The purpose of this study is to investigate evaluation and improvement of long-term care hospitals for changing long-term care hospitals fee system. Data were collected from 104 CEOs in nationwide long-term care hospitals using structured self-administered questionnaires during August 17 to 31, 2009. Major results of the empirical analysis are as follows; first, to change fixed sum medical fee per day caused to decline the level of geriatric service in 87% of CEOs. Second, 79% of CEOs were dissatisfied with changing fixed sum medical fee per day, and 47% of them were dissatisfied with graded fee for doctor and nurse management. Finally, they suggested that to specialize and to differentiate of long-term care hospitals will drive to improve long-term care hospitals function and to measure workforce based on rate of filled vacancies will increase efficiency and productivity of doctor and nurse management.
Objectives : This study developed and validated the local clinic Medical Doctor Role Stress Scale(MDRS). Methods : The interviews were conducted with 12 local clinic medical doctors to develop final preliminary questions. The scale was developed using statistical item analysis, exploratory and confirmatory factor analysis surveys with local clinic medical doctors in Seoul, Busan, Daejeon, and Gyeonggi province. Results : The MDRS developed in this study consisted of 14 items and three factors. The factors were role conflict, role ambiguity and role overload. The three factors explained 56.71% of the total variance, and the internal consistency of this scale was .90. The internal consistency for each factor was .81 ~ .90. Confirmatory factor analysis through a separate sampling met the fit criteria (CFI = .941, TLI = .927, RMSEA = .079, SRMR = .069). Conclusions : The results indicate that this scale is a reliable instrument for assessing local clinic medical doctor role stress.
Because of accelerated urbanization public body visiting nursing project that started according as matter of health on urban class in the lower brackets of income was concentrated on Social interests has a unsatisfied points to propel project efficiently from the lack of rating materials. Therefore centering around written contents in documentary literature of citizen health by household in five years from starting year of project to now. visiting frequency by medical manpower was evaluated quantitatively and qualitatively in aspect of management hereupon. for the sake of giving a basic materials for public health project of this field. This research presents documentary literature of citizen health which become materials is that as one person's charged region of nurse in duty scale. district is Kang-Buck Gu. the object is resident in the lower brackets of income grounded livelihood protection law and who is admitted by the head of organ~chief of health care). and the number of material centering around the head of a household is 415 copy. The result of research is summarized. as follow. 1. Average visiting frequency examinated by medical manpower show difference according to valuables of supervision characteristics namely average visiting. Frequency of nurse has long term residence in case registration season is early and supervision season is the first year and is high incase a kind of house is unlicdnsed mountain town. Average visiting frequency with doctor is high incase supervision season is the first year and the medical insurance system is admitted by chief of health care. That shows that a man of discomfort behavior left alone are yet many in local society. The meaning of this result shows that the continuity of official relation about class in the lowest brackets of income of long term residence goes well between househole who is a user of visiting nursing service of the object according to midway income under management influences a given duty of nurse s and so causes quantitative decrease. 2. In case behavier and condition of health that nurse diagnoses are bad. as the type matter is a lack of health and the number of patient is large. the average visiting frequency of nurse is high. because average visiting frequency with doctor is high as the condition of health is bad and the number of patient is large. That is similar with that of nurse. CD Average visiting frequency of nurse s seen by matter of disease is very high only in apoplexy by 39.50 and is confined within limits from 7.63 to 11.36 in other disease. But average visiting frequency with doctor is double as many as that of nurse but defined in apoplexy hypertension and articulate. (1) Average visiting frequency of nurse by existence in inoculation of hepatitis is low by 6.73 in unidentified group and very high by 26.89 in group of non-inoculation and the case of the antigenic positive man of B type hepatitis or epileptic who can't be inoculated shows 13.00 and that even family nursing service is needed to them. That result shows that though one person nurse of local charge has a large scale of duty. as visting nursing service is given a class who has a large demand preferentially by respectively accurate nursing diagnosis. the number of diagnosis service is similar with it. 3. During five years. average visiting frequency of nurse is 10.84 and average visiting frequency with doctor is 76.50 seeing from the official scale of nurse. visiting by household is performed two more per year to the average. Seeing this by type of service. average visiting frequency of nurse is higher in indirectly nursing than in directly nursing and that suggests that at the time of visiting household nurse performs education of protection lively save patient but at the time of contrastedly visiting with doctor. directly nursing is more contents of service show no difference by man power and medication dressing by demand is 14.3 and 18.6 the aid of hardship term of doctor and nurse is high by 18.7 and 17.00 in the request of hospitalization when seeing by demands. 4. Action by turns exemplified 1994 is well in sequence of 2/4 turn. 3/4 turn. 1/4 turn. 4/4 turn. When seen by average visiting frequency of nurse but gradually is even. Without difference by turns. average visiting frequency of doctor is much higher in 1/4 turn than other turns. Type of service by turns is all even but directly nursing is inactive in 4/4 and indirectly nursing. Very increases in 4/4 and so. Nurse's quantity of duty is plentiful that shows that by evaluation of last turn and plan of project. Contents of service follows that medication and dressing is the highest by' 5.57 in 1/4turn. goes down gradually by turn. becomes 3.57 in 3/4 turn. and increases again by 4.83 in 4/4 turn. the rest service is higher in 2/4 turn than other turns. 5. Total visiting frequency of nurse is explained to total $37.5\%$ by six valuables of visiting frequency of doctor. nursing demand. demand of diagnosis. condition of behavior. year. Special terms and magnitude of influential power is the same as sequence of enumerated valuables. Namely. the higher the visiting frequency of doctor. the bigger nursing and demand of diagnosis is. the worse the condition of behavior is. the older the object is and the more the household of special terms is. the high total visiting frequency of nurse is.
Purpose - The purpose of this study is to examine whether a psychological concept enhances healthcare users' service experience. Specifically, the study proposes and empirically examines a model of perceived control in which the user's sense of control is postulated as exerting positive influences upon his/her motivation, self-efficacy associated with his/her role as a patient, and satisfaction with his/her medical service experience. Methodology - Data were collected by a professional research company, using an online survey method. Participants of the study included adults nineteen years or older who had visited a medical service institute at least once during the previous one-year period. For the test of the research hypotheses, structural equation modeling using AMOS was used. Findings - Findings of this study denote a unique insight into the users' comprehension of medical service experiences and their behaviors. First, the concept of perceived control is identified as a factor that enhances the quality of individuals' medical service experiences. A sense of control directly influences medical users' self-efficacy to comply with doctor's recommendations, their motivation to comply with doctor's recommendations, and their satisfaction with the medical service experience. Second, one's perceived self-efficacy is found to exert positive influences upon both motivation and satisfaction. Third, one's motivation to comply with the doctor's recommendation is found to exert a positive influence upon one's satisfaction. Additionally, perceived control is found to exert an indirect influence upon medical service users' satisfaction through the mediation of both self-efficacy and motivation. Research Implications - The findings of the study support the notion that perception of control among medial service users enhances their service experience as patients. The main thrust of this study suggests that it is necessary for healthcare practitioners to consider implementing service encounter strategies that purposefully enhance the sense of control among their patients. The identification of significant inter-relationships among perceived control, motivation, self-efficacy, and satisfaction among medical service customers should also serve as a meaningful seed for further research pursuits.
Emergency Medical Service(EMS) requires a system that supports the communication between emergency medical technicians (EMT)s and the doctor in the emergency department. Because the rapid triage and on-site treatment of patients need doctor's medical advice. However, a system to assist the doctor assign for medical advice does not exist in Korea. This paper suggests a medical advice support system that focuses on appropriate doctor assign and real-time communication among the ambulance, the Emergency Medical Information Center (EMIC), and the doctor using an agent system. We expect that the system can help to solve the problems affecting prehospital EMS and improve its general quality.
Public health oriental medical doctor has played a great role in providing oriental medical treatment and oriental medical health program with public health medical services, the basic infrastructure, however, is not sufficient. In this study, the researcher surveyed the treatment working or service condition of public health oriental medical doctor. 1. The payment, allowance of doctors are fixed upon the law and guideline according to the financial status of local government. The branch of public health center has more support like an official residence with expenses. 2. The public health center mainly has assitants and ratio of full-timer is more than the branch public health center without any assistants if any, they are temporary employee 3. The public health center has 5.22 beds while the branch has 3.14 beds. The daily average number of patient for public health center is 15.01 while the branch has 8.7 More than half of outpatients are over sixties with musculoskeletal disease. 4. Regarding the traveling clinic, the public health center put into more operation than the branch. The 3rd year serving public doctor gives negative about the traveling clinic much more than 1st and 2nd year serving public doctor. The treatment service condition of public doctor of the public health center is better than the branch doctor, but we are on the point of role-changing as health promotion and preventive treatment to bring up motivation, education and competence strengthening for execution the local-bound health program.
The proportion and role of public sector in health care industry is very small in Korea. Asymmetric distribution of health care resources is one of the major health care concerns. This issue is so important that it raises a question of accessibility, availability, continuity of care and equity of rural area people's health care utilization. To solve these problems and to satisfy the basic demand of oriental medical service in rural areas, the oriental public health doctors were placed in rural health centers since 1998. The main objectives of this study are twofold: to measure the cognition and attitude of health center directors on the strategies for utilizing oriental public health doctors and to provide basic data for improving the health manpower management program. Data have been collected by way of the self-administrative questionnaires. Developing the questionnaire, the literature review on the previous studies and delphi method were carried out. The response rate was 38.7%. The results of this study are summarized as follows; 1. community people respond positively on the oriental medical service activity in health center. 2. In regard to workloads of oriental public health doctor, 'appropriate' was 81.1% and 'burdensome' was 18.2%, respectively. 3. The 94.0% of respondents thought that the oriental medical service will be continued. 4. To activate oriental medical service in health center, the sufficient budget and provision of aid workers is a necessity. 5. The 75.5% of health center directors respond positively on the allocation of oriental public health doctor to health sub-centers. 6. Health center directors agreed that oriental public health doctor should perform the clinical service as well as prevention and health promotion activity. These results recommend that oriental medical service in health center should be continued gradually, and oriental public health doctors working at health center perform their work efficiently. Undoubtedly, their activity should be more focused on health promotion and disease prevention than daily patient care. For achieving this objective, more support of governmental policy is essential for utilizing oriental public health doctor and better health of the rural area community people.
In December of 2016, 'The Forest Protection Act' was amended partly in The National Assembly and the socalled 'Tree Doctor Act' was promulgated. Tree Doctor Act will be enforced from June 28, 2018. Under the new Act, none other than 'Tree Hospital' can do disease and pest management work for trees in public living space. The only exclusive qualification for tree hospital is a 'Tree Doctor', the government registered license which is newly established by the Act. To become a tree doctor, he/she must complete the tree doctor training courses in the designated 'Tree Doctor Academy' and pass the qualification test. Currently, Korea Forest Service is drafting the enforcement ordinances and regulations for the implement of Tree Doctor Act. When taking into consideration that the most fundamental and important discipline of the plant and tree health care is the plant pathology, and that the tree health care is a promising business for young plant pathology people, Korean Society of Plant Pathology is ought to be actively involved in the preparation of the enforcement ordinances and regulations, and help the early establishment of the new tree health care system in living spaces of Korea.
Kim, Sang Me;Ahn, Bo Ryung;Kim, Jeong Lim;Lee, Hae Jong
Health Policy and Management
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v.30
no.1
/
pp.82-91
/
2020
Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion: Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.
Journal of The Korean Society of Integrative Medicine
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v.8
no.4
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pp.49-58
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2020
Purpose : This study examined the effect of a home visit cognitive training program that uses a tablet-based digital recognition rehabilitation application, Brain Doctor, on local elderly people's cognitive function and depression. Methods : This study featured 20 elderly people living in Busan Metropolitan City, South Korea, who received a voucher for a home visit service to prevent dementia. The subjects were evenly divided into an intervention group provided with Brain Doctor and a control group provided with a conventional cognitive training program. Korean version of Mini Mental State Examination (MMSE-K) and Korean version of Montreal Cognitive Assessment (K-MoCA) were used to assess cognitive function in each group. Patient Health Questionnaire-9 (PHQ-9) was used to evaluate the depression levels. Results : The intervention group showed a significant change in cognitive function and depression after the intervention (p<.05). There was a statistically significant change in cognitive function and depression between the intervention and control groups (p<.05). Conclusion : This study confirmed that Brain Doctor had a positive effect on the cognitive function and depression of elderly people in the local community. It is expected to become a useful home visit program for dementia prevention in the future.
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