• Journal of Korean Academy of Nursing
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• v.24 no.4
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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.

• Quality Improvement in Health Care
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• v.22 no.1
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• pp.11-26
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• 2016

The Organization for Economic Cooperation and Development, which has continuously evaluated the performance of healthcare systems, has recently invested much effort into hospital performance measurement. The purpose of this paper is to introduce the hospital performance measurement programs operated by international organizations or at the national level based on the OECD's hospital performance project. Health Insurance Review & Assessment service (HIRA)'s quality assessment was analyzed based on the analytical framework of the OECD's hospital performance project. The hospital performance measurement programs of WHO, Canada, Australia, United States and United Kingdom are briefly explored, in view of the conceptual framework, key performance dimensions and indicators that are currently in use. The OECD suggested seven key dimensions of hospital performance: timeliness, efficiency, continuity, effectiveness and appropriateness, staff orientation, patient orientation and safety. The analysis of the quality assessment program of HIRA, which operates 36 diseases and procedures and 347 indicators, shows that the numbers of indicators are relatively small in the areas of safety, patient centeredness and efficiency. Continuity of care and staff orientation are not fully developed also, but the situations are similar in other countries. In conclusion, hospital performance measurement using stable and comprehensive data should be developed to improve overall system performance, and discussions on a conceptual framework that can lay out directions and key performance domains need to take into place.

• Journal of the Korean Geographical Society
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• v.44 no.6
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• pp.813-832
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• 2009

As accessibility to health-care service in less populated rural areas is geographically limited and demand for public health-care by the aging is increasing, a new approach for health-care service such as a home care service is becoming more popular. For a home care service, health-care personnels directly visit to location of health-care clients. Such changes in provision of health services require developing innovative and scientific approaches for efficient allocation of health resources and managing services by public health-care organizations. The purpose of this study is to formulate a location model for visiting health-care districting for the rural elderly and to develop an Automated Zoning Procedure (AZP) to solve this model. Mobility, workload balance and contiguity criteria are considered in the model. Three different objective functions are evaluated; 1) minimizing the sum of network distance between the unit areas in a district, 2) maximizing spatial interaction between the unit areas in a district, and 3) minimizing tour distance that visits each unit area exactly once in a district. The AZP for solving the model is developed and applied to a rural area. The application results demonstrate that the AZP can generate different districting systems for each objective functions.

• Korean Journal of Occupational Health Nursing
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• v.26 no.4
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• pp.236-246
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• 2017

Purpose: This study aimed to investigate the relationships among job characteristics, knowledge sharing, organizational culture, and organizational commitment in occupational health nurses (OHN) and clinical nurses (CN) to identify factors that might influence organizational commitment. It aimed to contribute to the improvement of knowledge management in health care organizations, including industrial workplaces and hospitals. Methods: A convenience sample of 188 nurses, specifically 100 OHN and 88 CN, was selected. Data were analyzed with descriptive statistics, t-tests, correlation coefficients, and multiple regression analysis. Results: OHNs had a significantly higher education level and current work experience; higher proportion of participants with contract employment status, day work shift, less turnover experience, good lifestyle; and higher scores on organizational culture ($3.3{\pm}0.61$) and organizational commitment ($3.1{\pm}0.60$). Additionally, the correlations among organizational commitment, job characteristics, knowledge sharing, and organizational culture ware higher (r=.38~.57) among OHNs as compared to those among CNs. Further, the organizational commitment of OHNs was significantly influenced by knowledge sharing, organizational culture, working hours, and salary ($R^2=.32$), while that of CNs was influenced by organizational culture and life event stress ($R^2=.11$). Conclusion: There is a need to develop measures to enable nurses to contribute to the improvement of knowledge management in health care organizations as major human resources, by including interventions for the major factors leading to between-group differences in organizational performance.

• Journal of Korean Academy of Nursing Administration
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• v.23 no.1
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• pp.1-7
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• 2017

Nursing research in the United States (US) spans several decades. Many of the priorities/trends have stayed through the years. Today, the goal of producing evidence to support nursing care interventions coupled with the drive for Magnet Recognition has encouraged academic nurses (faculty) to work with nurse clinicians to form research teams. Interdisciplinary research teams have also formed to address growing concerns over patient safety and quality care. These issues are not just US issues but global ones. This article addresses US trends with the link to global research trends. The role that organizations such as the International Council of Nurses (ICN), the World Health Organization (WHO), and the Council of International Neonatal Nurses, Inc. (COINN) pay in shaping research agendas and promoting nursing research is highlighted. It emphasizes the key role that nurses, especially nurse leaders/administrators play in changing health outcomes through support of nursing research.

• Korea Journal of Hospital Management
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• v.10 no.4
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• pp.98-112
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• 2005

The purpose of this study is to develop a framework for evaluating security levels in hospitals. We classify security indicators into administrative, technical and physical safeguards. The security evaluation model for hospital information systems was applied to three general hospitals. The analysis of the results showed a low security level in information systems. In particular, requirements for administrative and physical safeguards were very low. Hospitals need strict security policies more than other organizations because their information systems contain patients' highly confidential data. The evaluation model developed in this study can be used for guidelines and as a checklist for hospitals. The security evaluation in hospital informational systems needs to be an essential element of hospital evaluation.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.41-69
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• 2012

First introduced in 1977, Korean health care system reached to national coverage in short period of time never seen before in any other countries, and rated as successful system protecting the health of the public at relatively low price. However, despite those positive evaluations, some of fraudulent medical organizations or pharmacies are hindering the sound development of the national health care system with meticulous false billing exaggerating the number of patients or the days of their treatment. To prevent aforementioned nursing home fraud and false billing, the misconduct should be punished as subject to the criminal law and severally punished for fines and payments which far exceed the expected amount of illicit gains as it is basically violation of criminal fraud, other than the forced return of illicit gains based on civil laws. Furthermore, the Health Insurance Review and Assessment Service should strengthen and complement the fraud investigators, the review process, and the professional training to raise the detection rates. It might also want to review ways to implement whistleblower rewarding system and rewards for evidences of healthcare fraud to overcome the limits of external review.

• Gut and Liver
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• v.12 no.6
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• pp.615-622
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• 2018

Despite the well-proven, safe and effective therapies for hepatitis B infection, delivery of treatment remains a significant challenge in resource-poor settings. Geopolitical and economic restrictions present additional difficulties in providing care in North Korea. However, treatment of patients with chronic hepatitis B remains a top priority for both the North Korean Ministry of Public Health and international agencies working in North Korean hepatitis healthcare facilities. Working in partnership, a path was created to institute this much-needed program. A consortium of United States and Australian humanitarian non-governmental organizations along with generous individual and corporate donors working in concert with local and national health authorities have succeeded in establishing the first hepatitis B treatment program in North Korea. The essential elements of this program include renovation of existing hepatitis hospitals, access to antiviral medications, establishment of laboratory facilities, creation of medical documentation and record-keeping, training of local health care professionals, and quarterly visits by international volunteer physicians and laboratory experts. Management and treatment decisions are made bilaterally. To date, nearly 1,500 patients have been evaluated, and over 800 have been started on long-term antiviral therapy. It is envisioned that this program will eventually be managed and funded by the Democratic People's Republic of Korea Ministry of Public Health. This program's success demonstrates a potential model for delivery of antiviral therapy for patients suffering from hepatitis B in other developing countries.

• The Southeast Asian review
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• v.27 no.4
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• pp.77-115
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• 2017

This study examines how a Burmese migrant clinic in a Thai border town cares for migrant patients and activates cross-border health care mobility. Established in 1989, the clinic has developed its capacity and serves as a prominent healthcare institution across the border. Despite its illegality, Thai authorities recognize its importance and collaborate with the clinic. The study reveals that collaborations with various partners play important roles in the constitution of the clinic. Unlike existing literature on the health of migrants, which concerns structural constraints, the study emphasizes migrants' agency in creating their own health care institution through collective partnerships, shedding light on the cross-border health care mobility of underprivileged patients. The legitimate presence of the migrant clinic in the border town mediates and strengthens their transnational mobility across the border. Partnerships with various individuals and organizations have empowered the clinic to undertake a unique role in the border society.

• Health Policy and Management
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• v.19 no.3
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.