• Perspectives in Nursing Science
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• 제6권1호
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• pp.55-65
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• 2009

The Korean government introduced Home Care Services System to cut medical cost and make efficient use of limited medical resources because of increasing chronic diseases and the growing population of the elderly. The Korean government established measures to control the use of insurance services by restricting the number of nurse's visits to patient's home and by asking the patients to shoulder the transportation fee of nurses during the visit. Factors such as oversupply of hospital facilities, low price of home care services, high insurance coverage for hospital services and increased nuclear family set up resulted in the limited use of home care nursing services. The introduction of long-term care insurance in 2007 brought the decrease in the number of home care agencies and these agencies are facing a crisis today. The increase in chronic diseases and growing population of the elderly recently resulted in the need to control the high medical cost. Home care services for early discharge patients and chronic-severe disease patients will contribute in the reduction of medical cost at the same time improves the quality of patient's life. To catch up with the demands of the nation, accessibility to home care services should be improved and policies such as the expansion of home care services insurance coverage and promotion of establishing home care agencies should be considered.

• 혜화의학회지
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• 제22권2호
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• pp.119-141
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• 2014

Objective : This study was designed to health-Care services recognition comparison of patient between Korean Medicine 00 Hospital and Seoul 00 Health Center. Methods : 277 subjects were participated in this study. After a treatment, we analyzed a patient type by using a questionnaire. After all treatment, we conducted a survey about Medical Trust Scale, Medical Happiness Index Scale, Service Quality Scale. To evaluate a satisfaction degree, we analyzed results of survey statistically. Results : The results of the analysis, Korean Medicine 00 Hospital group got a higher score than Seoul 00 Health Center group statistical significantly on Medical Trust Scale, Medical Happiness Index Scale, Service Quality Scale. Conclusion : Korean Medicine 00 Hospital group got a higher score than Seoul 00 Health Center group. It was more effective in Korean Medicine 00 Hospital group than Seoul 00 Health Center group.

• 대한예방한의학회지
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• 제7권1호
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• pp.87-102
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• 2003

This study was conducted to examine recognition of oriental medical doctors on the quality control of herbal medicine and to provide useful information for the establishment of effective quality control system of herbal medicine. Data were collected from 202 oriental medical doctors working in oriental medical hospitals or clinics in Daegu-Gyungbuk province. Generally, there is a tendency that most respondents have low degree of recognition, trust and satisfaction of the quality control of herbal medicine while they think standardization and complete quality control systems of herbal medicine is needed highly. Thus, in order to increase confidence of consumers in herbal medicine, and to increase the utilization of oriental medical services, both strengthening of quality control systems and standardization and establishment of Oriental KFDA as a new government agency responsible for the work should be required.

• 한국응급구조학회지
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• 제19권2호
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• pp.51-69
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• 2015

Purpose: This study aimed to identify the effects of job insecurity and job engagement on turnover intention of paramedics who work in emergency medical institutions. Methods: From October 14 to 28, 2014, data were collected by structured questionnaires from 171 paramedics who were working in emergency medical institutions. The data were analyzed by using SPSS/WIN 21.0. Results: Of the 171 subjects, 57.3% were temporary employees, of whom 87.5% were working in regional emergency medical centers. The mean scores were 3.19 for job insecurity, 4.58 for job engagement, and 3.28 for turnover intention. The correlation between the variables showed that the higher the job insecurity of the participants, the higher their turnover intention (r = .397, p <.001). Moreover, the higher their job engagement, the lower their turnover intention (r = -.354, p <.001). The variable that most significantly affected turnover intention was job insecurity. The coefficient of determination ($R^2$) of job insecurity and job engagement was 24.3%. Conclusion: A law should be enacted to involve paramedics as required personnel for emergency medical institutions in order to enhance the quality of emergency medical services and provide prompt and professional emergency medical services to emergency patients.

• 보건의료산업학회지
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• 제4권1호
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• pp.125-134
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• 2010

This study has been conducted to estimate the degree of cognition of military hospital services according to experience of military hospital services for serviceman, and to find out some factors affecting the medical services satisfaction. Questionnaires were given to 600 persons during October 5th though 24th 2009. All 600 questionnaires distributed affair, but 343 cases were collected. Statistical analysis methods used in this dissertation are t-test, Logistic Regression Analysis and other basic statistics such as frequency, percentage, and standard deviation using SPSS ver, 17.0. Results of the study are as follows: The satisfaction of the treat a patients' to compared military hospital and private hospital was providing free medical treatment for serviceman. The dissatisfaction of the treat a patients' to compared military hospital and private hospital was army doctors treated his very unfriendly. The level of medical treatment to providing military hospital was very low cognition for serviceman. In conclusion, to increase the preference of the military hospital is level of private hospital health care level of should be to developed. More support to financial should provide for medical workforce and setting of cutting edge medical equipment in the military hospital. Military hospital is should be competition with private hospital. Also should be improve the quality of military medical service.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5125-5129
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• 2012

Economic decision models are being increasingly used to assess medical interventions. Advances in this field are mainly due to enhanced processing capacity of computers, availability of specific software to perform the necessary tasks, and refined mathematical techniques. We here estimated the incremental cost-effectiveness of ten strategies for colon cancer screening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and profit of chemotherapy in Iran. We used a Markov model to measure the costs and quality-adjusted life expectancy of a 50-year-old average-risk Iranian without screening and with screening by each test. In this paper, we tested the model with data from the Ministry of Health and published literature. We considered costs from the perspective of a health insurance organization, with inflation to 2011, the Iranian Rial being converted into US dollars. We focused on three tests for the 10 strategies considered currently being used for population screening in some Iranians provinces (Kerman, Golestan Mazandaran, Ardabil, and Tehran): low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 39%, 60% and 76%, and mortality by 50%, 69% and 78%, respectively, compared with no screening. These approaches generated ICER (incremental cost-effectiveness ratios) of $9067, $654 and $8700 per QALY (quality-adjusted life year), respectively. Sensitivity analyses were conducted to assess the influence of various scales on the economic evaluation of screening. The results were sensitive to probabilistic sensitivity analysis. Colonoscopy every ten years yielded the greatest net health value. Screening for colon cancer is economical and cost-effective over conventional levels of WTP8.

• 한국응급구조학회지
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• 제22권3호
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• pp.47-54
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• 2018

Purpose: The purpose of this study was to present evidence for quality management based on analysis of patient transportation and response intervals among emergency medical squads. Methods: The chi-square test was used to determine whether mental status and patient assessment affected direct medical control and hospital destination. One way analysis of variance was used to compare response intervals depending on mental status and patient assessment using data drawn from 1172 prehospital care reports. Results: There was a statistically significant relationship between mental status and direct medical control (p<.001); there was a statistically significant relationship between patient assessment and hospital destination (p=.011). However, there was no statistically significant relationship between mental status and hospital destination. The interval from arrival at the patient's side to departure from the scene showed a statistically significant difference (p<.001, p<.001), however, it took the longest time (16.8 minutes) in unresponsive patients. It showed a statistically significant difference (p<.001) in the interval from arrival at patient's side to departure from the scene depending on patient assessment; however, it took the longest time (9.6 minutes) in emergency patients. Conclusion: There was call for direct medical control based on patient assessment; however, patient transportation and response intervals were not appropriate.

• 한국치위생학회지
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• 제13권3호
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• pp.411-418
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• 2013

Objectives : The quality of service is considered as the difference between services that customers perceive and expect by using SERVQUAL model and the basic data for the efficiency of management of dental hospital and clinics, the differentiation strategies of dental medical institutions and the improvements on quality of service are provided. Methods : Subjects were 469 patients who visited six dental hospitals and clinics in Daegu-Gyeongbuk regions. Questionnaire consisted of five items such as type, reliability, responsiveness, certainty and empathy properties. Data were analyzed using SPSS 12.0 program in this study. Results : Women had high satisfaction scores of medical services in certainty and empathy properties. 40s and higher had the highest score in the type property. 30s had high score in the certainty property. For expected service satisfaction, 30s had the highest score in dental practitioners and administrative staffs. For reuse of current medical institution and intent for recommendation, certainty property and factor of dentist and dental practitioners had high scores. Additionally, reliability and responsiveness properties were statistically significant. Conclusions : Medical institutions should make every effort to get the dentists or dental practitioners have the medical knowledge at a high level, a kindness for patients and trust from patients.

• 보건교육건강증진학회지
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• 제14권1호
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• pp.1-9
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• 1997

The health education in hospitals has many problems including lack of the division specialized in health education, lack of implementation system of health education, insufficient professional health education and insufficient health education materials. Despite these restraints, hospitals should reinforce health education program as a part of active response centered on disease prevention and health promotion targeting healthy people who have potential health risk before the onset of disease, rather than passive approach emphasizing the treatment. Accordingly, health education team should be organized in a hospital, in which health educators can provide the following education services. First of all, hospitals themselves should provide active community services in collaboration with community organizations. In addition, multi-disciplinary approach in cooperation with schools, work places should be reinforced to establish the comprehensive health education system. The establishment of medical service referral system with other medical institutions and the linkage system for medical information exchange are also needed. The utilization of education materials obtained through these system should be open to community residents as well as patients. Finally, medical staff working in hospitals should try to provide the high-quality health education that is as high as the level of medical services. The high-quality health education is possible when its level is based on one required by community residents and the county rather than the international or arbitrary standard.

• 간호행정학회지
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• 제8권1호
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• pp.169-191
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• 2002

As the tendency of the society is centralized into consumers and services, patients are getting to ask better medical services. The consumers influenced from various social surroundings became to have some expectation of nursing service. Compared with their expectation, the quality of the services which they virtually get may be recognized and evaluated. So it is necessary to know exactly what the consumers want in nursing services. The purpose of this study is to examine the determinants which can evaluate the quality of nursing services by researching into consumers' expectation and perception of the nursing services depending on the consumer-oriented attributions on the basis of the model of SERVQUAL. 1,144 of outpatients were selected as the subjects for this research. They used to continuously visit the same hospital after being hospitalized and nursed in 9 hospitals randomly selected among the second-level medical organizations in Seoul from January to February, 2001. The collected data are analyzed into the Descriptive Statistics, t-test, GLM and Multiple Regression through the SAS program. Delphi was used for the research tool and the results of the research are as follows; the determinants in evaluating the quality of nursing services consist of 5 categories such as Tangibility, Reliability, Responsiveness, Assurance, Empathy. The values of Cronbach' $\alpha$ appeared to be 0.96 in the expectation of nursing services, 0.94 in the perception of nursing services and 0.96 in the importance of nursing services. The determinants in the expectation of nursing services were ranged in the order of Assurance, Empathy, Reliability, Responsiveness and Tangibility. And those in the perception of nursing services were in the order of Assurance, Empathy, Reliability, Tangibility and Responsiveness. Those in the importance of nursing service were in the order of Empathy, Assurance, Reliability, Tangibility and Responsiveness. Finally, those in the quality of nursing service were in the order of Tangibility, Responsiveness, Empathy, Reliability and Assurance. Each expectation of nursing services appeared different depending on the subjects' age, gender, clinical department and reason for hospitalization. The hypothesis examined in this research shows that the group having higher personal needs shows meaningful differences in the expectation of nursing services, and the subjects who have had external communication show higher perception of nursing service than uncommunicative ones. After all, we can see that the statistical differences in the perception of nursing services depend on whether the subjects have external communications or not. The determinants in the expectation of nursing services can explain the quality of nursing service up to 14.96%. The statistically meaningful determinants in the expectation could be arranged in the order of Reliability, Assurance and Tangibility. And the more expectation brings about the lower evaluation of the quality of nursing services. The determinants in the perception of nursing service can explain the quality of nursing services up to 29.85%. The statistically meaningful determinants in the perception could be arranged in the order of Responsiveness, Reliability, Tangibility, Empathy, and Assurance. And the more perception brings about the higher evaluation of the quality of nursing services. According to the result of the above research, I would like to propose as follows. As long as this research is oriented to get knowledge of the consumer-oriented nursing services, it should be continued to draw the other elements determining the quality of the nursing services. Furthermore, this research is based upon the Parasuraman, A., et al.'s SERVQUAL Model(1991), which deals only expectation, perception and quality of consumer-oriented nursing services, so it will be necessary to inspect and verify it through the other models containing the offerers of nursing services in the future. On the other hand, as this research evaluates the actual quality of nursing services based on the expectation and perception of nursing services, it can be utilized as fundamental data to develop the marketing strategies and to estimate the qualities as well. I hope this research will be periodically estimated to be the useful data to develop the marketing strategies in the nursing service area.