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The Current Status of College Health Service Centers in Seoul (서울시내 대학 내 보건의료시설의 현황)

  • Park, Hyun-Ah
    • Journal of the Korean Society of School Health
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    • v.13 no.2
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    • pp.341-347
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    • 2000
  • Background : One-quarter of Koreans are either students or school employeeS. Therefore, school health programs for them have high levels of cost-benefit. School health programs, though, are focused on services such as vaccination and physical examination according to administrational regulations without systemic planning. Futhermore, college health programs run autonomously, not under the supervision of the Ministry of Education. It is my intention to analyse the current status of college school health service centers and use the basic data so generated to model how they might operate at an optimal level of efficiency. Methods : I intended to investigate all 29 colleges in Seoul except some specialized colleges such as theological schools in the two-month period of August and September, 1999. I used the telephone interview method to ask questions relating to personal composition, medical equipment in use, annual expenditure and the provision of school health services. School health services were composed of three items; health servies, health education and a healthy school environment. Results : 27 college health service centers were surveyed. The median number of medical personal in each center was 2, the range was 1-31. 7 centers(25.9%) have only nurses with no doctors. Annual expenditures of 11 centers(50.1%) was less than 10 million won, 19 center(70.4%) were maintained by support from their college. Thirteen centers(48.1%) provided doctor's examinations, 6 centers(22.2%) provided dental care services, laboratory services were provided by seven centers(25.9%). Some 81.5% of the centers had vaccination programs and 44.5% had health education programs. There was no school environment program except insecticide provisions. College health service centers with school doctors differed from centers without school doctors in terms of medical equipment range, annual expenditures and annual case loads. Conclusion : The structure and function of college health service centers in Seoul are diverse. However, no center has a well-organized school health plan.

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A Systematic Review on Role Conflicts of Medical Service Workers (의료서비스종사자의 역할갈등에 관한 체계적 문헌고찰)

  • Lim, Soon-Ryun;Lee, Soon-Young
    • Journal of Convergence for Information Technology
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    • v.8 no.5
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    • pp.1-10
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    • 2018
  • This study systematically collected and analyzed the results of previous studies on the role conflict of medical service workers. The data were collected according to the systematic review guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis). Among the collected documents, 33 were used for the final analysis. The documents using the tools of Kim Mun-sil and Park Sang-yeon were 14,, 12 articles using Rizzio et al's tool, and 3 articles using Eun-hee Lee et al. Qualitative research methods were used in five of the 33 references. As a result of literature analysis, the higher the conflict of roles, the lower the job satisfaction, the employee 's intention, and organizational commitment. The higher the role conflict, the more burnout, job stress, and turnover intention increased. In this study, there are limitations in analyzing the relationship between role conflict and various variables. Based on the results of this study, it is expected that the research on the countermeasures and mediation strategies of the role conflict of medical service workers will be actively conducted.

Research on Improvement of Patient Quality and Perception of Hospital Operation Effect after Medical Institution Certification - For Nursing Hospitals and Western Hospitals - (의료기관 인증 후 환자의 질 향상과 병원운영효과 인식도 조사연구 - 요양병원과 양방병원 대상 -)

  • Lee, Hye-Seung;Park, Hyun-Rin
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.559-570
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    • 2020
  • The purpose of this study was to classify the internal members of nursing hospitals and Western hospitals that received the certification system of medical institutions, and to examine the effect of certification on member satisfaction, job stress, hospital operation effect, and improvement of medical services. In nursing hospitals, the certification system was higher in member satisfaction, hospital operation effect, and medical service effect than in Western hospitals, and members of Western hospitals were higher in job stress. In both nursing hospitals and Western hospitals, the satisfaction of members, hospital operation effect, and medical service effect according to certification showed positive (+) results. It is believed that the effect of the certification system has been empirically high in nursing hospitals as mandatory certification from 2013. Therefore, this study aims to contribute to the efficiency of hospital management and improvement of patient satisfaction through continuous quality management of medical care by analyzing the effect of certification system on medical service improvement.

Analysis of the Impact of Medical Institution Certification by Hospital Type on Hospital Operation Effect to Increase Wellness - Comparison Before and After Certification - (병원유형별 의료기관인증이 병원운영효과에 미치는 영향 분석 - 인증 전과 후 비교 -)

  • Lee, Hye-Seung;Kim, Hwan-Hui
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.8
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    • pp.255-264
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    • 2020
  • The purpose of this study was to compare and analyze the differences before and after certification for internal members of nursing hospitals and Western hospitals that received the certification system of medical institutions after conducting a survey on 297 members of nursing hospitals and Western hospitals, SPSS 26.0 was used, and to understand the effect of improvement of member satisfaction, job stress, and medical service on the hospital operation effect. As for the hospital operation effect of a nursing hospital, it was revealed that the higher the satisfaction of the members and the improvement of the medical service, the higher the effect of the hospital operation. In the case of Western hospitals, the higher the satisfaction of the members and the improvement of the medical service, the lower the job stress, the more the hospital operation effect can be seen to increase. As the basic value system of the medical institution certification system is the improvement of patient safety and quality of care, it is believed that the effect of the certification system was higher than that of Western hospitals due to mandatory certification in nursing hospitals.

Current Status of Sanitary and Nutritional Food Service in Elderly Day Care Center (재가노인복지시설 급식소의 위생·영양관리 실태조사 연구)

  • Woo, Jeonghyeon;Park, Yoo Kyoung;Kim, Mi-Hyun;Lee, Soo-Kyung;Song, Kyunghee;Kim, Hye-Kyeong
    • Korean Journal of Community Nutrition
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    • v.25 no.5
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    • pp.374-385
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    • 2020
  • Objectives: This study was conducted to examine the status of foodservice management, with special interest on sanitary and nutritional food service in elderly day care centers. Methods: A total of 79 employees who managed foodservice facilities in elderly day care centers were included in the survey. The contents of the questionnaire consisted of general characteristics, importance and performance of sanitary and nutrition management, the reasons for poor performance, factors necessary for improvement, and the employee's demand for support. Data analysis was conducted using the SPSS v25.0. Results: Sanitary management showed an average importance score of 4.84 ± 0.40 and a performance score of 4.70 ± 0.61 (t-value: 8.260). The item with the lowest performance score was personal sanitary management (4.58 ± 0.71). In nutrition management, the average importance score was 4.52 ± 0.68, and the performance score was 4.20 ± 1.00 (t-value: 9.609). There were significant differences between the average score of importance and performance in both areas. As a result of an Importance-Performance Analysis, items that were recognized as important but had relatively low performance was "personal hygiene", "ventilation" and "food storage". Also in the nutritional management area, "menu planning for disease management" and "checking the saltiness in the soup" etc. had very low performance with low importance recognition. The items shown in the "low priority" quadrant were those that required professional management skills. In the areas that demanded support in foodservice management, education about sanitary and safe institutional food service had the highest score (4.42 ± 0.74), and all other items showed a demand of 4 points or more. Conclusions: Foodservice managers recognize the importance of foodservice facility management but performance is relatively low. Institutional support is, therefore, needed to improve performance. For items with low importance, it seems necessary to improve awareness of the necessity of these items and to provide education in this regard. To gradually improve foodservice management, continuous provision of education and training in these areas are of great importance.

What Can Koreans Learn from the Dutch Experiences in Reforming the Health Insurance System? (한국의료보험제도(韓國醫療保險制度)의 개혁필요성(改革必要性)과 네덜란드의 경험(經驗)이 주는 교훈(敎訓))

  • Kwon, Soon-won;Sunwoo, Duk
    • KDI Journal of Economic Policy
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    • v.12 no.3
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    • pp.47-69
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    • 1990
  • The measures taken to reform the Dutch health insurance system hold valuable lessons for countries such as Korea, where there has been increased concern regarding the efficiency and effectiveness of the health services provided. The growing literature on comparative health insurance policies suggests that nations can learn from each other. In addition, Korean policymakers have shown great interest in the health insurance systems of foreign countries, particularly in Japan. The development of Korea's health insurance scheme during the past 12 years has made a significant contribution to the increased accessibility of health care services. Although the insurance coverage is universal, the health insurance system today in Korea is by no means a product of systematic and planned efforts. Moreover, it lacks due considerations of insured's needs as well as the long-term objectives of the social security health care system. There are growing gaps in premium burdens and benefits between the rural health insurance program and the employee's health insurance programs. Furthermore, the regional health insurance program is experiencing financial difficulties in spite of the fact that the amount of the government subsidy has been sharply increased in recent years. Under the present payment method solely based on the fee-for-service schedule, both consumers and providers are encouraged to utilize and prescribe more services. The combination of the utilization-inducing reimbursement system and continuous pushes for expanding health insurance has played a crucial role in raising the country's medical bills. Current trends in Korea's health care sector and those anticipated in the near future necessitate changes in the structure and funding of health care. As indicated in the above, there are various shortcomings in this context, the health policy authority in Korea can draw valuable lessons from the Dutch experiences in reforming their health insurance system. The main elements of the Dutch reform measures are a restructuring of the insurance system and a greater role for market forces in the health care system. On this basis a new system will be created which reflects the social nature of health care while at the same time containing sufficient mechanisms to allow the health care sector to operate in a cost-effective and efficient manner.

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A Delphi Survey on Performance Indicators of Korean Advanced Practice Nurses (전문간호사 성과지표에 관한 델파이 조사)

  • Kim, Keum Soon;Kang, Ji Yeon;Kim, Bok Ja;Lee, Young Hee;Lee, Eun Nam
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.131-143
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    • 2010
  • Purpose: The purpose of this survey was to identify a set of performance indicators for Korean APNs (Advanced Practice Nurses). Methods: A convenience sample of 78 APNs working in 2 leading hospitals in south Korea participated in the three-round Delphi survey. In the first round, subjects were asked to propose performance indicators to evaluate the effectiveness of their practice. They rated the relevancy of each indicator during the second round. In the final round of survey, subjects rated the relevancy of indicators again in the light of second round's overall results and they also were asked to check on current and future use of indicators. Results: After 5 months of three-round Delphi survey, 60 performance indicators were identified. In regard to relevancy, the 10 highly ranked indicators were patient satisfaction, self-care ability, expertise of service, family satisfaction, nurse satisfaction, satisfaction in nursing education, advanced nursing service count, education for patient/ family, education for nurse, and compliance. Advanced nursing service count, education for patient/ family, and education for nurse are currently used as indicators by more than 70% of respondents. Conclusion: Additional research is needed to identify subsets of performance indicators for specialized areas and to determine the validity and sensitivity of indicators.

Distribution of Private Medical Practitioners' Income from Medical Insurance and its determinants (의원의 의료보험진료비 수입분포와 그 결정요인)

  • 서수교;박재용
    • Health Policy and Management
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    • v.5 no.1
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    • pp.1-30
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    • 1995
  • This study was conducted to investigate the distribution of private medical practitioners' income from the medical insurance and its determinants. Total amount of the medical service fee paid by the medical insurance to 1,268 private clinics(767 in Taegu and 510 in Kyungpook that had been in practice at least for one year) in 1993 was compared by the characteristics of practitioner, clinic, patient and population. The practitioners in 40-49 years of age and 6-10 years inpractice had the highest income. Total income of a clinic was increased with the number of physicians, employees and equipments. The largest income differentials were observed among obstetrics and gynecology clinics and the least differentials were among pediatrics clinics. The characteristics of practitioner, clinic and population accounted for 41.7% of the total variance of income. The important determinants of income were specialty of the clinic, age of the practitioner and number of the employee and equipments. The large income differentials among clinics imply a skewed distribution of patients and thus long waiting time, inefficient utilization of manpower and inadequate quality of care. Effective measures to reduce the income differentials need to be developed.

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Healthcare Utilization and Discrepancies by Income Level Among Patients With Newly Diagnosed Type 2 Diabetes in Korea: An Analysis of National Health Insurance Sample Cohort Data

  • Eun Jee Park;Nam Ju Ji;Chang Hoon You;Weon Young Lee
    • Journal of Preventive Medicine and Public Health
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    • v.57 no.5
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    • pp.471-479
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    • 2024
  • Objectives: The use of qualitative healthcare services or its discrepancy between different income levels of the type 2 diabetes (T2D) patients has seldom been studied concurrently. The present study is unique that regarding T2D patients of early stages of diagnosis. Aimed to assess the utilization of qualitative healthcare services and influence of income levels on the inequality of care among newly diagnosed patients with T2D. Methods: A retrospective cohort study of 7590 patients was conducted by the National Health Insurance Service National Sample Cohort 2.0 from 2002 to 2015. Insured employee in 2013 with no history of T2D between 2002 and 2012 were included. The standard of diabetes care includes hemoglobin A1c (HbAlc; 4 times/y), eyes (once/y) and lipid abnormalities (once/y). Multivariate logistic regression analysis was performed to examine the difference between income levels and inequality of care. Results: From years 1 to 3, rates of appropriate screening fell from 16.9% to 14.1% (HbA1c), 15.8% to 14.5% (eye), and 59.2% to 33.2% (lipid abnormalities). Relative to income class 5 (the highest-income group), HbA1 screening was significantly less common in class 2 (year 2: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.61 to 0.99; year 3: OR, 0.79; 95% CI, 0.69 to 0.91). In year 1, lipid screening was less common in class 1 (OR, 0.84; 95% CI, 0.73 to 0.98) than in class 5, a trend that continued in year 2. Eye screening rates were consistently lower in class 1 than in class 5 (year 1: OR, 0.73; 95% CI, 0.60 to 0.89; year 2: OR, 0.63; 95% CI, 0.50 to 0.78; year 3: OR, 0.81; 95% CI, 0.67 to 0.99). Conclusions: Newly diagnosed T2D patients have shown low rate of HbA1c and screening for diabetic-related complications and experienced inequality in relation to receiving qualitative diabetes care by income levels.

The study on outpatient-clinic practice by shift system at a hospital in Taegu (대구지역 한 중소병원의 교대제 근무에 의한 외래진료에 관한 연구)

  • Song, Jung Hup;Kim, Jing Kyun;Ha, Young Ae;Yeh, Min Hae
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.44-59
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    • 1994
  • Medical consumers(patients) want evening-clinic because of busy work. For patient's convenience and improving service, hospital should accept it. Considering payment system and patient's demand, personnel expenses, hospital can not accept. The practice of shift system to accept patient's demand and hospital's economic aspect was made. To analysis the effect of the system and probability to alternative to evening clinic this study was done. This study was composed of basal study, intervention, evaluation of effect. The basal study were composed of studying demand on evening clinic, the number of beds, doctors employee, the time table of practice and work, and the number of patients at arrival time. The intervention composed of changing of practice time, changing of working time by the number of patients at arrival time, increasing of employee. The evaluation of effect were composed of evaluating the number of patient at time, the effect of shift system, the comparison of the number of in and out patients and questionnairing the practice of shift system. In the practice time at 2 shift system First team works 7-15 hours and Second team 12-20 hours. there are no lunch and supper time. At 18-20 hours the number of patients were 25-30. The number of patient a depart were 6-7. The number of out-patient increase in 13% and inpatient increase in 10% before the system. Doctors(100%), employee(94.6%), and patients(86.4%) approved this system. The advantage of this system were utilization of surplus time, lengthen the practice time, even distribution of patients and shortening of waiting time, rapid treatment of emergent patients. The disadvantage of this system were shortage of manpower, not all depart practice, continuity of practice, no lunch and supper time, irregular rounding. At present because of small Demanding on evening clinic, this shift system was economical. To succeed this study more effectively all depart in hospital participate. But because of economical reason it is impossible for hospital to do it. If the government assist the economic loss that all depart participate in this system it is very helpful for hospital to succeed in implementing this system more early.

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