Health centers provided intensive health care services for local residents according to changes in the times and environment. Public health centers were given various roles such as medical treatment, administration, and service, and the demand for functional reorganization has emerged. We analyzed the literature on the functional restructuring of public health care institutions. In addition, the current status of medical services, which is the main function of institutions, will be analyzed through health insurance statistical data, and detailed contents will be analyzed according to regional types and income levels. As a result of the analysis of medical services at institutions, the total number of patients was 2,238,000, and the number of visits was 11,806 times. Total medical expenses were 169.6 billion won, of which 132 billion won was found to be benefit. When analyzing the number of patients per institution, public health centers had the largest number of 4,326, and the share of benefit was also the highest at public health centers. It should focus on the function of providing local health and medical services related to health promotion and disease prevention in the community. This functional reorganization of public health centers can contribute to forming cooperative relationships with private medical institutions in the local community. For this, first, to establish the role, essential functions for public health centers for preventive health management are established. Secondly, regular manpower expansion and flexible manpower management are required in the human resources sector. Finally, in the organizational sector, it is necessary to establish a step-by-step organizational system according to environmental changes.
There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.
Journal of Korean Society of Occupational and Environmental Hygiene
/
v.26
no.2
/
pp.198-209
/
2016
Objectives: This study aimed to provide basic data for the improvement of the guidance services for the management of the workplace environment of the specialized health management institution, by making inquiries on the perception and extent of practice by health managers and workers in the workplace. Methods: Workplaces with officially noted environmental hazards of noise, organic compounds and/or dust-metals were selected in a South Korean metropolitan city in 2015. The workplace health managers(hereinafter referred to as 'manager') and workers at 97 workplace were interviewed. Managers are those who are in charge of health management at the corresponding workplace and the workers were subjected to in-depth interviews by sampling one worker for each of the workplace. Results: The majority of the managers acknowledged the guidance services of the specialized health management institution affirmatively. Regarding the extent of practice in accordance with the guidance on engineering improvement, only 23 managers(37.1%) responded. With respect to education, 40 managers(41.2%) responded that it was implemented along with 35 workers(36.1%) who responded that they received education, showing no significant difference between manager and worker. Regarding the actual wearing of the protective equipment, however, 83 of the manager(85.6%) insisted that workers wore the protective devices while only 44 workers(49.5%) responded that they actually wore the devices, thereby illustrating a significant difference between managers and workers. Conclusions: These results suggest the urgent necessity of improvement in the mechanism of guidance services of the specialized health management institution for the workplace environment management.
Economists have identified informed consumer choice as one element of a better-functioning health care market, and thus increased attention is directed to the role of information in the health care system. In this country, however, little work has been done for understanding consumers' search behavior in health care market. Based upon this observation, expectant mothers' information search for the choice of delivery care institution was investigated. In doing so, two hypotheses were proposed: 1) Those women who were more active in the search for information would make choice of a delivery care institution with more confidence and would feel greater subsequent satisfaction. 2) The activeness of expectant mothers in information search would depend upon their various personal characteristics, such as socio-economic status, obstetric conditions, and knowledge and attitudes in relation to delivery and health care. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using prepared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with 319. The results of analysis were generally consistent with the proposed hypotheses. Apparently, information increased expectant mothers' confidence in selecting a delivery care institution and subsequent satisfaction with the institution. Indication is that policy efforts should be strengthened to produce and disseminate relevant, comprehensible and credible information that can aid patient decision making. Also, attention should be directed to motivate patients to actively engage in information search from adequate sources.
The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.
Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.
Objectives : This study was to determine how the perception and the satisfaction of outpatients who utilized clinics and hospitals are structurally related with their willingness to utilize the same institution in the future. Methods : Three hundred and ten responses (via convenient sampling) were collected from 5 hospitals and 20 clinics located in Seoul listed in the "Korea National Hospital Directory 2005". Service quality was utilized as the satisfaction measurement tool. For analysis, we used a structural equation modeling method. Results : The determining factors for general satisfaction with medical services are as follows: medical staff, reasonability of payment, comfort and accessibility. Such results may involve increased competition in the medical market and increased demands for quality medical services, which drive the patients to visit hospitals on their own on the basis of changed determining factors for satisfaction. Conclusions : The structural equation model showed that the satisfaction of outpatients with the quality of medical services is influenced by a few sub-dimensional satisfaction factors. Among these sub-dimensional satisfaction factors, the satisfaction with medical staff and payment were determined to exert a significant effect on overall satisfaction with the quality of medical services. The structural relationship in which overall satisfaction perceived by patients significantly influences their willingness to use the same institution in the future was also verified.
Objectives : This study was conducted to survey on uncovered services in National Health Insurance(NHI) of Traditional Korean Medicine(TKM) Institution. Methods : For TKM doctors working in hospital, it was surveyed to professors working in university-affiliated hospital. A total of 40 professors were participated online survey and all of them was included. For TKM doctors working in clinic, an e-mail survey was conducted for members of the association of Korean medicine. A total of 436 TKM doctors, 279 TKM doctors were included study and 157 were excluded because of duplication clinic or not working in clinic. It was conducted general status and uncovered services in NHI status. Results : The proportion of uncovered services in NHI was 54.7% for hospitals, 39.0% for clinics and there was a significant difference between hospital and clinic. Decoction and herbal(bee venom) acupuncture were most commonly used in both institutions. For decoction treated patients, It was commonly treated Sibjeondaebo-tang, Bojungykki-tang, Gwibi-Tang and patients chief complaints was thoraco-lumbar pain, functional dyspepsia, fatigue. Conclusions : It is necessary to expansion of benefits range of the NHI on TKM services.
In recent years, many of medical institution have reinforced educations for their employees aiming to secure competitiveness and to achieve higher performances. In an effort to actively response to the fast changing environment in the medical industry, the Ministry of Health and Welfare has implemented "Innovation and Service promotion" educations for employees of 34 regional medical institutions and 6 Red Cross hospitals. In this regards, the effect of the educations to change employees' mind for innovation and services and its results need to be evaluated. This study conducted surveys asking participants of the 2006 Education for Innovation of Regional Public Hospital Employees and Service Promotion and synthetically analyzes the effect of the education on their mind for services compare to their mind before the education. As a result, more them 92% of participants say that they are satisfied with the education, and many more participants agreed the effect of the education to change their mind for services. Under this circumstance, after the educations participants change more positively on "their mind for innovative services" and "their service skills in practice".
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