• Title/Summary/Keyword: Quality of Medical Service

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Analysis of related to unmet healthcare needs for the disabled in Korea using focus groups: Focused on the 2nd Pilot project for primary care for people with disabilities (포커스그룹을 이용한 한국 장애인 미충족 의료 관련 요인 분석: 장애인 건강주치의 2차 시범사업을 중심으로)

  • Kim, Mi So;Choi, Kyung-Hwa;Kim, Jung Ae;Park, Jinah;Jeong, Eunhye
    • Journal of the Korea Convergence Society
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    • v.12 no.12
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    • pp.443-451
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    • 2021
  • This study is a qualitative research using focus group interviews with disabled people and their families to understand the unmet healthcare needs perceived themselves and to analyze the experiences of 'The 2nd pilot project for primary care for people with disabilities', from 9 to 17 February 2021. The subjects of the study was the disabled who can express their opinions (group 1) or the guardians of the subjects who can not express their opinions (group 2). The participants were interviewed for about 100 minutes for each group once or twice. As a result of this study, the factors regarding unmet healthcare needs were extracted in subject, provider, institutional, and socio-cultural aspects. Further, the factors resolved and unresolved by the pilot project were extracted. Based on the results, we can recommend that the expanded application to the visiting service, inclusion of doctors from various departments, multidisciplinary approach including physical or occupational therapists, minimizing disconnection among the hospitals and healthcare centers, improvement of service quality by collecting opinions from people with disabilities, and more publicity activities should be applied.

The Survey of Awareness and Necessity on Introduce Home Physical Therapy in the Long-term Care Insurance (노인장기요양보험제도 내 가정방문물리치료 도입에 관한 인식도 및 필요성 조사)

  • Jung, Dae-In;Kim, Chan-Kyu;Ko, Dae-Sik
    • The Journal of the Korea Contents Association
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    • v.14 no.6
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    • pp.298-306
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    • 2014
  • This study aims to investigate the awareness and needs of patients as consumers and therapists as providers on the introduction of home physical therapy in the long-term care insurance. The survey participants were 96 patients and 132 physical therapists to a questionnaires, we analyzed for frequency of each questionnaire about awareness and necessity. As a result of the test, they considered that physical activity support services provided by nurse and nurses aid ware not specialized enough(pt 60,4%, PT 75,4%) and quality therapy should be available through a home physical therapy(pt 47.9%, PT 59.2%). Also, patients responded that the priorities to improve long-term care insurance were given to lowering expenses(35,4%) and expanding coverage of subjects(32.3%) while the physical therapists responded that professionals should be expanded(73.8%) and diverse rehabilitation services(20.2%) and a rehabilitation team should be introduced. They responded that the reasons of home physical therapy were needed that it was hard for patients to visit medical centers(PT 30.0%) themselves and it would be improvable for them to get physical function in elderly(pt 47.1%) through the service. In conclusion, as most patients as well as physical therapists responded that home visit therapy services should be introduced and their awareness of it was very high, it is suggested that the service should be quickly introduced as soon as possible.

Development of Job Description of Clinical Dietitians in Hospitals by the DACUM Method (DACUM 기법에 의한 병원 임상영양사의 직무기술서 개발)

  • Cha, Jin-A;Kim, Kang-Eun;Kim, Eun-Mi;Park, Mi-Sun;Park, Yoo-Kyoung;Baek, Hee-Joon;Lee, Song-Mi;Choi, Soo-Kyong;Seo, Jung-Sook
    • Journal of the Korean Dietetic Association
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    • v.19 no.3
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    • pp.265-286
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    • 2013
  • The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring evaluation, consultation cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

The Determinants of the Length of Stay in Hospital for Schizophrenic Patients: Using from the Health Insurance Claim Data of Inpatients (조현병 환자의 재원일수 결정요인 : 건강보험 입원환자데이터셋 자료를 이용하여)

  • Jeon, Yun-Hee;Jung, Mi-Yeong
    • Journal of Digital Convergence
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    • v.18 no.1
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    • pp.257-263
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    • 2020
  • This study was conducted to improve the quality of National Health Policy by analysing the effects of sociodemographic characteristics, Medical institutions characteristics and characteristics of Admission-Discharge on the length of stay in hospital for schizophrenic patients from the data of Health Insurance Review & Assessment Service. The subjects were 4,692 patients who were diagnosed with schizophrenia as main diagnosis from the data records of HIRA-NIS 2016. Regression analysis was performed to evaluate the effect on the length of stay. Sociodemographic characteristics, hospital characteristics and characteristics of Admission-Discharge were used as explanatory variables and length of stay in hospital was used as a dependent variable. The result of study showed that female, age, medical aid, the kind of hospital, gangweon-do and with mental disease were found to be the factors that affect the length of stay. The significance of this study is to use the public data for evaluating factors that affect the length of stay in hospital for schizophrenic patients. But this study did not consider disease severity, so further study is needed for evaluation of the effects of factors on the length of stay according to disease severity.

Factors Affecting the Satisfaction and Revisit Intension of Health Promotion Center In A University Hospital (한 대학병원 부속 건강검진센터 이용자의 만족도와 재이용 의사에 미치는 요인)

  • Kim, Hee-Kyoung;Ryu, Hwang-Gun
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.5-24
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    • 2001
  • The purpose of this study was to serve as a basis for providing quality medical service and mapping out consumer-centered marketing strategies to successfully cope with the rapidly changing medical environment and meet consumer needs, by examining what affected the satisfaction and revisit of health Promotion center Client. The subjects in this study were 186 of visitor to health Promotion center in a university hospital in the city of Busan. A survey was conducted with structured questionnaire from March 2 to 30, 2001. The collected data were analyzed with SPSS for Windows (ver10.0). For more statistical analysis, frequency analysis, component analysis, t-test, ANOVA and correlation analysis procedures were utilized. Results of the study can be summarized as follows: 1. Regarding demographic characteristics, 51.6% of the Client investigated were male, and 48.4% were female. The greatest number of them were in their 40s(38.9%). 86.5% were married, and 34.2% were self-employed. 44% were a high-school graduate, and the monthly mean income of 59.4% was one to three million Won. And, the residential area of 46.8%, the largest percentage, was a half-an-hour distance from health Promotion center. 2. The most common motivation of their selection of the health Promotion center was a recommendation by Staff and neighborhood(59.7%), followed by excellent facilities and services(17.2%), the tradition and reputation of the hospital(7.5%), and its publicity pamphlets(7.5%). 3. 45.9%, the largest percentage, acquired health-related information from their friends or acquaintances. 43.8%, the greatest percentage, visited there because they felt there's something wrong with their body. 53.4% worried about the possibility of being attacked by cancer, and 57.5% wanted to take a precise cancer examination. For health maintenance, 50.1% got regular exercise. Regular exercise was considered most crucial for health maintenance or promotion. 4. The largest reason they used that examination center again was the kindness of employees(52.7%), followed by the tradition and reputation of the hospital(21%) and excellent examination setting and equipment(10.8%). 5. By demographic factor, there was no significant difference between the man and women in satisfaction level with examination and expenses. The women expressed more satisfaction at facilities, and the high-school graduate group were more contented with expenses. 6. As a result of investigating their satisfaction level according to the motivation of selecting that examination center, the group that chose the center due to excellent facilities and services were more satisfied with examination and expenses. 7. As for the relationship of total examination satisfaction to revisit. intention, there was a higher correlational relationship between total health examination satisfaction and expense satisfaction. Especially, the more they were satisfied with examination, the more they were willing to revisit there for another examination.

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A study on the establishment and regional strunture of Seoul metropolitan region (서울대도시권역의 설정과 지역구조에 관한 연구)

  • ;;Lee, Hee-Yeon;Song, Jong-Hong
    • Journal of the Korean Geographical Society
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    • v.30 no.1
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    • pp.35-56
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    • 1995
  • During the last two decades, Korea has achieved remarkable economic growth. In this process the nation has become urbanized and industrialized. But we have also encountered widening regional disparity, housing shortage of larger cities, transportation congestion, environmental pollution and many other problems. Rapid increasing urbanization and continuous migration toward Seoul since the late 1960s have been one of the major concerns of government. Government has sought ways to moderate the population increase in Seoul. The regulation which include new town development near Seoul and dispersion strategies of higher education and other administration and living facilities outside of Seoul havemade a great expansion of the spatial influence of Seoul city. Seoul metropolitan reaion has evolved as the most powerful center of political and economical spaces. Generally within a metropolitan region, there exists a growing mutual interdependence economically, as well as socially between a central city and its surrounding area. Seoul metropolitan region manifests itself not only as a coherent system of urbanized regions, but also as an integral part of the daily urban system. The surrounding Gyunggi province and Seoul city become closely linked both economically and functionally, constituting true functlonai urban system. This study is primarily undertaken with the purpose of delineation of the sphere of influence of Seoul city in 1990. At the time of 1985, Seoul metropolitan region was delineated according to the result of the study which was performed by Korea Research Institute for Human Settlements. Afterward, the rapid speed of metropolitanization process with dramatic increase in mobility through the provision of wider transportation system across the Capital region have evolved, resulting in the great expansion of the spatial influence of Seoul city. So this study examines the expanded area of Seoul metropolitan regin during the period of 1985-90. In order to delineate Seoul metropolitan region, the indices of urbanization and functional linkage are selected. Variables included in the measurement of the urbanization level are agricultural structure, population characteristics, manufacturing and service industries, and cultural aspects such as newspaper circulation, the ratio of car ownership and piped water supply. Variables included in the measurement of functional linkage are commuting, shopping pattern, centralized service such as medical facilities and trade of agricultural products. The standardization method and factor analysis are employed in making the delineation of Seoul metropolitan region. According to the result of this study, 2 cities, 8 Eups and 46 Myuns are included Seoul metropolitan region in 1990. If we compare this delineated area in 1990 to that of 1985, we can find the distinctive pattern of expanded axes according to the main transportation routes such as Seoul-Suweon, Seoul-Gwangju, Seoul-Incheon. In 199O, all the Gyunggi province, except a few Myuns located at the north and northwest part of Gyunggi province, are included in Seoul metropolitan region. Furthermore, this study attempts to the analysis of regional structure of Seoul metropolitan region according to the functional characteristics of each city and Gun. Variables included in this analysis are the new residential function, manufacturing function, service function, education and infermation function, public facility function and agricultural function. Factor analysis and cluster analysis are employed in making regionalization. Seoul metropolitan reaion is subdivided into four subregions which reflect different functional specialization. The first group is the specialized region of newly formed residential function. The second group is the specialized reaion of manufacturing function. The third group is the specialized region of service function. And the fourth group has little specialized in terms of manufacturing, service, and residential function. But this region has some potentiality of development when Seoul metropolitan region grow continuously. Seoul metropolitan region accounted for 43% of national population, despite 11.8% of national land size in 1990. Although Seoul metropolitan region enjoys important agglomeration economies, it also has huge social cost in the form of transportation congestion, housing shortage, rapid increase of land value, environment pollution, and etc. Efficient metropolitan plan making is a vital element in promoting Seoul's economic development and providing high quality living environment at low cost. In the light of the result of this study, the outer ring of Seoul metropolitan region, especially northeastern part, are underdeveloped compared to overdeveloped southwestern area. It is needed to develop the guidelines for the implement of the growth control and management plan, inducing more balanced development for whole Seoul metropolitan reaion.

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A Commissioning of 3D RTP System for Photon Beams

  • Kang, Wee-Saing
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.119-120
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    • 2002
  • The aim is to urge the need of elaborate commissioning of 3D RTP system from the firsthand experience. A 3D RTP system requires so much data such as beam data and patient data. Most data of radiation beam are directly transferred from a 3D dose scanning system, and some other data are input by editing. In the process inputting parameters and/or data, no error should occur. For RTP system using algorithm-bas ed-on beam-modeling, careless beam-data processing could also cause the treatment error. Beam data of 3 different qualities of photon from two linear accelerators, patient data and calculated results were commissioned. For PDD, the doses by Clarkson, convolution, superposition and fast superposition methods at 10 cm for 10${\times}$10 cm field, 100 cm SSD were compared with the measured. An error in the SCD for one quality was input by the service engineer. Whole SCD defined by a physicist is SAD plus d$\sub$max/, the value was just SAD. That resulted in increase of MU by 100${\times}$((1_d$\sub$max//SAD)$^2$-1)%. For 10${\times}$10 cm open field, 1 m SSD and at 10 cm depth in uniform medium of relative electron density (RED) 1, PDDs for 4 algorithms of dose calculation, Clarkson, convolution, superposition and fast-superposition, were compared with the measured. The calculated PDD were similar to the measured. For 10${\times}$10 cm open field, 1 m SSD and at 10 cm depth with 5 cm thick inhomogeneity of RED 0.2 under 2 cm thick RED 1 medium, PDDs for 4 algorithms were compared. PDDs ranged from 72.2% to 77.0% for 4 MV X-ray and from 90.9% to 95.6% for 6 MV X-ray. PDDs were of maximum for convolution and of minimum for superposition. For 15${\times}$15 cm symmetric wedged field, wedge factor was not constant for calculation mode, even though same geometry. The reason is that their wedge factor is considering beam hardness and ray path. Their definition requires their users to change the concept of wedge factor. RTP user should elaborately review beam data and calculation algorithm in commissioning.

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An Analysis of Relationship Between Personal Factors of Radiological Technologists and Job Stressors (방사선사의 개인적 요인이 직무스트레스원에 영향을 주는 관련성 분석)

  • Jung, Hong-Ryang;Kim, Jeong-Koo;Lim, Cheong-Hwan;Kim, Myeong-Soo;Kwon, Dae-Cheol;Lee, Man-Koo
    • Journal of radiological science and technology
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    • v.28 no.1
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    • pp.45-53
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    • 2005
  • This study is aimed at analyzing the relationship between personal factors of radiological technologists and their job stressors. For this aim, a survey was conducted by means of 890 questionnaires from the middle of July to the end of August 2003 to the subjects of radiological technologists who are working for 44 general hospitals in 16 cities and provinces across the country. The results of the survey could be summed up as follows: 1. The biggest stressor that affects a radiological technologist personally under the working situation turned out to be position, job satisfaction and physical symptom(p<0.001), while job satisfaction and physical symptom also played an important role in personal relationship(p<0.001). 2. In terms of job conflicts, colleagues, immediate seniors, job satisfaction and physical symptoms appeared to exercise great impact(p<0.001), As for job autonomy, age, position and job satisfaction were known to be heavily influential(p<0.001). 3. With regard to job load, job satisfaction and behavioral symptom turned out to have great influence while, in job stability, position and job satisfaction seemed to be immensely influential(p<0.001). The present study has a limit in that it covers only radiological technologists who are working at the 3rd reference hospitals but excludes those who are working at the first and second reference hospitals. The findings, however, are surely believed to be able to serve as basic data to improve the medical service quality as they will help reduce the stressors of and enhance mental and physical health for radiological technologists who play important roles as teammates with expertise in the medical field. These outcomes could also be referred to in future studies in this area.

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Occupational Therapy for Community Mobility in Stroke Patients : Systematic review (뇌졸중 환자의 지역사회이동을 위한 작업치료 중재: 체계적 고찰)

  • Jo, Eun-Ju;Kam, Kyung-Yoon;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.3
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    • pp.77-89
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    • 2018
  • Objective : The purpose of this study was to analyze occupational therapy intervention on the community mobility for stroke patients, and to provide evidence of intervention in the clinical fields. Methods : A systematic review was executed according to the PRISMA checklist. The accessed database was PubMed, EMBASE, Cochrane Library (CENTRAL), ProQuest Dissertations & thesis (PQDT), RISS, and KoreaMed. We included the articles published from 2005 to September 2018. RoBANS checklist was used to evaluate the quality of the articles. Included articles, totally eight, were categorized according to the type of intervention. Results : The study design of the literature was varied from two-group randomized trial, quasi-experimental study, case-control trial, one group pre-post comparison study, and cross-sectional study. In the evidence level, 6 articles were included in level II (75%). The percentage of low risk of bias in each article ranged from 52.5%~87.5%. Four studies (50%) provided intervention based on virtual reality or virtual environment. The three (37.5%) provided intervention based on the protocol, and the other (12.5%) did wheelchair training. All studies reported significant effects of the intervention. Conclusion : This systematic review provided evidences to use proper intervention in the clinical fields. Various type of studies should be conducted to prove the effect of occupational therapy intervention for community mobility.

Life Pattern for Health Recognition and Management of Chronic Diseases in the Elderly (일개지역 노인의 고혈압과 당뇨병에 따른 건강인식과 건강관리 패턴 연구)

  • Kim, Eun-Yeob;Park, R. W.;Ham, Sung-Woo;Park, Ji-Won
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.9
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    • pp.3366-3374
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    • 2010
  • By identifying the patterns of diabetes and high blood pressure with elderly people in a certain region, this study was intented to obtain the basic information for the improvement of the elderly health. In this analysis, CART was used for studying the pattern for chronic illness, - with the basis on survival factor by each sex, marital status, occupation, methods of health management and age. Occupation related to agriculture showed the highest cases of diabetes. But in the occupations related to fishing industry and public service, number of diabetics were minimal. With occupations related to trades and others, the cases of diabetes increased as the age increased in 80's and 90's. In recent years, the elderly population is ever increasing. In addition, elderly health situation is surfacing as a significant social issue - this is especially the cases as their allowed activities are becoming even more limited. Therefore it is important to improve the functions for their livelihood and increase their satisfaction of life by considering their quality of life, so they could live the rest of their lives happily and comfortably.