• The Journal of Industrial Distribution & Business
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• v.10 no.4
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• pp.67-76
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• 2019

Purpose - This study attempted to construct and validate a structural model of the relationship between the quality of medical services, perceived risk, reputation and customer satisfaction, which is the main concept of the relationship between large hospitals as well as small and medium hospitals and medical consumers. Through this verification, the small and medium hospitals are to find the way for wise coping in competitive situation with large hospitals. Research design, data, and methodology - This research developed a hypothesis by constructing a structural equation that reaches the satisfaction and the relationship between reputation of perceived risk and perceived risk of service quality perceptions of customers of small and medium hospitals. Research data were collected through a questionnaire survey of respondents who had medical service experience from small and medium hospital. A total data of 252 respondents were used as the sample for the final analysis and analyzed using SPSS 23.0 and AMOS 23. Results - As a result, the relationship of quality of medical service, reputation, and customer satisfaction among small and medium hospitals was consistent with the results of precedent studies, and the perceived risk has a significant impact on reputation, so the greater the perceived risk, the higher the preference for reputable medical institutions as large hospitals. In addition, it was found that the direct route from perceived risk to customer satisfaction was not significant, and reputation was found to have a full mediating effect on perceived risk and customer satisfaction. Customers who use small and medium hospitals prefer to use reputable medical institutions if their perceived risk is high, which is different from risk perception when specific targets are specified. Conclusions - In terms of the effect from customer satisfaction, not only the path of perceived risk → reputation → customer satisfaction, but also the quality of service quality → reputation → customer satisfaction. These findings suggest that small and medium hospitals are appropriately responding to competition with large hospitals, rather than focusing on the perceived risks and reputation of customers in establishing and utilizing competitive strategies to create new customers and preserve existing customers.

• Journal of Internet Computing and Services
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• v.18 no.6
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• pp.75-84
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• 2017

As there has been growing interests in PHR-based personalized health management project, various institutions recently explore safe methods of recording personal medical and health information. In particular, innovative medical solution can be realized when medical researchers and medical service institutes can generally get access to patient data. As EMR data is extremely sensitive, there has been no progress in clinical information exchange. Moreover, patients cannot get access to their own health data and exchange it with researchers or service institutions. It can be operated in terms of technology, yet policy environment are affected by state laws as well as Privacy and Security Policy. Blockchain technology-independent, in transaction, and under test-is introduced in the medical industry in order to settle these problems. In other words, medical organizations can grant preliminary approval on patient information exchange by using the safely encrypted and distributed Blockchain ledger and can be managed independently and completely by individuals. More apparently, medical researchers can gain access to information, thereby contributing to the scientific advance in rare diseases or minor groups in the world. In this paper, we focused on how to manage personal medical information and its protective use and proposes medical treatment exchange system for patients based on a permissioned Blockchain network for the safe PHR operation. Trusted Model for Sharing Medical Data (TMSMD), that is proposed model, is based on exchanging information as patients rely on hospitals as well as among hospitals. And introduce medical treatment exchange system for patients based on a permissioned Blockchain network. This system is a model that encrypts and records patients' medical information by using this permissioned Blockchain and further enhances the security due to its restricted counterfeit. This provides service to share medical information uploaded on the permissioned Blockchain to approved users through role-based access control. In addition, this paper presents methods with smart contracts if medical institutions request patient information complying with domestic laws by using the distributed Blockchain ledger and eventually granting preliminary approval for sharing information. This service will provide an independent information transaction and the Blockchain technology under test will be adopted in the medical industry.

• The Journal of Internal Korean Medicine
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• v.35 no.3
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• pp.354-365
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• 2014

Objectives: Recently, the utility rate of Korean-Medical service has been a 6 percent of the domestic market share in medical service, so there is a lot of effort to increase utility rate of Korean medical service. However, in spite of the importance of image to promotion, there are still few studies about image of Korean medicine. Thus, the purpose of this study was to suggest ways to increase utility rate of Korean medical service by surveying and analysing recognition of image of Korean Medicine. Methods: People aged between 20s and 40s were targets of investigation. We divided respondents into three groups depending on relation approximation with Korean medicine (weak-related group, normal-related group, strong-related group). The questionnaire consisted of questions about images of Korean medicine, conducted through online and personal interviews. Results: In total, 282 members responded to the survey and the results of the analysis were as follows. The more a person was related to Korean medicine, the greater the tendency to experience Korean medical service. The most associated taste about Korean medical institutions was Bitterness, smell was smell of Korean medicine, color was yellow, feeling was warm, sound (instrument) was drum, and treatment pattern was Acupuncture, respectively. The most associated image of acupuncture was painful, and the most associated age of Korean medical doctors was 40s. The most associated general term of Korean medicine was physical constitution, and most associated pathological term was extravasated blood. Conclusions: This study can be very useful for future image marketing of Korean medicine because there have been no other studies about image on Korean medicine before now. But this study has also some limits like area, respondent selection, etc., so a more detailed and comprehensive survey is needed.

• The Korean Journal of Medicine
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• v.99 no.1
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• pp.1-3
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• 2024

Recently, several social issues have raised public concerns about a deficiency of doctors. The government says it will solve the problem by increasing the number of doctors, saying essential medical service is collapsing. However, the medical community argues that there is a fundamental problem with Korea's health care delivery system. The government needs to take advice from the medical community to make policies in the right direction. And the press should no longer provide the public with misinformation that doctors and the public are opposed to. In this article, I would like to mention problems among current medical services and suggest healthcare policies for them.

• The Korean Journal of Emergency Medical Services
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• v.3 no.1
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• pp.33-42
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• 1999

The purposes of this study which was conducted by studying the literature on Emergency Medical Dispatch System are to provide some developmental policies of quality management, pre-arrival instructions, priority dispatch protocols, training program for the dispatchers(Emergency Medical Dispatchers or EMDs) in Korea and to promote understanding emergency medical dispatching. The conclusions from this summarized as follows; (1) It is confirmed that there has been little study on the Emergency Medical Dispatch System in Korea, because for the first time, the real Emergency Medical Services were introduced into Korea in 1994, and the importance of the Emergency Medical Dispatch System has not been realized. (2) Only some squads are using a set of dispatch protocols, others aren't. (3) In spite of trying to introduce a new set of dispatch protocols, it isn't the priority dispatch system using a complete set of dispatch protocols which has key questions, pre-arrival instructions, mode & configuration based on patient assessment. (4) The EMS is unable to promote the service capacity by using quality management, because there is no medical control on the emergency medical dispatching and the EMDs. (5) There are no medical directors in the communications center who are in charge of the medical control to detect problems derived from the EMS and to solve them. (6) There are no systematic training program for the EMDs who are taking charge of dispatching. (7) Having a deep relation to the elements of the EMS, the emergency medical dispatching is subject to restriction of those elements.

• The Korean Society of Law and Medicine
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• v.13 no.2
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• pp.11-38
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• 2012

The Supreme Court stand in the position in specific lawsuit that it doesn't allow the discretionary not covered service, but recently in revocation suit of fine disposal that is imposed on medical fee of leukemia patient, it altered the existing adjudgement and admitted the discretionary not covered service exceptionally. It put forward the allowable condition roughly in that case. According as this alteration, it has become more important to embody the allowance conditions of exceptions. The Supreme Court presented three things, which are procedural condition, medical condition and subscriber's agreement. Concerning procedural condition, several present conciliation procedures are as follows: medical care benefit arret request, relative value conciliation etc, prior request on anti-cancer drug among chemicals which exceed acceptance criteria, request of non benefit object on common drugs. To be granted the existence of those system, there should be no obstacle to use that. Even if it were so, we should take circumstances into consideration; individual situation is unescapable concerning substance and urgency of the discretionary not covered service, process of the procedure, time required etc. Regarding medical condition, safety and effectiveness will be verified through evaluation procedures of new medical skill. About the necessity, the Supreme Court made clear through a sentence that it allow the discretionary not covered service, in case that needs to treat a patient out of the standard of medical benefit. Strict interpretation is right and it answer the purpose of the sentence that the supreme court permit the discretionary not covered service, exceptionally. We need to differentiate medical necessity and medical validity. Subscriber's agreement should holds true if it entails full explanation, and if it is preliminary, explicit and individual. On this account, it should be difficult to admit that someone agree effectively when he call for the affirmation that he is recipient of medical care. Reasonable expense needs to be a part of review whether the agreement is valid. Meanwhile If we adjust system of medical expense and eventually reorganize a fee for consultation payment system (Fee-for-service controlled by item to DRG (Diagnosis Related Groups)), controversial area of the discretionary not covered service will be decreased and that will guarantee the discretion of the doctor.

• Tuberculosis and Respiratory Diseases
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• v.84 no.1
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• pp.46-54
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• 2021

Background: The aim of this study was to investigate inhaler device handling in elderly patients. Inhaler devices with respect to misuse and error correction were also compared. Methods: Inhaler use technique was assessed using standardized checklists at the first visit and 3-month follow-up visit after retraining. The primary outcome was difference in the acceptable use ratio among inhaler devices. Secondary outcomes included differences in error correction, the most common step of misuse, and factors affecting the accuracy of inhaler use. Results: A total of 251 patients (mean age, 76.4 years) were included. The handling of 320 devices was assessed in the study. All patients had been trained before. However, only 24.7% of them used inhalers correctly. Proportions of acceptable use for Evohaler, Respimat, Turbuhaler, Ellipta, and Breezhaler/Handihaler were 38.7%, 50.0%, 61.4%, 60.8%, and 43.2%, respectively (p=0.026). At the second visit, the acceptable use ratio had increased. There were no significant differences among inhaler types (Evohaler, 63.9%; Respimat, 86.1%; Turbuhaler, 74.3%; Ellipta, 64.6%; and Breezhaler/Handihaler, 65.3% [p=0.129]). In multivariate analysis, body mass index, Turbuhaler, and Ellipta showed positive correlations with acceptable use of inhalers, whereas Chronic Obstructive Pulmonary Disease Assessment Test score showed a negative correlation. Conclusion: Although new inhalers have been developed, the accuracy of inhaler use remains low. Elderly patients showed more errors when using pressurized metered-dose inhalers than using dry powder inhalers and soft-mist inhalers. However, there were no significant differences in misuse among inhaler devices after individual training. Results of this study suggests that repeat training is more important than inhaler type.

• Health Policy and Management
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• v.13 no.4
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• pp.28-47
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• 2003

The purpose of this study was to assess the user's satisfaction of health care service in public health centers in Busan. The study respondents were 212, those who visited health centers for health care service. Data were collected in July 2002 by using SERVQUAL(comprehensive service quality measurement scale) and 3 open questions for more details about service satisfaction and the needs for health care service. SERVQUAL has 5 dimensions； tangibles, reliability, responsiveness, assurance and empathy. The results were as follows ： 1. The users reported more satisfaction at 'just service cost', 'convenient service procedure' and 'clean physical environment' at SERVQUAL. Among them the highest rated item was 'service cost'. And the less satisfaction items were 'understanding and individual concerns about service users', 'medical equipment' and 'health center facilities'. 2. There were no statistical differences by general characteristics except for the kind of services rendered. Those who visited for physical examinations and laboratory tests reported lower satisfaction than any other groups. 3. At the open questions, the respondents expressed that they were satisfied with the low service cost, kindness of employee and clean environment. But they criticized the old facilities and worn medical equipment, in addition to the less than kind attitudes. These strengths and weaknesses of health center's service could be applied for planning of customer­centered health care service.

• The Journal of the Korea Contents Association
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• v.18 no.11
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• pp.581-593
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• 2018

The purpose of this study is to examine the effect of the medical service quality of the nursing hospital on the inpatients' satisfaction, reuse intention and to verify the mediating effect of the inpatients' satisfaction. The subjects of this study were 255 male and female inpatients in Hiroshima in Japan. The collected data were used as a model of path coefficients obtained through analysis of covariance structure and hypothesis test. As a result of verification, level of medical team and medical service, reception, facility and fee of the medical service quality of the nursing hospital perceived by the inpatients showed a statistically significant positive correlation with the inpatients' satisfaction. The inpatients' satisfaction showed a statistically significant positive correlation with their reuse intention. The level of medical team and medical service, reception, facility and fee of the medical service quality of the nursing hospital perceived by the inpatients shows a statistically no significant positive correlation with the reuse intention. But, they show a statistically significant positive correlation with the reuse intention with the mediating effect of the inpatients' satisfaction. Finally, the result of this study is to confirm the effect of the medical service quality on the inpatients' satisfaction, reuse intention of the nursing hospital. In this process, it is meaningful to verify the role and function of medical service quality of the nursing hospital.

• Journal of Acupuncture Research
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• v.32 no.1
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• pp.37-51
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• 2015

Objectives : This study aimed to evaluate influential factors affecting patients' surveyed medical service perception of Traditional Korean Medicine(TKM). Methods : This study was a randomized single blind parallel design and 335 patients were participated. After treatment, we carried out a survey about medical service perception index from April 1st 2013 to January 31th 2014. We evaluated and analyzed the difference between Korean internal medicine and acupuncture & moxibustion, and also between the age groups of younger than 30s and older than 40s. Results : As the results of the analysis, acupuncture & moxibustion group had higher points on medical service perception sub factors than Korean internal medicine group. There was no meaningful difference between the age groups. Conclusions : The study showed higher satisfaction with acupuncture & moxibustion than Korean internal medicine, and as variable, department was more influential than age for medical service perception.