• 한국산학기술학회논문지
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• 제19권9호
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• pp.391-401
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• 2018

이 연구는 요양병원 의료기관인증제 시행 후 요양병원의 환자안전, 의료의 질, 조직문화 및 경영성과에 미친 영향을 파악함에 목적이 있다. 2015년 9월 말까지 요양병원 의료기관인증을 획득한 대구지역의 36개 요양병원 중 10개 기관을 임의로 선정하였으며 2016년 2월 15일부터 2016년 3월 25일까지 요양병원 종사자들에게 설문조사를 하여 253명을 최종분석 대상자로 선정하였다. 설문조사 내용으로는 일반적 특성, 인증이후 환자안전과 의료의 질 향상, 조직문화, 경영성과의 변화가 포함되어 있다. 연구결과 환자안전과 의료의 질 향상의 변화정도에서는 진료지원체계가 3.93점으로 가장 높았으며, 조직문화의 변화정도에서는 인적자원문화가 3.78점으로 가장 높았고, 요양병원의 경영성과 부분에서는 내부프로세스 관점, 학습 및 성장관점이 3.71점으로 가장 높게 나타났다. 병원경영성과에 영향을 미치는 요인을 파악한 결과 직종이 행정직보다 간호직, 직급이 국장보다 사원이거나 과장, 환자안전과 질 향상에서 기본가치체계가 개선되었다고 생각하는 경우, 조직문화에서 인적자원문화, 개방체계문화, 위계서열문화, 생산중심문화가 개선되었다고 생각하는 경우 병원경영성과를 긍정적으로 변화시키는 영향 요인이라 응답하였다. 요양병원 의료기관인증제 시행 후 환자안전과 의료의 질 향상에는 높은 변화를 보여 긍정적 영향을 미쳤으나, 조직문화의 4가지 유형 중 위계서열문화와 생산중심문화는 보통수준의 변화를 보였으며 병원경영성과 중 재무관점은 다른 관점에 비해 상대적으로 낮은 변화를 보였다.

• Journal of Preventive Medicine and Public Health
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• 제55권6호
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• pp.539-548
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• 2022

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

• 한국의료질향상학회지
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• 제19권2호
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• 한국전문물리치료학회지
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• 제30권1호
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• pp.32-40
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• 2023

Background: Equating is a statistical procedure used to create a common measurement scale across two instruments. Item-level information should be taken into consideration so that scores can communicate interchangeably across the instruments. Objects: To investigate a common measurement scale across two health-related quality of life questionnaires (HRQOL) applied to various cancer survivors who underwent palliative care in healthcare institutions. Methods: A total of 139 cancer survivors who underwent palliative care were recruited from two rehabilitation hospitals and an oriental medicine hospital. Participants consisted of various cancer survivors who presented to the sites for palliative care. They were asked to fill out Korean versions of the World Health Organization Quality of Life (WHOQOL-BREF) and EuroQOL-5 dimension (EQ-5D) questionnaires following the palliative care. For the item level comparison, the Rasch rating scale model was used to investigate how participants regarded individual test items of two instruments in relation to item difficulty calibrations. Results: All items except the three items fit the Rasch model. One item (anxiety/depression) of the EQ-5D and two items (dependence on medical aids and negative feelings) of the WHOQOL-BREF are misfit. The WHOQOL-BREF targets the survivors well, while the EQ-5D is able to target the survivors with lower HRQOL levels with some ceiling effects. By inspecting the item difficulty calibrations of the two instruments, five items of the WHOQOL-BREF are selected as common items in relation to the EQ-5D. These five items are considered compatible with each other. Differential item functioning (DIF) analysis reveals that the healthcare item of the WHOQOL-BREF vs the self-care item of the EQ-5D exhibits significant DIF. Conclusion: Findings suggest that one paired item should be taken into consideration when equating the WHOQOL-BREF and the EQ-5D applied to cancer survivors who underwent palliative care.

• 한국의료질향상학회지
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• 제2권2호
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• pp.72-111
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• 1996

Background: Group occupational health program by non-for-profit agency, started five years ago, for management of health problems in small and medium sized industries, is one of the measures to cope with limited human and financial resources in occupational health. The program has been rapidly expanding to include 54 participating institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. Objectives : The aim of this study are to develop and apply criteria to assess quality of newly developed Korean group occupational health program. Methods : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, we included followings as core elements of sound occupational health program; accessibility, continuity, intersectoral collaboration, comprehensiveness, community participation, technical quality, adequacy, focus on preventive services, acceptability, and workers' satisfaction. Again we divided each elements into five major components of national health system infrastructures developed by World Health Organization; development of health resources organized arrangement or resources, delivery of health care, economic support, and management. In turn, we categorized each component into input, process and outcome aspects. After discussions in expert panel, several criteria were selected for evaluation of program. The criteria were modified according to each group of interviewees. Results: We developed five sets of questionnaire that evaluate the quality of 'Group occupational health program'. Conclusion : The refining of the measurement tool and the continuing evaluation process for the 'Group occupational health institute' should be done further.

• 지역사회간호학회지
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• 제1권1호
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• pp.582-594
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• 1989

The purpose of this study is to analyze the factors affecting the school health teachers' self-confidence. This study was conducted with 87 school health teachers working in Jeonbuk province, from September to December, 1986, The results are follows; 1. Demographic characteristics of school health teachers 1) Age mean ; 34, range; 23-54 2) School Nursing experience mean; 11 years, range; 0-24 3) Clinical experience mean; 1.5 years, range: 0-13 2. Status of school health resources & nursing activities 1) Personnel resource school health teacher: pupils : 1 : 1,436 'classes=1:31 'general teacher=1:39 2) Budget Total school operating budget: School health budget : 100 : 4.2 (52.2 thousand Won) Half of the school health budget expend on medicine. 3) Clinic 80% of all schools have health clinic seperately. 71.32 of all schools have less than $35m^2$, 23.9%, $36-66m^2$. 4) Only 20% of all schools have organization for health 5) Average of clinic visitor for 1 year; 2,084 Major problem is on digestive system. And other problem: respiratory, skin, musculo - skeletal system, dental problem, etc... 6) Literal message for 1 year; 12 times. For health education (4), vaccination (3), examination of parasites (2), etc... 3. The degrees of the school health teachers' self-confidence 1) Program planning & evaluation; 2.9. 2) Clinic management; 2.8 3) Health education; 2.8 4) Management of school environment; 2.7 5) Health care services; 2.5. 6) Operating of school health organization; 2.3 4. Significances to self-confidence on school health nursing activities 1) Program planning & evaluation: home message (r=.228, p<.05) No. of clinic visitor (r=.220, p<.05) expending time for clinic management (r=.229, p<.05) religion (t: 2.5, p<.05) level of school (F=6.3, p<.005) 2) Clinic management: age of school health teacher (r=-.202, p<.05) school health experience (r=-.211, p<.05) salary step (r=.187, p<.05) expending time for clinic management (r=.315, p<0.1) marital status (t=3.97, p<.005) level of school (F=3,139, p<0.5) 3) Management of school environment: level of school (F=3.899, p<.05) expending time for clinic management (r=-,216, p<0.5) 4) Health care service: age of school health teacher (r=-.186, p<.05) marital status (t= 3.67, pH.005) 5) Health education: expending times for clinic management (r=-.252, p<05) level of school (F=5.343, p<.01) 6) Operating of health organization; age of school health teacher (r=-.258, p<.01)salary step (r=.188, p<.05) Based on the above results, the suggestions are as follows; 1. Need to raise ,appointment rate school health teacher. 2. Need to raise self-confidence on school health nursing activities through the inservice education or re-inforcement. 3. Need to secure adequate budget for school health. 4. Participation of school health teacher and support of school master for school health services are required. 5. Need for use the health clinic seperately, adequate facilities and free utilization by visitors.

• 대한간호학회지
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• 제24권4호
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• pp.568-583
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• 1994

In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

• 농촌의학ㆍ지역보건
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• 제14권1호
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• pp.30-36
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• 1989

In order to desirable attitudes of health subcenter personnel, affecting to utilization of a rural health subcenter for primary health care, a study carried out, through analyzing the specific survey datas of 228 out of 1151 total house-holders in a rural community, Su-Dong Myun, Yam-yang-ju kun, Kyung-Gi Do in Korea, and the medical re-cords of total out-patients of health subcenter in this district during 1981-1988. The following results were obtained: 1) The annual utilization rate showed decreasing tedency such as 723 per 1,000 inhabitants in 1981, 652 in 1982, 618 in 1985, 54H in 1984 and 341 in 1987, since 1981. 2) The utilization Rate in 1987 was unusually the lowest with 341 per 1,000 inhabitants in decreasing tendency, steadily. 3) In advatage on utilization of health subcenter for primary health care in a rural area, 68.8% of the respondents answered that it was in comprehensive health care with the highest rate and next order in near distance from living place with 16.7% in easy and simple process to utilize with 9.2% and in lower medical cost with 5.3%. 4) The order of desirable image of rural health subcenter personnel for primary health care was of good attitude(57.0%), of good skill(29.0 %) and of wide knowledge(14.0%), 5) The order of desirable image of doctor for primary health care in rural health subcenter was of good skill(.44.3%), of good attitude(36.8%) and of wide knowledge(18.9%), and nurse was of good attitude(76.8%), of good skill(14.0 %) and of wide knowledge(9.2%). 6) The percentage order by good attitudes of rural health subcenter personnel was the highest in responsibility(38.2%), kindness(26.3% ), proprieties(14.9%), sincerity(12.7%) and notion of duty hours(6.6%). 7) The statistical datas in health subcenter was written and kept, without distinction of definition of new and old patients, by month and for suitable method of medical expenses of medical insurance and medicaid by clerical convenience. 8) In future, the organization of health subcenter must be unified, systematized and rationlized for primary health care. Health subcenter must be organized by 3 parts of function(medical care, health service and clerical affair) and then function of health subcenter will be more activated by clerical activities.

• Journal of Information Science Theory and Practice
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• 제11권2호
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• pp.82-103
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• 2023

The Zimbabwean healthcare sector faces huge challenges due to increased demands for improved services for a growing number of patients with fewer resources. The use of information and communications technologies, prevalent in many industries, but lacking in Zimbabwean healthcare, could increase productivity and innovation. The adoption of health management information systems (HMISs) can lead to improved patient safety and high-level patient care. These technologies can change delivery methods to be more patient focused by utilising integrated models and allowing for a continuum of care across healthcare providers. However, implementation of these technologies in the health care sector remains low. The purpose of this study is to demonstrate the advantages to be attained by using HMISs in healthcare delivery and to ascertain the factors that influence the uptake of such systems in the public healthcare sector. A conceptual model, extending the technology, organization, and environment framework by means of other adoption models, underpins the study of adoption behavior. A mixed method methodology was used to conduct the study. For the quantitative approach, questionnaires were used to allow for regression analysis. For the qualitative approach, thematic analysis was used to analyse interview data. The results showed that the critical success factors (namely, relative advantage, availability, complexity, compatibility, trialability, observability, management support, information and communication technology expertise, communication processes, government regulation, infrastructure support, organizational readiness, industry and competitive support, external support, perceived ease of use, perceived usefulness, attitude, and intention to use) influenced adoption of HMISs in public hospitals in Zimbabwe.

• 보건의료산업학회지
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• 제9권1호
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• pp.31-39
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• 2015

This study was undertaken to investigate the effectiveness of a hospital organization targeting both hospital administrative staff members and internal/external customers under a rapidly changing organizational environment, where the effect of creative behavior on passion about one's job was controlled with the participation of 55 people from two larger general hospitals, with 103 people from four general hospitals, with 51 people from eight regular hospitals. Thus, data from a total 209 people were collected. The creative behavior of hospital administrative staff members working for general hospitals and larger general hospitals significantly affected job engagement, showing that 'Relevant knowledge, maintaining status, and application appetite' were higher than the scores of 'new knowledge pursuit activities.' However, a weaker relationship between creative behavior and job engagement was found in medical institutions than for hospitals.