• 한국병원경영학회지
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• 제28권2호
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• pp.32-43
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• 2023

Purposes: This research is conducted to identify main features and trends of mission, vision and core values in Korean tertiary general hospitals by using text-mining. Methodology: For the study, 45 mission, 112 vision and 190 core values are collected from 45 tertiary general hospitals' homepages in 2022 and use word frequency analysis and Leyword co-occurrence analysis. Findings: In the tertiary general hospitals' mission, there are high frequency words such as 'health', 'humanity', 'medical treatment', 'education', 'research', 'happiness', 'love', 'best', 'spirit', and mission mainly includes the content of contributing humanity's health and happiness with these words. In case of vision, high frequency words are 'hospital', 'medical treatment', 'research', 'lead', 'trust', 'centered', 'patient', 'best', 'future'. By using these words in vision, it represents the definition and characteristics of vision such as ideal organizations in the future, goals and targets. As a result of the Leyword co-occurrence analysis, vision includes the content of 'high-tech medical treatment', 'special care for patients', 'leading education and research', 'the highest trust with customer', 'creative talents training'. -astly, the high frequency word-pairs in core values are 'social distribution', 'innovation pursuit', 'cooperation and harmony', and it defines standards of behavior for organizations. Practical Implication: To correct the problems of vision, mission and core values from findings, firstly, it needs for Korean tertiary general hospitals to use the words that can explain organization's identity and differentiate others in their mission. Secondly, considering strengthening the role of hospitals in their community and the importance of members in organizations, it is necessary to establish vision with considering community and members to activate vision effectively. Thirdly, because there are no specific guidelines of establishing mission, vision and core values for healthcare organizations, this research concepts and results could be utilized when other organizations establish mission, vision and core values.

• 보건행정학회지
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• 제20권4호
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• pp.1-18
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• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.

• 중환자간호학회지
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• 제17권2호
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• pp.25-41
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• 2024

Purpose : This study aimed to investigate changes in critical nursing activities from 2009 to 2020 and explore the relationship between nurse staffing and such activities in intensive care units. Methods : A total of 446,445 adult patients admitted to intensive care units in tertiary and general hospitals from 2009 to 2020 were identified using the National Health Insurance claims database. The Critical Nursing Activities Index was calculated based on the following critical nursing activities: ventilator, extracorporeal membrane oxygenation (ECMO), and continuous renal replacement therapy (CRRT). Trend analysis was performed to analyze changes in critical nursing activities over 12 years and to assess linear trends across different staffing levels. Results : The annual utilization days for ventilators, ECMO, and CRRT, as well as the Critical Nursing Activities Index significantly increased over the study period (p-for-trend<.001) in tertiary and general hospitals, except for ventilator use in general hospitals. Ventilator, ECMO, and CRRT utilization exhibited a significant upward trend with higher nurse staffing levels (Bonferroni adjusted p-for-trend<.001). The Critical Nursing Activities Index was significantly higher in hospitals with higher staffing levels compared to those with lower staffing levels (Bonferroni adjusted p <.05). Conclusion : The findings underscore the need for improved nurse staffing levels in intensive care units. Government policies should ensure that staffing levels align with critical nursing activities among critically ill patients to uphold the quality of care.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5049-5054
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• 2013

Background: To assess the treatment pattern and expenditure incurred by cancer patients undergoing treatment at government tertiary hospitals in India. Materials and Methods: A cross-sectional study of 508 cancer patients randomly selected from tertiary cancer hospitals funded by central/state governments located in major cities of five states in India, namely Kerala, Maharashtra, Rajasthan, West Bengal and Mizoram, during March - May 2011 was conducted. Information related to direct costs, indirect costs and opportunity costs incurred on investigations and treatment, major source of payment and difficulties faced by patients during the course of treatment was collected. Results: About 45% of the patients used private health facilities as the first point of contact for cancer related diseases as against 32% in public hospitals. About 47% sought private health facilities for cancer investigations, 21% at district/sub-district hospitals, and about 4% contacted primary health care facilities. A majority of the patients (76%) faced financial problems while undergoing treatment. Conclusions: The results highlight the importance of involving the primary health care system in the cancer prevention activities.

• 중환자간호학회지
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• 제17권2호
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• pp.83-95
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• 2024

Purpose : This study aimed to investigate the impact of clinical reasoning competence, positive psychological capital, and nursing work environment on nursing performance of intensive care unit (ICU) nurses in tertiary general hospitals. Methods : Data were collected from 169 ICU nurses in tertiary general hospitals in Busan, South Korea, from July 27 to August 15, 2023, using a self-report questionnaire. After excluding 12 questionnaires with insufficient responses, 157 responses were analyzed. Descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis were employed. Results : Factors influencing nursing performance included clinical reasoning competence (β=.51, p <.001), hope as a subfactor of positive psychological capital (β=.31, p <.001), and the nursing foundations for quality of care in the nursing work environment (β=.21, p <.001). The explanatory power of the regression model was 62% (F=87.41, p <.001). Conclusion : The study underscores the importance of improving clinical reasoning competence among ICU nurses to enhance nursing performance and foster a hopeful attitude through reflective practices and personal growth. Organizational interventions, such as educational and psychological support programs, along with creating a supportive nursing environment, are crucial for improving nursing performance among intensive care unit nurses.

• Journal of Preventive Medicine and Public Health
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• 제29권2호
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• 한국치위생학회지
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• 제15권5호
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• pp.899-905
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• 2015

Objectives: This study aimed to investigate the regional difference of chronic periodontal care services in Korea by the analysis of 2010 raw data from Health Insurance Review and Assessment Service. Methods: The subjects were the chronic periodontitis patients over 35 years old from dental care facilities in Korea. The study population was 278,319 including 264,994 claims made by dental clinics, 8,084 by dental hospitals, 3,509 by general hospitals, and 1,732 by tertiary hospitals. Results: There was a significant difference in medical care cost benefit between the provinces(p<0.0001). The age groups showed a clear difference in the patient charge, cost of insurance, and medical care cost benefit(p<0.0001). In consideration of the first visit or revisit, there were differences in the rate of prescription, dental examination, and surgical procedures of the chronic periodontal patients from dental facilities. The radiographic use rate in the tertiary hospitals was 2.6 times higher than that of the dental clinic in the treatment of the new chronic periodontal patients. Conclusions: The use of dental services in the periodontitis is influenced by the types of medical services facility, cost of medical insurance, and patient charge. In consideration of cost benefit analysis, prevention is the most important care for the periodontitis. Regional difference in peridontitis is cause by the use of medical services and quality of treatment.

• 간호행정학회지
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• 제9권1호
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• pp.5-18
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• 2003

Purpose : For improvement of nursing services in ambulatory unit, ambulatory nursing activity was identified and the required time by nursing activity was measured. Method : The data were collected from 4 tertiary hospitals and 2 secondary hospitals. The method of data collection was used the self-reporting method. The 123 nurse-work days and 137 nurse-aid-work days in 6 hospitals were analyzed. Results : As a result, 11 ambulatory nursing domains and 79 ambulatory nursing activities were confirmed. Above 50% of subjects performed the general outpatient affair domain. The percentage of total time spent in each domain were as follows : general outpatient affair domain, 58.3%, patient education ${\cdot}$ counseling domain, 10.8%, therapeutic care domain, 8.6% and so on. And the average hours were measured by activity and domain. Conclusion : For the improvement of ambulatory nursing care, the strategies that keep the legal standard of number of ambulatory nurse and exchange the nursing-aid for the nurse is needed. And it is also needed to standardize the ambulatory nursing services.

• 대한간호학회지
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• 제35권3호
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• pp.535-545
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• 2005

Purpose: This paper reports a study exploring factors related to patient satisfaction and dissatisfaction with inpatient care. Method: A cross-sectional study design was used, employing data from the National Health and Nutrition Survey conducted in 2001. Socio-demographic factors, utilization, self-rated health status, and disease characteristics were assessed by employing univariate comparisons and multivariate logistic regression analyses. Result: Out of 37,769 respondents, 1,043 aged 20 years and over had been admitted to a hospital or clinic at least once during the past year. About a quarter of the respondents were discharged from tertiary hospitals and $21\%$ from clinics. The majority of patients ($58\%$) were satisfied with inpatient care received, whereas $11\%$ were dissatisfied. Greater satisfaction was found in patients aged 45-64 years and those having formal education, discharge from tertiary hospitals, national health insurance as a payer, medical expenses not being burdensome, good self-rated health status, and neoplasm. Living in non-metropolitan urban areas, shorter length of stay, and musculoskeletal diseases were associated with greater dissatisfaction. Conclusion: Different factors were related to patient satisfaction and dissatisfaction with care. Those factors need to be taken into account when evaluating and comparing satisfaction levels between health care institutions.

• 임상간호연구
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• 제19권3호
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• pp.345-356
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• 2013

Purpose: To provide clear estimates of the adoption and use of electronic nursing records (ENRs) with standard terminology in Korea and identification of the scope and use as well as perceived or potential benefits of ENRs. Methods: A survey was done of 733 hospitals at three levels: tertiary advanced hospitals, general hospitals, and community hospitals. After performing a literature review a modified version of an existing survey tool was used for 2 months in 2012. The collected information related to EHR functionality and coverage of nursing documentation and nursing process, application of standard terminology, and perceived satisfaction and benefits of ENRs. Results: The response rate was 39.4% (289/733), and 202 hospitals (70.1%, 95% CI64.8~75.5%) of the respondents had ENR systems (82.5% of tertiary hospitals, 66.7% of general hospitals, and 70.1% of community hospitals). Out of these hospitals less than 10% had ENRs fully covering nursing documentation. The adoption rate of standard terminology was 55%, and hospital satisfaction with ENRs was 70%. But personalized care was identified as needing improvement in ENRs. Conclusion: The ENR adoption rate was high but there are many potential opportunities for improving ENR systems in terms of the data standardization and personalized care.