• 제목/요약/키워드: Health service accessibility

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Perceived Service Quality among Outpatients Visiting Hospitals and Clinics and Their Willingness to Re-utilize the Same Medical Institutions

  • Jung, Min-Soo;Lee, Keon-Hyung;Choi, Man-Kyu
    • Journal of Preventive Medicine and Public Health
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    • 제42권3호
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    • pp.151-159
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    • 2009
  • 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.

공무원 인식유형에 따른 보건서비스 개선 방안 (Public Officials' Perceptions on Improving Quality of Community Health Care Service)

  • 양창훈;이제영
    • 한국콘텐츠학회논문지
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    • 제14권1호
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    • pp.223-237
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    • 2014
  • 국민 보건의 향상 및 건강증진에 대한 기대 요구가 높아지면서 공공 보건서비스의 공공성 강화 및 질적향상을 위한 노력이 전개되고 있다. 본 연구의 목적은 서비스 제공 주체인 보건소 공무원들에 대한 심층적인 조사를 통하여 보건서비스 개선방안을 어떻게 인식하고 있는지를 이해하고 그 유형을 발견하는데 있다. 보건서비스에 대한 보건소 공무원들의 인식 유형을 Q방법론을 통해 분석한 결과, 보건서비스 개선에 대한 인식은 주민들의 요구를 반영하여 사용자 중심의 세밀하고 친밀한 보건서비스가 이루어질 수 있어야 함을 강조하는 서비스 수용증진형, 지역사회의 기대와 주민의 보건의료 요구 변화에 부응할 수 있는 서비스 효용성형, 실질적으로 지역 주민들의 건강증진을 통하여 삶의 질을 향상시키고자 하는 서비스 전문화형, 지역사회 주민들과의 의사소통과 양질의 보건서비스에 대한 이용 가능성을 중요하게 생각하는 이용접근형, 그리고 총체적인 보건서비스 운영의 필요성을 강조하는 책임 운영형 등 5가지 유형으로 분류되었다. 그리고 보건서비스 개선방안에 대한 응답자의 주관성 인식은 유형별로 명확한 특성을 갖는 것으로 나타났다. 본 연구의 분석 결과는 보건서비스의 공공성 강화 및 질적 향상을 위한 전략을 수립하는데 있어 실용적 지침이나 실증연구를 위한 이론적 틀로 그 유용성을 제공할 것으로 본다.

거동불편노인의 구강건강과 삶의 질에 영향을 미치는 요인 (Factors Influencing the Dental Health and Living Quality of the Elderly With Physical Debilities)

  • 박남규;김한곤;김진아
    • 대한치과기공학회지
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    • 제33권4호
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    • pp.413-425
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    • 2011
  • Purpose: This study conducted a survey on the elderly with physical debilities, who are in a medically vulnerable social class, to examine closely their demo-sociological characteristics, unmet needs, dental states, and living qualities and satisfaction levels relating to oral health and social supports to them, and also to prepare the basis for effective public medical policies and health improvement programs aimed at improving the quality of life for the elderly with physical debilities. Methods: Twenty-two elderly care facilities within Jeju Special Self-Government Province participated in the survey. Between 11 January and 5 March 2010, a total of 250 elderly persons(65 and over) with physical debilities were interviewed and their dental health was checked. Results: The results of the survey are as follows. The need for social support for dental care of the elderly with physical debilities was high in the medical institution-supported service (49.6%). The unmet needs for physical care were high in bathing (49.6%) and using public transportation (71.6%). More than half of these surveyed had ten or fewer teeth. The survey found that 31.6% of the participants experienced problems eating, due to poor dental health. Concerning quality of life, 30.5% of those surveyed experienced physical pain. Conclusion: In summary, the ages of the survey participants directly relates to the degree of behavioral debility experienced. The more debility a participant exhibits, the greater is the need for social support and dental care. The dental health of a participant directly relates to a higher quality of life. Good dental health of a participant translate to better quality of life. In light of the fact that the elderly with physical debilities suffer from a lack of accessibility to medical care and worse oral health than do other elderly persons, it is essential to increase accessibility to medical institutions that can provide such services as door to door dental care. Current insurance policies, funding for denture insurance, and free denture and denture-upgrade programs desperately need to be expanded. Therefore, to improve effectively the quality of life for the elderly with physical debilities civil dental medical resources should be encouraged to provide inclusive and prevention-focused medical care. In the public domain, door to door dental care services and cooperation with civil dental care resources need to be improved to increase impartial accessibility to dental medical institutions.

가정간호서비스에 대한 대상자 만족도 측정도구 개발 (The Development of Client Satisfaction Instrument in Home Care Service)

  • 박현태;박정호
    • 가정간호학회지
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    • 제8권2호
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    • pp.159-170
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    • 2001
  • Client(patient) satisfaction has been used for a variety of purposes in different settings, yet, those receiving home care services have been the focus of few satisfaction studies. Satisfaction is considered an indicator of quality of care and is also being used to assess the performance of home care providers and home health care delivery at multiple levels. The aim of this study was to develop the tool for evaluating client satisfaction in several aspects with home care service while maintaining or achieving acceptable reliability and validity. Firstly, Client Satisfaction Instrument made preliminary of 43 items composed basic 6 criteria and 7 indicators, based on a review of literature, quality improvement and client satisfaction findings in home care. Secondly, there were consisted in two expert panel groups who were made in professionals of research and practice in home care field. The tool was modified to 6 criteria and 7 indicators, 25 items after reviewing by two expert panel groups. The content validity index of the tool was above 0.8 and the results of internal consistency was more than 0.8 in all items. Finally. The Client Satisfaction Instrument in Home Care Service was made up 6 criteria such as client satisfaction of nurses's instruction of home care educational need. knowledge/technique/attitude of homecare nurses's performance. interpersonal relationship and emotional support of nurse. easiness of homecare accessibility, continuity of homecare service. overall efficacy of homecare use, 7 indicators. and 25 items. The results of evaluating client satisfaction will be able to contribute in quality improvement and service marketing in home care.

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의료보험 건강진단사업의 개선방안 (Reform Measures of Health Examination Program in Health Insurance Scheme)

  • 박재용
    • 보건교육건강증진학회지
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    • 제16권2호
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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.

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지역거점 공공병원의 의료서비스 질과 고객충성도와의 관계 (Regional Hub Public Hospital Medical Service Quality and Customer Loyalty Relationship)

  • 이진우
    • 한국콘텐츠학회논문지
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    • 제16권12호
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    • pp.761-771
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    • 2016
  • 본 연구는 지역거점 공공병원의 의료서비스 질과 고객충성도와의 관계를 연구하여 의료서비스 질의 향상 방안을 제시하는데 그 의의가 있다. 조사대상자는 2014년 6월 9일부터 6월 30까지 지역거점 공공병원을 내원한 고객들로 604명을 최종 조사대상으로 선정하였다. 분석방법은 신뢰도 및 요인분석과 고객충성도에 영향을 미치는 요인을 파악하기 위하여 위계적 회귀분석을 실시하였다. 결론을 보면 고객충성도에 영향을 미치는 요인으로 접근성, 병원인지도, 지각 된 비용효과 가치, 인적서비스가 유의한 영향을 미치는 것으로 나타났다. 앞으로 지역거점 공공병원이 양질의 의료서비스를 제공하기 위해서는 지속적인 관리를 통해 고객관리의 연속성을 가지는데 집중함으로써 이용빈도와 충성도를 높이기 위한 노력이 필요하다.

지역별 응급의료접근성이 노인의 허혈성 심장질환 사망률에 미치는 영향 (Effect of regional emergency medical access on the death rate of elderly individuals with ischemic heart disease)

  • 고은정;조근자
    • 한국응급구조학회지
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    • 제25권2호
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    • pp.19-38
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    • 2021
  • Purpose: This study aimed to investigate the relationship between emergency medical service accessibility in different regions and the sudden death rate in elderly patients with ischemic heart disease using data analysis techniques and suggest improvements in regional emergency medical services. Methods: The study collected data from the NEDIS database and Statistics Korea. Data on a total of 75,867 patients aged ≥65 years were reviewed among patients with ischemic heart disease who visited emergency medical institutions in 2018. Frequency analysis, chi-square test, multiple logistic regression analysis, and simple logistic regression analysis were performed using SPSS PC Window 25.0. Results: With an emergency medical resource per 100km2, there was a concomitant reduction in the risk of death. There was a decrease in the death rate by 0.967, 0.970, 0.997, and 0.391 times with the increase in the presence of a fire department, an ambulance, a paramedic, and a regional medical center, respectively. Furthermore, a decrement in the death rate was witnessed 0.844, 0.825, and 0.975 times with the initiation of a local emergency medical center, a local emergency medical institution, and an angiography device, respectively(p <.001). Conclusion: To improve the accessibility of emergency medical services, the population and geometric area of the region should be considered essential factors when deploying emergency medical resources.

전문병원인지에 따른 병원 선택요인과 만족도·재이용 의사 및 추천 의사에 관한 연구 : 관절전문병원 입원환자를 대상으로 (Hospital Selection Factors and Satisfaction, Intention to Revisit and Recommend by Recognition of Specialized Hospital : Based on Joint Specialized Hospital Inpatients)

  • 이지영;박영희
    • 보건의료산업학회지
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    • 제13권2호
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    • pp.39-54
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    • 2019
  • Objectives: This study was performed to investigate selection factors for specialized hospital and to find out the impact of hospital selection factors on satisfaction, revisiting invention and recommendations. Methods: A survey was performed with 398 inpatients of 4 specialized joint hospital in Busan. Data were collected from August to October 2016 with questionnaires and analyzed using SPSS 24.0. Results: First, inpatients know that it was a specialized hospital were highly satisfied and willing to revisit and recommend. Second, in hospital satisfaction, influence size was shown in order of specialty factors, service quality factors, physical factors, and accessibility factors. Third, the intention to revisit hospitals was higher in the awareness of a specialized hospital and high satisfied inpatients, and recommendation intend were affected by the higher revisitation intention, the high satisfaction level, and the high professionality level. Conclusions: All the hospital selection 4 factors for joint specialized hospitals affects satisfaction level which is linked to revisit and recommend. Specialized Hospitals will have to strengthen qualitative management of hospital selection factors to enhance patient satisfaction.

간호사의 보건사업수행 경험과정 (The Process of Nurses Experience in Public Health Program Performance)

  • 김정수
    • 지역사회간호학회지
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    • 제21권4호
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    • pp.468-480
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    • 2010
  • Purpose: This study was to describe and develop public health nursing. Methods: Data were collected from 19 nurses sampled from 5 public health centers. The grounded theory of Strauss and Corbin (1990) was applied. Results: As a result, 48 concepts, 23 subcategories, and 11 categories were deduced from open coding. In axial coding, casual conditions 'facing difficulties of practical administration' and 'attaching importance to health support for residents' and context condition 'assessing of residents' service needs' impacted phenomenon 'searching for efficient performing methods.' Intervening conditions 'forming of support system' and 'working with positive,' and action-interaction conditions 'improving of resident's health and medical accessibility' and 'striving for self-development' lead to consequences 'carried out promptly for field-based problem solving,' 'mastered of successful program planning methods' and 'solving the issues with existing style.' The periods of process were divided into 4 stages, confirming program-contents, probing program-method, developing program-strategies, and applying program-competencies. The core category, ‘strengthening of practical-planning work competencies' incorporated the relationship between and among all categories and explained the process. Conclusion: This study described public health nurses' performance in Korea. These findings have important implications for the practice and must be considered to develop competencies for planning and practice of public health.

양방과 한방 의료 이용자의 서비스 선택요인 비교분석 - D병원의 사례를 중심으로 (Comparative Analysis on the Choice of Services between Western and Oriental Medicine)

  • 이선희;이혜진;최귀선;채유미;지영건
    • 보건행정학회지
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    • 제12권4호
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    • pp.18-33
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    • 2002
  • This study was planned to investigate the difference in the choice of services between western and oriental medicine. Data were collected from 493 outpatients who visited the D hospital by structured questionnare. The results were as follows; The older aged groups, there were the more oriental medicine visitors, significantly Oriental medicine visitor had more experience to use the complementary food than western medicine visitor. In comparison of reason for service choice, the proportion of oriental medicine visitors was higher than western medicine visitor in considering of specialty of institution. In contrast, western medicine visitor had interest to 'newly-developed facility and equipment' and 'convenience and accessibility of service' as factor of service choice. In analysis of evaluation the service experiences, oriental medicine visitors evaluated the oriental medicine highly in 'therapeutic efficacy' and ' less side effect'. But western medicine visitor evaluated the western medicine highly in 'quick effect of therapy' and ' scientific apprach'. We concluded from result that there were difference in service choice behavior between western and oriental medicine visitor. We hope that these information will be applied to planning of consumer-oriented marketing strategy of hospital.