• Title/Summary/Keyword: Quality of Medical Services

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Simulation on the Change of Practice Pattern after the Introduction of 7 Diagnosis-related Groups Prospective Payment System in a University Hospital (7개 질병군 포괄수가제 도입에 따른 일개 대학병원의 진료행태 변화 모의실험)

  • Shin, Sam-Chul;Kang, Gil-Won;Kim, Sang-Won
    • Health Policy and Management
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    • v.23 no.2
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    • pp.103-111
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    • 2013
  • Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

The Past and Current Status of Dentists in Japan

  • Sugiyama, Masaru;Nishimura, Rumi;Lee, Myung-Jin;Oh, Sang-Hwan
    • Journal of dental hygiene science
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    • v.21 no.1
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    • pp.8-18
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    • 2021
  • The purpose of this study is to provide the general history of fostering dentists in Japan and introducing their new roles. This research was conducted based on the government policy report on dentists and the information published by each educational institution. Based on the collected data, the official websites were used to represent the latest statistics of the institutions. The number of dentists in Japan has increased. The government established the National Examination for Dentists to guarantee the quality of dentists. After the standards for developing questions for the national examination were established in 1985, the contents of the examination have been appropriately improved by revising the standards every four years. This improvement has required dental students to study a variety of subjects for six years at dental school. Since dentists in Japan are required to respond to various demands from the nation; the Model Core Curriculum for Dental Education was developed to teach medical ethics and abilities to ensure that dentists conduct themselves professionally. Recently, the roles of dentists have been changing in Japan. When providing dental services to older patients over the age of 65, dentists and other dental professions focus on maintaining oral functions, such as saliva secretion, bite force, tongue movement, and masticatory/swallowing functions. However, oral function-related services for children are different. In addition to providing essential dental services, dental practitioners also provide special treatment, such as oral muscle training, myofunctional therapy, health guidance, and space retainers to the child patients with developmental insufficiency in oral functions. Dentistry in Japan has undergone numerous changes over the years and has continued to offer high-quality dental health services. Thus, information gained from the Japanese experience may be helpful to dental professions in other developed countries for planning oral health measures.

Subjective Health, Subjective Oral Health, and EQ-5D Level of Adults According to Health Management and Oral Health Management Behavior (성인들의 건강관리와 구강건강관리행태에 따른 주관적 건강과 구강건강, EQ-5D수준)

  • Chung-Mu Park;Hyun-Seo Yoon
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.1
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    • pp.1-12
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    • 2023
  • Purpose : This study examined the relationship between oral health management behavior and subjective health perception by using a tool that measures health-related quality of life named EQ-5D. The findings are expected to provide fundamental data for developing diverse programs, including health- and oral-health-related educational media, to ultimately enhance people's health-related quality of life. Methods : Adults over the age of 20 were extracted from the raw materials of the 8th national health and nutrition examination survey conducted in 2019. Among them, 4034 were finally chosen as the study subjects after checking the response distribution of relevant questions and excluding inadequate samples. Variables included general characteristics, health management behavior, oral health management behavior, subjective health perception, and EQ-5D level. Cross-tabulation test, independent t-test, one-way analysis of variance, and linear regression analysis were conducted using SPSS 25.0. Results : EQ-5D, which measures the level of health-related quality of life, was high when the subjects had a medical check-up experience, no experience of unsatisfactory medical service, and did not get an influenza vaccination (p<.001). The quality of life was higher when the subjects received dental inspections, did not require treatment, and used oral care goods (p<.005). Health-related quality of life was also higher when the subjective health level and subjective oral health level were high. Conclusion : Results indicate that subjective health, oral health perception level, and quality of life together were high when people had a regular check-up, did not neglect treatment, and used oral care goods. Considering the findings of this study, check-up programs that are customized for each age group are necessary. Health-related quality of life could be enhanced through the provision of diverse medical services and active efforts to prevent any medical blind spot.

Method of The Interface Terminology Mapping based Free Text Medical Data (텍스트기반 임상데이터의 인터페이스 용어 매핑 방법)

  • Yoo, Done Sik;Bae, Inho
    • Journal of the Semiconductor & Display Technology
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    • v.13 no.1
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    • pp.97-99
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    • 2014
  • Since 2010, issues for data sharing and data exchanging in hospital information systems have been emerged. In order to solve the issues, standards should be applied to develop the systems and there should be no ambiguities between terminologies in the systems. In this paper, the terminology mapping system for narrative clinical records was implemented. The term mapping precision was 83.4%. This system could help to upgrade the text based clinical system and it would be expected to support for high quality clinical services.

Strategies of Home Health Care Services Linkages in Korea Based on Delphi Technique (델파이 기법을 이용한 우리나라 재가간호서비스 연계방안)

  • Lee, Seung-Hee;Lim, Ji-Young
    • The Journal of the Korea Contents Association
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    • v.12 no.12
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    • pp.282-290
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    • 2012
  • Today, home health care services needs a linkage plan of the customized home visiting health service in public health center, the medical institute home health care service, and home visiting nursing service based on long term care insurance for the elderly program which acknowledges the independence and professionalism of the home health care services while minimizing overlap through linking the projects. So, this study was performed by applying the Delphi technique, which draws agreement from professional opinion, to determine a method to link home health care services in Korea. The results of this study are as follows. Specialists agreed on 24 important items within the two domains of institutional linkage and medical linkage. And the significance of this study is as follows. The 24 items deduced for the approved nursing service linkage plan are expected to improve the home health care service business system, enhance the quality of home health care service, and bring increased satisfaction for service recipients. Also, seeking ways to minimize overlap in service can increase the effectiveness of health care and public health management at a national level. In addition, it is considered that this will ultimately reduce public medical costs as well as improve home health care service.

Satisfaction Gaps among Physicians, Nurses, and Patient Family in the Emergency Department (응급실 서비스 만족도에 대한 환자 가족의 평가와 의료진의 인식 차이)

  • Kang, Kyunghee
    • Health Policy and Management
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    • v.23 no.2
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    • pp.145-151
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    • 2013
  • Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.

Factors Affecting Patient Satisfaction of Dental Services Organizations (치과의료서비스에 대한 환자만족 영향원인 -경남 일부 지역 치과의원을 중심으로-)

  • Lee, Eun-Sook;Park, Jeong-Ran;Choi, Mi-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.5 no.2
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    • pp.247-261
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    • 2005
  • The main objective of this study is to investigate the factors affecting patient satisfaction, repeat-use intention, and inducement intention for providing the suggestion for patient-oriented management of dental services organizations. For this study, the patient satisfaction model including 14 facets of satisfaction factors such as distance(time/location), human services(dentist-hygienist), treatment results, and facilities(convenient facilities/parking lot) was examined. Data were collected from 196 patients who visiting the same dental services organization more than two times of ten dental clinics at Kyeongsangnam-do area using self-administered questionnaire. Major results of the empirical analysis are as follows: First, patient satisfaction, repeat-use intention, and inducement intention were significantly correlated with gender, age, economic conditions among patients of dental clinics. Second, kindness of hygienist, treatment results, kindness of receptionist, waiting time, emergency medical services, and right-fee for services were found to have significant influence on dental services organizations. These research findings suggest that improvement of service quality in dental care and advancement in treatment ability of dentist and hygienist are very important to improve patient satisfaction and patient-oriented service system in dental services organizations.

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Quality Assurance and Performance Evaluation of PET/CT (핵의학 영상장비 PET/CT의 정도관리와 성능평가)

  • Lee, Byeong-Il
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.137-144
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    • 2008
  • Positron emission tomography-computed tomography (PET/CT) provides both functional and anatomical images of high quality non-invasively with better precision in localization than PET alone. Increase in the use of PET/CT, coupled with increasing concerns about the quality of medical services accrued the demands for accurate evaluation of system performance and quality assurance. Thus, well designed programs for performance evaluation and quality assurance are needed. Widely used protocols for performance evaluation of PET are the methods proposed by National Electrical Manufacturers Association (NEMA) in 1994 and 2001. In addition, in order to maintain high quality of PET/CT images, quality assurance programs including periodic (daily, monthly, and yearly). Therefore, in this article, the methods and present state of performance evaluation and quality assurance of PET/CT are reviewed.

The Satisfaction Analysis for Patient Care Service in National University Hospitals (국립대학병원의 환자 만족도 분석 - 7개 국립대학병원의 입원.외래간 비교 -)

  • Lee, Kyu-Sik;Lee, Hae-Jong;Cho, Kyung-Sook;Seol, Dong-Jin
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.165-191
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    • 1998
  • The objectives of this research are 1) to identify different motivation of choice for each National University hospitals 2) to examine the factors influencing the patients' satisfaction, 3) and to investigate that the patients' satisfaction effects the hospital re-choice and recommendation on seven National University's hospitals. The data for this analysis were collected by questionnaire survey. Totally 852 interviews were conducted. The major statistical methods used for the analysis are paired t-test, factor analysis, x2-test, and multiple regression. We find that satisfaction level is a function of not only the quality of medical service but also non-medical service. The main results of research are follows: 1) The most important factor of hospital choices is 'the trust and fame as National University hospitals'; 2) Overall satisfaction of inpatients is turned to be influenced by the doctor's services, nurse's services, environment, and convenience. And overall satisfaction of outpatients is also found to be influenced by the waiting time for lab test; 3) Highly satisfied patients preferred to revisit and to recommend to others.

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A Strategic Quality Initiative and Its Opportunities to Improve Healthcare Environment (진료환경개선을 위한 우선적 전략과제 설정 및 그 적용)

  • Tark, Kwan-Chul;Park, Hyun-Ju;Park, Chang-Il;Kang, Jin-Kyung
    • Quality Improvement in Health Care
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    • v.5 no.2
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    • pp.324-334
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    • 1998
  • Background : Strategic planning is an organizationwide or systemwide, ongoing look into the future usually of 2~3 years, based on objective analysis of the current environment and trends, but it can incorporate both short-term and long-term goals. The strategic planning process includes external analysis, internal analysis, issue analysis, development of mission, vision and values, and lastly development of organizational goals and objectives. As a part of the strategic quality planning process, certain service lines, important organizationwide functions, or key processes supporting these functions can be prioritized to expedite and roll out certain strategic goals. This is called strategic quality initiatives. Methods : We organized a quality improvement team, a subgroup of 21st century vision planning corps of our medical center, and pursued QI activities for improvement of healthcare environment, particularly in the admission setting. We developed a strategic quality initiative based on the results of patient satisfaction surveys, and carried out functions of self-directed work team. Results : The strategic goal was to be the benchmark for peer group hospitals in Korea for providing cost-effective best-practice. The QI team included 3 medical doctors, 1 nurse, 1 social worker, and 1 QI consultant as well as many operational members to support services and quality initiatives met every Tuesday for 18 weeks. Outcome objectives were to improve patient satisfaction score. The issues included in the objectives were comfort, temperature, noise, cleanliness of the admission wards, quality and education of patient meals, matters regarding the admission process, and an appurtenant facility such as restaurant or convenience store. Every issue was discussed and recommendations, conclusions and opportunities were implemented. Conclusions : By developing a strategic quality initiative as a part of the strategic quality planning process, and pursuing a self-directed work team, certain sen/ice lines, important organizationwide functions, or key processes supporting these functions can be improved effectively within a short period. Strategic quality initiatives serve to support, or roll out, certain strategic goals that are relevant to performance improvement and development of specific measurable outcome objectives, and associated performance measure for each initiative. Each strategic quality initiative should include a statement of intent outcome objectives, and performance measures. We will come back with follow up of the strategic quality initiative, for improvement of healthcare environment, and results of patient satisfaction re-survey.

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