• 제목/요약/키워드: 상급종합병원

검색결과 239건 처리시간 0.031초

A study on the change of complication incidence rate according to introduction of quality evaluation by the DRG payment -focussing on patients with lens surgery (질병군 포괄수가 적정성 평가 도입에 따른 합병증 발생률 변화에 대한 연구 -수정체 수술 환자를 대상으로)

  • Kim, Myoung-Ok;Park, Arma;Lee, Chong Hyung;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • 제9권6호
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    • pp.99-106
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    • 2018
  • The purpose of this study is to investigate incidence rates of complications in response to the introduction of quality evaluation of the DRG(diagnosis related group) payments, focusing on an increasing number of patients with lens surgery as the population aging increases.Fourthly, there were three dependent variables ('vitreous prolapse', 'IOP elevations', and 'other complications') in this study, and therefore multivariate logistic regression was performed. The result of the analysis indicates that as the number of hospitalized days increased, vitreous prolapse decreased to 0.27 times(95% CI 0.08~1.00) and IOP elevation decreased by 0.14 times(95% CI 0.03~1.59), compared to other complications, and this was statistically significant. From the above results, this study is meaningful in that it has compared the evaluation results of the appropriateness of DRG payment and the medical quality for lens surgery complications patients, in response to the introduction of quality evaluation by DRG payment.

Analysis of changes National Health Insurance Policy and Claim Data of PET (양전자단층촬영 건강보험 적용 정책 및 이용량 변화에 관한 연구)

  • Cho, Young-Kwon
    • Journal of the Korean Society of Radiology
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    • 제14권6호
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    • pp.801-810
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    • 2020
  • In this study, the health insurance application of PET and the change in the pay standard were examined, and the amount of health insurance use over the past 10 years was analyzed. Positron tomography was applied as health insurance in 2006, and after 18F-FDG was first applied as health insurance, positron tomography tests using various radioactive isotopes have been applied as health insurance. As of 2019, the number of positron emission tomography tests was 198,651 cases, and the treatment amount was about 88.3 billion won, and the number of tests according to general characteristics was higher in men than in women, and by age, the number of tests was the highest in 60s. The number of outpatient examinations was higher than that of inpatient examinations, and the number of examinations in tertiary hospitals(68.2%) was significantly higher than that of general hospitals and hospitals. As for the test site, torso test was the most common at 86.6%, and radioisotope was the most at 93.6% using 18F-FDG. The change in the use of PET for 10 years increased steadily from 2010 to 2014, but the amount of use decreased sharply afterwards as the recognition of asymptomatic long-term follow-up tests was deleted due to the government's change in health insurance application standards in 2014. As changes in health insurance standards have a great influence on changes in health insurance usage, continuous monitoring will be required in the future.

A Comparison of Empowerment, Job Satisfaction, Organizational Commitment between Advanced Practice Nurses and Registered Nurses of Hospitals (전문간호사와 일반간호사의 임파워먼트, 직무만족, 조직몰입 비교)

  • Jung, Im-Jin;Kim, Yun-Mi
    • The Journal of the Korea Contents Association
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    • 제16권3호
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    • pp.354-365
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    • 2016
  • The purpose of the study was to identify and compare levels of recognition of empowerment, job satisfaction, organizational commitment between Advanced Practice Nurses(APN) and Registered Nurses(RN) of hospitals. Data collection was done by the 85 APN and 120 RN of six large hospitals, four medium sized hospitals in Seoul and Incheon. T-test and ANOVA using SPSS 18.0 were performed. There were no significant differences of empowerment between APN($3.56{\pm}0.53$) and RN($3.50{\pm}0.54$)(t =-. 861, p = 0.390). job satisfaction between APN($3.36{\pm}0.53$) and RN($3.25{\pm}0.46$)(t =- 1.575, p = 0.117), organizational commitment between APN($3.11{\pm}0.34$) and RN($3.05{\pm}0.36$)(t =- 1.301, p = 0.195). Empowerment, job satisfaction, organizational commitment of APN and RN showed no significant differences. There are some reasons why it resulted in no significant difference between APN and RN. APN's role in Korea is not clearly established and distinguished from RN, lack of appropriacy of employment and reward, and lack of the institutional foundation for APN's operation and efficiency.

Influences of Emotional Labor, Hardiness on Job Satisfaction of Nurses in Comprehensive Nursing Care Service Units (간호·간병통합서비스 병동 간호사의 감정노동, 강인성이 직무만족도에 미치는 영향)

  • Lim, Hye-Sook;Song, Eun Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제21권4호
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    • pp.65-72
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    • 2020
  • The purpose of this descriptive research study was to identify the effects on job satisfaction of nurses working at comprehensive nursing care service units. The study was conducted in five hospitals, two of 250 beds or more in three cities and three of 800 beds. The study subjects were nurses working at comprehensive nursing care service units. A structured questionnaire of 150 questions was distributed to them and 146 were collected. The data collection period was from August 1, 2019 to November 15, 2019. The collected data were analyzed using the SPSS 22.0 program, using x2-test, t-test, ANOVA, Pearson correlation, and multiple linear regression. Emotional labor and toughness were negatively correlated (r=-.20, p=.018), and emotional labor and job satisfaction were positively correlated (r=.25, p=.004). The predictive variables affecting the job satisfaction of the subjects were the aptitude of the ward service (β=-.35, p=<.001) and hardness(β=.21, p=.009). The explanation of job satisfaction in the variables was 18.2% (F=3.54, p=.009). The study results revealed that the predictive variables affecting job satisfaction were the hardiness and aptitude of the ward service. Therefore, in order to increase the job satisfaction of ward nurses, it is necessary to provide administrative support to control the hardiness of the nurse and to allocate manpower in consideration of the aptitude in the hospital personnel system.

Convergence factors Affecting Burnout of Emergency Room Nurses During the COVID-19 Pandemic (COVID-19 팬데믹 상황에서 응급실 간호사의 소진에 영향을 미치는 융합적 요인)

  • Noh, Seung-ae;Yang, Seung Ae
    • Journal of Internet of Things and Convergence
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    • 제8권6호
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    • pp.99-113
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    • 2022
  • This study is descriptive research to investigate the effects of COVID-19 stress, interpersonal (caregiver-patient) stress, and emotional labor on burnout in emergency room (ER) nurses during the COVID-19 pandemic. The data collection of this study was conducted from December 9 to 23, 2021 with ER nurses working at five tertiary general hospitals and general hospitals of Medical Center H. The data was collected with a questionnaire using tools measuring the subjects' general & job-related characteristics, COVID-19 stress, interpersonal(caregiver-patient) stress, emotional labor and burnout. The collected data was analyzed using the SPSS/WIN 25.0 statistical program for frequency analysis, descriptive statistical analysis, independent sample t-test, one-way ANOVA, Scheffé test, correlation analysis, and multiple regression analysis. The average score of COVID-19 stress in ER nurses was 3.64, interpersonal(caregiver-patient) stress 4.35, emotional labor 3.38, and burnout 3.44. As a result of analyzing differences according to general & job-related characteristics, burnout showed a significant difference according to gender, marital status, total clinical experience, and working organization. And burnout showed a significant positive correlation with COVID-19 stress, interpersonal stress and emotional labor. As a result of multiple linear regression analysis, regional emergency medical centers and local emergency medical centers among the work organization types, interpersonal stress, COVID-19 stress, and gender and the explanatory power was 28.6%. Through these results, we intend to provide basic data for the development of an intervention program to prevent burnout of emergency room nurses and improve nursing performance at the time of a new infectious disease pandemic.

The Factors influencing on the Interpersonal Caring Behavior of Clinical Nurses in COVID-19 (COVID-19 상황에서 임상간호사의 대인돌봄행위에 영향을 미치는 요인)

  • Lee, Sook;Choi, Ae-Sook;Yim, So-Youn;Chun, Yeol-Eo;Ryu, Young-Mi
    • Journal of Convergence for Information Technology
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    • 제12권5호
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    • pp.246-255
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    • 2022
  • This study aimed to identify the influence of caring character and knowledge of COVID-19 on interpersonal caring behavior of clinical nurses. The subjects were nurses working at one tertiary hospital in Seoul and two general hospitals in Gyeonggi province. The data were collected from October 15 to November 5, 2021. A total of 130 nurses participated in the online survey. The collected data were analyzed by performing stepwise multiple linear regression using SPSS/Win 27.0. As a result, the factors affecting the interpersonal caring behavior of clinical nurses were caring character (β=.50, p<.001), age (β=-.24, p=.002), and job satisfaction (β=.16, p=.040), and they explained 36.0% of caring behavior (F=24.49, p<.001). Therefore, it is necessary to improve caring character and job satisfaction to enhance the interpersonal caring behavior of clinical nurses. More efforts of the hospital should be made to provide caring character building education and to increase job satisfaction of clinical nurses.

Long-Term Trend Analysis in Nuclear Medicine Examinations (핵의학 영상 검사의 중장기 추세 분석 - 서울 소재 일개 상급 종합병원을 중심으로 -)

  • Jung, Woo-Young;Shim, Dong-Oh;Choi, Jae-Min
    • The Korean Journal of Nuclear Medicine Technology
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    • 제23권1호
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    • pp.15-28
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    • 2019
  • Purpose Nuclear medicine was initially introduced in Korea in 1969 and widely applied to treat hyperthyroidism with $^{131}I$. Also, gamma camera was adopted in 1969 in the first place and its application has been growing continually in many ways. We analyzed long-term trend in nuclear medicine examinations for the last 2 decades. The purpose of this paper is to make predictions and to set both plans and directions on the development of nuclear medicine. Materials and Methods We analyzed the performance of nuclear medicine examinations and therapies performed in Asan Medical Center from 1998 to 2017. Results Results from the last 20 years regarding Bone scan, Renal scan, MUGA scan and $^{18}F$-FPCIT, Bone Mineral Density were on a increase. And Myocardium perfusion SPECT, Thyroid scan, Lung scan were on a decrease while $^{18}F-FDG$ PET maintained on a steady course. Until 2010 there was a positive performance with the therapy but after the excessive medical care in thyroid examination performance is at status quo. Key events such as a medical strike(2000), Middle-East Respiratory Syndrome (2015) influenced the overall performance of the therapy. Conclusion In order to promote a long-term growth in nuclear medicine examination and therapy, it is inevitable to respond to the changes in current medical environment. Furthermore, it is strongly suggested to put efforts to maintain and develop new examinations and clinical indicators.

A study of Mission statements for strategic management - Focusing on the tertiary care hospitals in korea and special functioning hospitals in Japan- (한국과 일본병원의 미션선언문 비교연구 - 한국의 상급종합병원과 일본의 특정기능병원을 중심으로-)

  • Dang, Ji-Yeon;Choy, Yoon-Soo;Kim, Young-Hoon
    • Korea Journal of Hospital Management
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    • 제18권1호
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    • pp.70-87
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    • 2013
  • This study investigated contents of mission statements for Strategic Management of hospitals in Korea and Japan. For the study, 44 tertiary care hospitals in korea, which were accredited by the Ministry of Health and Welfare, were selected. And 83 special functioning hospitals in Japan, which were approved by the Minister of Health, Labour and Welfare, were included. Both quantitative and qualitative analyses were conducted by classifying 5 components of the mission statement; market, service, philosophy, image, contribution. Findings from this study are as follow. First, hospitals in Korea emphasized image(93.2%) and philosophy(81.8%) components in their mission statements, whereas hospitals in Japan highlighted components of service(89.2%) and market(72.3%). In detail, mission statements of Korean tertiary care hospitals describe the components of hospital's image (93.2%), philosophy(81.8%), contribution(56.8%), market(22.7%) and service (18.2%) in order. On the other hand, mission statements of Japanese special functioning hospitals describe hospital's service(89.2%), market(72.3%), contribution(61.4%), image (49.4%) and philosophy(34.9%), respectively. Second, as results of Content analysis, there were some differences in mission statements of hospitals between two countries, and it is mainly from the divergences of standards for recognition of medical institutions, environmental factors, and different ways of mission statement description. For strategic hospital management, carrying out innovative restructuring organization or promoting of research and training for medical development is considered as a desirable approach. However, clear description of mission statement is more important and it is required for effective control and managing organization. And then the mission should be communicated within an organization so all internal members understand it and put their efforts to achieve the mission of organization. In conclusion, it is recommended that a leader and senior managers should re-evaluate its mission statement whether it reflects characteristics of an organization. In addition, a mission statement should be created or improved based on critical decision, as well as it should be clearly shared within an organization in order to become a future oriented organizations.

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A Comparative Study on the Nurses Job Satisfaction and Quality of Life in Integrated Nursing Care Service and General Wards in a Tertiary Hospital (상급종합병원 간호·간병통합서비스병동과 일반병동 간호사의 시점별 직무만족도 및 삶의 질 비교연구)

  • Ha, Yu-Mi;Ha, Eun-Ho;Kim, Ji-Hee;Kim, Hyo-Ju
    • Journal of Convergence for Information Technology
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    • 제12권4호
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    • pp.56-66
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    • 2022
  • The purpose of this study was to investigate the job satisfaction and quality of life of nurses in a integrated nursing care service ward (INCSW) and a general ward (GW). A total of 88 nurses working in INCSW and GW were invited and followed up for 6 months over 3 times. There was no significant difference in job satisfaction between INCSW and GW for 6 months, while there was a difference in quality of life: overall quality of life (1st p=.033, 2nd p=.030), and overall general health (1st p=.049). Comparison of two groups by period in job satisfaction, there were statistically significant differences of the item 'recognition from the organization and professional achievement' (2nd versus 3rd, p=.037) and 'interpersonal interaction with respect and recognition' (1st versus 3rd, p=.005; 2nd versus 3rd, p=.006) in the INCSW. Comparison of two groups by period in quality of life, there was a statistically significant difference of the item 'overall quality of life' (1st versus 3rd, p=.025; 2nd versus 3rd, p=.010) in the INCSW. Development of various nursing strategies (such as manpower arrangement that reflects the nursing skill levels, patient needs, job training and organizational culture before placement) can be helpful for improving nurses job satisfaction and quality of life in INCSW and GW.

Characteristics and outcomes of patients with septic shock who transferred to the emergency department in tertiary referral center: multicenter, retrospective, observational study (상급종합병원 및 종합병원 응급실로 전원된 패혈성 쇼크 환자의 특성과 예후: 다기관 후향적 관찰연구)

  • Kim, Min Gyun;Shin, Tae Gun;Jo, Ik Joon;Kim, Won Young;Ryoo, Seung Mok;Chung, Sung Phil;Beom, Jin Ho;Choi, Sung-Hyuk;Kim, Kyuseok;Jo, You Hwan;Kang, Gu Hyun;Suh, Gil Joon;Shin, Jonghwan;Lim, Tae Ho;Han, Kap Su;Hwang, Sung Yeon;Korean Shock Society (KoSS)
    • Journal of The Korean Society of Emergency Medicine
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    • 제29권5호
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    • pp.465-473
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    • 2018
  • Objective: We evaluated the clinical characteristics and prognoses of patients with septic shock who transferred to the emergency department (ED) in a tertiary referral center. Methods: This study was performed using a prospective, multi-center registry of septic shock, with the participation of 11 tertiary referral centers in the Korean Shock Society between October 2015 and February 2017. We classified the patients as a transferred group who transferred from other hospitals after meeting the inclusion criteria upon ED arrival and a non-transferred group who presented directly to the ED. Primary outcome was hospital mortality. We conducted multiple logistic regression analysis to assess variables related to in-hospital mortality. Results: A total of 2,098 patients were included, and we assigned 717 patients to the transferred group and 1,381 patients to the non-transferred group. The initial Sequential Organ Failure Assessment score was higher in the transferred group than the non-transferred group (6; interquartile range [IQR], 4-9 vs. 6; IQR, 4-8; P<0.001). Mechanical ventilator (29% vs. 21%, P<0.001) and renal replacement therapy (12% vs. 9%, P=0.034) within 24 hours after ED arrival were more frequently applied in the transferred group than the non-transferred group. Overall hospital mortality was 22% and there was no significant difference between transferred and non-transferred groups (23% vs. 22%, P=0.820). Multivariable analysis showed an odds ratio for in-hospital mortality of 1.00 (95% confidence interval, 0.78-1.28; P=0.999) for the transferred group compared with the non-transferred group. Conclusion: The transferred group showed higher severity and needed more organ support procedures than the non-transferred group. However, inter-hospital transfer did not affect in-hospital mortality.