• 대한청각학회지
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• 제25권1호
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• pp.8-13
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• 2021

Background and Objectives: In 2013, the Singapore government reviewed and expanded the Senior Mobility Fund (SMF) to provide subsidy for assistive devices, including hearing aids (HA). While SMF has improved accessibility to HA, its impact on HA acquisition has not been determined. The study aims to elucidate the influence of SMF on HA acquisition and the relationship between financial funding and compliance to HA use. Subjects and Methods: Retrospective review of 643 patients seen between January 2017 to January 2018 at the earnose and throat specialist outpatient clinic, who were referred for a hearing aid evaluation. Of the 643 patients, 109 patients with baseline hearing handicap (HH) scores recorded, and no formal diagnosis of cognitive impairment were included. The patients were grouped according to SMF eligibility and clinical data were obtained. Results: The odds ratio for acquiring HA was significantly higher with SMF, regardless of HH scores. When looking at actual degree of hearing loss (DHL), HA uptake was significantly higher in the least severe of DHL categories. There is no relationship between SMF and compliance to HA use. However, HH score is positively correlated with data log in regression analyses. Conclusions: SMF appears to influence HA acquisition. Especially in financially funded patients with low self-perceived HH, the benefits of HA may be underappreciated given the few hours of HA use. Further studies are warranted to investigate the impact of financial funding on outcomes of HA users to help policy planners and clinicians be prudent in the utilization of SMF.

• 대한간호학회지
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• 제53권4호
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• pp.385-396
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• 2023

Purpose: Drawing on person-environment fit theory and social cognitive theory, this study aimed to examine how self-efficacy affects nurses' workplace well-being via person-job fit and the moderating role of digital competence. Methods: A two-wave survey was conducted to collect data. Data were collected from six hundred and ninety-five nurses at three Chinese hospitals between May 2022 and September 2022. We employed hierarchical regression analysis and bootstrapping to analyze the data. Results: Self-efficacy positively influenced person-job fit (β = .55, p < .001), which positively affected nurses' workplace well-being (β= .32, p < .001). Person-job fit mediated the effect of self-efficacy on nurses' workplace well-being. Additionally, digital competence strengthened the positive impact of self-efficacy on person-job fit (β = .12, p < .001). Conclusion: Recruiting nurses with both self-efficacy and digital competence benefits hospitals. It is critical for nurses to improve their digital competence for achieving person-job fit and attaining workplace well-being in the post-coronavirus disease 2019 (COVID-19) era.

• 한국병원경영학회지
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• 제9권1호
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• pp.66-94
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• 2004

The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

• Clinical and Experimental Pediatrics
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• 제50권4호
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• pp.340-347
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• 2007

목 적 : 현행 중 고등학교 교과서 중 '기술가정', '가정과학' 교과서에 소아의 건강 관리 및 육아에 관한 내용이 수록되어 있어, 이 들 교과서의 내용이 의학적으로 적절한지를 살펴보고 만약 부정확하거나 틀린 내용 혹은 근거가 없는 내용이 수록되어 있다면 이를 시정하여 잘못된 정보가 전달되지 않도록 하기 위하여 검정교과서를 검토해 보았다. 방 법 : 2007년 발행된 중 고등학교 교과서 중 '기술가정', '가정과학' 교과서 47편을 대상으로 하였고, 각 교과서에서 소아의 건강 관리 및 육아에 관련된 내용이 차지하는 비중과 부적절한 내용을 찾아 정의가 잘못된 경우, 정보 자체가 틀린 경우, 부연 설명이 부족한 경우 등으로 나누었으며, 각 교과서의 저자들의 전공분야도 함께 분석해 보았다. 결 과 : 중학교 '기술가정'에서는 청소년기의 정신 및 신체적 변화와 영양에 대해 다루고 있었고, 고등학교 '기술가정', '가정과학'의 경우, 결혼 및 육아에 대해 다루고 있었다. 각각이 차지하는 비중은 중학교 '기술가정'이 평균 27.5%, 고등학교 '기술가정' 및 '가정과학'이 평균 11.7%였다. 내용에 있어서는 정의가 잘못된 경우로는 신생아 및 영아기의 연령 구분이 가장 많았고, 내용 자체가 틀렸거나 부정확한 경우는 주로, 숫구멍, 원시반사, 모유 및 이유식 등에 관한 내용들이었으며, 이 밖에도 배꼽소독 및 영유아의 발달 단계 등에 관해 부적절한 정보를 전달하고 있었다. 예방 접종표는 개정판이 아닌 1997년판을 사용하고 있었다. 부연설명이 부족했던 경우로는 태아기의 설명이나 증상만으로 의심해 볼 질병에 대한 기술이 너무 비약적이어서 혼란을 야기할 가능성이 많았다. 모유수유나 이유식에 대해서도 기술이 불충분하거나 적절하지 못하여 잘못된 인식을 가지기 쉬운 부분이 많았다. 이들 중학교와 고등학교 교과서 저자들의 전공을 살펴보면 가정 계열이 각각 75.7%, 74.1%로 가장 많았으며, 그 다음으로 현직 교사 및 장학사가 각각 24.3%, 25.9%를 나타내었고, 집필 과정에서 관련 의학 전문 학술단체나 전문가의 검토를 거친 근거는 없었다. 결 론 : 교과서 내에 소아의 건강 관리 및 육아에 관한 내용을 기술할 때 '대한소아과학회'와 같은 전문 학술단체의 감수를 거쳐 정확한 의학 정보를 제공함으로써 중 고등학교 학생들이 실생활에 적용하는데 있어 혼란이 초래되지 않도록 교과서 집필 과정을 시급히 개선하여야 한다.

• 한국임상약학회지
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• 제32권3호
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• pp.215-225
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• 2022

Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.

• 경영정보학연구
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• 제20권2호
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• pp.111-137
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• 2018

의료보험 혜택의 증가 및 베이비붐 세대의 노인 인구 증가 등에 기인하여 2020년에는 헬스케어로 소비되는 금액이 미국 GDP의 20%를 차지할 것으로 전망되고 있다. 이처럼 헬스케어 산업이 발전하면서 병원의 의료서비스 간 경쟁도 치열해지며, 의료서비스 품질을 관리하고자 하는 병원의 니즈가 증가해 왔다. 더불어 온라인 리뷰가 병원 품질을 예측하는 하나의 도구로 활용되면서 병원 온라인 리뷰에 대한 관심 또한 증대되었다. 소비자들은 의료서비스 제공자를 선택함에 있어서도 온라인 리뷰를 참고하는 경향을 보이며, 서비스를 제공받은 후 서비스 품질에 대해 온라인상에서 평가를 진행한다. 따라서 본 연구는 온라인 리뷰 사이트인 Yelp의 병원 리뷰를 중심으로 고객이 평가한 서비스 품질 유형의 감성 수준이 병원 평가에 미치는 영향을 파악하는 것을 목적으로 한다. 본 연구는 1차적으로 온라인에서 수집한 대량의 텍스트 데이터를 SERVQUAL 이론의 다섯 가지 서비스 품질 측정 지표로 구분한다. 다음으로 지표 별 감성 수준을 병원 단위로 도출한 뒤, 각 SERVQUAL 지표의 감성 수준이 병원 평가에 미치는 영향을 계량경제학적으로 분석한다. 또한, 병원의 네 가지 특성인 운영 목적(비영리 여부), 병원이 위치한 도시의 인구밀도, 보유 침대 수, 그리고 응급센터로 운영 여부가 병원 평가에 어떠한 상호작용 효과를 나타내는지 분석한다. 본 연구 결과를 통해 병원 경영 실무자들에게 온라인 상의병원 평판을 긍정적으로 형성해 나가려면 어떠한 서비스 품질을 더욱 집중 관리해야 하는지 방향을 제시해 줄 수 있을 것으로 기대한다.

• 대한간호학회지
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• 제44권2호
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• pp.198-208
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• 2014

Purpose: This research was an empirical study designed to identify precursors and interaction effects related to nurses' patient identification behavior. A multilevel analysis methodology was used. Methods: A self-report survey was administered to registered nurses (RNs) of a university hospital in South Korea. Of the questionnaires, 1114 were analyzed. Results: The individual-level factors that had a significantly positive association with patient identification behavior were person-organization value congruence, organizational commitment, occupational commitment, tenure at the hospital, and tenure at the unit. Significantly negative group-level precursors of patient identification behavior were burnout climate and the number of RNs. Two interaction effects of the person-organization value congruence climate were identified. The first was a group-level moderating effect in which the negative relationship between the number of RNs and patient identification behavior was weaker when the nursing unit's value congruence climate was high. The second was a cross-level moderating effect in which the positive relationship between tenure at the unit and patient identification behavior was weaker when value congruence climate was high. Conclusion: This study simultaneously tested both individual-level and group-level factors that potentially influence patient identification behavior and identified the moderating role of person-organization value congruence climate. Implications of these results are discussed.

• Safety and Health at Work
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• 제2권2호
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• pp.176-182
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• 2011

Objectives: Previous investigations have presented some evidence of late cognitive effects in dental personnel exposed to metallic mercury. We wanted to examine if Norwegian dentists have an increased prevalence of symptoms consistent with neurological and/or cognitive malfunction. Methods: The study group consisted of 406 dentists from central Norway and 217 controls from the general population, all under the age of 70. They had responded to a standardised postal questionnaire (Euroquest) inquiring about seven symptoms in regard to neurology, psychosomatics, memory, concentration, mood, sleep disturbances, and fatigue. A score was calculated for each symptom based on 4 to 15 single questions scored on a scale from 1 (seldom or never) to 4 (very often). Results: The dentists and controls had a participation rate of 57.2 % and 42.9 % respectively. The dentists reported no more cognitive symptoms than the controls, with low average symptom scores from 1.16 for neurological symptoms in males to 1.73 for fatigue in females. Corresponding figures for the controls were 1.22 and 1.77. There were a total of 1.2 % of the dentists and 1.8 % of the controls who reported having three or more of the seven symptoms "often" or more frequently. Conclusion: Norwegian dentists do not report more cognitive and neurological symptoms than controls from the general population.

• 한국병원경영학회지
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• 제27권1호
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• pp.1-10
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• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

• The Journal of Asian Finance, Economics and Business
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• 제9권4호
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• pp.273-285
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• 2022

Using data from a departmental profit and loss management questionnaire survey conducted for a group of hospitals consisting of various establishment entities, this study evaluates the effectiveness of departmental profit and loss management practices, such as break-even analysis, based on objective performance data. The study also examines whether the implementation of departmental profit and loss accounting is still effective in improving profitability in the financial year 2021 and whether the effectiveness of the implementation of departmental profit and loss accounting is robust. This study reconfirmed that the implementation of departmental profit-and-loss accounting has a positive effect on objective financial performance in hospitals and that the effect of improving profitability can be enhanced by implementing it monthly with high frequency and regularity and by using the accounting results more actively. It was also found that the department's implementation of break-even analysis had a positive impact on financial performance, which was enhanced by more active use of the data. Given the current economic climate, a hospital organization's active participation in income statement management, not only for the hospital as a whole but also for each department, would be an effective management activity.