• Title/Summary/Keyword: Health Care Cost

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A Study on the Nurses' Contingent Employment and Related Factors (간호사의 비정규직 고용실태 및 관련요인에 관한 연구)

  • Choi, Sook-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.477-500
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    • 1999
  • Korean labor market has showed remarkable change of the increase in the amount of unemployment and contingent employment since IMF bailout agreement. There is a theoretical position to explain this increase in contingent employment at hospitals with the notion of flexibility. The high flexibility of employment due to the increase of contingent employees is becoming very important part in new business strategy of hospitals. The types of contingent employment of the nurse are part-time employment temporary employment, fixed-term employment, and internship which was introduced in early 1999. Recently, Korean health care industry managers have paid attention to the customer oriented service, rationalization of business administration, service quality control so that they can adjust their business to outer environment. Especially their efforts concentrate on the wage reduction through efficient and scientific control of man power because wage shares about 40% of total cost. This dissertation aims at verifying the phenomena of the contingent employment of the nurse and analyzing the related factors and problems. To rephrase these aims in ordinal: First, verifying the phenomena of contingent employment of the nurse. Second, verifying the problems of that phenomena. Third, analyzing the related factors of the contingent employment of the nurse. To accomplish these research goals, a statistical survey was executed. in which 384 questionnaires-66 for manager nurses, 318 for contingent nurses - were given to nurses working at 66 hospitals-which have at least 100 beds-in Seoul. Among them, 187 questionnaires-38 from manager nurses, 149 from contingent nurses'- 'were returned. Then, the data coded and submitted to T-test, $X^2$ -test, variance analysis(ANOVA), correlation analysis, multiple regression analysis, Logistic Regression with SAS program. The research results of the contingent nurses are followings: 1. The average career term at the present hospital 8.4 months: duty-on days per month are 24.2 days: working time per day is 7.9 hours. These results showed little difference from regular nurses. 2. Their wage level is about 70% of regular nurses except for internship nurses whose wage level is 41% of regular nurses. To break down the wage composition, part-time nurses and internship nurses get few allowance and bonus. And contingent nurses get very low level of additional pay except for fixed-term nurses who are under similar condition of employment to regular nurses. These results show that hospital managers are trying to reduce the labor cost not only through the direct way of wage reduction but through differential treatment of bonus, retirement allowance, and other additional pay. 3. The problem of contingent employment: low level of pay; high level of turn-over rate: weakening of union; low level of working condition: heavy burden of work; inhuman treatment. The contingent nurses consider these problems more seriously than manager nurses do. What manager nurses regard problematic is the absence of feeling-belonged and responsibility of the contingent nurses. 4. The factors strongly related with the rate of the number of contingent nurses for the number of regular nurses; gross turn-over nurses; average in-patients per day; staring wage of graduate from professional college: the type of hospital ownership; the number of beds; the gap between gross newcomer nurses and gross turn-over nurses. The factors related with their gross wage per month; the number of beds; applying of health insurance; applying of industrial casualty insurance; applying of yearly-paid leave; the type of hospital ownership; average out-patients per day; gross turn-over nurses. The meaningful factors which make difference by employment type: monthly-paid leave; physiological leave. The logistic regression analysis using these two factors shows that monthly-paid leave is related with the type of hospital ownership; the number of beds; average out-patient per day, and physiological leave is related with the gross newcomer nurses; gross turn-over nurses; the number of beds.

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Development of Internet Information Push-Delivery System Design of Smoking Cessation for Health Promotion (지역주민의 건강증진을 위한 인터넷 금연 강화 프로그램 개발)

  • Kim, Young-Bok;Shin, Jun-Ho;Kim, Shin-Woel
    • Journal of agricultural medicine and community health
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    • v.29 no.2
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    • pp.287-301
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    • 2004
  • Objectives: The development of internet programs for smoking cessation was motivated to quit smoking in the large group of smokers. This personalized program consisted of tailored message to consider the smokers characteristics, and contain the informations on the outcomes of smoking cessation and the skills to be used in the quit attempts. The purpose of this study was to develop the internet management program and information push-delivery system for smoking cessation to encourage the personal intention to quit smoking. Methods: We conducted in 3 steps as developing push service to encourage intention of smoking cessation, analyzing problems of smoking cessation program through the pilot test and suggesting improvements by implication stages. Results: This program is delivered for 30 days. if the participants do not fail to quit smoking. The contents consisted of 13 stages which were divided on starting period. practical period, maintenance period and success period. And push service afforded the tailored message to participants using their e-mail. According to the evaluation of pilot test, the problems of internet information push-delivery service for smoking cessation were the over-tasks per visiting time, recording style of participants, difficulty of terms and sentences, lack of visual effects, absence of follow-up module and unsuitable link with main homepage. Improvements were divided on 3 stages by implication period. The first stage included the immediate improvements as improving link with homepage, modifying menu of smoking information and upload file of notice part. The second stage included the short term improvements as alleviating condition of withdrawal, coordinating start stage of retrial, modifying errors of information push-delivery service and addition of educational materials. The third stage included the long term improvements as development of follow-up module, cost-effectiveness evaluation, reducing contents quantity, introduction of checking style, compensation of graphics effect and review for SMS utilization. Conclusions: This program contribute to improving smoking cessation rate. Therefore this program should be tested in a community to evaluate the effectiveness. To promote the effectiveness, this program should be developed the contents and the strategies for various targets, and established the follow-up system for ex-smokers.

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Child Rearing Practice of Working Mothers in a Poor Area of Pusan (부산시 영세지역 취업여성들의 영유아 양육실태)

  • Hwang, Yeon-Ja;Park, Jung-Han
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.3 s.27
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    • pp.389-397
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    • 1989
  • To identify the problems in child rearing practice of employed mothers in urban poor area, all of 201 women with children under 6 years old living in Yun San 3 Dong, a poor area of Pusan city, were interviewed with a questionnaire by a trained interviewer from 10th April to 10th May 1989. Among 201 women, 51 women were employed and 150 women were unemployed. Of the employed mothers 78.5% got their jobs because of economical need and 31.4% of them worker for 60-69 hours per week. Their average monthly income was 100,000-190,000 Won in 33.4% and 200,000-290,000 Won in 25.4% Breast milk was fed in 66.0% of the children of unemployed mothers while 49.0 of the children of the employed mothers were breast-fed (p<0.05). The most common reason for not breast feeding was shortage of breast milk among unemployed mothers (58.9%) but that of the employed mothers was their job(63.6%). The basic immunization for children was completed in 70.5% of children of employed mothers as compared with 82.0% of the children of the unemployed mothers were completely immunized (p>0.1). Accident experience rate of children among the employed mothers was 23.5 a and that of the children of the unemployed mothers was 17.3% . The most common cause of acident in children of the unemployed mothers was carelessness while they were playing(34.6%) but in children of the employed mothers it was traffic accident(25.0%) and falling(25.0%). Most of the traffic accidents took place while the children's brother or sister of age under 14 years were baby sitting. When the accident took place 73.1% of the unemployed mothers were just at home, but 58.3% of the employed mothers were out of home for work. In case of the employed mothers, 58.7% of their children were looked after by an adult mainly grandparents, 15.7% by the children's brothers and sisters under 14 years old, and 3.9% of the children were left alone. A majority of the unemployed mothers wanted to get a job if someone could take care of their children. To facilitate the women employment and for the safety and health of the children, good nurseries for working mothers need to be established at a cost they can afford.

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Evaluation of Dental Hygienist Job Validity according to Judgment Standard of Medical Practice in Medical Law (의료행위 기준에 따른 치과위생사 직무 타당도 평가)

  • Bae, Soo-Myoung;Shin, Sun-Jung;Lee, Hyo-Jin;Shin, Bo-Mi
    • Journal of dental hygiene science
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    • v.18 no.6
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    • pp.357-366
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    • 2018
  • The purpose of this study was to evaluate the validity of dental hygienist job according to judgment standard of medical practice in medical law. In this study, we conducted a self-administered questionnaire survey to evaluate the validity of dental hygienist job for 12 professors of dental college in Gangneung-Wonju National University from November 10 to 20, 2017. We investigated whether the dental hygienist job conforms to the three criteria of medical practice such as disease prevention and treatment, patient care, and health hazard. The response rates were scored and classified into four categories according to the final score. As a result of this study, dental hygienist job are classified into four categories according to judgment standard of medical practice. The higher the level of the category, the higher the degree of difficulty, and the higher the level of expertise and skills required. More than 50% of respondents answered that measuring the gingival pocket, bleeding on probing, professional tooth cleaning, oral health education, counseling after dental treatment are all three criteria for medical treatment. And these were classified into Level 4 group which requires the difficulty and expertise in the final score 4.3. It is necessary to develop and utilize standardized guidelines on the level of knowledge, education, and qualification standards required for dental practice in order to effectively allocate work among the dental personnel while ensuring the health rights of patients in the dental clinic field in Korea. In addition, there is a need to evaluate the various aspects of cost effectiveness, dental health service productivity, and health promotion contribution to dental hygienist jobs, And based on this evidence, it is necessary to continue to expand and adjust the dental hygienist job and to reorganize the dental workforce system.

Anti-inflammatory Effect of Boswellia sacra (Franckincense) Essential Oil in a Mouse Model of Allergic Asthma (알러지성 천식 모델 생쥐에서 프랑킨센스 에센셜 오일의 염증 억제 효과)

  • Lee, Hye-Youn;Yun, Mi-Young;Kang, Sang-Mo
    • Microbiology and Biotechnology Letters
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    • v.36 no.4
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    • pp.343-352
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    • 2008
  • Frankincense, the gum resin derived from Boswellia species, is complex mixtures composed of about $5{\sim}9%$ highly aromatic essential oil, $65{\sim}85%$ alcohol-soluble resins, and the remaining water-soluble gums. The anti-inflammatory properties of frankincense, alcohole-soluble resins, are well-recognized, but the question of whether aromatic essential oil also plays a role in the allergic asthma remains unanswered. This study was performed to evaluate anti-inflammatory effects of Boswellia sacra essential oil (BSEO) on ovalbumin (OVA)-induced asthma mouse model. BALB/c mice after intraperitoneal OVA sensitization were challenged with intratracheal OVA. One experimental group was inhaled with 0.3% BSEO for the later 8 weeks. BALB/c mice were sensitized and challenged with OVA and developed airway eosinophilia, mucus hypersecretion, and airway hyperresponsiveness. In contrast, the BSEO treated mice had reduced a number of eosinophils among BALF cells, goblet cell hyperplasia, and airway hyperresponsiveness. Cytokine analysis of BALF revealed that BSEO caused an increase in Th1 cytokine (interferon-$\gamma$ (IFN-$\gamma$)) and a decrease in Th2 cytokines (interleukin-4 (IL-4), IL-5 and IL-13) levels. In addition, the OVA-specific serum IgE and eotaxin levels were also reduced. In mice inhaled BSEO, $CD4^+$, $CD3^+/CCR3^+$, and $B220^+/CD23^+$ mediastinal lymph nodes cells were also decreased. These results suggest that inhaled BSEO as a immunomodulator in Th1/Th2 mediated asthma may have therapeutic potential for the treatment in allergic airway inflammation by a simple, cost-effective way.

A Study on the Introduction of Electronic Commerce for Purchasing Section in Hospitals - Focused on the Understanding of Purchasing Managers - (병원구매업무에 있어서의 전자상거래 도입에 관한 연구 - 구매부서 관리자의 인식도를 중심으로 -)

  • Hwang, Eun-Bum;Nam, Sang-Yo;Ha, Ho-Uk;Lee, Chang-Eun
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.69-89
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    • 2001
  • This study is focused that the electronic commerce(EC) on the purchasing section may improve the efficiency and transparency of the hospitals management. After reviewing the purchasing activity of hospitals, I study the introduction, expected effects, and problems of EC. So, I am going to provide basic information for activating EC. The samples are managers of 170 hospitals, which are located on Seoul. As a result of collection this survey, I analyze 79 hospitals. For data analysis, I use $X^2$-test and ANOVA for purchasing management and the relevance of EC according to the level of care. The results of this study are 1. The problems on the management of purchasing section are: firstly, they don't have sufficient time to study market. Secondly, it is difficult to find competitive suppliers. And, lastly, they cannot gather a lot of information about the price of products. 2. There are many answers of the needs on the introduction of B2B. However, some hospitals think they don't need it. But, the most answers are that the EC will be settled within 4 years. So, we can realize that these hospitals are getting interested on the EC. On the other hand, I find that they prefer outside EC companies for the introduction of EC. 3. On the expected effects on EC, first is the effectiveness of the market survey. The next is to collect information of adequate price of products owing to clear transaction, find easier new suppliers and gather useful data. 4. On the external problems of the introduction of EC, there is low credibility related to the security and the weakness of suppliers' information system. Especially, on the Real Transaction Price Payment system, the bigger bed size, the higher understanding on these problems. On the internal problems of the introduction of EC, first is the burden of the introduction of EC and operating cost. Especially, on the burden of the disclosure of revenue source, the smaller bed size, the higher understanding on this problem So, this is a point which deserves my attention statistically. However, this shows relatively little understanding about incomplete the standard of product category and the weak information system of hospital. Through this study, I am going to suggest 3 points for the activation of the introduction of EC on hospitals. 1. The reform of the Real Transaction Price Payment System on medical supplies and materials for medical treatment 2. The establishment of the standard of product category 3. The promotion of information system based on network.

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An Analysis of Accreditation Preparation Process and Costs in Hospitals (의료기관들의 인증평가 준비와 비용지출에 대한 실태분석)

  • Kim, Minji;Jung, Yumin;Kim, Kyungsook;Lee, Sunhee
    • Korea Journal of Hospital Management
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    • v.20 no.3
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    • pp.45-55
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    • 2015
  • While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

A study of the Guidelines for Investigation and Management of Uterine Myomas with Korean Medicine Therapies in Korea (자궁근종의 한의학 연구 경향과 임상적 접근에 관한 연구)

  • Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.19 no.2
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    • pp.240-260
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    • 2006
  • Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

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Global Convergence for Healthcare ICT Services (헬스케어 ICT 서비스의 글로벌 컨버전스)

  • Won, Dal Soo;Lee, Sang San;Jung, Yong Gyu
    • The Journal of the Convergence on Culture Technology
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    • v.2 no.2
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    • pp.45-49
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    • 2016
  • It may be summarized to four kinds of innovation through global convergence, and the convergence of adjacent areas according to mega-trends in medical services market and actively introduced ICT technologies, public and private partnership. Health care is no longer a local industry, it is becoming Global Convergence. In the case of developed countries, it is increased to income levels, the development of new medical technologies, while the increase in specialized medical services and need of aging population. It increases migration of foreign medical personnel, geographical proximity and choice of the best medical technology, regardless of the cost. The increasing demand for high quality yet relatively low foreign prices of medical services. Hospitals are especially spread of international certification such as the US JCI standards. Hospital exports are being evaluated and opened the way for the export industrialization as ICT convergence hospital that can be exported to the fusion-related technologies more efficiently. Current local hospital has already reached saturation, globalization of Korean hospital is being the time necessary. Thus, unlike a strategy for each country, as well as technology transfer it is also possible, such as total exports provided the building, medical equipment procurement, local medical personnel (doctors and nurses) selection and training, PR and marketing. In the current medical law and need to be revised prospectively maintained for publicity and abroad, there is a need for further legal dragons and actively support a more flexible policy on the application of national law overseas medical services.

Achievements of Characterized Education for Healthcare Data Science Initiative (대학 특성화 사업 성과에 관한 연구-보건의료 데이터 사이언티스트 프로그램을 중심으로)

  • Park, HwaGyoo
    • Journal of Service Research and Studies
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    • v.9 no.3
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    • pp.87-99
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    • 2019
  • Healthcare and data science are often linked through finances as the industry attempts to reduce its expenses with the help of large amounts of data. Data science and medicine are rapidly developing, and it is important that they advance together. Data science is a driving force in transition of healthcare systems from treatment-oriented to preventive care in healthcare 3.0 era. It enables customized precision-based medicine that current healthcare systems cannot facilitate, and discovers more cost-effective treatment. Currently, healthcare big data is in the reality of medical institution, public health, medical academia, pharmaceutical sector as well as insurance agency. With this motivation, the medical college of Soonchunhyang university has performed a 'healthcare data science initiative(HDSI)' since 2014. Most of domestic HDSI programs focus on short-term contents such as mentoring and sharing cases for data science. Therefore, it is difficult to provide education tailored to the level of skills and job competency required at the practical site. Soonchunhyang HDSI implemented specialized strategies for improving resilience and response to changes in the IT education of current healthcare with the emphasis on the need for systematic activation of the practical HDSI. The HDSI has been performed as a part of on industry-academic link program in CK-1. Through quantitative and qualitative analysis, this paper discussed the HDSI process, performance, achievement, and implications.