• 제목/요약/키워드: Quality of Medical Service

검색결과 1,169건 처리시간 0.037초

중환자실 흡인간호 및 인공호흡기관리 표준화를 통한 인공호흡기 관련 폐렴발생 감소효과에 관한 연구 (The Effects of Standardized Suction and Ventilator Management Protocol on Ventilator Associated Pneumonia in the Intensive Care Unit)

  • 송경자;유정숙;권은옥;정은자;신현주;박옥향;옥순옥;유미;윤선희;이복남;최진아;황정해;오향순
    • 한국의료질향상학회지
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    • 제8권1호
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    • pp.44-55
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    • 2001
  • Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

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환자안전 주제별 보고서의 주제 우선순위 설정: 델파이 조사를 통한 분석 (Prioritizing Themes Using a Delphi Survey on Patient Safety Theme Reports)

  • 박정윤;신은정;김리은;김수경;박춘선;박태준;최윤경;허영희
    • 한국의료질향상학회지
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    • 제28권1호
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    • pp.45-54
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    • 2022
  • Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

구조방정식을 이용한 치과위생사의 전문직업성, 자기효능감이 직무만족에 미치는 영향 (Effects of Professionalism and Self-efficacy on the Job Satisfaction of Dental Hygienists Using the Structural Equation Model)

  • 이선미;김수화
    • 치위생과학회지
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    • 제12권3호
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    • pp.271-277
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    • 2012
  • 본 연구는 구조방정식을 이용한 치과위생사의 전문직업성, 자기효능감이 직무만족에 미치는 영향을 파악하고자 616명을 대상으로 설문조사 하였으며, SPSSWIN 18.0과 AMOS 20 통계프로그램을 이용하여 분석한 결과 다음과 같은 결론을 얻었다. 1. 치과위생사의 전문직업성은 3.34점, 자기효능감 3.76점, 직무만족도 3.36점으로 나타났다. 2. 연령이 많을수록, 교육정도가 높을수록, 기혼인 경우, 근무경력이 많을수록 전문직업성, 자기효능감 및 직무만족도 정도가 높은 것으로 나타났고, 통계적으로도 유의한 차이를 보였다. 3. 본 연구모형은 전문직업성과 자기효능감의 상관계수는 .69, 전문직업성$\rightarrow$직무만족도 경로에서는 .33, 자기효능감$\rightarrow$직무만족도 경로에서는 .59로 정의 영향을 미치는 것으로 나타났다. 즉 전문직업성과 자기효능감과의 상관관계는 어느 정도 있는 것으로 나타났고, 전문직업성 보다는 자기효능감이 높을수록 직무만족도가 증가하는 것으로 볼 수 있다. 직무만족은 조직 내의 다양한 환경과 개인의 내적 요인에 영향을 받는다. 직무만족이 중요한 이유는 의료서비스의 질생산성과 함께, 치과위생사 개인의 삶의 질과도 연관되기 때문이다. 변화하는 시대에 대응하기 위해서는 치과위생사의 직무만족도를 증가시키기 위한 조직의 변화와 노력뿐만 아니라, 치과위생사들의 직업에 대한 확신, 전문직업성과 자기효능감을 향상시키기 위한 노력이 함께 동반되어야 한다.

피그말리온 리더십이 병원 종사자의 조직몰입에 미치는 영향과 리더 - 구성원 교환관계의 매개효과 (Effect of Pygmalion Leadership on the Organizational Commitment and the Mediating Effect of Leader-Member Exchange among Hospital Employees)

  • 홍병호;배성윤;김미숙
    • 한국산학기술학회논문지
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    • 제14권9호
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    • pp.4258-4269
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    • 2013
  • 본 연구는 부산시내 9개 병의원에 근무하는 근로자 349명을 대상으로 구조화된 설문지를 통하여 자료를 수집하였으며, 의료조직에서 피그말리온 리더십이 종사자의 리더-구성원 교환관계와 조직몰입에 미치는 영향을 파악함으로써 병원의 조직성과 제고방안을 제시하고자 하였다. 수집한 설문자료는 SPSS ver.18.0과 AMOS ver.18.0 프로그램을 이용하여 분석하였으며, 빈도분석, 상관분석, 요인분석, 신뢰도분석, 경로분석 등을 수행하였다. 주요 분석결과는 다음과 같다. 첫째, 병원조직에서도 피그말리온 리더십이 리더-구성원 교환관계의 질에 영향을 미치는 것으로 나타났다. 둘째, 피그말리온 리더십은 병원 종사자의 조직몰입에 직 간접적으로 영향을 미치는 것으로 나타났다. 셋째, 리더-구성원 교환관계는 조직몰입의 정서적 몰입, 지속적 몰입, 규범적 몰입에 각각 직접적인 영향을 미치며 그 중에서도 정서적 몰입에 가장 큰 영향을 미치는 것으로 나타났다. 넷째, 리더-구성원 교환관계는 병원 조직에서 피그말리온 리더십과 조직몰입의 관계를 부분적으로 매개하는 것으로 나타났다. 본 연구는 병원 조직에서 피그말리온 리더십과 리더-구성원 교환관계, 조직몰입 간의 관계를 최초로 연구하였다는 데 의의가 있다.

지역 주민의 공공병원에 대한 부정적 인식에 영향을 미치는 요인 (Factors Affecting the Negative Perception of Public Hospitals among Local Residents)

  • 최은혜;조정희;엽경은;박보희;김소영;박종혁
    • 보건행정학회지
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    • 제34권2호
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    • pp.211-221
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    • 2024
  • 연구배경: 코로나바이러스감염증-19로 인한 공중보건 위기는 공공병원의 확충 및 강화의 필요성을 강조하지만, 공공병원에 대한 전반적인 인식은 여전히 부정적인 것으로 나타났다. 공공병원에 대한 부정적 인식은 공공병원의 역할과 기능 수행에 어려움을 초래할 수 있어 이 연구에서는 공공병원에 대한 부정적 인식에 영향을 미치는 요인을 분석하고자 한다. 방법: 이 연구는 충청북도공공보건의료지원단에서 수행한 충청북도 도민의 공공보건의료 인식에 대한 실태조사 자료를 활용하였다. 연구에는 조사에 응답한 만 19세 이상 성인 1,916명이 포함되었으며, 공공병원 이용 경험과 공공의료 및 공공병원 정책 평가가 공공병원의 부정적 인식에 미치는 영향을 분석하기 위해 로지스틱 회귀분석을 활용하였다. 결과: 공공병원 미이용 경험(adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74)과 공공의료 및 공공병원 정책에 대한 부정적인 평가는 공공병원의 부정적 인식에 유의한 영향을 미치는 것으로 나타났다. 구체적으로, 공공의료 정책에서 필수의료 제공이 부족하다고 느낀 경우(aOR, 4.14; 95% CI, 2.59-6.62), 지역 간 격차가 크다고 느낀 경우(aOR, 1.59; 95% CI, 1.02-2.49), 보장성(aOR, 1.99; 95% CI, 1.25-3.16)과 의료의 질(aOR, 2.39; 95% CI, 1.50-3.80)이 낮다고 평가한 경우 공공병원에 대한 부정적 인식이 증가하였으며, 공공병원 정책에서는 시설·장비가 열악하다고 느낀 경우(aOR, 3.74; 95% CI, 2.36-5.94), 진료과목 및 서비스가 부족하다고 느낀 경우(aOR, 1.91; 95% CI, 1.21-3.01), 진료수준이 낮다고 평가한 경우(aOR, 2.71; 95% CI, 1.72-4.25) 공공병원에 대한 부정적 인식이 증가하는 것으로 나타났다. 결론: 이 연구는 공공병원 이용 경험과 공공의료 및 공공병원 정책 평가를 고려한 공공병원 인식 제고의 필요성을 강조한다.

농촌(農村) 주민(住民)들의 의료필요도(醫療必要度)에 관(關)한 연구(硏究) (A Study Concerning Health Needs in Rural Korea)

  • 이성관;김두희;정종학;정극수;박상빈;최정헌;홍순호;라진훈
    • Journal of Preventive Medicine and Public Health
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    • 제7권1호
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    • pp.29-94
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    • 1974
  • Today most developed countries provide modern medical care for most of the population. The rural area is the more neglected area in the medical and health field. In public health, the philosophy is that medical care for in maintenance of health is a basic right of man; it should not be discriminated against racial, environmental or financial situations. The deficiency of the medical care system, cultural bias, economic development, and ignorance of the residents about health care brought about the shortage of medical personnel and facilities on the rural areas. Moreover, medical students and physicians have been taught less about rural health care than about urban health care. Medical care, therefore, is insufficient in terms of health care personnel/and facilities in rural areas. Under such a situation, there is growing concern about the health problems among the rural population. The findings presented in this report are useful measures of the major health problems and even more important, as a guide to planning for improved medical care systems. It is hoped that findings from this study will be useful to those responsible for improving the delivery of health service for the rural population. Objectives: -to determine the health status of the residents in the rural areas. -to assess the rural population's needs in terms of health and medical care. -to make recommendations concerning improvement in the delivery of health and medical care for the rural population. Procedures: For the sampling design, the ideal would be to sample according to the proportion of the composition age-groups. As the health problems would be different by group, the sample was divided into 10 different age-groups. If the sample were allocated by proportion of composition of each age group, some age groups would be too small to estimate the health problem. The sample size of each age-group population was 100 people/age-groups. Personal interviews were conducted by specially trained medical students. The interviews dealt at length with current health status, medical care problems, utilization of medical services, medical cost paid for medical care and attitudes toward health. In addition, more information was gained from the public health field, including environmental sanitation, maternal and child health, family planning, tuberculosis control, and dental health. The sample Sample size was one fourth of total population: 1,438 The aged 10-14 years showed the largest number of 254 and the aged under one year was the smallest number of 81. Participation in examination Examination sessions usually were held in the morning every Tuesday, Wenesday, and Thursday for 3 hours at each session at the Namchun Health station. In general, the rate of participation in medical examination was low especially in ages between 10-19 years old. The highest rate of participation among are groups was the under one year age-group by 100 percent. The lowest use rate as low as 3% of those in the age-groups 10-19 years who are attending junior and senior high school in Taegu city so the time was not convenient for them to recieve examinations. Among the over 20 years old group, the rate of participation of female was higher than that of males. The results are as follows: A. Publie health problems Population: The number of pre-school age group who required child health was 724, among them infants numbered 96. Number of eligible women aged 15-44 years was 1,279, and women with husband who need maternal health numbered 700. The age-group of 65 years or older was 201 needed more health care and 65 of them had disabilities. (Table 2). Environmental sanitation: Seventy-nine percent of the residents relied upon well water as a primary source of dringking water. Ninety-three percent of the drinking water supply was rated as unfited quality for drinking. More than 90% of latrines were unhygienic, in structure design and sanitation (Table 15). Maternal and child health: Maternal health Average number of pregnancies of eligible women was 4 times. There was almost no pre- and post-natal care. Pregnancy wastage Still births was 33 per 1,000 live births. Spontaneous abortion was 156 per 1,000 live births. Induced abortion was 137 per 1,000 live births. Delivery condition More than 90 percent of deliveries were conducted at home. Attendants at last delivery were laymen by 76% and delivery without attendants was 14%. The rate of non-sterilized scissors as an instrument used to cut the umbilical cord was as high as 54% and of sickles was 14%. The rate of difficult delivery counted for 3%. Maternal death rate estimates about 35 per 10,000 live births. Child health Consultation rate for child health was almost non existant. In general, vaccination rate of children was low; vaccination rates for children aged 0-5 years with BCG and small pox were 34 and 28 percent respectively. The rate of vaccination with DPT and Polio were 23 and 25% respectively but the rate of the complete three injections were as low as 5 and 3% respectively. The number of dead children was 280 per 1,000 living children. Infants death rate was 45 per 1,000 live births (Table 16), Family planning: Approval rate of married women for family planning was as high as 86%. The rate of experiences of contraception in the past was 51%. The current rate of contraception was 37%. Willingness to use contraception in the future was as high as 86% (Table 17). Tuberculosis control: Number of registration patients at the health center currently was 25. The number indicates one eighth of estimate number of tuberculosis in the area. Number of discharged cases in the past accounted for 79 which showed 50% of active cases when discharged time. Rate of complete treatment among reasons of discharge in the past as low as 28%. There needs to be a follow up observation of the discharged cases (Table 18). Dental problems: More than 50% of the total population have at least one or more dental problems. (Table 19) B. Medical care problems Incidence rate: 1. In one month Incidence rate of medical care problems during one month was 19.6 percent. Among these health problems which required rest at home were 11.8 percent. The estimated number of patients in the total population is 1,206. The health problems reported most frequently in interviews during one month are: GI trouble, respiratory disease, neuralgia, skin disease, and communicable disease-in that order, The rate of health problems by age groups was highest in the 1-4 age group and in the 60 years or over age group, the lowest rate was the 10-14 year age group. In general, 0-29 year age group except the 1-4 year age group was low incidence rate. After 30 years old the rate of health problems increases gradually with aging. Eighty-three percent of health problems that occured during one month were solved by primary medical care procedures. Seventeen percent of health problems needed secondary care. Days rested at home because of illness during one month were 0.7 days per interviewee and 8days per patient and it accounts for 2,161 days for the total productive population in the area. (Table 20) 2. In a year The incidence rate of medical care problems during a year was 74.8%, among them health problems which required rest at home was 37 percent. Estimated number of patients in the total population during a year was 4,600. The health problems that occured most frequently among the interviewees during a year were: Cold (30%), GI trouble (18), respiratory disease (11), anemia (10), diarrhea (10), neuralgia (10), parasite disease (9), ENT (7), skin (7), headache (7), trauma (4), communicable disease (3), and circulatory disease (3) -in that order. The rate of health problems by age groups was highest in the infants group, thereafter the rate decreased gradually until the age 15-19 year age group which showed the lowest, and then the rate increased gradually with aging. Eighty-seven percent of health problems during a year were solved by primary medical care. Thirteen percent of them needed secondary medical care procedures. Days rested at home because of illness during a year were 16 days per interviewee and 44 days per patient and it accounted for 57,335 days lost among productive age group in the area (Table 21). Among those given medical examination, the conditions observed most frequently were respiratory disease, GI trouble, parasite disease, neuralgia, skin disease, trauma, tuberculosis, anemia, chronic obstructive lung disease, eye disorders-in that order (Table 22). The main health problems required secondary medical care are as fellows: (previous page). Utilization of medical care (treatment) The rate of treatment by various medical facilities for all health problems during one month was 73 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 52% while the rate of those who have health problems which did not required rest was 61 percent (Table 23). The rate of receiving of medical care for all health problems during a year was 67 percent. The rate of receiving of medical care of those who have health problems which required rest at home was 82 percent while the rate of those who have health problems which did not required rest was as low as 53 percent (Table 24). Types of medical facilitied used were as follows: Hospital and clinics: 32-35% Herb clinics: 9-10% Drugstore: 53-58% Hospitalization Rate of hospitalization was 1.7% and the estimate number of hospitalizations among the total population during a year will be 107 persons (Table 25). Medical cost: Average medical cost per person during one month and a year were 171 and 2,800 won respectively. Average medical cost per patient during one month and a year were 1,109 and 3,740 won respectively. Average cost per household during a year was 15,800 won (Table 26, 27). Solution measures for health and medical care problems in rural area: A. Health problems which could be solved by paramedical workers such as nurses, midwives and aid nurses etc. are as follows: 1. Improvement of environmental sanitation 2. MCH except medical care problems 3. Family planning except surgical intervention 4. Tuberculosis control except diagnosis and prescription 5. Dental care except operational intervention 6. Health education for residents for improvement of utilization of medical facilities and early diagnosis etc. B. Medical care problems 1. Eighty-five percent of health problems could be solved by primary care procedures by general practitioners. 2. Fifteen percent of health problems need secondary medical procedures by a specialist. C. Medical cost Concidering the economic situation in rural area the amount of 2,062 won per residents during a year will be burdensome, so financial assistance is needed gorvernment to solve health and medical care problems for rural people.

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물리치료사에 있어서 물리치료 사고의 경험에 관한 연구 (A Study on the Experience of Physical Therapy Accident in The Physiotherapist)

  • 김종대
    • 대한물리치료과학회지
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    • 제9권1호
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    • pp.69-80
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    • 2002
  • The objective of research provides the physical therapy of good quality to the patients to search for the problem pant against a physical therapy accident and it simultaneously respects physical therapy company law, the possibility of preparing a system defensive ability in order to be. The data were collected from 2000 October 1 to December 30th, and analyzed by a frequency and a percentage, oneway ANOVA, Scheffe method, $x^2$ official approvals. Conclusion (1) the accident where the patient falls from inside the treatment 'room is many and occasionally' 29.3% (63 people) with was many most. (2) Because of a mistake by a part-time therapist in holiday or a colleague therapist to do, the fracture or bum accident happens 12.5% (27 people), by a assist nurse due to more showed 12.1% (26 people) experience degree in the patient. (3) From physical therapy process breakdown of the medical treatment machinery and tools or it is in malfunction to do and the experience which has a failure to physical therapy is one enemy 68.1% (147 people) was in item. Also it treats and the patient or in the protector it sends an explanation in advance not to be, the experience which it enforces 50% (108 people), of service hour treatment equipment the medical treatment directives broad way of the doctor is accurate in insufficiency and does not enforce the experience is 45.4% (98 people), the patient whom I am treating Hot Pack (electricity has pack inclusion) with to do, the art dealer (over at 1 buffoonery) the experience which it puts on 27.1% (58 people), The patient whom I am treating is the electrotherapy flag (electricity has pack exclusion) with to do, the art dealer (1 degree art dealer over) the experience which it puts on 16.3% (35 people), the experience boat song the patient against a fracture from physical therapy process 9 person (4.2%) was visible an experience degree. (4) With hospital infection to do, from the patient the experience and the therapist which receive a problem proposal were caused by with hospital infection and the answer back regarding the experience which tries to receive a treatment appeared 6% (13 people), 42% (9 people) with each. (5) It listened to the treatment hour patient or the appeal of the protector and especially it does not appear to be being important it was not and and the management which is special it did not take, also the experience where the condition of the patient is deteriorated after that was 10.3% (22 people). (6) The condition or state of the patient does not agree with the medical treatment instruction of the doctor not to be, amendment one experience was 67.5% (145 people). (7) The experience degree of the physical therapy accident which relates with physical therapy recording and a secret maintenance 59.7% (129 people) 'is many and occasionally it is,' it showed an answer back and e it showed a most high accident experience degree. (8) The business overweight of physical therapy company 43.3% (93 people) with was high most from recognition degree of the physical therapy company against a physical therapy accident. (9) Against the question which asks the responsibility subject matter of physical therapy accident the whole answer back volition 42.8% did it is a joint responsibility where the multi person relates. (10) The accident occurs most the hour unit which plentifully in the afternoon 64.3% (133 people) with appeared from the recognition degree against the frequency hour unit of physical therapy accident. (11) Physical therapy it bought and after the various medical treatment accident which relates against the attitude of the, patient side against the physical therapy company it understood and trillion it was many most with 33.3% to be finished. (12) After physical therapy accident the management against the physical therapy company of the hospital authorities concerned above all do not experience 70.6% (149 people), from event right and wrong submission 22.7% (48 people), warning management 2.8% (6 people), the event report requirement and money compensation were each 0.5% (1 person). (13) As the prevention book of physical therapy accident most it is important, the fact which it thinks that, the persons supplement of physical therapy company 58.8% (127 people) with was high most. (14) It related with a physical therapy accident and the medical law 43.5%, civil law 23.9%, was visible the answer back ratio of the criminal law 13.7% from the degree which probably is a relation law.

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영양 상담서비스 품질에 대한 환자의 만족도와 인식조사 (Patient Satisfaction and Perception on Nutritional Counseling Services Quality)

  • 최기보;이송미;이승민;이은;박미선;박유경;차진아;류은순
    • 한국식품영양과학회지
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    • 제46권2호
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    • pp.251-258
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    • 2017
  • 전국의 43개 상급종합병원과 20개 상급병원의 환자 1,095명을 대상으로 환자의 영양 상담서비스에 대한 인식을 조사하고, 만족도는 서비스 품질 개념을 적용하여 분석하였다. 환자의 영양 상담서비스 인식 평균점수는 4.54/5.00점이었다. 환자의 영양 상담서비스 만족도를 요인 분석한 결과 서비스 품질 5개 영역으로 추출되었고, 각각 공감성, 반응성, 유형성, 신뢰성, 전문성으로 명명, 분류하였다. 5개 영역의 전체 평균 점수는 4.56점/5.00이었고 공감성 4.62점, 반응성 4.52점, 유형성 4.53점, 신뢰성 4.65점, 전문성 4.61점이었다. 학력에 따른 차이에서 영양 상담서비스 품질 만족도 총 평균은 대졸 이상이 중졸 이하보다 유의적(P<0.001)으로 높았다. 수도권 병원의 만족도 점수는 비수도권 병원보다 전체 평균 점수와 반응성, 공감성, 전문성, 신뢰성(P<0.001), 유형성(P<0.05)에서 유의적으로 높았다. 상담횟수에서는 반응성 영역에서 상담을 1회 받은 군이 2회보다 유의적(P<0.01)으로 높은 만족도를 보였다. 환자의 영양 상담서비스 인식과 만족도 간에 신뢰성(r=0.721), 반응성(r=0.697), 공감성(r=0.690), 전문성(r=0.678), 유형성(r=0.622)에서 양(+)의 상관관계를 보였다. 이상을 살펴볼 때 비수도권 병원에서는 임상영양사 수의 확보를 통해 환자의 영양 상담서비스 품질을 향상시키는 것이 필요하겠다. 또한, 영양 상담이 반복될수록 환자의 기대치가 높아질 수 있으므로 임상영양사는 영양 상담 내용 및 기법에 변화를 주고 다양한 자료를 활용하여 영양 상담서비스 품질을 향상시킬 수 있을 것이다. 영양 상담서비스 품질 만족도와 영양 상담 인식 간에는 높은 상관관계가 있는데 서비스 품질 만족도에서 유형성과 반응성은 다른 영역보다 상대적으로 낮은 점수를 보였으므로, 상담실 분위기를 쾌적하게 하고 다양한 교육매체를 활용하며 환자와의 여유 있는 상담시간 및 선택적 상담시간 확보 등 해당 영역에 대한 관리가 특히 필요할 것으로 여겨진다.

한방건강보험 약제 투약 실태 및 활성화 방안 연구 (A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement)

  • 권용찬;유왕근;서부일
    • 대한본초학회지
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    • 제27권2호
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

오피니언 마이닝을 이용한 지능형 VOC 분석시스템 (Intelligent VOC Analyzing System Using Opinion Mining)

  • 김유신;정승렬
    • 지능정보연구
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    • 제19권3호
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    • pp.113-125
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    • 2013
  • 기업 경영에 있어서 고객의 소리(VOC)는 고객 만족도 향상 및 기업의사결정에 매우 중요한 정보이다. 이는 비단 기업뿐만 아니라 대고객, 대민원 업무를 처리하는 모든 조직에 있어서도 동일하다. 때문에 최근에는 기업뿐만 아니라 공공, 의료, 금융, 교육기관 등 거의 모든 조직이 VOC를 수집하여 활용하고 있다. 이러한 VOC는 방문, 전화, 우편, 인터넷게시판, SNS 등 다양한 채널을 통해 전달되지만, 막상 이를 제대로 활용하기는 쉽지 않다. 왜냐하면, 고객이 매우 감정적인 상태에서 고객의 주관적 의사를 음성 또는 문자로 표출하기 때문에 그 형식이나 내용이 정형화되어 있지 않고 저장하기도 어려우며 또한 저장하더라도 매우 방대한 분량의 비정형 데이터로 남기 때문이다. 본 연구는 이러한 비정형 VOC 데이터를 자동으로 분류하고 VOC의 유형과 극성을 판별할 수 있는 오피니언 마이닝 기반의 지능형 VOC 분석 시스템을 제안하였다. 또한 VOC 오피니언 분석의 기준이 되는 주제지향 감성사전 개발 프로세스와 각 단계를 구체적으로 제시하였다. 그리고 본 연구에서 제시한 시스템의 효용성을 검증하기 위하여 의료기관 홈페이지에서 수집한 4,300여건의 VOC 데이터를 이용하여 병원에 특화된 감성어휘와 감성극성값을 도출하여 감성사전을 구축하고 이를 통해 구현된 VOC분류 모형의 정확도를 비교하는 실험을 수행하였다. 그 결과 "칭찬, 친절함, 감사, 무사히, 잘해, 감동, 미소" 등의 어휘는 매우 높은 긍정 오피니언 값을 가지며, "퉁명, 뭡니까, 말하더군요, 무시하는" 등의 어휘들은 강한 부정의 극성값을 가지고 있음을 확인하였다. 또한 VOC의 오피니언 분류 임계값이 -0.50일 때 가장 높은 분류 예측정확도 77.8%를 검증함으로써 오피니언 마이닝 기반의 지능형 VOC 분석시스템의 유효성을 확인하였다. 그러므로 지능형 VOC 분석시스템을 통해 VOC의 실시간 자동 분류 및 대응 우선순위를 도출하여 고객 민원에 대해 신속히 대응한다면, VOC 전담 인력을 효율적으로 운용하면서도 고객 불만을 초기에 해소할 수 있는 긍정적 효과를 기대해 볼 수 있을 것이다. 또한 VOC 텍스트를 분석하고 활용할 수 있는 오피니언 마이닝 모형이라는 새로운 시도를 통해 향후 다양한 분석과 실용 프레임워크의 기틀을 제공할 수 있을 것으로 기대된다.