• 한국병원경영학회지
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• 제10권2호
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• pp.45-63
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• 2005

The purposes of this study are to understand the doctors' attitude and satisfaction about the review system of national health insurance claim in Korea and to suggest the way to improve this system This study conducted a survey of the doctors registered in the medical association in Seoul city. The survey was performed as a form of self-administered questionnaire from January 2004 to February 2004. The contents of questionnaire dealt with doctors' attitude and satisfaction about the review system of medical service claim. Totally, 1,037 members replied to our survey and we analysed 981 doctors' data, excluding incomplete responses. As a result, 89.7% of repliers showed a negative attitude about the influences of the review system on improvement of medical service quality, 98.0% of repliers have had experiences that they have given distorted insufficient medical services in order to evade the curtailment of service claim. Also, 91.6% of repliers stated that they have had experiences of intentional modification or alteration of diagnostic code to shun the curtailment. Most of the doctors showed negative attitude to the curtailment procedure and the review system of service claim originally intended to be one of the quality control methods of medical service in Korea also, the development of both scientific and reasonable parameters and criteria for claim is needed. 'Through the improvement of review system for appropriate medical service, there is a need of a way to increase the satisfaction of medical service providers, and to encourage the motivation for quality control. Also, education is strongly needed to provide doctors with sufficient information about review criteria and curtailment cases.

• 지역사회간호학회지
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• 제32권2호
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• pp.175-185
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• 2021

Purpose: Influenza immunization among health personnel is of particular importance given their elevated risk of influenza infection, role in transmission and influence on patients' immunization status. The purpose of this study is to identify factors associated with the influenza vaccination intention among health personnel based on the theory of planned behavior. Methods: The research was a cross-sectional, descriptive design using questionnaires. The participants were 131 health personnel in five general hospitals in two cities in South Korea. The data were analyzed using descriptive statistics, t-test, ANOVA and multiple regression with the SPSS 26.0 program. Results: There were statistically significant differences in influenza vaccination intention according to the high-risk group in the family, occupation, length of employment, and influenza vaccination status within a year. The influenza vaccination intention of these health personnel showed significant positive correlations with attitude, subjective norms, and perceived behavioral control towards influenza vaccination. Multiple regression analysis for influenza vaccination intention revealed that the significant predictors were attitude, subjective norms, influenza vaccination within a year and physician in occupation. These factors explained 41.4% of the variance. Conclusion: The results suggest a need to strengthen attitude and subjective norms. The findings also suggest that their characteristics through influenza vaccination status within a year and occupation should be considered for tailored interventions related to the intention. Furthermore, it is necessary to develop programs strengthening attitude and subjective norms to enhance influenza vaccination intention among health personnel.

• 보건행정학회지
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• 제16권2호
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• 한국컴퓨터정보학회논문지
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• 제19권6호
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• pp.119-128
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• 2014

본 연구는 사회복지현장실습이 전문직업인으로서 성장하는데 있어 진로의식에 미치는 영향력을 검증하기 위하여 진행되었다. 연구대상은 G지역 4년제 대학교 사회복지전공학생 198명을 목적표집에 의하여 조사하였으며, 자기기입식 설문을 통하여 진행하였다. 분석방법은 대상 및 변수의 특성을 파악하기 위해 빈도 및 기술분석, T-test, F-test, ANOVA, 상관관계(correlation), 회귀분석(regression)을 위해 SPSS 14.0을 사용하였다. 연구결과는 다음과 같다. 첫째, 개인요인으로 실습생이 개인의 의사가 반영(${\beta}=.197$)되는 것과 사회복지학 전공을 선택한 것에 대해 만족감(${\beta}=.205$)이 사회복지전공학생의 진로정체감에 유의미한 영향을 미쳤다. 둘째, 개인요인으로 자신이 사회복지학을 전공으로 선택한 것에 만족감(${\beta}=-.291$)을 느끼는 경우와 부모가 사회복지학을 전공으로 선택한 것에 만족감을 느끼는 경우 사회복지전공학생의 진로결정수준에 유의미한 영향을 미쳤다. 셋째, 개인요인으로 개인의사 반영(${\beta}=.156$)이 진로준비행동에 유의미한 영향을 미쳤다.

• 근관절건강학회지
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• 제6권1호
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• pp.22-36
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• 1999

The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

• 한국산학기술학회논문지
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• 제17권5호
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• pp.104-115
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• 2016

연구목적: 본 연구는 의사로부터 고혈압으로 진단받은 사람들을 대상으로 개인 건강행태 및 지역 보건의료수준이 치료순응에 미치는 영향을 파악하고자 실시하였다. 고혈압 치료순응은 고혈압 약물치료율로 조작적 정의를 하였다. 정의는 의사에게 고혈압을 진단받은 30세 이상 사람 중 현재 혈압 조절약을 한 달(30일)에 20일 이상 복용하고 있는 사람의 분율로 정의하였다. 연구방법: 2010년도 지역사회건강조사대상 만 19세 이상 성인 229,229명을 대상으로 개인특성에 따른 고혈압 치료순응지표의 차이 비교는 카이제곱 검정을 사용하였으며, 개인 및 지역수준 변수를 고려한 고혈압 치료순응의 관련지표의 지역 간 변이 파악은 다수준 로지스틱회귀분석 실시하였다. 통계 프로그램은 SPSS 18.0과 HLM 7(hierarchical linear model)을 이용하였다. 연구결과: 개인 건강행태 및 지역 보건의료수준이 고혈압 치료순응에 미치는 관련성 연구에서 건강행태 및 지역의 보건의료수준에 따라, 치료순응에 미치는 영향이 크다는 것을 알 수 있었다. 결론: 본 연구에서는 지역보건의료 수준의 변수들의 교차비가 높지는 않았지만, 개인수준의 변이에 초점을 맞춘 기존연구와는 달리 지역보건의료수준의 변이를 찾을 수 있었다는데 의의가 있었으며, 추후 많은 연구에서 지역수준을 고려한 다수준 분석이 필요할 것으로 사료된다.

• 대한간호학회지
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• 제36권4호
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• pp.596-603
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• 2006

Purpose. This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. Methods. A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. Results. Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, 'SARS-patient caring would be a new experience', 'during SARS-patient caring, I should be apart from my family', 'after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event' and 'with my SARS-patient caring, patients could recover from SARS' were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, 'SARS-patient caring would be a challenge' 'SARS-patient caring is a professional responsibility', 'tension during the care of SARS patients' and 'support from team members' were the significant determinants of the intentions. Conclusions. Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.

• 한국학교보건학회지
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• 제13권2호
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• pp.261-270
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• 2000

Background: Adolescence is the transitional period between childhood and adulthood. We have to pay attention to their psycho-social problems as well as their physical symptoms. In this context, we need to investigate the adolescent depression tendency and its related factors. Method : From May to June in 1008, we chose one elementary school, one middle school and one high school in Seoul and surveyed for all students who were above the 4th grade of elementary school and their parents. We analyzed the data for 3,685 students. Result: From the 6th grade of elementary school to the 1st grade of high school, the girls' DSRS(Depression self-rating scale) score was significantly higher than the boys'. The DSRS score was increased from the 2nd grade of high school for boys and from the 1st grade of high school for girls. The Pearson correlation coefficient between age and DSRS score was 0.16(p<0.01) and that between APGAR and DSRS score was -0.45(p<0.01). The median number of psychosomatic symptoms of the past month was 6, and when students complained for more psychosomatic symptoms, the DSRS scores were higher. Those who drank or smoked ranked significantly higher in DSRS score; and, those who exercised regularly, had leisure activity, and had a faithful person for counselling ranked significantly lower in DSRS score. Conclusion : Adolescents who complained of many psychosomatic symptoms needed to be screened for depression. A primary physician have to intervene about health related behavior such as family function, smoking, exercise and relieving stress.

• 한국임상약학회지
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• 제25권4호
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• pp.264-272
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• 2015

Background: The over-prescription of acid-suppressive therapy for the provision of stress ulcer prophylaxis (SUP) in hospitalized patients has been identified in a proceeding study. Objective: This study was conducted to evaluate clinicians' beliefs, knowledge and other factors that influence the over-prescribing of SUP in low-risk, non-intensive care unit (non-ICU) patients. Method: A cross-sectional survey consisting of multiple-choice queries and close-ended questions was distributed to healthcare personnel at a major teaching hospital in Korea. Results: More than half of total respondents reported that they would continue SUP following patients discharge from the ICU (77.8%, 43.5%, and 39.7% in the physician, pharmacist, and nurse groups, respectively). Over 55% of physicians would also initiate non-ICU patients on SUP upon hospital admission, and 42.6% of physicians would even continue prophylaxis post hospital discharge. The mean knowledge score regarding SUP indications and side effects was higher in pharmacists compared to physicians and nurses (12.44, 7.40, and 7.28, respectively; p<0.001). High-prescribing behavior was associated with a prescriber's belief that SUP is effective for preventing bleeding (odds ratio 7.40; 95% confidence interval 1.57 to 31.94; p=0.012). Low knowledge score and computerized order set also showed statistically significant association with the overutilization of SUP.

• 보건행정학회지
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• 제23권2호
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• pp.112-123
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• 2013

Background: Under the risk of financial sustainability of National Health Insurance, Korean government attempted a series of regulations over pharmaceutical prices. The first price-cut was implemented to the hyperlipidemial treatments, and the prices of statins were reduced on 15th, April in 2009. The purposes of this study are 1) to investigate the impact of this price-cut on pharmaceutical expenditure, and 2) to identify the factors associated with drug-switch among statins. Methods: Using the national patients sample data, this study conducted time series analysis on the expenditures, prices, and volumes of statin drugs. To understand the factors associated with drug-switch, the multinomial logit model was analyzed at the patients level. Results: The results of time series analysis demonstrated that the price-cut of hyperlipidemic medicines did not lead to the reduced expenditure, suggesting the increased volume was the major cause. The multinomial logit analysis identified the switch of healthcare provider as the significant factor that was highly associated with drug-switch, implying the physicians' preference was the major motivation of drug-switch. Conclusion: Without control of utilization, price regulation itself could not reduce pharmaceutical expenditure. This suggests that the pharmaceutical regulations should be implemented on the basis of understanding of provider behaviors. The findings of this study will form the first step for further empirical studies.