• Health Policy and Management
• /
• v.25 no.1
• /
• pp.40-52
• /
• 2015

Background: The purpose of this study was to analyze the increase in Grade of Nursing Management Fee of medical institutions and establish a reasonable government policy by examining which factors affect the increase of nurse staffing. Methods: Analyzing data collected from the Health Insurance Review & Assessment Service resource management department with targets of 1,104 medical institutions. The study period was 5 years from June 30, 2008 to June 30, 2013. SAS ver. 9.2 (SAS Institute Inc., Cary, NC, USA) was used for statistical analysis. The data was analyzed by a chi-square test and also conducted muiltivariate logistic regression analyses for variables of basic characteristics, human resource characteristics, and material resources. Results: Adjusted odds ratio (AOR) of the rise in Grade of Nursing Management Fee among other hospitals compared to hospitals owned by government or universities was 0.264. The AOR in hospitals established after November 2006 compared to those before June 1995 was 2.383. The AOR in Gangwon, Chungcheng South, and Jeolla South Provinces compared to Seoul was 0.084, 0.036, and 0.194, respectively. The AOR in hospitals with more than 6.75 specialists per 100 beds compared to those with less than 6.75 specialists per 100 beds was 7.514. The AOR in hospitals with more than 17.48 nurse per 100 beds compared to those with less than 17.48 nurse per 100 beds was 3.300. The AOR in hospitals with 50% to 75% bed utilization, 75% to 90% bed utilization and more than 90% bed utilization compared to those with less than 50% bed utilization was 5.428, 9.884, and 10.699, respectively. The AOR in hospitals with one magnetic resonance imaging (MRI) and more than two MRI compared to those with no MRI was 2.018 and 2.942, respectively. Conclusion: This result has showed policies to induce the rise in Grade of Nursing Management Fee among old hospitals and the incentive system for local medical institutions are needed. Also we need to develop a governmental policy for medium-small hospitals with low operation rate of beds and insufficient medical personnel and number of equipment in hospitals.

• Journal of the Korean Society for Library and Information Science
• /
• v.19
• /
• pp.63-112
• /
• 1990

The environment of the modern library is changing rapidly with advancements in information technology, massive increse in information, and with the changing needs of users for information in order to keep up with developments in science and technology. The library should also be in a constant state of change in accordance with the changing environment. But the current situation is that library organizations in Korea do not show any change. Here arises the need to diagnose the health of these organization. Organizational innovations can be achieved either by change in the organizational structure or administrative methods or in personal attitudes. In making organizational innovations, however, it is not sufficient only to change the organizational structure or the administrative methods without changing personal attitudes. The purpose of this thesis is to diagnose the health of university library organizations in Korea and to suggest prescriptions based on the results of this diagnosis, by means of organization development theory. In this study, the action research model and the diagnostic model were developed for the health of university library organization in Korea. The action research model consisted of 3 steps: diagnosis, intervention and evaluation. The diagnostic model comprised diagnostic criterion and diagnostic indicators. The health of an organization was selected as the diagnostic criterion. Diagnostic indicators were divided into 3 levels: personal job-satisfaction at the individual level, cohesiveness at the group level, and the organizational climate at the organizational level. Both the interview and the questionaire were used as diagnostic methods. The questionaire form was designed according to the Likert typle 5-point scale. For the investigation, 10 university libraries were selected from the private universities in Seoul, and questionaire sheets were sent to their 156 librarians and responses were received from 116 persons. An interview was carried out with a selected chief of departments of the library concerned. The results of the diagnosis show that the average personal job­satisfaction was 3.57, the group cohesiveness was 3.15 and organizational climate was 2.93, and accordingly the comprehensive health indicator was 3.22. The health of university library organizations in Korea was generally on the decline at all 3 levels. In particular, the organizational climate was in a very weak state. Most problems concern dissatisfaction with personnel policy, communications and non-professionally qualified directors. As the prescriptions, the following was suggested: institutionalization of the staff meeting for resolving problems with communication, appointement of professional directors, performance appraisal, conferring faculty status for librarians, and a suggest system. And for the improvement of the organizational climate, managerial grid training was suggested as one of the educational strategies for organizational development.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.3
• /
• pp.428-436
• /
• 2017

The purpose of this study is to investigate the study subjects' awareness on hospice & palliative care service; and explore its activation methods of Long-term care hospitals located in the metropolitan cities B and K. The total of returned survey was answered from 183 employees on Long-term care hospitals which it was selected 13 institutions. One month to study during from July 1 to July 30, 2016 the researchers visited to investigate relevant data and surveyed to examine their awareness and activation methods. The returned survey questionnaires were processed with SPSS 21.0 for basic data analysis. The results of the 13 institutions under this research, 9 institutions provided hospice & palliative care education once a year. Most of the staff members were found to be aware of the idea of hospice & palliative care, think of it as a good program, and wish it to be implemented(81.9%). They answered that the reason of not implementing the hospice&palliative care was the 'lack of personnel(50.8%)', 'lack of knowledge on hospice&palliative care program; and presented activation method was 'insurance fee introduction(15.8%)' followed by 'service education(15%)' and 'governmental financial support(14%)'.

• Journal of Korean Academy of Nursing
• /
• v.26 no.3
• /
• pp.576-590
• /
• 1996

Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-highways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.

• Korean Journal of Occupational Health Nursing
• /
• v.4
• /
• pp.5-29
• /
• 1995

Occupational health services in Korea have been operated as dual types : one is operated by occupational health care manager and the other is health care agency without their own personnel. The performance of occupational health service should be different due to the variety of characteristics of health care manager and workplace, qualification of health care manager. This study is to analyze performance of occupational health care services with a particular consideration of job performance shape and efficiency, based on comparing those two types of health care management to show on the basic data for the settlement of more qualitative health care management system at workplace. For this study, total 391 places in Seoul and Inchon city area ; 154 places (39.4%) managed by designated health care manager and 237 places (60.6%) by the agency with their commission are selected as research samples. Tools for data collection are questionnares that have been investigated during the period of 20 September 1993-20 December 1993. Those data are compared with percentiles, mean, standard deviation and B/C ratio using SPSS PC program. Conclusions observed from the tests and each comparison could be summerized as follows : 1. Occupational health care have been accomplished at workplaces with designated people than with agencies people, and coverage rate of the occupational health care services has differences, due to management types. The reason of these results is due to visit only one or two times monthly by the agencies, while their own health care manager obsess, at the workplaces all the times. 2. Most of the expense for environmental control of all health care services expenditures shows that there is almost no fundamental improvement because more expenses are needed for procuring personal protective equipment and measuring work environment instead of environmental improvement. 3. It is investigated how much the cost of occupational health care services needs per worker, and calculated how much the cost needs per service hour per worker. The results from this show that the cost of occupational health services at workplaces with their own managers used less than the cost of health care agencies, eventually the former gives better services with less cost than the latter. 4. Benefit/Cost ratio is also produced by total benefit/total cost. The result from the above way reads 4.57 as a whole, while their own manager having workplaces reads 4.82 and the agencies do l.56. Even if their own manager performing workplaces spent more cost, this system produces more benefit than the agencies management. 5. The B/C ratio for medical organization such as local clinic, health care center and pharmacy shows more than or equal to at the workplaces controlled by the agencies. It is inferred that benefit would be much less than the cost used, with so being inefficient. 6. It is assumed that the efficiency ratio of health education is equal to reduction rate of workers medical organization visit. Estimated reduction rate 5%, 10%, 15%, show that the efficiency ratio of health education have an effect on producing benefits. It is estimated that more benefit can be produced if more qualitative education will be provided for enhancing health care efficiency. 7. Results of this study cannot be generalized because there are large scale of deviation in case of workplaces with less than 300 full time workers, but B/C ratio reads 2.69 as a whole and 3.25 at workplaces with their own health care manager are higher than 1.63 at the workplaces manged by the agencies. Finally, all the benefit concerning health care services could not be quantified, measured and shown on the value of money. This is a reason that a considerable part of benefits are so underestimated. This is also thought that measurement tools should be developed for measuring benefits of health care services with a comprehensive quantification. in the future. It is also expected that efficiency of occupational health care services should be investigated using cost-effectiveness analysis.

• Journal of the Korean Society of School Health
• /
• v.1 no.2
• /
• pp.118-135
• /
• 1988

This study is designed to analyze the problems of health education in schools and explore the ways of enhancing health education from a historical perspective. It also shed light on the managerial aspect of health education (including medical-check-up for students disease management. school feeding and the health education law and its organization) as well as its educational aspect (including curriculum, teaching & learning, and wishes of teachers). At the same time it attempted to present the ways of resolving the problems in health education as identified her. Its major findings are as follows; I. Colculsion and Summary 1. Despite the importance of health education, the area remains relatively undeveloped. Students spend a greater part of their time in schools. Hence the government should develop a keener awareness of the importance of health education and invest more in it to ensure a healthy, comfortable life for students. 2. At the moment the outcomes of medical-check-up for students, which constitutes the mainstay of health education, are used only as statistical data to report to the relevant authorities. Needless to say they should be used to help improve the wellbeing of students. Specifically, nurse-teachers and home-room teachers should share the outcomes of medical-check-up to help the students wit shortcomings in growth or development or other physical handicaps more clearly recognize their problems and correct them if possible. 3. In the area of disease management, 62.6, 30.3 and 23.0 percent of primary, middle, and highschool students, respectively, were found to suffer from dental ailments. By contrast 2.2, 7.8, and 11.5 percent of primary, middle and highschool students suffered from visual disorders. The incidence of dental ailments decreases while that of visual impairments increases as students grow up. This signifies that students are under tremendous physical strain in their efforts to be admitted by schools of higher grade. Accordingly the relevant authorities should revise the current admission system as well as improve lighting system in classrooms. 4. Budget restraints have often been cited as a major bottleneck to the expansion of school feeding. Nevertheless it should be extended at least, to all primary schools even at the expense of parents to ensure the sound growth of children by improving their diet. 5. The existing health education law should be revised in such a way as to better meet the needs of schools. Also the manpower for health education should be strengthened. 6. Proper curriculum is essential to the effective implementation of health education. Hence it is necessary to remove those parts in the current health education curriculum that overlaps with other subjects. It is also necessary to make health education a compulsory course in teachers' college at the same time the teachers in charge of health education should be given an in-service training. 7. Currently health education is being taught as part of physical education, science, home economics or other courses. However these subjects tend to be overshadowed by English, mathematics, and other subjects which carry heavier weight in admission test. It is necessary among other things, to develop an educational plan specifying the course hours and teaching materials. 8. Health education is carried out by nurse-teachers or home-room teachers. In connection with health education, they expressed the hope that health education will be normalized with newly-developed teaching material, expanded opportunity for in-service training and increased budget, facilities and supply of manpower. These are the mainpoints that the decision-makers should take into account in the formation of future policy for health education. II. Recommendations for the Improvement of Health Education 1. Regular medical check-up for students, which now is the mainstay of health education, should be used as educational data in an appropriate manner. For instance the records of medical check-up could be transferred between schools. 2. School feeding should be expanded at least in primary schools at the expense of the government or even parents. It will help improve the physical wellbeing of youths and the diet for the people. 3. At the moment the health education law is only nominal. Hence the law should be revised in such a way as to ensure the physical wellbeing of students and faculty. 4. Health education should be made a compulsory course in teachers' college. Also the teachers in service should be offered training in health education. 5. The curriculum of health education should be revised. Also the course hours should be extended or readjusted to better meet the needs of students. 6. In the meantime the course hours should be strictly observed, while educational materials should be revised in no time. 7. The government should expand its investment in facilities, budget and personnel for health education in schools at all levels.

• Journal of agricultural medicine and community health
• /
• v.17 no.1
• /
• pp.34-45
• /
• 1992

In this county, the gap between the urban 'haves' and the rural 'have-nots' continues to be an increasing problem. WHO and UNICEF see primary health care(PHC) as the key to achieving an acceptable level of health throughout the world as a community development. PHC is essential health care made accessible to individuals and families in the community by means acceptable to them. It is the first level of contact of individual, the family, and community with the national health system. It includes at least education on health system. It includes at least education on health problems, promotion of food supply, MCH including family planning, immunization against infectious diseases, control of endemic diseases, treatment of common diseases and injuries, promotion of mental health, and provision of essential drugs. However, of the aboves, education concerning of mental health problems and the methods to identify, prevent, and control them is the principal step of establishment. In Korea, the category of PHC worker includes the physician as public doctor and nurse as primary health care practitioner and community health leader as village health worker. PHC workers of the aboves will thus function best if they are appropriately trained to respond to the health needs of the community. However in this country, since the national PHC service project launched in 1980, the government has not developed and performed appropriate and enough education and training activities. In light of above reasons, several categories of health education activities had been planned and performed being aimed at above specific target groups and the main focus was on the village health workers for about one year from July 1991 to July 1992 in Yeoju Kun of Kyonki Province. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. At the end of the period, evaluation of education input was carried out to measure the improvement of healthful life of people in terms of awareness, attitude, and practice. The totals of 80 village health workers, 13 public health practitioners and 9 public docters took in the course of health education for a few hours at every month and the evaluation works of educational effect were taken. The results the study were as follows. 1) Number of persons who realized the maxim "health care of the people is a duty of the government" increased after the education course, On the other hand, the rate of satisfaction on the effort of government for health promotion of the people decreased. 2) Public doctors and primary health care practitioners(nurses) liked and enjoyed the education schedule as a meeting of peer group. It provided chances of communication with staffs of Korea University Hospital. It was said that lectures covered great deal of knowledge and technic they urgently needed in the field. 3) After finishing the education course, more of village health workers(VHW) thought they adapted themselves to their roles and functions showing increased number of home visit and contact with primary health care practitioners by month. 4) In case of patient refer, VHW preferred primary health care practitioners to public doctors. 5) Capability of VHWs in most of their functions increased dramatically after when the education course finished except tuberculosis control.

• Journal of Korean Academy of Nursing
• /
• v.4 no.1
• /
• pp.151-161
• /
• 1974

Home visiting as a Public Health Horsing function is believed to be of therapeutic value to, the patient. However, home visiting is time consuming and expensive. Is the gain in knowledge and treatment for patients with Tuberculosis in Korea enough to make the necessary outlay in finances and personnel worthwhile\ulcorner While this study does not attempt to completely answer this question it does, under the following objectives, attempt to answer part of the question. The objectives of the study were to l) ascertain if there is a difference between patients, who receive home visits from the public Health Nurse and those who do not, in the following areas: a) their compliance with medical regimen, b) their ability to answer general questions about Tuberculosis, and c) their compliance with medical advice concerning prevention (B.C.G. immunization) and early diagnosis (contact X-rays), and 2) to determine if there is any correlation between the patient's answers to questions about Tuberculosis and his action both in the areas of treatment and prevention. The patients participating in the study were all newly diagnosed patients at Kwangju Christian Hospital. A control group and an experimental group were selected. The patients in the control group were seen according to the regular schedule at the Kwangju Christian Hospital except that they received no home visits from the Public Health Nurses. The patients in the experimental group were visited on an average of three times during the first two months of their treatment by the investigator, a Public Health Nurse. At the end of two months the patients in the two groups were compared as to compliance both in the treatment and preventive areas. They were also compared according to their answers to a questionnaire regarding both the prevention and treatment of Tuberculosis. The following results were obtained : 1. Patients in the experimental group (68.2%) showed a significantly higher compliance rate for medical treatment than patients in the control group (43.2%). 2. Patients in the experimental group (87.5%) showed a higher compliance rate for B.C.G. immunization than those in the control group (40%). 3. Women patients in the experimental group showed a higher mean score (7.2$\pm$2.6) on the questionnaire than did women in the control group (6.2$\pm$3.4). The results of this study seem to indicate that while home visiting is beneficial to the patient with Tuberculosis as far as treatment is concerned, something more concrete needs to be done if home visiting is to help the patient learn more about Tuberculosis and its prevention. Further study is indicated in the following areas: 1) A similar type of study over a longer period of time involving more subjects and using Korean Public Health Nurses to make the home visits. 2) Study to develop an adequate approach to education considering the problems unique to patients with Tuberculosis living in Korea.

• Health Policy and Management
• /
• v.18 no.4
• /
• pp.148-169
• /
• 2008

As the Korean Government began to perceive healthcare as one of foundational industries for national dynamics, there has been mounting advocacy for the introduction of for-profit hospitals with a view to bringing efficiency in healthcare services industries and improvement of their international competitiveness. The Government is now considering the issue from all angles in favor of permitting for-profit hospitals. However, There have been few precedent studies on this subject to provide helpful data for the discussion and in the health policy making. This study used private hospitals - for-profit and nonprofit - in Florida, USA as study subjects to accumulate basic data that may be utilized for those involved in debates and health policy making relating to the introduction of for-profit hospitals in Korea. Among all the private general hospitals in Florida, those surveyed by AHA(American Hospital Association) for four consecutive years from 2001 and 2004 and others reported about to MCR(Medicare Cost Report) included in the collected data for analysis. In total 139 private general hospitals consisting of 73 for-profit hospitals and 66 nonprofit hospitals were included in the collected analysis data. Results of analysis revealed no significant difference between for-profit hospitals and nonprofit hospitals in the usage aspects of healthcare services including the average length of stay and the ratio of Medicare vs Medicaid patients. However, financial performances indicated by such factors. as the pre-tax return on assets and the pre-tax operating margin showed to be significantly higher in for-profit hospitals compared with nonprofit hospitals. And the ratio of personnel expenses and the turn period of total assets showed to be significantly lower in for-profit hospitals. Based on the hypothesis that arguments about the introduction of for-profit hospitals have considerably different viewpoints depending on the size of hospital represented by the number of bed, these two hospital types were compared again using the number of beds as a controlled factor, but the results were similar. We, therefore, could conclude that the for-profit hospitals in Florida included in this study could, in their for-profit operation, improve their financial performance by pursuing cost reduction and effectively utilizing their assets without limiting the amount and the range of their services or avoiding less medically protected groups such as Medicare and Medicaid patients.

• Journal of Preventive Medicine and Public Health
• /
• v.33 no.4
• /
• pp.436-448
• /
• 2000

Objectives : To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. Methods : A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was peformed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience, OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. Results : There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. Conclusions : There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.