• 보건행정학회지
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• 제17권2호
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• pp.68-90
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• 2007

Nurse staffing level is an important factor that influences the quality of health service and patient outcomes. This study was carried out to examine the current state of acute hospital nurse staffing and find out factors that affect the nurse staffing level. Nurse staffing of individual hospitals was measured using the number of registered nurses per 100 beds. Descriptive and multiple regression analyses were conducted using 592 acute care hospitals' data. Regression model included structure factors such as referral level, ownership, medical and general staffing, and financial outcome factors such as occupancy rate, inpatient and outpatient revenues. Market characteristics included strength of competition, supply of nurses, and income and health status level of consumers. The average number of nurses per 100 beds was 28 and showed a great variation according to the referral level. Regression model explained this variation as much as 76.87%. Hospital structure variables which affecting the hospital nurse staffing level positively were ICU bed ratio, the staffing level of specialist, training doctor and employees except doctor and nursing personnel, while the negative factor was nurse aid staffing level. General hospitals employed more nurses than hospitals. Among outcome characteristics, occupancy rate and the amount of health insurance inpatient revenue affected positively on the hospital nurse staffing level. The more supply of the new nurse and the higher consumer income and health status in the medical service markets, the more nurses were employed by the medical institutes. According to the study result, hospitals employed more nurses when they had more financial incentive by increasing nurses. This means appropriate hospital incentive policy and regulation policy, which hospital violate nurse staffing level have to pay penality, should be needed. Clarifying job description between nurses and nurse aids and the reentry program for unemployed experienced nurses will be helpful to increase nurse staffing level.

• 한국병원경영학회지
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• 제23권1호
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• pp.87-106
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• 2018

Purpose: 본 연구는 미국 캘리포니아와 플로리다에 위치한 의료기관을 대상으로 급성심근경색증, 심부전, 폐렴을 주진단으로 받은 메디케어 입원환자들에게 제공된 의료서비스의 과정적 질과 잠재적으로 예방이 가능한 30일 이내 위험 보정 재입원율과의 관계를 살펴보았다. Methods: 본 연구의 종속변수는 잠재적으로 예방이 가능한 30일 이내 위험 보정 질환별 재입원율이며 3M PPR 소프트웨어를 이용하여 재입원의 예방 가능 여부를 결정하였다. 미연방 의료 비용 및 이용 프로젝트 데이터베이스, 미국병원협회의 병원조사 자료, 미연방 보건복지부소속 메디케어 및 메디케이드 서비스 센터의 병원비교 자료를 이용하였다. 자료의 위계적 구조를 고려하여 다수준 로지스틱 회귀분석을 이용하여 분석하였다. Findings: 의료서비스의 과정적 품질과 퇴원 후 30일 이내 잠재적 예방 가능 위험도 보정 재입원율과의 관계는 질환별로 차이를 보였다. 폐렴의 경우 의료서비스의 과정적 질은 30일 이내 잠재적 예방 가능 보정 재입원율과 유의한 부(-)의 관계를 보였으나, 급성심근경색증과 심부전의 경우 대체로 유의한 관계를 관찰할 수 없었다. Practical Implications: 잠재적으로 예방 가능한 급성심근경색증, 심부전 재입원율을 줄이기 위해서는 의료기관에서 가이드라인으로 따를 수 있는 더욱 다양한 근거 중심의 과정적 질 지표의 개발에 대한 정부와 보건의료계의 노력이 필요하다.

• 한국엔터테인먼트산업학회논문지
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• 제15권1호
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• pp.199-206
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• 2021

초고령 사회가 임박함에 따라 노인성 질환자 또한 증가하고 있으며 이로 인한 사회적 문제로 시설과 정책의 부족이 제기되고 있다. 의료보장의 현실적 대안으로 국민건강보험이 이야기되고 있으며, 요양병원은 급성기 병원과 장기요양시설 사이로 분류되며 의료비 절감의 대체재로 작용하고 있다. 그러나 유지기 재활의 핵심인 요양병원은 서비스의 질적 문제가 심각히 제기되고 있고, 현 의료체계의 문제로 재활 난민이 양산되는 문제가 있다. 특히 2015년 선행연구에서 전라북도의 요양병원 현황이 가장 열악하였으며 이에 공공데이터를 활용하여 전라북도 요양병원 일반현황, 다빈도 상병 현황, 재활서비스 관련 현황, 재활서비스 중 작업치료 관련 현황에 대하여 탐색하고자 한다.

• 디지털융복합연구
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• 제11권10호
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• pp.639-651
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• 2013

본 연구는 간병인의 직무를 분석하여 간병인의 처우를 개선하고, 환자에게 양질의 간병서비스를 제공하기 위함이며 또한 간병서비스 제도화를 위한 기초자료를 제공하기 위함이다. 연구 과정은 문헌조사를 통하여 직무분석을 위한 기본원리를 설정하고, 관찰법으로 직무에 관한 소요시간과 기초 정보를 수집하였다. 이를 기초로 하여 11개의 직무와 72개의 책무로 개발하였고, 이에 대한 간병인의 업무여부, 중요도, 직무 수행의 빈도를 서울특별시와 경기도에 소재하는 급성기병원 중에서 공동간병인실을 운영하는 병원에서 근무하는 60명의 간병인을 대상으로 하여 설문조사하였다. 자료수집 시기는 2012년 3월 2일부터 4월 20일까지이다. 자료 분석은 통계패키지인 SPSS 18.0을 이용하여 빈도분석, 백분율, 평균, 표준편차의 기술통계를 활용하였다. 조사대상자의 특성을 분석하기 위하여 빈도분석을 실시하였으며 간병인서비스의 직무는 10개의 직무와 60개의 책무로 확인되었다. 본 연구의 결과를 보면 직접관찰법을 통하여 정한 10개의 직무와 68개의 책무에 전문가 실무자의 면접으로 1개의 직무와 4개의 책무를 추가하였다. 그러나 전문가 실무자의 면접으로 추가한 1개의 직무와 4개의 책무가 설문법에 의한 분석결과에서 제외되었다.

• 보건행정학회지
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• 제1권1호
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• pp.116-135
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• 1991

Few studies have been conducted on the detailed routes of medical care utilization under the National Health Insurance. This study was undertaken to identify the utilization patte군 of health care facilities among industrial workers and their dependents. One of the largest health insurance association was purposively chosen for this objective. The association had 345, 757 members as of 31 December, 1990. The study sample of 297, 948 subjects have been drawn from the membership pool on the basis of their continuous membership status during 1 January through 31 December 1990. This study has tried to identify differential utilization patterns between acute and chronic conditions, and among standard income classes. All the diagnoses were recoded in a manner to achieve the objective of this study. As for acute diseases, most age group had used one medical facility as much as by 60% except the age group of 1-4, This young age group had used over three different health facilities as much as by 10.9-15.8%. The finding suggests that some policy measures by sought for remedying the excessive/inappropriate use of services. In addition, mid-income classes(between 17 and 48) were more likely to use multiple sources of care than lower income classes(between 1 and 16) and upper income classes(above 49). This study has revealed that chronic cases are more likely to pursue multiple sources of care, however those with chronic conditions tend to use single health facility more than those with acute conditions(67.9% versus 52.4%). As many as 12.2% have visited more than three health facilities in chronic conditions, but 5.9% for acute conditions. The most likely source of care was primary clinics for both acute and chronic conditions. Compared with the role of general hospital, small-size hospitals found to play a minimal role in the care and referral of patients. This indicates the need of strengthening the function of small-size hospitals. While a minor cross utilization of western medicine and pharmacy was noted, no significant boundary crossing was identified between western medicine and oriental medicine, or between pharmacy and oriental medicine. It is too early to confirm that whether there is substitutability or cross utilization among these alternative sources of care. A further study is needed to identify these relationship.

• 한국병원경영학회지
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• 제19권4호
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• pp.1-8
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• 2014

The purpose of this study is to analyze the performance difference between public and private hospitals. It is believed that private hospitals may have a better performance compared to public hospitals. The study support the hypothesis. By analyzing 425 acute-care hospitals in Korea, this research shows a less performance of public hospitals compared to private hospitals. Higher labor and administrative cost by public hospitals may account for the difference, and it means they are not effective at cost control. Managers in public hospitals, therefore, should pay attention on cost-reducing issues to regain managerial efficiency of organizations.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제14권2호
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• pp.3-14
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• 2008

The rehabilitation for the workplace accident victims is basically aimed to get them back to their working place through the secondary care processes which have some more special and more professional rehabilitation than any others, after the primary treatments like operation in an acute hospital since the accident. They need more concentrative rehabilitation efforts according to classified injury types during the period of acute, sub-acute and convalescent. This study is for the partial research of rehabilitation hospital for workers' accident victims and presents design data which can be used for the appropriate area calculation and spatial composition. Drawing documents analysis, interviews, observation were used to examine the condition of existing rehabilitation hospitals.

• 보건의료산업학회지
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• 제11권3호
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• pp.91-104
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• 2017

Objectives : This study was a methodological study to verify the validity and reliability of the translated and modified Older Patients in Acute Care Survey-US (OPACS) tool, which was originally developed by Dikken and his colleagues. Methods : The OPACS was translated into Korean, and the content validity, composition validity, and reliability were verified using 348 nurses working for hospitals with over 200 beds and located in C city, B city, and K province. Results : The analysis showed that the Korean version of the OPACS had of eleven questions in the practice experience section and twelve in the general opinion section for older patients in the acute phase. Cronbach's ${\alpha}s$ were 0.84 for practice experience and 0.81 for general opinion. Conclusions : The study showed that the OPACS could measure the practice and opinion of Korean nurses who cared for elderly patients in the acute phase. The significance of the study was that it provided baseline data information regarding the performance and opinion of these nurses for nursing managers to improve the nursing environment.

• 보건행정학회지
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• 제22권1호
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• pp.109-128
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• 2012

The purpose of this study is to analyze the performance difference between multi-hospitals and free-standing hospitals. Scholars in industrial economics argue that, due to economies of scale and integration, multi-hospital system may have a better performance compared to freestanding hospitals. The study overturned the hypothesis based on a theory. By analyzing 425 acute-care hospitals in Korea, this research shows that multi-hospital systems and market factors, which have been perceived to be strengths to hospitals, are negatively related to hospitals' financial performance. Specifically, the results showed a better performance of freestanding hospitals compared to multi-hospital systems. Higher labor and administrative cost by multi-hospital system may be the reason for the difference, and it means they are not more effective at cost control. Managers in multi-hospital system, therefore, should pay attention on cost-reducing issues to regain managerial efficiency of organizations.

• 근관절건강학회지
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• 제24권1호
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• pp.14-23
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• 2017

Purpose: The purpose of this study was to identify the factors affecting the perceptions of patient safety culture, safety care knowledge, and safety care activity among nurses at orthopedic hospitals. Methods: Data were collected during Feb. 16 and Feb. 26, 2017, from 195 nurses of 9 small to medium sized orthopedic hospitals. Questionnaires about patient safety culture, safety care knowledge and activity were used. Data were analyzed by descriptive statistics, t-test, ANOVA, $Scheff\acute{e}$ test, Pearson's correlation coefficient, and stepwise multiple regression. Results: The safety care activity was positively correlated with perceptions of patient safety culture (r=.50, p<.001) and knowledge (r=.48, p<.001). Factors that had influence on the safety care activity were the patient safety culture (${\beta}=.30$, p<.001), age (${\beta}=.27$, p<.001), and knowledge of the safety activity (${\beta}=.21$, p=.004). The patient safety care activity was explained 36.6% by those factors. Conclusion: To enhance the patient safety care activity, it should be provided the environment and open communication for the perceptions of patient safety culture and the in service education program for safety care knowledge.