgus angle (r=0.747, p=0.001). The correction loss of hallux valgus angle had a significant correlation with the severity of valgus angle of the second toe (r=0.802, p=0.001). Conclusion: The existence of the second toe valgus deformity may present itself as a cause of correction loss of hallux valgus angle. The preoperative measurement of the second toe valgus angle may be a good predictor of correction loss; therefore, thorough preoperative warning on the possibility of correction loss should be conducted to maximize patient satisfaction after the procedure.