• 보건행정학회지
• /
• 제12권1호
• /
• pp.21-53
• /
• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• 간호행정학회지
• /
• 제14권3호
• /
• pp.249-259
• /
• 2008

Purpose: This study was performed to identify the patient characteristics significantly affecting nursing outcomes and their predictability in gastrointestinal surgery patients. Method: The subjects were 149 abdominal surgery patients from 3 general surgical nursing units of 3 general hospitals. Two instruments were used to measure nursing outcomes and acuity of the subjects. The nursing outcomes were measured at post-operation 4 and 7days using review of patients' records, observation of patients, and interviews with patients by a trained nurse. For data analysis, T-test or ANOVA, Pearson Correlation and Stepwise Multiple Regression were done. Result: Age, severity score, diagnosis, cancer or not, operation site were the subjects' characteristics that were significantly related to the nursing outcomes in both post-operation 4 and 7days. Cancer or not, age, diagnosis and severity score were the significant predictors for the scores of nursing outcome in post-operation 4days and the predictability was 34.9%. The predictability of cancer or not was highest, 22.6%. Age, diagnosis and cancer or not were the significant predictors for the scores of nursing outcome in post-operation 7days and the predictability was 27.8%. The predictability of age was highest, 17.3%. Conclusions: The patient characteristics affecting nursing outcomes should be considered when nursing care is planned and provided. Especially, careful attention should be given to the patients with cancer and older age. And, these patient characteristics should be adjusted for correct estimation of the effectiveness of nursing interventions on nursing outcomes.

• 보건의료산업학회지
• /
• 제4권1호
• /
• pp.1-10
• /
• 2010

The purpose of this study is to investigate the effects of provider and consumer characteristics, and patient trust on relational commitment among healthcare customers of an university hospital, and to suggest some implications for improving customer relation management of hospitals. Data were collected from 250 patients of an university hospital located in Ulsan using structured self-administered questionnaire. Major result of the analysis is as follows: First, study variables are significantly varied by age and income among socio-economic factors. Second, assurance, and empathy among provider characteristics and customer satisfaction and reputation among consumer characteristics are found to be significant affecting factors on patient trust. Third, trust affects significantly both on re-visit and recommendation among relationship commitment, while reputation affects on re-visit and customer satisfaction and reputation affect on recommendation. Above results imply that relationship management strategy for enhancing patient trust is crucial to improve competitiveness of hospitals in turbulent competition environment.

• 간호행정학회지
• /
• 제11권2호
• /
• pp.195-207
• /
• 2005

Purpose: The purpose of this study was to confirm the change of nursing organizational characteristics and to define the difference of organizational outcome by measuring the organizational commitment and job satisfaction perceived by nursing staffs and patient satisfaction before and after organizational redesign. Method: The structured questionnaires of which contained organizational characteristics, organizational commitment and job satisfaction were developed from previous published studies after modification by researcher. The questionnaires were distributed to 1,200 and 679 nurses before and after nursing organizational change. patient satisfaction were measured before and after organizational change by direct interview with structured questionnaire from 1,566 and 1,291 patients. Results: 1. The organizational characteristics were significantly increased and the leadership of team leader and head nurse was significantly increased among the factors of organizational characteristics. 2. Organizational commitment was showed decreased tendency, but the difference was not significant. Job satisfaction was increased significantly and administration, autonomy, and job tasks were increased significantly in the factors of job satisfaction. Patient satisfaction was also increased significantly. 3. There was significant positive correlation between organizational commitment and job satisfaction and also job satisfaction and nursing organizational characteristics. All factors of organizational characteristics and satisfaction in present working unit were major factors to influence organizational commitment and explained 43.8% in a significant level by multiple regression analysis. The major factor which affect job satisfaction were the factors of nursing organizational characteristic except 'interaction with team leader' and satisfaction in present working unit among general characteristics and these factors explained 58.8% of job satisfaction. Conclusion: In conclusion, the nursing organizational change was very effective to bring about desirable change in nursing organizational characteristics and also to improve job satisfaction and patient satisfaction. Therefore the nursing productivity and comparability would be increased when the nursing organizational change is accomplished by the way of improving the factors of organizational characteristics and it would be followed by the promotion of job satisfaction and organizational commitment.

• 가정∙방문간호학회지
• /
• 제27권3호
• /
• pp.250-258
• /
• 2020

Purpose: This study aimed to investigate the relationship between nursing work environment, patient safety culture, and patient safety nursing activities in hemodialysis units at primary care centers. Methods: In this cross-sectional descriptive study, 116 nurses working in hemodialysis units at 22 primary care centers were enrolled as participants. They were selected them by the convenience sampling method. Data were collected using structured questionnaires that included questions on general characteristics, nursing work environment, patient safety culture, and patient safety nursing activities. Results: The nursing work environment was relatively good; however, the patient safety culture and patient safety nursing activities were poor. A positive correlation was found between nursing work environment, patient safety culture, and patient safety nursing activities. Factors that affect patient safety culture were rated high in the order of nursing work environment and patient safety nursing activities, and factors affecting patient safety nursing activities were rated high in the order of patient safety culture and age. Conclusion: This study showed that the development of tailored patient safety training for nurses in hemodialysis units working in primary care and administrative support from those institutions are needed. In particular, strategies accounting for nurses' characteristics such as age are required to strengthen patient safety nursing activities.

• 한국의료질향상학회지
• /
• 제22권1호
• /
• pp.71-90
• /
• 2016

Purpose: Objective of this study was to investigate how often nurses to perform patient safety activities. Methods: 521 observations were collected in 9 hospitals by 107 nursing students. Nurses' patient safety care activities were measured 0 (not at all) to 10 (all the time) scores. Descriptive statistics, independent t-test, one way ANOVA, correlation, multiple regression used to analyse data. Results: Items like 'Initial nursing assessment', 'drug management bring on', 'preparation for radiology test', 'falls assessment', 'nursing record' got high scores. But, scores of 'patient identification', 'verbal order management', 'hand hygiene' were lower than others. Each scores were different significantly according to institutions and departments. Within a same institution, the variance of scores, especially in 'patient identification', 'hand hygiene' were great. Scores of activities were different according to characteristics of institutions like type, location, number of beds, teaching hospital, number of accreditation, JCI accreditation. Predictors influencing nurses' patient safety activities were type, location and accreditation. These predictors account for 19.4% of variance. Conclusion: Performance of nurses' patient safety activities were different significantly according to characteristics of institutions. The important items like 'patient identification', 'hand hygiene' had achieved lowest performance. Further researches are needed to improve the basic safety activities.

• 한국콘텐츠학회논문지
• /
• 제18권9호
• /
• pp.199-208
• /
• 2018

본 연구는 치과위생사 269명의 근무특징과 환자유형에 따른 감정노동이 직무만족도에 미치는 영향을 조사하였다. 일반적인 특징에 따른 감정노동 전체평균은 2.85이며, 성별은 남성, 음주는 하는 경우 높았다. 일반적인 특징에 따른 직무만족도 전체평균 3.02이며 성별은 여성, 연령은 많은 경우, 결혼은 기혼이 높았다. 근무특성에 따른 감정노동은 치과위생사가 다른 직위보다 높았으며, 근무특성에 따른 직무만족도는 경력이 높을수록, 직위는 치과위생사, 수입은 많을수록 높았다. 환자유형별 감정노동은 남성환자, 연령은 20-64세, 진료시간대는 오후 7시 이후가 가장 높게 나타났다. 환자유형별 직무만족도는 환자연령은 65세 이상, 치료 종류는 치아우식 및 치주질환치료, 진료시간대는 오후 7시 이상, 경제수준은 '상'인 경우 높았다. 감정노동 정도에 따른 직무만족도는 감정노동이 '보통'일 때 상승하였으나 '높은군'에서는 가장 낮게 분석되었다. 근무특성, 환자유형, 감정노동이 직무만족도에 미치는 영향을 알아보기 위한 위계적 회귀분석결과 월 수입이 많은집단(t=1.994, p=.047), 환자나이가 많은집단(t=3.027, p=.003), 감정노동이 낮을수록(t=13.858, p=.000) 직무만족도가 높은 것으로 나타났다. 즉 치과위생사들의 직무만족도를 높이기 위해선 감정노동이나 환자의 특성을 고려하여 쾌적한 근무환경을 위한 노력이 이루어져야 할 것이다.

• 종양간호연구
• /
• 제3권2호
• /
• pp.155-163
• /
• 2003

This study was designed to assess the level of family function between cancer patient's families and normal families, and to seek better quality family-Mcentered nursing care. The subjects for this study were 95 ca patient's families who were selected from th university hospitals and 95 normal families who selected from 1 university hospital. The instrument used for this study was McMaster Family Assessment Device (FAD) developed by Epstein, Baldwin and Bishop (1983). The scale consisted of 53 items covering 7 areas: 'problem solving', 'communication', 'roles', 'affective responsiveness', 'affective involvement', 'behavior control', and 'general functioning'. As for data analyses, descriptive statistics, ${\chi}^2-test$, t-test, ANOVA were adopted using SAS program. The result of this study was as follows: There there was no significant difference between cancer patient's family function and normal family function. Also there was no significant difference on cancer patient's family function with regard to family characteristics, disease's characteristics, and clinical stage of cancer.

• 보건행정학회지
• /
• 제15권2호
• /
• pp.16-36
• /
• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• Journal of Korean Biological Nursing Science
• /
• 제23권1호
• /
• pp.43-54
• /
• 2021

Purpose: This study aimed to identify the factors influencing infection-related characteristics and patient safety culture on awareness of blood-borne infection prevention between operating room nurses and general ward nurses. Methods: Participants were 198 nurses(operating room nurses 98 and general ward nurses: 100) working at three general hospitals and three university hospitals in three cities. Data were collected using a structured questionnaire from September 11 to October 14, 2020. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficient, and multiple regression with IBM SPSS/WIN 26.0 program. Results: Typically, 39.8% of nurses in the operating room and 24.0% of ward nurses experienced injuries such as needles and sharp instruments used by the patient. The awareness of patient safety culture was identified to be higher for the ward nurses. Factors influencing the awareness of blood-borne infection prevention in operating room nurses were patient safety culture and wearing protective equipment for infection prevention while nursing infected patients. Moreover, the explanatory power of these variables was 19.4%. In general ward nurses, the patient safety culture was identified as a significant predictor, which accounted for 16.5% of awareness of blood-borne infection prevention. Conclusion: To prevent hospital infection, a strategy is needed to improve the level of awareness of blood-borne infection prevention and patient safety culture of operating room nurses. To this end, the difference in infection-related characteristics and influencing factors between the operating room nurses and the general ward nurses should be considered and planned.