• Journal of muscle and joint health
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• v.27 no.3
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• pp.247-254
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• 2020

Purpose: This was a descriptive observational study examining the reasons for, frequency of, and factors affecting work interruption among intensive care unit (ICU) nurses. Methods: Convenience sampling was used to recruit 46 regular nurses who had been working in an ICU at D tertiary hospital in B metropolitan city for at least six months. To measure the degree of work interruption, this study revised a tool used by Brixey et al. (2007) for analyzing the type of work interruption. Results: A total of 1,787 work interruptions occurred during 368 hours of observation, i.e., at an average of 4.85 times per hour. Communication-related factors caused work interruption most frequently, followed by environmental, work-related, and personal factors. As for the work-related characteristics of nurses, participants experienced work interruption more frequently while working on weekdays, when the medical staff were stationed, than on weekends. Conclusion: ICU nurses experienced work interruption frequently. With the health care system expected to become more complicated in the future, efforts should be made to reduce unnecessary work interruptions to improve the operation efficiency of ICUs.

• The Southeast Asian review
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• v.28 no.1
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• pp.173-218
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• 2018

This study focuses on the healthcare sector in Vietnam which is promoting universal health insurance for the achievement of Universal Health Coverage (UHC) under Sustainable Development Goals (SDGs). The purpose of this study is to examine the characteristics of the reform process of the health care system and the law on health insurance through the historical and cultural contexts and its implications from the perspective of development. Based on the three dimensions of UHC - extension of protection for population, provision of various medical services, and financial protection, the current status of the Vietnam healthcare sector is summarized respectively as follows. First, according to the revised Health Insurance law which came into effect in 2015, the mandatory health insurance premiums are calculated based on household units. Second, there is a medical network that can provide preventive and healthcare services centered on primary health care facilities, for example commune health stations (trạm y $t{\hat{e}}$ $X{\tilde{a}}$). Third, out-of-pocket expenditure is still a large proportion although public spending has increased and private spending has decreased since the enforcement of the health insurance law and various schemes. Vietnam is currently striving towards a universal health care system. The development of institutions and systems should be designed in a way that is appropriate for the members of the society rather than efficiency. This article findings shed light on the role of social values, family culture, and informal institutions.

• Health Policy and Management
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• v.4 no.2
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• pp.77-110
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• 1994

This study is an empiriacl analysis of effects of government intervention on the health care delivery system in Korea. The purposes of this study are to find out the effects of government intervention on the per capita national health expenditure(per capita NHE), crude mortality rate(CMR), and institutional efficiency. Here, the institutional efficiency is defined as a formula shown below: log$\frac{100-curde mortality rate }{per capita NHE}$$\times$100. The formula indicates that the instiutional efficiency increases if the CMR and/or per capita NHE goes down. In the meantime the government intervention is measured by six independent variables: I) the degree of social developments, ii) the numberr of physicians per 100, 000 population, iii) the proportion of specialists among the total physicians, iv) the proportion of public expenditure among the NHE, v) the proportion of public beds to the total number of beds, vi) the proportion of physicians working at the public sector to the total number of physicians. In the above six independent variables iv), v) and vi) are the ones that reflect the degree of government intervention. In actual calculation, the two independent variables v) and vi) are integrated into a new variable based on one to one correspondence. The materials used are the time-series data from 1970 through 1990 in Korea. A path analysis and the time-series regression analysis were adopted to estimate and examine the causal relationship between variables involved. And decomposition of the effect of causal relationship is made to find net effect, direct and indirect effect. The major findings are as follows; 1. The effect of public expenditure, number of physicians per 100, 000 population, the proportion of specialists among the total physicians and social development shows a positive relationship with per capita NHE. Only if the government intervention would be counted, the effects of the number of physicians and the proportion of specialists succeed in containing per capita NHE. 2. In additionn to the above four variables, one additional variable, per capita NHE, was also responsible for the reduction of CMR. The factor of social development found to be the most potent predictor of the CMR reduction. However, the CMR reduction due to government intervention was negligible. 3. Meanwhile, the above four variables were found to was have negative effects on the institutional efficiency. The reverse is true when the government intervention is counted. For example, the number of physicians and the proportion of specialists have played a positive role in raising institutional efficiency via goverment intervention. This comes from the factual effect that the increment of institutional efficiency via the reduction of per capita NHE is bigger than via the reduction of CMR.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.205-233
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• 1999

This study is an effort to make policy suggestions by analysing the current health examination program as a benefit service provided by the national health insurance system, including health screening for the insured, screening of cancer and chronic diseases for their dependents. Analyses found some issues being gave attention to; 1) The insured under the community health insurance system do not get the health examination benefit. A program for them should be set to have equity in benefit services. 2) Low rates of using screen services compromise purpose and the efficiency the services have first intended to. An immediate attention should be made to increase low rate of use of screen test to detect chronic diseases in particular. 3) Selection of diseases and test items covered by health examination program does not reflect the need of the insured, but to reflect financial resources of the national health insurance system. 4) Lack of health screening facilities and their geographical maldistribution is observed, which with preference of a general hospital as a screening post by the insured may lead to unreliable test. 5) A follow-up system should have been developed for the suspected classified by test results of carrying chronic diseases. They should be cared for within the health examination program. Public health care systems incorporate such a system, along with caring for those who are in need of having a health counselling on preventive care. In conclusion, the national health insurance system should be a medical insurance of giving a higher priority on preventive care benefits, health examination program in particular. That could be done by making rearrangements of test items, screening methods and system, rationalizing current reimbursement system of service fee, increasing accessibility to and utilization of the services, and making an establishment of follow-up system.

• Journal of Home Health Care Nursing
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• v.26 no.3
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• pp.319-328
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• 2019

Purpose: The purpose of this study was to establish baseline data for the development of employment policies to improve the efficiency and stability of visiting healthcare services. It identifies factors affecting visiting nurses' intention-to-retention at healthcare centers in Seoul. Methods: This descriptive study investigated subjective health perception, job stress, professionalism, job satisfaction, and intention-to-retention of 269 nurses with more than one year of work experience as a visiting nurse. These factors were analyzed using t-tests, chi-square, partial correlation, and stepwise multiple regression. Results: The results indicate that satisfaction for professional status in job satisfaction, educational level, autonomy in professionalism, and visiting nursing career were significant factors that impacted the retention of visiting nurses. Conclusion: It is necessary to frame policies and provide support to enhance the satisfaction and autonomy for visiting nurse as a profession for the efficiency and stability of visiting healthcare services.

• Korea Journal of Hospital Management
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• v.26 no.3
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• pp.56-67
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• 2021

There are few domestic studies on medical services in medically vulnerable areas where medical use is not met due to a lack of medical resources. The past studies on smart medicine targeting medically vulnerable areas grasp only the overall satisfaction level, or the sub-dimensions of satisfaction are not classified clearly. Also, it lacks consideration of the patient's needs. This study aims to analyze the effect of users' experience of the smart medicine pilot project conducted in medically vulnerable areas on satisfaction and demand. The user's experience was measured by variables in the dimensions of structure, process, and outcome. Among the pilot project participants, 282 subjects responded to the 2019 survey. Using the hierarchical regression method, we tried to find out the determinants of satisfaction and service demands. Experience factors affecting satisfaction were found to be accessibility, certainty, effectiveness, and efficiency. In addition, it was found that the demand in their 60s was high and that accessibility, certainty, effectiveness, and efficiency had a statistically significant effect on the demand. It is expected that the smart medicine pilot project will be effectively operated by well utilizing the factors influencing satisfaction and demand revealed in this study.

• Journal of Korean Public Health Nursing
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• v.9 no.2
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• pp.1-16
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• 1995

This study was conducted to propose a model for nursing performance in group occupational health service. To achieve such a goal, the writer choose and analysed two kinds of journals which were thought to be the most suitable for that purpose and authoritative on community health nursing: The Journal of Korean Community Nursing and the Journal of Korean Academic Society of Industrial Nursing. The total number of the articles analysed in this study was 16 and in the analysis of them the writer was specially concerned with the following questions: 1) Have there been any different performances in occupational health management between staying nurses and visiting ones? 2) What are the levels of knowledge, attitude, and practice of workers and how can we, on the basis of them, develop the program that workers are able to participate positively in ? the obtained conclusions are as follows. 1) Different performances are revealed between staying nurses and visiting ones: Common symptom management frequently appeared in staying nurses. Counseling, health education and follow-up care after medical examination were more frequently revealed in visiting nurses. 2) As for the lovel of knowledge, attitude, and practice of occupational health, workers have average one respectively. The major factors influencing the level of KAP of workers were area, age, sex and status. Counseling, health education, follow-up care after medical examination, and health promotion should be reinforced as core programs in group occupational health services. And for the part of visiting nurses, it is necessary to put more emphasis on efficiency training using the method of nursing process.

• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.154-168
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• 2015

Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

• Korea Journal of Hospital Management
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• v.25 no.1
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• pp.1-12
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• 2020

Purposes: The aim of this study is to evaluate whether the contents of hospital reservation and reception applications(apps) are qualitatively useful in meeting the needs of medical consumers and improving hospital accessibility and convenience. Methodology: (1) identify consumer needs through social data web mining, (2) describe the status of key contents of mobile apps to improve accessibility and convenience of care, and (3) verify the quality of apps through validated tools Finding: The contents of 'mobile reservation function' and 'waiting time information provision' that can contribute to reduction of delay time of care and efficiency of desk work were supported, but the level of utilization was insufficient. The quality level of the app, including the level of consumers' needs, has shown a wide gap between the apps. Implications: The recent development of mobile apps for hospital accessibility and consumer needs has shown a wide gap in the quality of apps, including information and aesthetic. Therefore, it is necessary to develop apps based on user interface(UI), user experience(UX) based designs that can promote the usefulness and convenience of apps while monitoring needs of consumers continuously.