Lee, Chan Hee;Lim, Hyunsun;Kim, Youngnam;Park, Ai Hee;Park, Eun-Cheol;Kang, Jung-Gu
Health Policy and Management
/
v.24
no.3
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pp.254-260
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2014
Background: The purpose of this study is to assume appropriate outpatient consultation time for each clinical department on the basis of measured outpatient consultation time and satisfaction of outpatient. Methods: We surveyed the feeling and satisfactory outpatient consultation time, satisfaction, revisiting intention and recommendation to others to 1,105 patients of single general hospital in Gyeonggi-do and measured their real outpatient consultation time from October 28 to November 27 in 2013. On the basis of satisfaction, we estimated appropriate outpatient consultation time through area under the receiver operating characteristic curve in logistic regression model. Results: Feeling outpatient consultation time was 5.1 minutess, satisfactory outpatient consultation time which was suggested by patient was 6.3 minutes, and real outpatient consultation time was 4.2 minutes. Department which had longest real outpatient consultation time was infection (7 minutes) and department which had longest satisfactory outpatient consultation time was neurology (9.4 minutes). From the univariate and the multiple linear regression analysis, real outpatient consultation time was longer in pulmonology patient, new patient and afternoon patient, satisfactory outpatient consultation time was longer in infection, neurology, neuropsychiatry, neurosurgery, and rehabilitation patient. Appropriate real outpatient consultation time was suggested as 5.6 minutes which differentiated high and low satisfied patient group. However, we could not assume appropriate outpatient consultation time for each clinical department because the number of patient who had bad satisfaction was too low. Conclusion: To improve patient's satisfaction, we hope outpatient reservation system is operated as each patient's outpatient consultation time is at least 5.6 minutes.
The effects of characteristics of community pharmacists on consultation time for prescription (RX) and nonprescription drugs (nRX) were investigated. A crosssectional descriptive design was established with a self-administered anonymous mail survey. Response rate was 52%. Significant pharmacists' factors related to having less than 3 minutes consultation for RX were one's dispensing duties exceeding 50%, low satisfaction with one's own level of consultation, working at the pharmacies nearby clinics, or shorter duration of consultation time for nRX. Consultation promoting conditions should be built up for the provision of sufficient consultation.
Objectives : The purpose of this study was to identify the characteristics influencing consultation and waiting time in ambulatory patients. Methods : This study was conducted in a tertiary teaching hospital. Subjects were a total of 10,383 ambulatory patients. Consultation time was measured by time spent for meeting with his/her physician per patient. Waiting time was defined as the time difference between each patient's reserved time and time to meet with his/her physician for ambulatory care. Multiple regression analyses were performed to determine the factors influencing consultation and waiting time. Results : Consultation time was different according to patient' age, previous experience of clinic visit, recent admission history, medical department, specialist care, type of reservation, and day of the week. Significant factors influencing waiting time were patient' age, residential area, previous experience of clinic visit, recent admission history, medical department, specialist care, time spent after ambulatory care begins, and day of the week. Conclusions : The medical department was the strongest factor affecting both consultation time and waiting time. The ambulatory reservation management systems should take into account patient characteristics as well as care-related features.
This paper analysed the RBRVS for a doctor's consultation by measuring the time consumed in outpatient consultation, and compared the time among medical doctors, dentist, and oriental medical doctors. The time used in consultation could be a proxy for measuring RBRVS for medical services because it is the only common factor we observe in three different clinical settings. The results show that the optimal RBRVS for consultation is 183.22 for medical doctor, 99.12 for dentist, and 236.17 for oriental medical doctor. This implies the current fee schedule for consultation should be revised as 10,740 Won for a visit to medical doctor, 5,808 Won for dentist, and 13,832 Won for oriental medical doctor.
We introduce a new multimedia telemedicine system which is called Telemedicine for Real-time Emergency Multi-consultation(TREM), based on multiple connection between medical specialists. Due to the subdivision of medical specialties, the existing one-to-one telemedicine system needs be modified to a simultaneous multi-consulting system. To facilitate the consultation the designed system includes following modules: high-quality video, video conferenceing, bio-signal transmission, and file transmission. In order to enhance the operability of the system in different network environment, we made it possible for the user to choose appropriate data acquisition sources of multimedia data and video resolutions. We have tested this system set up in three different places: emergency room, radiologist's office, and surgeon's office. All three communicating systems were successful in making connections with the multi-consultation center to exchange data simultaneously in real-time.
Objectives : This study was performed to evaluate the status of psychiatric consultation at a newly opened university hospital, to explore problems related to psychiatric consultation and to contribute for future consultation to be more systematic and more efficient. Methods: The subjects of this study were 284 patients hospitalized at Inha University Hospital between September 1, 1996 and August 31, 1997, who were referred for psychiatric consultation during hospitalization. This study was evaluated demographical characteristics of referred patients, resons for referral, recommendations by psychiatric consultant, clinical diagnoses, psychiatric diagnoses, relationship between referral time and hospitalization following the day of consultation and consultation referral types based upon psychiatrists' reports and patients' medical charts. Results : Most common patients referred to consultation were females aged 20s who visited at the department of internal medicine and related to the risk of suicidal attempts. Mood disorder was the most frequent psychiatric diagnosis, and the most common recommendations were to use psychopharmacological treatment along with outpatient visits. The 30% of subjects were referred to consultation within a day after hospitalization. In the case of consultation referral timing within two days and after three days, there was significant difference between early consultation and shorter hospitalization following the day of consultation. Most frequent type of consultation(29.6%) was categorized as IIIa type(physical complication type as a "Mending" request type). Conclusion : In review of consultation referral timing and consultation referral type of the subjects, who were referred for psychiatric consultation for one year at a newly opened University Hospital, referrals were found to be made within two days after their admission to hospital(50.7%), which was observed to be early request. We found that there was significant association between early consultation and shorter hospitalization following the day of consultation. The physical complication type(29.6%) which belongs to "Mending" request type was found to be the most frequent consultation referral type. This result indicates that more systematic psychiatric consultation is needed for the future.
Lee, Chan Hee;Lim, Hyunsun;Kim, Youngnam;Yoon, Soojin;Park, Yang Sook;Kim, Sun Ae;Park, Eun-Cheol;Kang, Jung-Gu
Health Policy and Management
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v.27
no.1
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pp.39-46
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2017
Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.
In this paper, we carry out a cyber group consultation by means of the video-based education system, and verify the effects. For the verification of this study, two assumptions were set up. These assumptions were inspected by selecting 45 students of D elementary school located in a big city, and coming up with a test utilizing one of video-based education systems. Following up, a self-respect test form and a questionnaire were made to verify of the group consultation to the video-based education system, and by analyzing the test form and the questionnaire, the conclusion of this study was finally drawn. The conclusion gained through the process adove is as follows: It turned out that real-time video-based cyber group consultation promoted self-respect and enthusiastic participation of consulters as well as formed emotinal stability and a close affinity between the consultant and the consulter through active interaction. The results of this video-based education system operation will be helpful to broaden the area of elementary school cyber group consultation. Further, it is thought that it will contribute to the basic investigation to verify the educational effects of Multi-point imaging system in the run-up to the operation of full-scale real-time video-based education systems.
Objectives : The purpose of this study is to investigate necessity of overtime hospital business hours and patient's visiting time preferences. Methods : The study was composed of 117 children's protectors who visited the pediatrics department in Kyunghee university oriental medicine hospital between on April 14th and on July 4th in 2008. Results and Conclusions : 1. Question for asking the preference of weekdays regular consultation hours 27% of preschool children preferred time around 11 am to 12 pm, each 32% of school aged children preferred time around 3:30 to 4:30 pm, 4:30 to 5:30 pm. 2. Question for 'Have you ever experienced inconvenience for regular consultation hours' 41% of them said 'Yes', and 59% said 'No'. 3. School aged children more experienced inconvenience for regular consultation hours than preschool children, and more likely to come at overtime hospital business hours. 4. Question for 'If the hospital extends the business hours for holidays and weekdays and Saturdays, would you prefer to come at that time?' 88% of them answered 'Yes'. 5. Question for asking the preference time on weekdays, 35% of them preferred 6:30 to 7:00 p.m. 6. Question for asking the preference time on Saturdays, 44% of them preferred 1:30 to 2:30 p.m. 7. Question for 'Do you willing to pay extra charges if you visit in non office hours?' 66% were willing to pay, 24% of them said "no", 'the other opinion' is 10%.
The purpose of this research which was conducted by surveying the transfer consultation records from 360 medical institutions such as general hospitals, hospitals, clinics to the Emergency Medical Center at E University Hospital for six months(Jan. 1, 2000 - Jun. 30, 2000) are to standardize & complete transfer consultation record of hospitals at the 1st & 2nd referral level and to give patients transferred emergency medical center medical information services on a better quality. The conclusions and suggestions from this study were summarized as follows; (1) Examing the distribution of the referral medical consultation(transfer) sheet type, surgery part local clinic sheet types were 34.4%, medical part local clinic sheet types were 26.7%, undifferentiated local clinic sheet types were 23.9% and hospital level sheet types were 15.0%. (2) The items of the transfer consultation records had been standardized more than 75% in the order of patient's name, date, doctor's name, diagnosis, patient's status, impressions. (3) That the degree of recording completion on these items is in the order of patient's name, date, diagnosis, impressions was revealed. (4) Because the standardization and the degree of recording completion are very low in the patient's gender, age, address, electronic recording system was needed for more perfect input of initial patient informations. (5) This standardizing & complete recording on examination and medication will prevent re-examination and abuse of medication for patients transferred emergency medical center. (6) EMT Transfer System should be fixed in all medical institute for the standardizing & complete recording on care period and departure time will give many emergency patients the proper treatments at the proper time. (7) It was revealed that developing new standardized transfer consultation record & using electronic recording system are needed. (8) The complete recording & Fast Track System were needed for higher rate of bed operation at emergency medical center and more hospital profit.
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