• 한국병원경영학회지
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• 제20권3호
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• pp.45-55
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• 2015

While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

• 한방안이비인후피부과학회지
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• 제27권1호
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• pp.117-129
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• 2014

Objective : To study current status on characteristics of allergic rhinitis patients by using the electronic medical record (EMR) data and to explore the feasibility of clinical studies using the EMR data in three different Korean medical hospitals. Methods : We studied allergic rhinitis patients who visited the department of ophthalmology, otolaryngology and dermatology in the three different Korean hospitals from January 1, 2012 to December 31, 2012. We retrospectively collected medical history and characteristics of study subjects using data of EMR. Results : In hospital A, we were able to collect data of 18 years of age or older. In hospital C, we could only collect data after July 1, 2012. Therefore, each hospital's data had different settings in measuring them. Men and women were accounted for similar percentage, and teens were the highest in the age group. J30.4, unspecified allergic rhinitis, was the highest in diagnosis of the allergic rhinitis. Most of the patients have received acupuncture treatments. Moreover, 74.6 percent of the total patients were prescribed with Chinese medicine. Conclusions : Based on this exploratory study, further studies were needed on clinical studies using data of systematic EMR.

• 한국의료질향상학회지
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• 제2권1호
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• pp.126-135
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• 1995

Background: Korean Hospital Standardization Program(KHSP), as a hospital accreditation program initiated and promoted by Korean Hospital Association since 1981, has played a key role in the hospital quality improvement in structural aspect particularly. Recently, however, KHSP has been critisized by hospitals and health personnels in that it is unpractical to be utilized as an initiative to improve hospital quality. In particular, the section of quality assurance in KHSP, strongly influenced by old version of Hospital Accreditation of Joint Commission in U.S.A., has been required to be fundamentally revised. For design of new criteria in quality assurance section, a survey for evaluation of existing program and collection of opinions for ideal one was conducted. Methods: For a month in 1994, structured questionnaires were administered by mailing to 470 hospital staffs from 200 hospitals, participated in the survey for the 1994 KHSP in each hospital. The total number of respondents was 116. Results: Less than half of the respondents(34.5%) value positively on the impact of current KHSP in general on the quality improvement of their hospitals. Moreover, most responses indicated that KHSP should be reorganized towards more practical and applicable one. Current KHSP criteria for quality activities in hospitals were regarded as a unpractical one which should be basically renewed. For new criteria and standards, most respondents emphasized the importance of applicability of those in real situations. Conclusion: For the KHSP to be effective, new evaluation criteria for quality activities should be more practical and fully accommodated to hospital situations in reality.

• 한국병원경영학회지
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• 제25권3호
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• pp.29-37
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• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• 대한예방한의학회지
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• 제19권3호
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• pp.77-90
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• 2015

Objective : The purpose of this study is to discuss the role and ways to improve the position and rights of Korean Medicine Doctors (KMDs) working at long-term care hospitals (LTCHs) through survey analysis. Method : (1) The legal and institutional position of KMDs is studied using current law and related papers. (2) The online survey was conducted through KMD community websites, targeted at KMDs working at LTCHs. Results : (1) Whereas there is perceived added benefit for the eight specializations for a specialist of Western medicine at LTCHs, in the case of a specialist of Korean Medicine, their value is not institutionally recognized at all. (2) A Western inpatient's medical fee is more than a Korean inpatient's medical fee, and the individual fee for the same medical treatment is also higher in Western hospitalization. So, Korean medical hospitalization actually cannot be made. Because of that, Korean Medicine Doctors find it difficult to be primary care physicians. (3) Musculoskeletal diseases and the aftereffects of cerebrovascular diseases were the most common chief complaints addressed in Korean medical consultations. Conclusion : This study shows that KMDs working at LTCHs have suffered many kinds of inequality. That is because of the limited medical scope of the current medical system and real constraints from the gap in Korean-Western medical fees by the National Health Insurance Corporation. Therefore, it is necessary to eliminate these variations along with revising the statute with continuous research.

• 대한예방한의학회지
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• 제22권2호
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• pp.41-53
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• 2018

Objectives : It was to classify and its affecting factors to the patients of Korean medicine hospital with short term and long term hospitalization. Methods : I focused on long-term hospitalized patients. I was conducted on 344 hospitalized patients among the original data of usage and consumption of Korean medical report in 2014. Among those patients, I have classified them into long term inpatients(131 patients) and short term inpatients(213 patients) based on 16 days of hospitalization. Also multiple regression analysis was conducted to investigate the characteristics of the hospitalization, treatment satisfaction and dissatisfaction, the characteristics of long term hospitalization according to the sociodemographic of the subjects, the top 21 diseases and the distribution of human bodies, side effects and kinds of Korean medicine. Results : There was a statistically significant difference between the short term and long term hospitalized patients due to age, occupation, marital status, all 21 diseases and institutional fees, experience of Korean medical treatment due to traffic accidents. There was no significant difference in gender, education level, residence, income level, type of medical insurance, whether private insurance, type of medical treatment for Korean medicine, medical expenses for car accidents, reason for dissatisfaction with treatment. The number of long term patients at Korean medicine hospitals increased by a statistically significant by age in model 1 where confounding factors were differently controlled. In model 2, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases. The number of long term patients at Korean medicine hospitals decreased by a statistically significant amount among the unemployed and others in model 2. In model 3, the number of long term patients at Korean medicine hospitals increased by a statistically significant by age, among those who earned 5,000,000 Korean won or more, and among those with nerve diseases, while the number decreased by a statistically significant amount among the married. Conclusions : These results suggest that the factors affecting the short term and long term hospitalization of patients with Korean medicine hospital are different from each other. Especially it was significant by age, over 5,000,000won Income per month, nerve disease, but decrease significant married.

• 대한한의학회지
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• 제31권5호
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• pp.82-89
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• 2010

Objectives: The aim of this study was to determine distribution patterns of TOAST subtypes of ischemic stroke patients admitted to oriental hospitals and to get a better understanding of present conditions in oriental medicine by comparing with the Korea stroke registry (KSR), the largest and representative data. Methods: Clinical data were collected from acute ischemic stoke patients. MRI studies including vascular images were performed in all cases. TOAST criteria were used to determine subtypes of ischemic stroke patients. According to the duration from disease onset to hospital admission time, patients were assigned to 3 groups (Group I0 to 3 d, Group II4 to 7 d, Group III8 to 28 d) and the distribution of TOAST subtypes were compared among these three groups. Results: We collected 514 sets of clinical data from 10 oriental hospitals between May 2007 and September 2009. Small vessel occlusion (SVO) subtype was the most common (57.62%), followed by large artery atherosclerosis (LAA, 29.98%). Compared with TOAST distribution of KSR, the proportion of ischemic stroke patients with SVO subtype was higher than that of KSR. On the other hand the proportion of patients with stroke of undetermined etiology (SUE) was lower. Distributions of SVO, LAA and cardioembolism (CE) in group were I 66.4%, 23.8% and 8.9%, respectively; those in group IIIwere 51.03%, 34.71% and 11.57%, respectively. Conclusions: In oriental hospitals, the proportion of ischemic stroke patients diagnosed as SVO type was higher than that of KSR. At early stage (from onset to 2 d) proportion of SVO was very high, however after 7 days from onset it decreased with concomitant increases in proportions of LAA and CE. These phenomena may be due to the facts that 1) at early stage emergency treatments are limited in oriental hospitals, 2) after early stage many patients prefer oriental treatments, including rehabilitation.

• 대한간호학회지
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• 제45권4호
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• pp.565-575
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• 2015

Purpose: The purpose of the study was to examine mission statements and their elements and to investigate correlations between mission statements and organizational performance. Methods: The current research was a descriptive study based on the examination of mission statements of 353 hospitals that posted mission statements on their webpage and 92 hospitals that made their income statements public. Results: The most common mission element was 'identification of principal services', which accounted for 92.6%. Mission statements of hospitals included the average of 4.82 mission elements out of 9, and the objective of medical quality improvement was 0.81 among 6 objectives of IOM (Institute of Medicine). Net profit of hospitals with mission statements that have above average number of mission elements were significantly higher (t=2.71, p=.008) than those of other hospitals. Net profit was significantly correlated with mission statements (r=.26, p<.001), and mission elements (r=.29, p<.001). Conclusion: The results of the study empirically reveal that mission statements in the hospital affect organizational performance. That is, better organizational performance is shown for hospitals with better, more diversified, and more firmly stated mission statements which include identification of target customers, identification of principal services, contribution to society as a non-profit organization, and concern for employees.

• 한국의료질향상학회지
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• 제23권1호
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• pp.25-38
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• 2017

Root cause analysis (RCA) is systematic process for identifying contributing factors and root causes. It detects system-level vulnerabilities and prevents them from occurring in the future. In many countries, RCA guidelines have been developed and used for these purposes, and various practical tools are suggested according to stages of RCA implementation. In Korea, adverse events occur in 7.2-8.3 percent of inpatients according to studies conducted in hospitals. However, frontline staffs are suffering from lack of knowledge about RCA implementation. This study introduces RCA guidelines that may be used in hospitals to improve the quality of medical care and patient safety.

• 대한한방내과학회지
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• 제22권4호
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• pp.691-702
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• 2001

Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.