• 산업공학
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• 제24권4호
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• pp.274-280
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• 2011

Delayed access to surgery may lead to deterioration in the patient condition, poor clinical outcomes, increase in the probability of emergency admission, or even death. The purpose of this work is to decide the number of patients selected from a waiting list and to schedule them in accordance with the operating room capacity in the next period. We formulate the problem as an infinite horizon Markov Decision Process (MDP), which attempts to strike a balance between the patient waiting times and overtime works. Structural properties of the proposed model are investigated to facilitate the solution procedure. The proposed procedure modifies the conventional value iteration method along with the binary search technique. An example of the optimal policy is provided, and computational results are given to show that the proposed procedure improves computational efficiency.

• Journal of Preventive Medicine and Public Health
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• 제41권5호
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• pp.295-299
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• 2008

Objectives : The Korean government in January 2006 instigated an exemption policy for hospitalized children under the age of six years old. This study examines how this policy affected the utilization of medical care in Korea. Methods : A total of 1,513,797 claim records from the Health Insurance Review Agency were analyzed by complete enumeration methods. The changes of medical utilization were compared from 2005 to 2006. In addition, the changes of medical utilization between 2004 and 2005 were compared as a pseudo-control group. Results : The admission rate increased 1.14-fold from 15.20% in 2004 to 17.32% in 2005, and this further increased 1.08-fold to 18.65% in 2006. The increase of patients with a common cold (1.2-fold) was higher than that of both the general patients (1.08-fold) and the patients, with the top 10 fatal diseases (0.91-fold). The average length of stay per case for clinics showed the highest increase rates (1.06-fold). The rates of patients with the common cold showed a higher increase (1.05-fold) than that of the general patients. The average medical expense per case was increased by 1.10-fold from 2005 to 2006, which was higher than that from 2004 to 2005 (1.04-fold). The increase rate for patients with the common cold was higher at 1.18-fold than that of the general patients. Conclusions : The cost exemption policy has especially led to an increase in the utilization of clinics and the utilization by patients with a common cold.

• 보건행정학회지
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• 제28권4호
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• pp.352-359
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• 2018

Background: The purpose of this study is to propose an analysis of trends and characteristics of high-cost patients who take over 40% of total national health insurance medical expenses. Methods: It has been analyzed the tendency of high-cost patients by open data based on the medical history information of 1 million people among national health insurance subscriber from 2002 to 2015. To conduct detailed study of characteristics of high-cost patients, multiple regression has been performed by sex, age, residence, main provider, and admission status based on the top 5% group. Results: The amount of medical expenses and the number of high-cost patients have gradually increased in decades. The number of high-cost patients for Korean won (KRW) 5,000,000 category has increased by 7.6 times, KRW 10,000,000 category has increased by 14.1 times in comparing of year 2002 and 2015. Top 5% medical expenses have increased by 4.6 times. In consideration of the characteristics of patients, the incidence of high medical expenses has been higher in female patients than male ones, the older patients than in the younger. Patients residence in Gyeonsang or Jeonla province have had a high incidence of medical expenses than other area. The disease including dementia, cerebral infarction, and cerebrovascular disease for high-cost patients has been also increased. Conclusion: The major increase factor for high medical expenses is the aging of population. The elderly population receiving inpatient care residing in the province that increases high medical costs have to management. There is an urgent need to develop a mechanism for predicting and managing the cost of high-cost medical expenses for patients who have a heavy financial burden.

• 한국의료질향상학회지
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• 제7권1호
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• pp.118-131
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• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

• 디지털융복합연구
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• 제20권2호
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• pp.543-551
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• 2022

본 연구의 목적은 간호대학생의 통합성과 임상실습 스트레스 정도를 파악하여 학과만족도와의 관계를 파악하는 것에 있다. 자료 수집은 2021년 6월부터 7월까지 진행하였다. 임상실습 경험이 1회 이상인 간호대학생 3, 4학년을 대상으로 통합성, 임상실습 스트레스, 학과만족도 척도로 이루어진 설문지로 자료를 수집하였고, 총 394부의 자료를 SPSS 프로그램으로 분석하였다. 연구결과 통합성은 학과만족도에 정적 상관관계를(r=.412, p<.01), 임상실습 스트레스와는 부적 상관관계를 보이는 것으로 나타났다(r=-.193, p<.01). 간호대학생의 학과만족도에 영향을 미치는 예측요인은 통합성(β=.406, p<.001)과 입학 동기(β=.166, p=.006)로 전체 변량을 20% 설명하였다. 결과적으로 통합성과 입학 동기는 학과만족도에 영향을 미치는 것으로 확인되었으며, 간호대학생들의 학과만족도를 높이기 위해서는 입학초기부터 통합성 증진프로그램과 학과적응 프로그램 운영이 필요할 것으로 사료된다.

• 부모자녀건강학회지
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• 제13권2호
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• pp.102-109
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• 2010

Purpose: The purpose of this study was to identify the knowledge and practice on hospital infection prevention of caregivers of hospitalized children. The results will be the basic data of future policy and education program for hospital infection prevention. Methods: A descriptive survey design was utilized, The subjects included 151 caregivers from a university hospital in Gyeongnam Province, Korea. The data was collected using a self-reported questionnaire which included 17 items for knowledge, 18 items for practice, developed by researchers from March 2005 to January 2006. The collected data was analyzed with descriptive statistics, t-test, and ANOVA using SPSS program. Results: The mean score of knowledge on infection prevention was .87 of 1 (especially low in method of hand washing item), and practice, 2.60 of 3 (especially low in protection from other people items). There were differences in practice by admission frequency (F=2.83, p = .04), but there were no differences in knowledge by any general characteristics. Conclusion: The degree of knowledge and practice on caregiver's infection prevention was not enough to prevent hospital infection of hospitalized children. Therefore, effective strategies should be developed to prevent hospital infection of hospitalized children.

• 여성건강간호학회지
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• 제17권1호
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• pp.52-63
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• 2011

Purpose: The purpose of this study was to investigate the effects of education and practice of the maternal role and becoming a mother using the concepts of self-confidence in caring, maternal attachment, and maternal identity. Methods: A non-equivalent control group non-synchronized design was used. Data was collected with the use of self-administered questionnaires from November 2007 to April, 2008. A total of 54 women at a Sanhujoriwon (postpartum care center) participated in the study. The experimental group consisted of 26 women (Nov-Dec), whereas the control group had 28 women (Feb-Apr). Education and practice on the maternal role was given individually and consisted of explanations, demonstrations and practice on breast feeding (day1 to 3), maternal attachment (day 8 to 9), bathing (day 10 to 11) and infant healthcare (day 13 to 14). The experimental group received education and practice on the maternal role while the control group received routine education only. Results: Data collection was done using pre and post questionnaires at admission and fourteen days later. The experimental group showed significant increases in self-confidence in caring (t=-3.31, p=.002) and maternal identity (t=-2.16, p=.036) compared to the control group. Conclusion: Education and practice on the maternal role and being a mother was an effective intervention in increasing self-confidence in caring and maternal identity.

• 디지털융복합연구
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• 제15권11호
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• pp.317-327
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• 2017

본 연구는 간호대학생의 간호전문직관과 비판적 사고성향이 환자안전에 대한 태도에 미치는 융 복합적 영향을 규명하고자 시도되었다. 연구 대상자는 S지역 소재 2개 대학의 4학년 학생 172명이며 자료 수집기간은 2017년 5월 15일부터 5월 26일까지이다. 수집된 자료는 SPSS 23.0 Version을 이용하였으며 t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation coefficient와 Hierarchical regression analysis를 실시하였다. 연구 결과 연구대상자의 환자안전에 대한 태도는 3.76점으로 중간 정도이었다. 간호전문직관과 비판적 사고성향은 환자안전에 대한 태도와 양의 상관이 있는 것으로 나타났다. 환자안전에 대한 태도에 유의한 영향을 미치는 변수는 간호학과 지원동기의 '주변권유'와 학업성적, 전공만족, 간호전문직관으로 이들 변수의 설명력은 17.8%로 나타났다. 따라서, 간호대학생의 환자 안전에 대한 태도를 향상시키기 위하여 학과 지원동기, 학업성적, 전공만족도 및 간호전문직관 확립을 위한 체계적인 관리가 필요하며, 향후 환자안전에 대한 태도에 영향을 미치는 설명력 있는 변수에 대한 추가연구가 필요하다.

• 의학교육논단
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• 제25권2호
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• pp.109-113
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• 2023

An educational outcome cohort has been established at Keimyung University School of Medicine to help make educational policy decisions and improve educational programs based on data. The purpose of the educational outcome cohort is to support educational policy decisions for achieving graduation outcomes smoothly and to accomplish the intended human resources development of the university through objective analyses and regular monitoring, providing continuous feedback. The data collected for the educational outcome cohort include the student identifications of freshmen, entrance exam scores, premedical and medical school grades, titles and forms of student academic research, the results of psychological testing, scholarship recipient lists, volunteer clubs, and so forth. The data are collected using an information utilization agreement approved by the Institutional Review Board, and the collected data are encrypted and stored on a dedicated computer for enhanced personal information security. Proposals to access and utilize the educational outcome cohort data must be discussed and approved by the Educational Outcome Cohort Committee, which decides on the scope and method of utilization. The collected and managed educational outcome cohort data have been used to develop comparative programs to improve students' competency and to support admission policy decisions through an analysis of the characteristics and performance of medical school students. The establishment and utilization of the educational outcome cohort will play an important role in determining the School of Medicine's educational policies and suggesting new directions for educational policies in the future.

• Biomolecules & Therapeutics
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• 제14권1호
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• pp.56-65
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• 2006

Adverse drug events (ADEs) are the most common type of adverse events in medical practice. Hospital admissions related to ADEs cost high and should be monitored to prevent them. While concerns about the ADEs are increasing, the frequency and characteristics of admissions related to ADEs have not been reported in Korea. The objective of the study was to assess the rate of hospital admission related to ADEs and their characteristics through ADE signal-based retrospective reviews of medical records. As results, a total of 1,420 patients had ADE signals suggesting potential ADEs from 3,494 patients who discharged from an academic medical center over one month period. Six pharmacists independently assessed the presence of ADEs after the review of patients' medical records. Among the 3,494 discharges, 62 admissions (1.8%) were found to be realted to ADEs. Of admissions with ADEs, 83.9% were moderate (category F by the NCC MERP classification), 37.2% were preventable, and 85.5% were type A reaction. The most frequent suspected drugs causing ADEs were antineoplastics (48.9%), and the most frequent ADE signal detecting hospital admissions related to ADEs was white blood cell count (24.2%). Hospital admissions related to ADEs were found through screening the ADE signals. The ADE signal-based retrospective review could be a practical approach for identifying hospital admissions related to ADEs.