• Quality Improvement in Health Care
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• v.10 no.2
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• pp.204-215
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• 2003

Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.

• Women's Health Nursing
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• v.19 no.4
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• pp.201-210
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• 2013

Purpose: The purpose of this study was to identify chemotherapy induced peripheral neuropathy, quality of life of patients with gynecologic cancer. Methods: This was a cross-sectional survey design. We collected 130 patients with gynecologic cancer. They complete a self reported questionnaire including items related neuropathy and quality of life (FACT-GOG/Ntx subscale, FACT-G scale). Results: The neuropathy score was $14.3{\pm}7.9$. The quality of life score was $64.8{\pm}16.4$. The neuropathy induced significant difference according to diabetic status, difficulties in performing household chores and willing to discontinuity of chemotherapy. And duration of cancer diagnosis, neuropathy, number of total chemo agent associated with quality of life. There was a negative correlation between number of total chemo agent and quality of life. Neuropathy independently affected quality of life. Conclusion: Chemotherapy induced peripheral neuropathy of patients with gynecologic cancer adversely affected women's quality of life and activities of daily living. To improve patient's quality of life, it is important that accurate assess and appropriately manage neuropathy in patients with gynecologic cancer.

• Korea Journal of Hospital Management
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• v.8 no.4
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• pp.26-58
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• 2003

This research first finds out the resources, activities, and effectiveness of quality management effort and the resulting customer satisfaction when the total quality management is lacking in most Korean medical agencies today. Then, it analyzes the relationship among the factors mentioned earlier. This paper utilizes actual data and presents a theoretical model which explains that the resources of quality management affect the activities and that the fruit of the quality management effort benefits the customers in the end. In addition, this study conducts a corroborative analysis through executing a survey, getting a descriptive statistical result on the subjects' characteristics and the research variables using SPSS 9.0 WIN PROGRAM, and the model is approved through analyzing its make-up using LISREL 8.12 WIN PROGRAM. The study's finding is the following: First, the management leadership affects the worker's, educational training, the quality of medical service, and the survey of customer satisfaction positively. However, it does not affect the quality of work positively. Second, the internal customer satisfaction affects the worker's participation, educational training, the quality of medical service, and the survey of customer satisfaction positively. Third, the quality of medical service and the survey of customer satisfaction affects the result of quality management positively, but the worker's participation, educational training, and the quality of work do not affect the result of quality management positively. Fourth, the management leadership does not appear to affect the result of quality management positively. Fifth, the internal quality management appears to affect the result of quality management positively. Sixth, the external customer satisfaction appears to affect the result of quality management positively. In conclusion, the findings in this study indicate that medical agencies need to utilize the active variables of quality management in order to successfully establish a total quality management.

• Journal of Korean Academy of Nursing Administration
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• v.11 no.1
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• pp.59-66
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• 2005

Purpose: The purpose of this study was to identify the effects images about medical organizations and the quality of service on customer satisfaction of obs and gyn patients. Method: The subjects of this study were selected conveniently 220 women among obstetrics and gynecology outpatients( who visited H- doctor's office of the first medical organ, P- hospital of the second medical organization, Chospital of the third medical organization). The data were collected from August, 20th 2004 using structured questionaires which included modified form of SERVPERF and customer's satisfaction scale by oliver & swan(1989), and modified form of image scale by kang(1997). Results: Image of hospital(45.3%), visiting frequencies(9.3%), service provider (3.9%) and convenient use(1.2%) of the quality of medical service were significant predictors to explain customer's satisfaction. Conclusion: To increase customer's satisfaction of obs and gyn patients, it is required to developed strategies that improve image of hospital and the quality of service to service provider and convenient use of hospital.

• The Korean Journal of Emergency Medical Services
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• v.19 no.3
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• pp.51-68
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• 2015

Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.38-46
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• 1999

Background : To evaluate the frequency and cause of return to the emergency department within 48 hours and to identify the nature of the problem. Methods : We reviewed the medical records of 76 patients who returned to the emregency department within 48 hours from September 1998 to February 1999. Results : Overall revisit rate within 48hours was 2.6%. Of 76 patients, 5(6.6%) had planned return, 64(84.2%) had unplanned return and 7(9.2%) had incomplete documentation. The causes of unplanned return were inadequate medical management (11.8%), discharge against medical advice (27.6%), return after scheduled ambulatory care (22.4%), and unavoidable revisit due to symptom aggrevation or development of new symptom (22.4%). Conclusion : The study provided a basic information for us to improve the quality of emergency care by reducing unnecessary return to the emergency department. It is necessary to monitor continuously the quality of emergency care and to develop the standard of emergency return rate.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.2
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• pp.877-881
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• 2014

Objective: To evaluate risk factors for gallstones after gastrectomy. Methods: To identify documents published from 1990 to 2011 the Pubmed, Cochrane Library, Springer Link, CBM and WanFang databases were searched and a meta-analysis was performed with RevMan 5.2 software for odds ratios and 95%CIs. Results: Fifteen studies were selected for the meta-analysis. The pooled ORs [95%CIs] were 0.56 [0.43, 0.73], (P<0.0001) for digestive tract reconstruction, 0.80 [0.54, 1.17], (P=0.25) for pylorus preservation, 0.33[0.15, 0.75], (P=0.008) for resection scope of stomach, 0.33 [0.15, 0.75], (P=0.008) for lymphadenectomy, and 0.13 [0.05, 0.33], (P<0.0001) for vagotomy. Conclusions: Digestive tract physical reconstruction and vagus nerve preservation can reduce the morbidity of gallstones after gastrectomy. Total gastrectomy can add to the morbidity of galltones as does increasing the degree of lymph node dissection. There was no significant difference in gallstones with or without pylorus preservation.

• The Korean Journal of Health Service Management
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• v.7 no.2
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• pp.53-67
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• 2013

This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, admission procedure, hospital image, service quality of physicians that patients perceived. For inpatients, hospital image and service quality of medical technicians have an effect on perceived value. Service quality of physicians has an effect on the patient satisfaction. For outpatients, hospital image and service quality of physicians and medical technicians have an effect on perceived value. Outdoor environment, hospital image, service quality of physicians and medical technicians, and perceived value have an effect on patient satisfaction. Perceived value and patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve specialty hospitals.

• Health Policy and Management
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• v.31 no.4
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• pp.399-408
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• 2021

The emergency medical service system in Korea was built upon the Emergency Medical Service Act, 1995 to respond adequately to be much in demand for emergency medical services. In addition, the government recognized the importance of the trauma care system and set out to plan for the designation and establishment of the regional trauma center by 2012. This study aimed to investigate features of quality management and trauma fee schedule on better understanding of trauma care system. First, quality management of the regional trauma center has been implemented by several quality programs involved in quality assessment, committee on trauma quality management, and mortality and morbidity conference. Second, the trauma fee schedule has reflected a specific quality of severe traumatic conditions and added the result to it, which are graded A, B, and C according to quality assessment. Although the government has contributed to instituting a trauma quality assessment program and trauma fee schedule for the regional trauma center, it could not lead to such a fixed standard for quality management of them. Therefore, it will promote discussion on the sustainability of the regional trauma center that requires reducing preventable trauma death rate and the way to apply comprehensive quality management.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.346-354
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• 2023

Objective: The objective of this study is to provide medical institutions with theoretical basis by analyzing the effect of service quality-related factors. It will be helpful for hospitals to enhance service quality which will be of use to attain customer satisfaction and ultimately competitive advantage. Design: An empirical study. Methods: To verify the model, I conducted a questionnaire survey analysis. Items for measurement have been extracted from several related studies on medical industry. The survey target has been set by convenience sampling method and consists of citizens reside in Seoul and Gyeonggi-do Province, and total number of 161 samples have been analyzed. To verify validity and reliability, I conducted factor analysis and reliability analysis, and for hypotheses verification, multiple regression analyses have been performed. Results: This study aims to investigate the relation between service quality factors and customer satisfaction, and also those factors and customer loyalty. Service quality factors consist of Tangibles(X1), Reliability(X2), Assurance(X3), Responsiveness(X4), and Empathy(X5). According to the results of regression analyses, X1, X2, X3, and X5 have been proved to have positive relations with customer satisfaction and loyalty, whereas hypothesis related X4 has not been supported. Finally, customer satisfaction has been founded to affects positively to customer loyalty. Conclusions: Service quality factors are significantly related to customer satisfaction and loyalty. So medical institutions should aware of this and try to enhance service quality for attaining competitive advantage.