• 제목/요약/키워드: Community hospital

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전국 아동병원 영양사의 식품알레르기 관련 인식도 및 수행도: 임상영양사 자격증 유무에 따른 비교 (Food Allergy-related Awareness and Performance of Dietitians at Children's Hospitals in Korea: Comparison of Certificate Possession among Clinical Dietitians)

  • 신혜란;김숙배
    • 대한지역사회영양학회지
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    • 제24권6호
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    • pp.512-524
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    • 2019
  • Objectives: The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate. Methods: A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification. Results: The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, 'needs to provide nutrition counseling in children's hospitals', 'providing nutrition counseling services in working hospitals', and 'whether there is a nutrition counseling room' scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, 'self-assessment of food allergy knowledge understanding level', 'awareness of open oral food challenge (OFC)', 'recognition of the need for education and counseling on food allergy for patients / guardians', and 'food allergy related educational experience' scored higher among holders of clinical dietitians certificates than in non-holders. Conclusions: Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.

외래에서 항암화학요법을 받는 암환자들의 영양불량 위험도 연구 (Nutritional Risk in Oncology Outpatients Receiving Chemotherapy)

  • 김원경;박미선;이영희;허대석
    • 대한지역사회영양학회지
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    • 제13권4호
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    • pp.573-581
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    • 2008
  • Although it is well known that cancer patients suffer from malnutrition, there are few published studies on malnutrition in outpatients receiving chemotherapy in Korea. This study aimed to evaluate nutritional risk in oncology outpatients receiving chemotherapy and to show the baseline data to set up nutritional management programs for cancer patients. This is a retrospective observational analysis on 1,962 patients referred for nutritional education before or during chemotherapy at Seoul National University Hospital Cancer Center from January 2006 to May 2007. According to a malnutrition screening tool, the proportion of patients having malnutrition risk was 23.0%. In the case of upper gastrointestinal cancer, more than 50% of patients were assessed as being at the risk of malnutrition. They showed more than 7% weight loss compared to their usual body weight and poor oral intake; energy intake was less than 100% of Basal Energy Expenditure(BEE) and protein intake was less than or equal to 0.77 g/kg/d. However, only 6.3% of breast cancer patients had risk of malnutrition and their oral intake was better; energy intake was 121% of BEE, and protein intake was 0.90 g/kg/d. Outpatients receiving chemotherapy had different nutritional risk depending on their cancer site. Nutritional management program should be conducted differently, depending on the cancer site and upper gastrointestinal cancer patients at high risk of malnutrition should basically have nutritional assessment and intervention.

비영리법인 의료기관의 과세 제도를 정비해야 할 시점: 미국 수준의 면세혜택 제공을 검토해야 (For Non-for-Profit medical institutions, tax exemption benefits such as the United States should be basically provided.)

  • 이진용;김현주;은상준
    • 한국병원경영학회지
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    • 제23권4호
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    • pp.81-86
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    • 2018
  • Purposes: The purpose of this study is to argue that the taxation system for non-for-profit medical institution in Korea should be revised and that the basic direction should be to expand tax exemption like the US. Methods: We analyzed the US context of taxation policy for non-for-profit medical institutions and compared the US and Korean situation. Findings: In the United States, for-profit or non-for-profit medical institutions eternities are the most important criteria for hospital classification. Basically, full tax-exemption has been applied for non-for-profit medical institutions. The reason why many hospitals maintain their status as non-for-profit are following. First, the American society places great importance on the social responsibility and role of non-for-profit hospitals. Second, maintaining the status of non-for profit medical institutions is financially beneficial while maintaining good social reputation. The most powerful financial incentives are tax deductions and tax deductions for donations. Practical Implications: How will the taxation system for medical institutions in Korea be reformed in the future? First, if Korean government do not allow for-profit medical institutions, Korean government should consider implementing a full tax exemption system suitable for non-profit medical institutions like the US. Second, there are many variation in taxation for non-for-profit medical institution according to their legal positions. Therefore, current taxation system should be revised. Third, the reorganization of such taxation system should be in a direction that can finally encourage community benefit activities of medical institutions of nonprofit hospitals.

텍스트 마이닝을 통한 상급종합병원의 미션, 비전, 핵심가치 분석 연구 (Analysis of Mission, Vision and Core values in Korean Tertiary General Hospitals Through Text Mining)

  • 이지훈
    • 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.

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구전(WOM)활동과 의료기관 선택요인 : - 피부과와 산부인과의 20~30대 여성고객 중심으로 - (A Study on WOM and Determinants of Hospital Choice)

  • 신영희;서창진
    • 한국병원경영학회지
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    • 제16권2호
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    • pp.31-52
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    • 2011
  • The cutthroat competition of the market for the medical services caused changes and developments of hospital management from the traditional provider-oriented management to a consumer-oriented management toward the customer. And the popularization of on-line community through the growth and spread of internet technology is developed into an important exploration activity to provide various medical information to patient(or customer) who wishes a high-quality medical services. This is an on-line Word-of-Mouth(WOM). It is a kind of information exploration that is performed by customers before choosing the hospital with off-line word-of-mouth. In this study, we develop our research model to verify the causal relationships among on/off-line WOM, key determinants of hospital choice and the customer's will to make use of the hospitals, and total effect of these variables. We adopt a component-based PSL method for an empirical analysis of the patients experienced dermatology or obstetrics gynecology. Finally, we understand the characteristics of the various medical services and draw new and significant strategic previews.

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중소병원의 진료과목개설전략 - 지방공사의료원을 중심으로 - (The Strategy for Restructuring the Clinical Departments at Small and Medium Size Hospitals - With Cases of the Provincial Hospitals -)

  • 정기선;정수경;류규수
    • 한국병원경영학회지
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    • 제6권1호
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    • pp.147-163
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    • 2001
  • The purpose of this study was to find out the restructuring strategy for five provincial hospitals through the business analysis and survey of the service area. Through the survey of the service area of 5 hospitals. service area was classified into three groups, such as underserved area, adequate area, and overserved area. The strategy for the restructuring the clinical departments was set up based on the result of the business analysis and characteristics of the service area. The result of the study was as follows; 1) Whether or not a provincial hospital has specialized in specific area according to the circumstances and the needs of the community was the major factor influencing on the operating result of the hospital. 2) Provincial hospitals at the underserved area has to invest according to the changes of the occupancy rate and increasing pattern of the number of patients while maintaining the status as a general hospital. 3) Provincial hospitals at the adequate area has to lower the grade from the general hospital down to the hospital first and has to upgrade the competency through the restructuring the clinical departments and investment in specific area. 4) Provincial hospitals at the overserved area has to lower the grade from the general hospital down to the hospital first and has to seek ways to change the hospital fundamentally into geriatric hospital, pneumoconiosis hospital or psychiatric hospital etc. Provincial hospitals incapable to compete with private hospitals and clinics has to lower the grade from the general hospital down to the hospital first, to specialize in specific area and to restructure some clinical departments into rental base or self-operating basis. In case such methods are judged not so good solution, provincial hospitals has to find out ways such as shut-down of several departments or operating under the attending system.

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당뇨식 잔반 감량을 위한 영양서비스 개선 활동의 효과 (Effects of Nutrition Service Improvement Activities for Reducing Plate Waste of the Diabetic Mellitus Diet in a General Hospital)

  • 손정민;염혜선
    • 대한지역사회영양학회지
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    • 제13권5호
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    • pp.674-681
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    • 2008
  • Hospital malnutrition could be caused by not completing the food served in the hospital. This has been a big problem since it delays the recovery of the patient and extends the length of hospital stay. The purpose of the study was to reduce the plate waste for the DM diet by performing several nutrition service improvement activities. The study was performed in a general hospital with 900 beds. A questionnaire survey was taken by 39 DM patients to obtain their aspect of the hospital foodservice systems and the quality of the meals at the beginning of the study. The amounts of foods served in the hospital kitchen and returned were measured by weights. After the improvement activities, the measurement of the plate waste was performed again for comparison. The average percentage of plate waste for the DM diet was 23.2%. The survey showed no difference by sex, age or duration of admission in plate waste. However, this food wastage percentage showed differences between the patients having a chance to get information about the diet therapy (12.21%) and not having one (26.06%) (p < 0.05). Using a five-point Likert-type scale, the quality of food by its taste was 2.49 (1: very poor, 5: excellent), the temperature score was 3.56 (1: very poor, 5: excellent), and the amount of food served score was 2.95 (1: very poor, 5: excellent), and the preference score was 3.13 (1: very dislike, 5: very like). Nutritional care improving activities were performed by adjusting seasonings, developing new menus, and standardizing cooking methods in order to increase the satisfaction of meal quality. The dietitian's inpatients care protocol was adjusted to expand the nutritional counseling chance for the DM patients. After the improvement activities, the average plate waste was reduced to 14.6%, and the satisfaction of food taste and preference increased to 3.21 (p < 0.001), and 3.36 (p < 0.05) correspondingly. The result shows that, for therapeutic diet patients, food intake could be increased by improving the food service satisfaction by controlling the meal quality and clinical nutritional service activities.

일개 응급의료센터에서 분석한 불화수소산 대량 누출이 지역사회 건강에 미친 영향 (Analysis of the Impact on Community Health after Accidental Leak of Hydrofluoric Acid)

  • 김영갑;이주택;박상현;이찬희;최마이클승필;제동욱;이창재;고대이;조혜정
    • 대한임상독성학회지
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    • 제11권2호
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    • pp.106-113
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    • 2013
  • Purpose: The purpose of this study is to verify the influence of a massive hydrofluoric acid spill on community health through patients who claimed to have been exposed. Methods: We analyzed 2459 patients who visited our emergency department with the claim of exposure to hydrofluoric acid, and retrospective analyses were performed. We analyzed changes in numbers of visitors per day from the day of the accidental hydrofluoric acid spill, symptoms presented by the 1924 patients, and general characteristics. Comparisons of symptoms and hematologic characteristics were made between the initially set evacuation zone(1.3 km radius parameters from the spill) and the outer zone. Results: A total of 2,459 patients who claimed exposure visited our ED from 27 September 2012 to 23 October 2012, and there was a significant increase in the number of visiting patients from day 8 of the hydrofluoric acid spill. The most common complaints were a sore throat, 729(37.9%) and no specific symptom with health concern, 547 (28.4%). Statistically significant findings were pulmonary symptoms (p=0.001), nasal symptoms (p=0.001), diarrhea (p=0.023), and skin symptoms (p=0.007). In hematologic study, a statistically significant difference was observed in white blood cell count (p=0.018), creatine phosphokinase (p<0.001), erythrocyte sediment rate (p=0.013), and phosphorus (p<0.001). Conclusion: A significant increase in the number of patients was observed one week after the accidental spill of hydrofluoric acid. The most frequent symptoms were sore throat, headache, cough, and sputum. Statistically significant increase in creatine phosphokinase level and decrease in phosphorus level were noted in patients within the evacuation zone.

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Virtual Reality Community Gait Training Using a 360° Image Improves Gait Ability in Chronic Stroke Patients

  • Kim, Myung-Joon
    • The Journal of Korean Physical Therapy
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    • 제32권3호
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    • pp.185-190
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    • 2020
  • Purpose: Gait and cognitive impairment in stroke patients exacerbate fall risk and mobility difficulties during multi-task walking. Virtual reality can provide interesting and challenging training in a community setting. This study evaluated the effect of community-based virtual reality gait training (VRGT) using a 360-degree image on the gait ability of chronic stroke patients. Methods: Forty-five chronic stroke patients who were admitted to a rehabilitation hospital participated in this study. Patients meeting the selection criteria were randomly divided into a VRGT group (n=23) and a control group (n=22). Both these groups received general rehabilitation. The VRGT group was evaluated using a 360-degree image that was recorded for 50 minutes a day, 5 days per week for a total of 6 weeks after their training. The control group received general treadmill training for the same amount of time as that of the VRGT group. The improvement in the spatiotemporal parameters of gait was evaluated using a gait analyzer system before and after training. Results: The spatiotemporal gait parameters showed significant improvements in both groups compare with the baseline measurements (p<0.05), and the VRGT group showed more improvement than the control group (p<0.05). Conclusion: Community-based VRGT has been shown to improve the walking ability of chronic stroke patients and is expected to be used in rehabilitation of stroke patients in the future.

병원의 보건교육 활성화 방안에 관한 고찰 -지역사회와 병원의 연계방안을 중심으로- (A Study on Improvement of Health Education in Hospitals)

  • 홍인정
    • 보건교육건강증진학회지
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    • 제14권1호
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    • pp.1-9
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    • 1997
  • The health education in hospitals has many problems including lack of the division specialized in health education, lack of implementation system of health education, insufficient professional health education and insufficient health education materials. Despite these restraints, hospitals should reinforce health education program as a part of active response centered on disease prevention and health promotion targeting healthy people who have potential health risk before the onset of disease, rather than passive approach emphasizing the treatment. Accordingly, health education team should be organized in a hospital, in which health educators can provide the following education services. First of all, hospitals themselves should provide active community services in collaboration with community organizations. In addition, multi-disciplinary approach in cooperation with schools, work places should be reinforced to establish the comprehensive health education system. The establishment of medical service referral system with other medical institutions and the linkage system for medical information exchange are also needed. The utilization of education materials obtained through these system should be open to community residents as well as patients. Finally, medical staff working in hospitals should try to provide the high-quality health education that is as high as the level of medical services. The high-quality health education is possible when its level is based on one required by community residents and the county rather than the international or arbitrary standard.

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