• Title/Summary/Keyword: hospital physicians

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Predictors of Complementary and Alternative Medicine Use by Breast Cancer Patients in Bandung, Indonesia

  • Azhar, Yohana;Achmad, Dimyati;Lukman, Kiki;Hilmanto, Dany;Aryandono, Teguh
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2115-2118
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    • 2016
  • Background: The study aimed to assess complementary and alternative medicine (CAM) use and their associated factors with breast cancer patients in Bandung, Indonesia. Materials and Methods: In total, 330 breast cancer patients were administered questionnaires on their CAM use and CAM predictive factors including socio-demographic parameters, clinical data and quality of life, trust in physicians, trust in hospitals, satisfaction and informational needs. Data were analyzed using univariate analysis and multivariate log regreesion analysis. Results: Overall 33.3% of patients reported use of CAM. Lower income, lower education, presence of metastasis, prolonged diagnosis, less trust in physician were found to be highly associated with CAM use. Conclusions: CAM use by breast cancer patients can be interpreted as an attempt to explore all possible options, an expression of an active coping style, or expression of unmet needs in the cancer care continuum. Physicians need to openly discuss the use of CAM with their patients and identify whether they have other unmet supportive needs.

Studies on the variations of hospital use and the changes in hospital revenues of 10 KDRGs under the PPS (일개 대학병원의 환자군별 진료서비스 변이와 포괄수가제 적용에 따른 진료수익 변화)

  • 전기홍;송미숙
    • Health Policy and Management
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    • v.7 no.1
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    • pp.100-124
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    • 1997
  • In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

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The association of physicians' caring attitude with patient satisfaction: an analysis of the national e-survey data

  • Park, Chanhyun;Kim, Namhyo;Shin, Dong Yeong;Feldman, Steven R.;Balkrishnan, Rajesh;Chang, Jongwha
    • Korea Journal of Hospital Management
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    • v.20 no.2
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    • pp.15-27
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    • 2015
  • As patient satisfaction is a crucial component of improved health care outcomes, there is a need to evaluate the relationship between physicians' attitude and patients' satisfaction. The objective of this study is to examine the relationship between patients' satisfaction and physicians' friendly and caring attitudes by using recent physician ratings by patients. Data from a cross-sectional survey using a convenience sampling was utilized to examine the relationship between physicians' attitudes and patients' satisfaction. The independent variable was the physician's attitude, and the dependent variables were patients' satisfaction with the physician and the office setting. A total of 273,994 patients it the US were included. The patients' average (standard deviation, SD) satisfaction with the physician was 78.08 (0.14), and the average (SD) satisfaction with the office setting was 78.62 (0.12) out of 100. Physicians' attitude was a significant predicting factor impacting the patients' satisfaction with the physician and the office setting (p < 0.001). To facilitate patients' satisfaction with healthcare, a continuous effort to develop physicians' ability to communicate in an empathetic manner should be undertaken so that patients perceive their physicians as empathetic.

Various injury patterns due to combustion (typical but unfamiliar to physicians and easy to miss) in Korea: a case report

  • Hyung Il Kim
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.393-398
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    • 2023
  • Patients transported from fire sites may exhibit various injury patterns. Major trauma, skin burn, inhalation burn, and carbon monoxide poisoning are typical injuries. However, most physicians may be unfamiliar that cyanide poisoning can frequently occur due to combustion. Cyanide poisoning is highly significant owing to high mortality and the existence of antidotes. I present a 35-year-old man who was transported from a burning building and suffered severe metabolic acidosis despite no major bleeding as well as mild carbon monoxide poisoning. I suspected cyanide poisoning and administered the antidote; subsequently, the patient showed improvement. The next day, sudden airway obstruction developed, and emergency endotracheal intubation was performed. The inhalation damage was detected only in the lower airway tract and not in the upper airway. Physicians should be aware of cyanide poisoning and inhalation burn to avoid missing treatment opportunities.

Breastfeeding Belief and Attitudes of Physicians and Nurses (모유수유에 관한 의사, 간호사의 신념 및 태도조사)

  • Kang, Nam-Mi;Hyun, Tai-Sun;Kim, Ki-Nam
    • Women's Health Nursing
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    • v.6 no.4
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    • pp.516-527
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    • 2000
  • The purpose of this study was to investigate belief and attitudes on breastfeeding of physicians and nurses. A questionnaire was mailed to obstetricians, pediatricians and nurses at the department of pediatrics or obstetrics of university hospital and private hospital in Seoul and Choong-Chung Province) in South Korea. Total numbers of study subjects were 346 (pediatrician 67, obstetrician 41, nurse 238). The results were as follows : 1. The main reasons not to educate breast feeding in the hospitals were a lack of interest of the health professionals, a lack of educators and education programs. 2. The respondents thought that the best ways for lactating mother to get advices about breastfeeding during the first month were to give a call to health professionals in the hospitals where she had been delivered, or call to relatives or friends. 3. Breastfeeding attitudes of physicians and nurses did not differ according to gender, job, or type of the hospitals they work. 4. Breastfeeding attitudes were related with personal breastfeeding experience, breastfeeding knowledge, extracurricular education experience, encouragement experience. Physicians and nurses should give appropriate advices and support to lactating mothers to increase breastfeeding rate. They were, however, ill-prepared to counsel breastfeeding mothers. Therefore, it is necessary to instruct breastfeeding in the curriculum of the medical and nursing schools, and incorporate clinically based breastfeeding training into continuing education workshops. Improved breastfeeding education is a critical step in ensuring that health professionals are adequately prepared for this important role.

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Telehealth for Rural Health Problems: Experiences in The U.S.A and Korea (농촌의 보건의료문제 해결을 위한 원격보건 : 미국과 한국의 경험)

  • Lee, Won-Jae
    • Korea Journal of Hospital Management
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    • v.1 no.1
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    • pp.188-202
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    • 1996
  • Telehealth is widely tested in the U.S.A and other developed countries. This system is expected to solve rural health problems reducing professional isolation. Some demonstration projects showed that the system can provide quality care in reasonable prices to rural residents. However, few study has been done on whether telehealth system can attract physicians by reducing professional isolation. The system is not available to most of the rural hospitals because the price for the equipment and telephone charges are not low enough. It is promising that the system cost and telephone charges are decreasing gradually. As time passes, rural hospitals will be more viable for the system. Satisfaction of the physicians and patients is a key factor for the implementation of the system. The physicians need to understand more about telecommunication and computer systems. After physicians are well-versed about the system, we can expect wide use of telehealth in rural areas. Effort for the confidentiality and standardization should be devoted to assure patient's privacy and compatibility of patient records and exam results. In Korea, two projects are being operated in Uljin and Kurye. A study evaluated the economic efficiency of the projects suggesting that increase of the number of patients up to three times of current number or decrease in hardware costs and telecommunication charges into two thirds of the current costs. The hardware and telecommunication charges are decreasing. Another area telehealth system can be applied is psychiatric accommodation facilities. Establishment of telehealth in the psychiatric facilities will increase the access of psychiatric care for patients and is expected to be economically efficient.

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Comparison Study for Learning Transfer Factors of the Leadership Training Program in Different Types of Job : Focused on Physicians in Hospitals and Managers in Firms (리더십 교육훈련 프로그램 학습의 현장 전이 비교 연구 : 병원 의사와 기업 관리자를 중심으로)

  • Hwang, Jae-Il;Park, Byeung-Tae;Gu, Ja-Won
    • Korea Journal of Hospital Management
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    • v.18 no.4
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    • pp.54-77
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    • 2013
  • This paper is a comparison study about leadership training transfer factors between physicians working in large scale hospitals and managers working in firms. To fulfill this purpose, this study conducted a regression analysis on 101 managers and 59 physicians who had attended similar leadership training programs more than 16 hours recently in order to identify the differences on the learning transfer factors. 6 factors such as Learner readiness, Performance self-efficacy, (so far as Trainee Characteristics group), Organization Culture, Supervisor's tangible incentives and Supervisor's intangible support, (so far as Work environment group), Content Validity & Transfer Design (so far Training Design group) were used as independent variables while the personal Managerial Capability Increase and Leadership Capability Increase were used as dependent variables. And also we used 5 factors as control variables ; Job style (Manager or Physician), Age, Gender, Working years and Organization size. Here are the summary of major findings ; first, there were statistically significant differences between the learning transfer factors in leadership training programs for managers and those of physicians. Second, there were also statistically significant differences among trainees' working years and their organization size factors while age and gender do not affect the learning transfer factors. Third, for the physician's leadership training the practitioners should focus on two factors ; Organization Culture and Learner readiness.

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Determinants of Patient Satisfaction and Intent to Revisit at National University Hospitals in Korea (국립대학교병원의 환자만족도 및 재이용 의사 결정요인)

  • Jung, Seung-Won;Seo, Young-Joon;Lee, Hae-Jong;Lee, Kyun-Jik
    • Korea Journal of Hospital Management
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    • v.10 no.2
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    • pp.1-25
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    • 2005
  • This study purports to investigate the determinants of patient satisfaction and intent to revisit at national university hospitals in Korea. A total of 8 independent variables for outpatients, 9 independent variables for inpatients, and an intervening variable of overall patient satisfaction were selected through literature review. The independent variables for outpatients contain the level of satisfaction with physicians, nurses, ancillary staff, administrative procedure, medical cost, physical environment, facility convenience. and health recovery. With regard to the independent variables for inpatients, the quality of ward services was added to those of outpatients. Each variable contains 3 to 8 items measuring the level of satisfaction with various aspects of the variable. The sample used in this study consisted of 879 outpatients and 821 inpatients. Data were collected with interview survey and analyzed using path analysis. The major findings of the study are as follows: 1) The following variables have significantly positive effect on the intent to revisit of outpatients: health recovery, overall satisfaction, satisfaction with physicians, and ancillary staff. 2) The following variables have significantly positive effect on the intent to revisit of inpatients: health recovery, satisfaction with nurses and physicians, overall satisfaction, and administrative procedure. 3) The following variables of admission procedure, satisfaction with ancillary staff, facility convenience, quality of ward services were found to have significantly positive effect only on the level of overall satisfaction, even though they do not have significant total effect on the intent to revisit. The results of the study indicate that national university hospitals in Korea should make an effort to improve the satisfactory level of patients with clinical outcome, services provided by physicians, nurses, and ancillary staff, and the quality of administrative procedure for enhancing the intent to revisit of patients.

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The Comparison of Physicians' and Nurses' Knowledge and Attitudes Toward Cancer Pain Management (통증 관리에 대한 의사와 간호사의 지식과 태도 비교)

  • Lee, Eun-Ok;Heo, Dae-Seok;Kim, Soon-Ja;Kim, Yeul-Hong;Yoon, Sung-Soo;Kwon, In-Gak;Cho, Seok-Goo;Park, Myung-Hee;Park, Jung-Yoon
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.7-15
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    • 1999
  • This survey was designed to evaluate knowledge and attitudes of physicians and nurses toward cancer pain management in South Korea and to compare physicians' knowledge and attitudes with nurses' Ninety-nine physicians and 152 nurses working at four major institutions in South Korea were included for the study. With the 30 items of the knowledge with true and false answers about cancer pain such as pain assessment(6 items), pharmacokinetics of opioids(8 items), analgesics classification(11 items), and drug administration(5 items), total score of knowledge answered by physicians was 21.40, which was not significantly higher than 20.87 answered by nurses. Rates of the correct answer were more than 70% in both physicians and nurses. Physicians were more knowledgeable in pharmacokinetics and analgesics classification than nurses, while nurses higher only in pain assessment than physicians. Since physicians and nurses could not effectively manage the cancer pain because of inappropriate knowledge, it is important to provide intensive education to physicians and nurses about cancer pain management.

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Types of injuries caused by isolated electric scooter accidents

  • Kyongwon, Yoo;Hyung Il, Kim
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.232-239
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    • 2022
  • Purpose: The recent increase in electric scooter (e-scooter) use has been accompanied by an increase in injuries from e-scooter-related accidents. Studies have reported that most such injuries are minor, and physicians may therefore underestimate the severity of such injuries. This study investigated the types and severity of injuries caused by isolated e-scooter accidents (i.e., those that did not involve colliding with other cars or falling from heights). Methods: This prospective observational study was conducted from May to December 2021 at Dankook University Hospital tertiary medical center. The demographic data of patients injured in isolated e-scooter-related accidents were collected. All injuries were categorized by body part. Results: Fifty eligible patients visited our emergency department during the study period. Of these, 76% were categorized as nonemergency, and 62% were discharged after initial evaluation and treatment at the emergency department. Another 10% were admitted to the intensive care unit (ICU) and 18% to the ward, with nine patients receiving at least one operation. The average hospital stays were 2.4 days in the ICU and 9 days in the ward. One death occurred due to traumatic brain injury (overall mortality rate, 2%). Multiple fractures of the left third through ninth ribs combined with lung laceration and fractures of T12 and L4 were noted. Conclusions: Various types and severities of injuries can occur in isolated e-scooter accidents. While most such injuries are minor, some will require ICU admission or surgery, and deaths can occur. Physicians should not underestimate the severity of such injuries.