• 간호행정학회지
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• 제9권2호
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• pp.251-264
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• 2003

Purpose : The expectations are defined as desired expectations in initial SERVQUAL scale(1985, 1988), but in modified SERVQUAL scale(1991), are defined as a feasible ideal point expectations. In assessment of nursing service quality by SERVQUAL scale, the definitions of expectations is important problem. The purpose of this study was to compare the feasible ideal point expectations with the desired expectations in assessment of nursing service quality using SERVQUAL scale. Methods : The subjects were 256 inpatients at 4 general hospitals in Jeju-do(123 for feasible ideal point and 133 for desired). The data were collected by two types of self-reporting questionnaires to measure the feasible ideal point and desired expectations. For data analysis, t-test, multiple regression, and comparative analysis of multiple Rs via Fishers Z transformation. Results : Compared with the SERVQUAL scores, the feasible ideal point expectations better explained the variations of the overall consumer satisfaction($R^2$=O.33) than the desired($R^2$=O.25). Conclusion : The feasible ideal point expectations were more suitable to the assessment of nursing service quality using SERVQUAL scale. It will be need to explore the conceptual definitions of expectations using SERVQUAL scale in different settings. Also, further study needs to be conducted to compare alternative service quality measurement scales.

• 영어어문교육
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• 제17권4호
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• pp.339-356
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• 2011

This study explored pre-service English teachers' participation in the development of a rubric and examined evaluation of their own English poetry. The current study would investigate: 1) the pre-service English teachers' perception as a rubric developer and self-evaluator, 2) the number of analytic area that the participants included in their rubrics and the scoring scheme that they designed in their rubrics, and 3) the inter-rater differences between self-assessemnt and expert-assessment across analytic areas. Twenty-four EFL learners participated in the current study. The researchers analyzed the learners' own English poetry, their field notes which contained the process of their writing, their rubrics, scores of self-assessment, and expert raters' scores. The results revealed that learners showed positive responses on learner-directed assessment, that 'content' is the most important area, and that inter-rater difference is small across all analytic areas.

• 지역사회간호학회지
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• 제14권1호
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• pp.75-82
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• 2003

The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

• 보건행정학회지
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• 제24권2호
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• pp.120-127
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• 2014

Background: Since December 2010, online computerized prospective drug utilization review (pDUR) has been implemented in Korea. pDUR involves the review of each prescription before the medication is dispensed to the individual patient. The pDUR is performed electronically by Health Insurance Review & Assessment Service (HIRA), which is a Korean governmental agency, and then HIRA provides medical institutions and pharmacies with information that can be helpful to them in preventing potential drug problems such as drug/drug interactions or ingredient duplication. The aim of this study was to assess the impact of the Korean pDUR implementation on the proportion of drug-drug interactions (DDIs) using claims data from HIRA. Methods: A before-after comparison of the prevalence of DDIs between prescription was conducted, using HIRA administrative claims data of medical institution from January 2010 to December 2011. The analysis unit was the prescription issued and pairs before and after. The main outcome measures were the proportion of DDIs within- (control group) or between- physician encounters. To examine the difference, a paired t-test was applied. Results: We found that DDIs proportion between prescription decreased significantly (t=3.04, p=0.0026) after the implementation of pDUR, whereas there is no significant reduction within prescription (t=1.15, p=0.2518). With respect to the prevalence of DDIs between drug groups, the most dramatic reduction was occurred between 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors and anti-fungal agents. Conclusion: It seems effective that giving a direct feedback to prescribers by a prospective DUR. Further research is needed to assess the impact of DUR to final outcomes such as hospitalization.

• 간호행정학회지
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• 제14권3호
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• pp.229-240
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• 2008

Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

• 보건행정학회지
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• 제30권2호
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• pp.164-177
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• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• 한국과학교육학회지
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• 제42권5호
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• pp.501-514
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• 2022

온라인 교수학습 환경으로의 변화에 따라 온라인 형성평가에 대한 관심이 높아지고 있으며, 이에 대한 예비 교사들의 준비가 필요하다. 본 연구에서는 교사 교육의 기초 토대 마련을 위해 예비 과학교사 22명을 대상으로 온라인 수업과 온라인 형성평가, 형성평가에 대한 인식을 조사하고, 이를 바탕으로 실행 과정에서 나타나는 주요 사항을 분석하였다. 사전 인식은 개방형 설문을 통해 얻은 응답을 오픈 코딩을 통해 범주화하여 범주별 빈도를 파악하였고, 사전 인식의 범주 분류 결과를 바탕으로 실행의 모습을 분석하였다. 이를 통해 현재 상태와 바람직한 활용 목표 간의 격차를 파악하고, 교사 교육에서 중점을 두어야 하는 사항은 무엇인지에 대해 논의하였다. 연구의 결과, 사전 인식에서는 온라인 수업의 어려움으로 상호작용을 언급하고, 온라인 형성평가의 장점으로 테크놀로지의 활용 및 피드백과 수업 조정을 언급하였다. 지도안과 조별 사전 인식 과정에서는 플랫폼의 테크놀로지를 활용하여 자동화된 피드백을 대부분 활용하였지만, 응답 분석 결과를 활용한 수업 조정과 상호작용이 나타나지는 않았다. 또한 온라인 형성평가의 형성적 기능에 적합하지 않은 활용 방식이 다수 나타났다. 이러한 원인은 예비 교사들의 형성평가 활용에 대한 이해가 부족하고, '평가'의 측면에 치중했기 때문으로 분석된다. 형성평가의 피드백을 통한 '형성적' 기능과 활용 방법에 대한 예비 교사들의 충분한 이해가 바탕이 될 때, 온라인 형성평가의 장점을 활용한 상호작용으로 이어질 수 있다. 따라서 형성평가의 핵심적 기능이 잘 발휘될 수 있도록 형성적 활용에 대한 역량 강화와 실질적 적용 방법에 대한 교육이 예비 교사 교육에서 강조되어야 할 것이다.

• 한국환경복원기술학회지
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• 제24권2호
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• pp.115-126
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• 2021

Strategic Environmental Impact Assessment (SEA) is a decision-making process taking into account the environmental impact, economic and social impact of policies, plans, and programs at the higher stage prior to the project plan for promoting sustainable development. In this study, we analyzed the process and criteria for selecting appropriate alternatives when establishing development plan in SEA. First, the criteria for estimating changes in ecosystem services following the implementation of development project of industrial complex were presented. Second, alternative evaluations were conducted through an analysis of ecosystem service scenarios to explore suitable alternatives in Anseong. As a result, the environmental quality of selected area as the existing project site deteriorated according to the implementation of the project, and the dimensional reduction technique confirmed that the change in ecosystem service factors in project area was the optimal location. In addition, the results of the scenario assessment to explore suitable alternatives in Anseong City showed that the existing site had large capacity in terms of water quality control services (scenario 1), scenario 2 in terms of preconditioning services, and scenario 3 in terms of water supply services. The guidance of Ecosystem service assessment is expected to be available in decision-making of large-scale strategies (e.g., SEA) and projects by presenting more quantitative criteria for determining the adequacy and location feasibility of development plans and policy plans. This is expected to require various support, including legislation and revision of related laws, believed to be supported by advanced research.

• Journal of Chest Surgery
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• 제49권sup1호
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• pp.37-43
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• 2016

Background: While demand for cardiovascular surgery is expected to increase gradually along with the rapid increase in cardiovascular diseases with respect to the aging population, the supply of thoracic and cardiovascular surgeons has been continuously decreasing over the past 10 years. Consequently, this study aims to achieve guidance in establishing health care policy by analyzing the supply and demand for cardiovascular surgeries in the medical service area of Korea. Methods: After investigating the actual number of cardiovascular surgeries performed using the National Health Insurance claim data of the Health Insurance Review and Assessment Service, as well as drawing from national statistics concerning the elderly population aged 65 and over, this study estimated the number of future cardiovascular surgeries by using a cell-based model. To be able to analyze the supply and demand of surgeons, the recent status of new surgeons specializing in thoracic and cardiovascular surgeries and the ratio of their subspecialties in cardiovascular surgeries were investigated. Then, while taking three different scenarios into account, the number of cardiovascular surgeons expected be working in 5-year periods was projected. Results: The number of cardiovascular surgeries, which was recorded at 10,581 cases in 2014, is predicted to increase consistently to reach a demand of 15,501 cases in 2040-an increase of 46.5%. There was a total of 245 cardiovascular surgeons at work in 2014. Looking at 5 year spans in the future, the number of surgeons expected to be supplied in 2040 is 184, to retire is 249, and expected to be working is 309-an increase of -24.9%, 1.6%, and 26.1%, respectively compared to those in 2014. This forecasts a demand-supply imbalance in every scenario. Conclusion: Cardiovascular surgeons are the most central resource in the medical service of highly specialized cardiovascular surgeries, and fostering the surgeons requires much time, effort, and resources; therefore, by analyzing the various factors affecting the supply of cardiovascular surgeons, an active intervention of policies can be prescribed for the areas that have failed to meet the appropriate market distributions.

• 보건행정학회지
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• 제30권1호
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• pp.82-91
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• 2020

Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion: Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.