Client(patient) satisfaction has been used for a variety of purposes in different settings, yet, those receiving home care services have been the focus of few satisfaction studies. Satisfaction is considered an indicator of quality of care and is also being used to assess the performance of home care providers and home health care delivery at multiple levels. The aim of this study was to develop the tool for evaluating client satisfaction in several aspects with home care service while maintaining or achieving acceptable reliability and validity. Firstly, Client Satisfaction Instrument made preliminary of 43 items composed basic 6 criteria and 7 indicators, based on a review of literature, quality improvement and client satisfaction findings in home care. Secondly, there were consisted in two expert panel groups who were made in professionals of research and practice in home care field. The tool was modified to 6 criteria and 7 indicators, 25 items after reviewing by two expert panel groups. The content validity index of the tool was above 0.8 and the results of internal consistency was more than 0.8 in all items. Finally. The Client Satisfaction Instrument in Home Care Service was made up 6 criteria such as client satisfaction of nurses's instruction of home care educational need. knowledge/technique/attitude of homecare nurses's performance. interpersonal relationship and emotional support of nurse. easiness of homecare accessibility, continuity of homecare service. overall efficacy of homecare use, 7 indicators. and 25 items. The results of evaluating client satisfaction will be able to contribute in quality improvement and service marketing in home care.
Objectives : This research analyzed the general characteristics of care workers and verified the correlation among self-perceived health, job stress and customer orientation. Methods : We conducted a survey from May 1st, to May 31st, 2015 of 260 care workers who are affiliated with elderly care facilities or home care facilities in Busan, Korea. Results : The more the workers were stressed about their organizational culture, the more they recognized psychological difficulties. However, there was no correlation between organizational culture and their tendency to be oriented toward customers. It was verified that the recognized psychological health has a positive regulation effect between customer orientation and job stress such as job skill requirement(p<0.01), job autonomy(p<0.01), and organizational culture(p<0.01). Conclusions : Because both suppliers and recipients of care services are aging, it is necessary for elderly care facilities to make a greater effort to minimize the physical and psychological losses of recipients.
Purposes: The purposes of this study were to evaluate parent satisfaction with inpatient hospital services in children's hospitals and to identify variables related to parent satisfaction. Method: A descriptive correlation study was conducted. Parents of 165 children who were inpatients in two children's hospitals participated in the study. Data were collected using structured questionnaire at the time of discharge. For statistical analysis, t-test, ANOVA, and Pearson correlation analysis were used. Results: The highest parent satisfaction domain was nursing service, and the lowest parent satisfaction domain was hospital service and accommodations. Parents were less likely to be satisfied with hospital facilities, equipment, noise and cleaning and less likely to be satisfied with the lack of information they received and with the lack of communication with health care professionals. Parents with longer length of stay and with older children reported higher satisfaction than their counterparts. Moreover, parent satisfaction was related to their intention to revisit and related to intention to recommend this surveyed hospital over others. Conclusions: Efforts to improve parent satisfaction in children's hospital service and accommodation are needed to improve the quality of health care. Communication by health care professionals with parents and a partnership between parents and health care professionals are necessary to improve quality of care.
Purpose: This study is to investigate the recognition regarding Hospital - Based Home Care Service among physicians and nurses in a G University Hospital. Method: Data were gathered from 92 physicians and 257 nurses. working at G University Hospital. from January 15 to January 22. 2003 by questionnaire. The data were analyzed by using the SPSS/PC +. Result: 1) As to the previous information about a hospital based home care service. those who have been familiar to it were 85.9% of the physicians. and 98.8% of the nurses. 55.4% of the physicians and 55.1% of the nurses responded that they are willing to refer their patients to the home health care only if their patients and families want to. 47.8% of the physicians and 44.4% of the nurses perceived the present cost of a hospital based home care service to be moderate. 2) Most of the physicians and nurses reported that the most available service was 'wound dressing' (98.4%, 92.6%) and the least available service was 'incision and drainage'(1l7.4%, 42.8%). 3) As to the necessity of home nursing business and the anticipated effects. nurses perceived higher than physicians($3.46\pm.74$). and both showed a significant difference according to age of subjects. Conclusion: For the stabilization and successful implementation of a hospital based home care service. it should be accompanied with education programs about home care for physicians. in particular junior staff.
Objectives: This study confirms the current status of visiting oral health-care services for the elderly to draw policy implications for revitalization of the visiting oral health care services in the future. Methods: First, a survey was conducted on health centers about the current status of the elderly visiting oral health-care service and how to revitalize it. Next, the number of oral hygiene services provided to the elderly was checked in the long-term care insurance system. Results: Oral health education (100%) was the most common practice in visiting oral health-care service for the elderly, and the most difficult thing in providing services was the lack of dental hygienists (38.9%). The status of oral health-care services in the long-term care insurance system for elderly revealed that the total number of service claims has been confirmed to be zero since the introduction of the system. Conclusions: Despite the existence of a system that provides elderly visiting oral healthcare services, to revitalize it, the law must be amended to secure a dental hygienist as the main agent of the activity and to further take responsibility for autonomous authority and performance.
Park, Choon-Seon;Choi, HyoJung;Hwang, Soo-Hee;Im, JeeHye;Kim, Kyoung-Hoon;Kim, Sun-Min
Quality Improvement in Health Care
/
v.22
no.1
/
pp.11-26
/
2016
The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.
The purpose of this study is to describe the health care status of Korean Immigrants in New Zealand. The sample consisted of 155 Koreans who were randomly selected from the Korean Immigrants telephone book in Auckland, N.Z. They had health problems that required health management both physically (50.3%) and psychologically(70.3%). During the previous year, the average rate of medical contact with a general practitioner was 1$\pm$1.29 times. Korean immigrants who had health problems first attempted to resolve the problem through self medication rather than utilize health care services. They would only visit a general practitioner if they had severe subjective symptoms or no relief from self medication. Even if they think they need to visit the health care service, 41.9% of the subjects did not go back for follow-up care. Generally, the person who demonstrated positive health care behaviors was male, a college level graduate or higher, lived in N.Z. longer than 2 years, had a high score on health status by self assessment, and he placed few demands on health care services. Barriers to a healthy lifestyle are communication difficulties in expressing subjective symptoms, understanding the physician's treatment and medication plans, difficulty in accessing the appointment system and the high cost of service.
Background: Informal care is increasingly recognized as placing a significant burden on the lives of family caregivers. The purpose of this study is to investigate factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system, using the Stress Process Model developed by Pearlin (1990). Methods: Total 1,233 family caregivers with the disabled elderly, using the long-term care services in their home from May to June 2009, completed questionnaires finally. The questionnaire of this study consists of a total of 32 questions, including 11 questions related to background and context, 17 questions related to objective stressors, and 4 questions related to coping resourses. Family caregivers' burden is measured by the Korean Revised Caregiving Appraisal Scale (K-RCAS, Cronbach's alpha=0.86). To investigate factors related to family caregivers' burden, multiple regression analysis was conducted. Results: The average score of caregivers' burden was 22.0 (${\pm}6.12$). In multiple regression analysis, there were statistically significant factors affecting on the family caregivers' burden, that are related to background and context (region, living status, education level, relationship with beneficiary), objective stressors (duration of caregiving), coping resourses (caregiver's health status). Conclusion: This study found that family caregivers experience a considerable burden. The findings suggest that policies must be taken to relieve family caregivers of their duties temporarily, and to support them with counselling and education.
Background : Surgical site infection(SSI) is one of the important nosocomial infections with pneumonia, urinary tract infection. SSI increases mortality, morbidity, length of stay, and costs for postoperative patients. The purpose of this study was to estimate length of stay(LOS) and health care costs from SSI using the large observational data. The ultimate objective was to show the effect of prevention of SSI. Method : This study used antibiotic prophylaxis evaluation data and claims data of the HIRA(Health Insurance Review and Assessment Service). The study population included 18,361 patients who underwent gastric surgery, endoscopic cholecystectomy, colon surgery, hysterectomy, cesarean section in nationwide hospitals from August to October 2007. SSI group and non-SSI group were matched according to propensity score resulted from logistic regression. The paired t-test was used to compare the difference of the LOS and health care costs between SSI group and non-SSI group. Results : The 598 cases of SSI were detected of total subjects, and the crude SSI rate was 3.3%. For each surgery, SSI rates were 5.5% for gastric surgery, 4.7% for cholecystectomy, 6.6% for colon surgery, 2.6% for hysterectomy, and 1.6% for cesarean section. The 596 cases of SSI and the 596 cases of non-SSI were matched by propensity score. The LOS of SSI group was longer than that of non-SSI group, and the difference was statistically significant. Health care costs of SSI group was more than that of non-SSI group which was significant. Conclusions : SSI increased apparently the LOS and healthcare costs. The economic loss might affect the cost of national healthcare as well as patients and hospitals. This study provided the evidence that the healthcare expenditure could be reduced by preventing SSI.
Purpose: The purpose of this study is to understand nurses' perception of visiting nursing services of long-term care insurance. Method: The descriptive survey study involved 188 nurses selected by the convenient sampling of visiting nurses who participated in professional education sessions. Results: Of the 188 participants, 149 (79.3%) were aware of long-term care insurance. Awareness of aspects of long-term care services was 78.7% for facility service, 77.7% for ordinary visiting care service, 85.1% for visiting nursing service and 77.7% for visiting bathing service. Concerning visiting nursing service provision, the majority of the study subjects considered nurse-aid not to be the appropriate route for delivery of services including nasogastric tube exchange, tracheostomy tube management and stitch removal. Conclusion: Continuous evaluation and research on the standards and requirements of the nursing workforce is needed to secure and maintain the high quality of visiting nursing services. Exhaustive studies concerning task division and workforce separation according to nursing services type and level of difficulty should be done to develop the appropriate job description for visiting nursing service staff.
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