• 대한간호학회지
• /
• 제44권4호
• /
• pp.418-427
• /
• 2014

Purpose: Objectives of this study were to investigate the association between efficiency and quality of health care in Long-term Care Hospitals (LTCH) and determine related factors that would enable achievement of both high efficiency and high quality at the same time. Methods: Major data sources were the "2012 Korean Assessment of Propriety by Long-term Care Hospitals" obtained from the Health Insurance Review & Assessment Service. Cost variables were supplemented by a National Tax Service accounting document. First, data envelopment analysis was performed by generating efficiency scores for each LTCH. Second, matrix analysis was conducted to ascertain association between efficiency and quality. Lastly, kruskal-wallis and mann-whitney tests were conducted to identify related factors. Results: First, efficiency and quality of care are not in a relationship of trade-offs; thus, LTCH can be confident that high efficiency-high quality can be achieved. Second, LTCH with a large number of beds, longer tenure of medical personnel, and adequate levels of investment were more likely to have improved quality as well as efficiency. Conclusion: It is essential to enforce legal standards appropriate to the facilities, reduce turnover of nursing staff, and invest properly in human resources. These consequences will help LTCH to maintain the balance of high efficiency-high quality in the long-run.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제5권8호
• /
• pp.7-14
• /
• 1999

Current Korean healthcare facilities face on a difficult period as much as financial difficulty in Korean economy. Most of all the hospitals have difficulty in minus profit margin and hospital investments are also reducing rapidly. Probably, these seem to set in the period of re-organizing its structures and enhancing productivity from the rapidly growing period, which was to concentrate its resources and prefer large scaled structures. Analyzing the developing process and future trend in the U. S. health care facilities, already experienced in financial difficulty of current Korean health care facility in 70s thru. 80s, this paper is to present directions in future Korean health care policy and healthcare facility planning.

• 한국의료질향상학회지
• /
• 제2권2호
• /
• pp.112-129
• /
• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• 농촌의학ㆍ지역보건
• /
• 제11권1호
• /
• pp.44-54
• /
• 1986

This study was aimed at investigating the health seeking behaviors of patients; For the purpose of analyzing the research theme we classified the study into two phase. First, the types of patients' health seeking behavior were categorized into a scheme according to what medical care resources were utilized in patients' coping process. Second, from patients' first visits to third visits to medical resources, we analyzed variations of factors which noted as crucial elements in constituting the patients' sickness career. To grasp the generalized characteristics from complicated empirical data, we limited the scope of our analysis to third stage of health seeking. A total of 121 persons who had beer suffering from chronic diseases more than 3 months was sampled among the residents of Banwol-Eup, the target Area of Korea University Health Project. The findings are as follows ; 1) In the course of visiting medical care resources, 34 different types of health seeking Behavior were found. From this result we inferred the idea that patients in Banwol-Eup had not any stable norms to cope with their pains. Clinics, hospital, pharmacy, Herb-doctors', folkways (self-treatment) were accessed by patients in orders. But more than half of patients who had utilized clinics or hospitals from their first to third visits, changed medical care resources to others, for example herb doctors or folkways, which had fundamentally different treatment models. Upon these two facts, the diversified types and capricious patterns in the health seeking behavior of Banwol patients, we observed a typical Shopping-Around phenomenon. 2) Factors which influenced patients' to their sickness career were changed along the courses of health seeking, from first to third visits as follows ; $\cdot$ Perceived seriousness of diseases were tended to decrease. $\cdot$ Professional medical personnel tended to be influencial in the patients' sickness career, (5.0%, 25.0% and 65.7%). The influence of the primary interaction groups such as parents, friends, neighbours, tended to decrease ; (90.9%, 71.2% and 30.0%). $\cdot$ The subjective reasons why to choose such a medical care resource were related to economic affordability and disease-itself as main motives. Credibility of health resources tended to increase 14.9%, 24.0% and 31.4 sequently. $\cdot$ Geographic accessibility factors did not change significantly. Most of patients had utilized health resources in Banwol and Anyang area. 3) Cultural inclination in the shopping-around phenomenon has shown difference among age groups. The age group' over 50 years' preferred traditional health resources to modern health resources. 4) Consistency of health seeking behavior on the shopping around phenomenon has shown difference according to the degrees of patients' economic affordability and those of psychological satisfaction toward modern health services. However, there were some restrictions in this thesis ; a) the study was limited to the 3rd health seeking career so it did not allow us to collect more informations after that, b) the study was not able to carry out causal analysis on patients health behavior determinated by explanatory model of health resources, and c) the study was not able to take into consideration of factors connected with social structural circumstances. Despite of restrictions described above, we are sure that this thesis would promote health providers' understanding toward patients' inclinations, through which they could provide efficient and accurate medical service.

• Asian Pacific Journal of Cancer Prevention
• /
• 제17권9호
• /
• pp.4289-4294
• /
• 2016

Background: Studies have shown that a return to spirituality is a major coping response in cancer patients so that therapists can adopt a holistic approach by addressing spirituality in their patient care. The present study was conducted to develop a guideline in the spiritual field for healthcare providers who serve cancer patients in Iran. Materials and Methods: Relevant statements were extracted from scientific documents that through study questions were reviewed and modified by a consensus panel. Results: The statements were arranged in six areas, including spiritual needs assessment, spiritual care candidates, the main components of spiritual care, spiritual care providers, the settings of spiritual care and the resources and facilities for spiritual care. Conclusions: In addition to the development and preparation of these guidelines, health policy-makers should also seek to motivate and train health service providers to offer these services and facilitate their provision and help with widespread implementation.

• Clinical and Experimental Pediatrics
• /
• 제50권1호
• /
• pp.1-6
• /
• 2007

In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.

• 대한예방한의학회지
• /
• 제9권1호
• /
• pp.77-89
• /
• 2005

Since 1990's, the Korean society, experiencing the low fertility and aging society, has been confronting with the threats in health care sector. The threats are the increases in the demand for health care, health care financial burden, and so on. In particular, the change of disease pattern and aging population result in the increases patients' demand for not only western medical services but also oriental medical services and complimentary medicine. Recently, the increases in availability of oriental medical services and the health care resources related to oriental medicine are raising some issues and conflicts in the Korean health sector. Theses circumstance required policy makers, central and local government, and public health sector to develop health policies related to oriental medicine and interface or integrate of traditional Korean medicine and Western medicine. For the near future, these issues will probably remain the focus of integration of traditional Korean medicine and Western medicine in public health sector. To cope with the threats in health care sector, one of the opportunities is to scale-up e public role of traditional Korean medical services. The main purpose of this study was to develop strategies to scale-up the Public role of traditional Korean medical services for the future society. The research questions are: what are the trends and problems in traditional Koran medical sector; what are the causes of or associated factors to the problems; how to cope with the problems and how to resolve the cause?; what are the health policy directions and its strategies that the government should take to cope with the future demand and the burden on health care sector? The results of this study are as follows. In order ta scale-up the public role of traditional medicine, this research offered health policy directions for traditional Korean medicine in response to a change environment of health care sector. There are four directions to be addressed: 1) the development of and investment in public oriental medicine infra-structure; 2) the development of public policy on oriental medicine; 3) modernization and globalisation of traditional Korean medicine; 4) the expansion of academic exchange between Western medicine and traditional Korean medicine. Finally, we discussed stakenholders' on traditional Korean medicine in the health care market. Then, public policy options for future society was suggested.

• Journal of Preventive Medicine and Public Health
• /
• 제57권4호
• /
• pp.356-369
• /
• 2024

Objectives: The objective of this study was to explore healthcare providers' experiences in managing the coronavirus disease 2019 (COVID-19) pandemic and its impact on healthcare services. Methods: A qualitative study was conducted with 34 healthcare professionals across 15 districts in Bangladesh. Among the participants, 24 were health managers or administrators stationed at the district or upazila (sub-district) level, and 10 were clinicians providing care to patients with COVID-19. The telephone interviews were conducted in Bangla, audio-recorded, transcribed, and then translated into English. Data were analyzed thematically. Results: Most interviewees identified a range of issues within the health system. These included unpreparedness, challenges in segregating COVID-19 patients, maintaining isolation and home quarantine, a scarcity of intensive care unit beds, and ensuring continuity of service for non-COVID-19 patients. The limited availability of personal protective equipment, a shortage of human resources, and logistical challenges, such as obtaining COVID-19 tests, were frequently cited as barriers to managing the pandemic. Additionally, changes in the behavior of health service seekers, particularly increased aggression, were reported. The primary motivating factor for healthcare providers was the willingness to continue providing health services, rather than financial incentives. Conclusions: The COVID-19 pandemic presented a unique set of challenges for health systems, while also providing valuable lessons in managing a public health crisis. To effectively address future health crises, it is crucial to resolve a myriad of issues within the health system, including the inequitable distribution of human resources and logistical challenges.

• Journal of Hospice and Palliative Care
• /
• 제5권2호
• /
• pp.101-110
• /
• 2002

Purpose : With the elongation of the average life span, the main causes of death are chronicle illness including cancers resulting in a large amount of medical resources. And there are still many patients to whom a sufficient medical care is not given. All these bring on the uneven distribution of medical resources together with the increase of medical cost. Hence, an efficient system should be set up to solve these problems. Methods : The hospice draws a great attention as a resolution of high medical cost and uneven medical resource distribution, and has been proved to be an alternative to the existing medical system. So, the characteristics of the hospice has been reviewed, particularly with respect to its scopes and related resources. And by tracking the actual cases, the necessary services and supports are investigated. Results : The intrinsic characteristics of hospice is that it executes not only the medical exercise but also all the subjects related with patients and their families. And the hospice is performed not only by the medical experts but also by all the disciplines including social and spiritual affairs. This indicates that the hospice requires the integrated system comprised of medical, social and other welfare entities. Conclusion : To establish the actual hospice, an efficient and systematic integration of all the existing medical and other welfare resources in the local society is necessary. The most practical way is the networking of resources, which practices the hospice more efficiently without additional investment.

• 한국정보통신학회:학술대회논문집
• /
• 한국정보통신학회 2014년도 춘계학술대회
• /
• pp.844-847
• /
• 2014

정부의 '창조경제' 키워드와 의학과 정보통신기술(ICT) 융합을 중심으로 대두된 '헬스케어 3.0' 패러다임이 만나 새로운 고부가가치 시장과 산업, 일자리 창출을 가져올 '기회의 땅'으로 부각되고 있다. 세계적인 경기후퇴에도 불구하고 세계 헬스케어 시장은 지난 2009년부터 꾸준한 성장을 보이며 국내 산업은 2010년 기준 153조원 규모로 연간 10% 이상의 높은 성장세가 전망된다. 특히 의료와 ICT, 생명기술(BT), 나노기술(NT)을 결합한 이른바 '슈퍼 융합'이 헬스케어 산업 도약의 새 패러다임을 열어줄 것으로 기대를 모은다. 이와 더불어 2020년경에는 IT융합 헬스케어 산업이 모든 IT융합산업 중 가장 큰 비중을 차지하고, 5만 여명의 고용창출 효과를 낼 것으로 전망하고 있다. 이에 여러 학문들이 융합되는 융합학문분야가 생기고 이를 교육하기 위한 융합학부가 새롭게 생기고 있다. 따라서 본 연구에서는 의료 IT 융합 기술의 문제점을 살펴보고 의료 IT 융합과 의료서비스 산업의 미래, 수요 인력을 분석하고 의료 IT 융합 인재 양성 방안을 제시한다.