• Journal of the Korean Data and Information Science Society
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• 제21권5호
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• pp.945-950
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• 2010

As the U.S. Congress has continued to debate over the health care reform pushed by President Obama, there is an ample reason to believe that the systematic risk of the health care industry, especially health care plan providers, is increasing. This study measures and compares the systematic risk of two health care industry indexes and one portfolio of health care plan providers from before and after the introduction of the health care legislation into Congress in September, 2009. The Capital Asset Pricing Model (CAPM) is used to measure the systematic risk, and a dummy variable approach and the Chow test are used to formally compare the systematic risk from before and after the introduction of the legislation.

• Asian Pacific Journal of Cancer Prevention
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• 제15권23호
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• pp.10071-10077
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• 2015

Background: Cervical cancer has become a major public health problem worldwide. Iran, like other developing countries, is facing a number of challenges in managing the disease. This qualitative study documents challenges encountered in cervical cancer preventing programs in Iran. Materials and Methods: In-depth interviews were conducted with 28 participants including eleven patients with cervical cancer, three gynecologic oncologists, five specialists in Obstetrics and Gynecology, five midwives, three health care managers and one epidemiologist in Mashhad Iran, between May and December of 2012. The sample was selected purposively until data saturation was achieved. Data credibility verified via allocated sufficient time for data collection, using member checking and peer debriefing. Data analysis was carried out using conventional content analysis approach with ATLAS. ti software. Results: Findings from data analysis demonstrated 2 major themes and 6 categories about challenges of providing cervical cancer prevention programs including: individual and social challenges (cognitive/behavioral challenges and socio/cultural challenges) and health system challenges (stewardship, financing, competency of health care providers and access to services). Each category included some subcategories. Conclusions: Managing the cervical cancer prevention programs need to include the consideration of individuals, health care providers and health system challenges. Addressing the low level of knowledge, negative attitudes, socio cultural challenges, Poor intersectional collaboration and coordination and intra-sectional management, financing and competency of health care providers are essential steps toward significantly reducing the burdens of cervical cancer.

• 대한영양사협회학술지
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• 제25권4호
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• pp.295-309
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• 2019

The purpose of this study were to identify the dietary practices of vulnerable older adults and to assess the foodservice and food provision service programs perceived by the health and welfare service providers in the community. A survey was conducted on health and welfare service providers working in outreach community centers and community health centers in Seoul. A total of 260 nurses and social workers participated in the survey and 224 responses were used for data analysis after excluding significant missing data. The respondents consisted of nurses (58.5%) and social workers (41.5%). In terms of the dietary life of the vulnerable older adults, they perceived that the food cost was burdensome to the older adults and poor dental conditions prohibited them from eating various foods. The health and welfare service providers rated highly for 'home-delivered meal and side dish services are effective for checking older adults' conditions' but rated low for availability of menu choices. In targeting vulnerable older adults for food and nutrition service programs, the home-delivered meal service was found to be suitable for older adults living alone, those over age of 80 years, those with mobility difficulties, and those with economic difficulties. The food provision service was appropriate for older adults living with their spouse or other family members. Vulnerable older adults are a heterogeneous population with diverse needs related to food and nutrition. Home-delivered meal/side dish service and food provision services will achieve their goals when they reach the correct targets with a customized service.

• Journal of Preventive Medicine and Public Health
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• 제56권2호
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• pp.190-195
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• 2023

Objectives: Pregnancy complications, including pre-eclampsia, gestational diabetes (GDM), and perinatal mood and anxiety disorders (PMADs), impact long-term health. We compared the frequency of screening documentation for pregnancy complications versus a general medical history at well woman visits between providers in primary care and obstetrics and gynecology. Methods: We conducted a retrospective cohort study of subjects with at least 1 prior birth who presented for a well woman visit in 2019-2020. Charts were reviewed for documentation of a general medical history (hypertension, diabetes, and mood disorders) versus screening for comparable obstetric complications (pre-eclampsia, GDM, and PMADs). The results were compared using the McNemar and chi-square tests as appropriate. Results: In total, 472 encounters were identified, and 137 met the inclusion criteria. Across specialties, clinicians were significantly more likely to document general medical conditions than pregnancy complications, including hypertensive disorders (odds ratio [OR], 2.45; 95% confidence interval [CI], 1.18 to 5.48), diabetes (OR, 7.67; 95% CI, 3.27 to 22.0), and mood disorders (OR, 10.5; 95% CI, 3.81 to 40.3). Obstetrics and gynecology providers were more likely to document any pregnancy history (OR, 4.50; 95% CI, 1.24 to 16.27); however, they were not significantly more likely to screen for relevant obstetric complications (OR, 2.49; 95% CI, 0.90 to 6.89). Overall, the rate of pregnancy complication documentation was low in primary care and obstetrics and gynecology clinics (8.8 and 19.0%, respectively). Conclusions: Obstetrics and gynecology providers more frequently documented a pregnancy history than those in primary care; however, the rate was low across specialties, and providers reported screening for clinically relevant complications less frequently than for general medical conditions.

• 여성건강간호학회지
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• 제28권1호
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• pp.65-73
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• 2022

Purpose: This study investigated Korean healthcare providers' attitudes toward sexual and gender minority (SGM) persons and their knowledge and behavior concerning the collection of data on sexual orientation and gender identity (SO/GI). Methods: In this cross-sectional, descriptive study, 137 Korean healthcare providers were recruited through convenience sampling from internet communities for medical professionals. A structured questionnaire was created using Google Surveys. The Mann-Whitney U-test, Kruskal-Wallis test, and Spearman correlation analysis were performed. Results: The sample was mostly women (80.3%) and nurses (83.9%), who had overall negative attitudes toward SGM persons and low levels of knowledge and behavior with regard to the collection of patients' SO/GI data. Participants in their 20s, who were religious, and had clinical experiences in treating or providing nursing care for SGM persons had higher levels of knowledge about the collection of SO/GI data. The level of engagement in collecting SO/GI data was higher among women and in their 20s and 30s, unreligious participants, nurses, and those with less than 10 years of clinical experience. Positive attitudes toward SGM persons were associated with higher levels of knowledge, but lower levels of behavior, regarding the collection of SO/GI data. Conclusion: It is important to recognize the diversity of patients' SO/GI and to collect the corresponding information. To this end, it is necessary to develop and use a standardized SO/GI form. Healthcare providers should also receive education and training related to the health of SGM persons to resolve health problems that disproportionately affect SGM persons and related health disparities.

• 한국의료질향상학회지
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• 제25권1호
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• pp.52-65
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• 2019

Purpose: Outbreaks resulting from medication injections have recently been on the rise in Korea despite various established guidelines. The objective of this study was to assess the degree to which healthcare professionals are aware of safe injection practice guidelines and to account for the adherence to and the deviation from safe injection guidelines formulated by healthcare providers. Methods: In November 2016, a cross-sectional anonymous questionnaire covering general characteristics of injections, patient safety culture, awareness of safe injection practices, and adherence to and barriers to safe injection guidelines was issued to healthcare providers who administer medication injections or manage and supervise these injections (N=550). Multivariate logistic regression analysis via enter method was performed to define the influencing factors of adherence of safe injection practices. Results: On average, respondents adhere to 17 of the 24 guidelines. Multivariate logistic regression found that those who were more likely to adhere to safe injection guidelines either underwent a patient safety training experience within the last year, provided care in a setting characterized by a highly developed patient safety culture, or were employed as physicians or nurses, as opposed to some other type of care provider. Barriers to safe injection guidelines were attributable to; thoughts of waste to discard leftover medicine, provisions that made adherence cumbersome, a weak culture of compliance, and insufficient amounts of injectable medicine, products, and education. Conclusions: The results of this study indicate that controllable factors like training experience of healthcare providers and patient safety culture were positively associated with adherence to safe injection practices. It was suggested that the training of healthcare providers on safe injection practices be a continuous process to promote patient safety. Additionally, there should be an increased focus on developing and implementing policies to improve patient safety culture from a prevention rather than post-management perspective.

• 보건행정학회지
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• 제20권2호
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• pp.17-39
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• 2010

This study explored the impact on the DRG(Diagnosis-Related Groups)-based prospective payment system(PPS) operated by voluntarily participation providers. We analyzed whether the provides in the DRG-based PPS and in traditional fee-for-service(FFS) systems showed different the degree of variation in length of stay(LOS), and the providers' behaviors depending on the differences according to the varied participation periods. The study sample included all data 2,061 institutions participated in DRG-PPS in 2007 and all cases 473 FFS institutions which reported fee-for-service claims were reviewed same diagnosized diseases at least 10cases claims during three months We compared the differences of the LOS among health care institutions according to their type, region, and size. For DRGs showing significant differences in LOS, multiple regression analyses were performed to find out factors associated with LOS and interaction effect participation and hospital types or participation periods. The result provide the evidence that the DRG payment system operated by volunteering health care institutions had impact on resources use, which can reduce the institutions' the length of stay. While some DRGs had no correlation between participation periods and LOS, other DRGs, DRG participation period reversely linear relationship with LOS. That is to say, the longer participation year, the less reducing the LOS. These results support the future expansion of the DRG-based PPS plan to all health care services in Korea.

• 동서간호학연구지
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• 제22권1호
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• pp.51-59
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• 2016

Purpose: This phenomenological study aimed to identify breast cancer patients' experience of unkindness of healthcare providers. Methods: Ten participants who were diagnosed with breast cancer were recruited to participate in the study and asked to share their experience related to healthcare providers. Data were analyzed using the phenomenological method of Colaizzi. In-depth interviews were conducted from November, 2014 to March, 2015. Results: Seven consistent categories and fourteen theme clusters emerged from collected data. The seven themes were 'being treated thoughtlessly', 'not giving special services for breast cancer patients', 'cold and authoritative manner', 'incomplete explanation', 'not accepting an appeal', 'being sorry for having short consultation hours', and 'unskilled and careless treatment'. Conclusions: It is needed to develop health care services in the view of beneficiaries. This may reduce the patients' experience of unkindness of the healthcare providers and improve the satisfaction of health care service.

• 한국임상약학회지
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• 제32권1호
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• pp.20-26
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• 2022

Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

• 보건행정학회지
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• 제27권2호
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• pp.121-127
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• 2017

The effort to measure and improve the quality of healthcare is a common health policy issue worldwide. Korean Value Incentive Programme is one of that effort, but some concerns exist. Compared to pay for performance program in other countries, it measures healthcare quality with relatively narrow performance domain using a small number of clinical indicators. It was designed without involving hospitals and other key stakeholder, and program participation was mandated. Highest and lowest performers get bonus and penalty using relative ranking. As a suggestion for development, the direction for quality management at the national level should be given first. Therefore the philosophy or strategy for quality improvement should be reflected to the program. And various domains and indicators of healthcare quality should be developed with active communication with healthcare providers. The evaluation method is necessary to be changed to provide achievable goal to the healthcare providers and attract quality improvement.