• Quality Improvement in Health Care
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• v.22 no.1
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• pp.29-37
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• 2016

Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

• Quality Improvement in Health Care
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• v.16 no.1
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• pp.7-13
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• 2010

• Quality Improvement in Health Care
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• v.16 no.1
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• pp.15-26
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• 2010

• Health Policy and Management
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• v.27 no.2
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• pp.114-120
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• 2017

The hospital standardized mortality ratio (HSMR) is a widely used generic measure for assessing quality of hospital care in many countries. However, the validity of HSMR as a quality indicator is still controversial. We critically reviewed characteristics of HSMR and suggested how to use HSMR as a quality indicator in the Korean setting. The association between HSMR and other quality measures of hospital care is inconclusive. In addition current HSMR model has shortcomings in risk adjustment because of the lack of clinical data, accuracy of disease coding, coding variation among hospitals, end-of-life care issues, and so on. Therefore, HSMR should be used as an indicator for improvement, not for judgement such as public reporting and pay-for-performance. More efforts will be needed to tackle practical and methodological weaknesses of HSMR in the Korean setting.

• Korean Journal of Occupational Health Nursing
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• v.13 no.2
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• pp.140-147
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• 2004

Purpose: The purpose of this study is to identify the types of worksite health promotion programs. Method: Data were collected from the excellent 35 cases chosen at the contest for worksite health promotion held by Korea Occupational Safety and Health Agency. Result: Out of all the health promotion programs, the exercise program recorded 35.0%, the nutrition program 29.4%, the smoking cessation program 28.0%, and the alcohol reduction program 7.6%. The major element of worksite health promotion programs were awareness raising intervention. Behavior change intervention and supportive environment intervention occupied a small portion of the health promotion programs. Evaluation of health promotion programs was made mainly by indicators of health behavior change and clinical symptom. Yet economical indicator was not used at all. Conclusion: Use of various evaluation indicator and development of various interventions including behavior change and supply of supportive environment are required to encourage worksite health promotion program.

• Journal of Korean Clinical Health Science
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• v.6 no.2
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• pp.1097-1105
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• 2018

Purpose: Loneliness is an extremely subjective experience that is influenced by life experiences and circumstances. This study attempted to provide basic data for the development of nursing intervention strategies to understand the concept of loneliness and to reduce loneliness on various topics. Methods: The research analysis method is based on the framework of concept analysis proposed by Walker and Avant (1988). Results: The results of this study are as follows: 1) Self-alienation 2) Isolation of human beings 3) Psychological damage reaction 4) Pain 5) Loneliness is the loss of a comfortable "frame". The prerequisites can be divided into personal characteristics and situational characteristics. Empirical criteria include intimate others, lack of social relationships or problems, family and friendship, belonging, recognition or expression of loneliness, emotional state changes and changes in health behavior, and physical symptoms. Conclusions: Loneliness is an important indicator of well-being and a cause of physical and mental illnesses, so nurses facing various subjects should be able to recognize the signs and symptoms of loneliness. By promoting and sustaining their interest, they should be able to enjoy lonely people.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.3
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• pp.157-163
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• 2016

Objective: The decision to use in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), or split insemination (IVF-ICSI) in the first cycle is based on the number of motile sperm. Hence, total fertilization failure (TFF) often occurs during IVF cycles, despite normozoospermia. To investigate whether the cumulative motile swim-up spermatozoa percentage at 22 hours post-insemination (MSPPI) is an indicator for ICSI, we analyzed TFF, fertilization, blastocyst development, chemical pregnancy, clinical pregnancy, and live birth rates. Methods: This prospective study was performed using data obtained from 260 IVF cycles. At 22 hours after insemination, the remaining swim-up spermatozoa were observed and divided into six groups according to MSPPI (<10%, 10% to <30%, 30% to <50%, 50% to <70%, 70% to <90%, and 90% to 100%). Results: Regardless of the ejaculated motile sperm concentration ($0.6-280{\times}10^6/mL$ motile spermatozoa), the incidence of TFF significantly increased when MSPPI was <10%, and the fertilization rate significantly decreased when MSPPI was <30%. We found that cumulative MSPPI correlated with the cumulative fertilization rate (Spearman correlation, 0.508, p<0.001). Regarding embryo development, we observed no significant differences in the rates of blastocyst development, chemical pregnancy, clinical pregnancy, or live birth among all groups. Conclusion: Our findings suggest that MSPPI is a viable indicator for split IVF-ICSI and ICSI. Taken together, by employing the MSPPI test in advance before IVF, ICSI, or split IVF-ICSI cycles, unnecessary split IVF-ICSI and ICSI may be avoided.

• Health Policy and Management
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• v.33 no.4
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• pp.411-420
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• 2023

Background: The purpose of this study was to analyze the demand and supply status of patient beds by type of medical institution, categorized into 70 clinical privilege, in order to understand the regional bed supply situation. Methods: Utilizing the 70 clinical privilege defined by the Ministry of Health and Welfare, we calculated bed demand and supply quantities from 2019 to 2021 using data from Statistics Korea and the Health Insurance Statistical Yearbook. The bed demand calculation formula was based on the detailed guidelines for the medical sector by the Korea Development Institute and the 3rd edition of bed supply basic policies announced by the Ministry of Health and Welfare. Additionally, to mitigate distorted bed supply situations caused by factors such as regional levels and patient outflows, we classified bed supply types using the population decrease index indicator published by the Ministry of Public Administration and Security. Results: Among the 70 clinical privilege, it was analyzed that a relatively balanced bed supply situation exists overall, irrespective of the type of healthcare institution. However, in medical institutions at or above the level of hospitals, regions with bed supply ratios exceeding 20% compared to demand, particularly in institutions at or above the level of general hospitals, showed a relatively high rate of demand diversion. Conclusion: We have identified the bed supply types in the 70 clinical privilege in South Korea. Based on the results of this study, we emphasize the need for bed supply policies that consider regional characteristics. It is expected that this research can serve as fundamental data for future efforts aimed at managing or rectifying bed supply imbalances on a regional basis.

• Journal of Dental Anesthesia and Pain Medicine
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• v.21 no.4
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• pp.269-282
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• 2021

This review aimed to assess and compare the outcomes of the anesthetic efficacy of inferior alveolar nerve block (IANB) and Gow-Gates mandibular nerve block (GGMNB) in patients with symptomatic irreversible pulpitis. A descriptive systematic review of quantitative research was conducted wherein the "Preferred Reporting Items for Systematic Reviews (PRISMA)" was adopted, and the Problem/Patient/Population, Intervention/Indicator, Comparison, Outcome (PICO) criteria were used to structure the research question. A literature search was performed using PubMed/Medline, Cochrane Library, Google Scholar, and Ovid. Selection criteria were applied for populations over nine years of age, of either sex, with irreversible pulpitis, and articles published in English regarding conventional IANB or IANB and Gow-Gates techniques between 2009 and 2019. Prospective randomized clinical trials or randomized controlled trials were included in the review, in which anesthetic efficacy or success was measured. After screening, four articles were included. Three studies were randomized clinical trials, and two were randomized controlled trials. The validity and reliability of the individual studies were examined. There was evidence of the higher efficacy of the GGMNB technique than that of the IANB technique. However, both techniques can be mastered through training.

• Health Policy and Management
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• v.9 no.4
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• pp.87-119
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• 1999

The main purpose of this research is to measure and analyze how productive the health centers are and how much inputs(or outputs) in the inefficient health centers should be decreased(or increased) for efficiency. The evaluation of the performance of health centers gives a strong incentive to improve resource allocation in regional health planning. It has been, however, implemented very rarely until now. In this regard, this paper measures the performance of the health centers with a single indicator for multiple-outputs in terms of productivity(technical efficiency), based on Data Envelopment method. The 20 Kyungnam health centers which provide clinic services and specific primary health care services were analyzed. The results show that 50.0% of 20 health centers were productive with respective to overall technical efficiency, 65.0% were productive for pure technical efficiency, and 50.0% for scale efficiency. The inefficient group includes Geoje, Mahsan, Miryang, Sahchun, Tongyoung, Gosung, Nahmhae, Euryang, Hahmahn, Hahbchun health centers. The worst case was identified as Tongyoung health center which represented a 47.5% efficiency, compared with productive health centers. The empirical results for input-output analysis indicates that the low-productive health centers have excessive manpower in administration department, producing low outputs in clinical services and vaccination program. These findings imply that a systemic evaluation of the performance of the Korean health centers and the subsequent structural reform are strongly required.