• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.46-68
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• 2001

The study was to examine the relationships among those variables related to total quality management and to reveal those variables affecting total quality management in Health-Care Organizations. To study the relationship, a questionaire was designed and sent to 220 hospitals of which the number of beds is over 200 beds. Out of 660 questionaire, 263 questionaire were collected. Data analysis were conducted by using t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression. The result were as follows: 1. TQM was significantly different according to activities of QI, department of QI, age, and position. 2. Leadership was significantly different according to activities of QI, department of QI, age, and position. 3. Significant differences in the level of satisfaction of employee were found according to activities of QI, department of QI, age, position, and duration of employ. 4. Significant differences in the level of participation of employee were found according to activities of QI, department of QI, and position. 5. Education trainning was significantly different according to amount of bed, activities of QI, department of QI, level of education, kind of job, and position. 6. Medical technique was significantly different according to activities of QI, department of QI, and position. 7. Quality of work was significantly different according to activities of QI, department of QI, age, and position. 8. Significant differences in the level of investigation's system in satisfaction of client were found according to activities of QI, department of QI, kind of job, and position. 9. Positive correlations were observed between TQM and those variables related to TQM. 10. TQM was significantly predicted by the level of satisfaction of employee(40.9%), participation of employee(7.0%), investigation's system in satisfaction of client(2.7%), leadership(1.4%), and medical technique(1.1%), respectively.

• Journal of the Health Care and Life Science
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• v.9 no.1
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• pp.95-102
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• 2021

This study analyzed all medical institutions located in the Yeongbuk area of Gangwon Province by dividing the use of medical institutions by "including nursing hospitals" and "excluding nursing hospitals" from 2003 to 2017. As a result, high blood pressure, dementia, musculoskeletal diseases, small-scale mechanical diseases, and other diseases were accounted for in the use of hospitalization for the elderly (including nursing hospitals) in the Yeongbuk region. In the case of hospitalization use of the elderly population (excluding nursing hospitals), blood and circulation machine diseases, digestive and urinary system diseases, mental diseases, and other diseases, including high blood pressure, were shown in the order. Therefore, the treatment and health care of the elderly are very important, and the expansion of public health organizations is necessary to establish governance with local medical institutions, organizations, universities, etc. Based on this, health projects should be carried out at a preventive level to maintain a healthy life for senior citizens in Yeongbuk, Gangwon-do.

• Health Policy and Management
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• v.4 no.1
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• pp.138-175
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• 1994

The objectives of this study are (i) to review current situations and problems of the occupational health care system with emphasis on reforming the organizations and services, (ii) to find out a disirable occupational health system model based on integration of the occupational health system and the general health system, and finally, (iii) to suggest policy implications in occupational health services in the light of objectives of the newly emerging national health insurance reform in Korea. The major policy implications of this study are as follows: 1. In the long-run, within the occupational health system, preventive occupational health services such as employees' physical check-up, working environment examination, etc should financially be integrated with industrial accident compensation insurance. Currently separately paying expenses for each different category of services by the owner of an enterprise should be disbursed once through the payment of contributions of industrial accident compensation insurance. And then, it is necessary to strengthen and expand the role and function of industrial accident compensation insurance to cover preventive occupational health services. 2. The occupational health system should be integrated with general health system for its effective management. For the short-term policy, it is necessary to eliminate fiscal and access barrier between industrial accident compensation insurance and national health insurance by means of ex post facto settlement of accounts. The duplication of employees' physical check- ups between under the health insurance program and under the industrial health services must be coordinated in a manner either through mutual authorization by the two parties concerned or through merge into the health insurance. 3. The intent of current employees' physical check-up system focused on detection of occupational diseases, should be converted to an idea of medical surveillance system or biological moritoring system. The introduction of medical surveillance or biological monitoring system is a necessary condition to build a positive, effective and inexpensive occupational health care system.

• Korean Journal of Health Education and Promotion
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• v.27 no.4
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• pp.1-6
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• 2010

Objectives: This paper aims at addressing the importance of community-based health promotion. It would identify the origin of community health programs in Korea, which emphasized community involvement. And it would reveal the discontinuity of community-oriented health programs in the current health promotion activities. Finally, the methods of attaining community-based health promotion would be suggested. Results and Conclusion: Community-based health promotion had been implemented in rural areas by medical schools in the 1970s and 1980s, which emphasized the role of village health workers. But their roles has disappeared since the government-initiated health promotion policies and programs have been implemented in the mid-1990s. This paper addressed the factors contributing to this discontinuity, such as the expansion of heath insurance system, the change of health care discourses, the monopoly of resources for health promotion by government, and the bureaucratic approach to health promotion, etc. This paper suggested the utilization of voluntary and civic organizations in community for realizing the goal of community-based health promotion.

• The Journal of the Korea Contents Association
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• v.11 no.2
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• pp.367-375
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• 2011

This study conducts analysis on integrated care cases in Korea and other nations regarding health, medical, and welfare services that are segmented and fragmented in order to provide foundational data to establish an integrated care system appropriate for the situation of Korea. According to the result of the cases, integrated care provides various services in common through cooperation with organizations, collaborative participation of various professionals, provision of intervention and individualized protection, and experts for taking care of the cases. Based on those cases, this paper provides suggestions to establish an integrated care system of Korea. In fact, it is necessary to build integrated care general support centers, arrange service providing places in common, establish a care management system, develop resources and expand manpower, develop an integrated care case management system, and develop integrated care computer network.

• The Journal of Korean Physical Therapy
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• v.34 no.2
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• pp.80-89
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• 2022

Purpose: In Japan, the long-term care insurance and health insurance acts have stipulated the visiting rehabilitation system to provide support at the national level. The prior case of Japan would provide guidelines for seeking a suitable policy direction in South Korea. This study aims to examine the historical transition process of the visiting rehabilitation system in Japan, and the issues that emerged in the process of the institutionalization of this system. Methods: To examine the historical transition process of the system, the regulations announced by the government and their reports were reviewed. The relevant issues were qualitatively analyzed based on the opinions of scholars, therapists, and interested organizations that were reported in published papers on the topic. Result: The visiting rehabilitation system has been implemented in the following chronological order: The Health and Medical Service Act for the aged (1982-2006), the Health Insurance Act (1988-), and the Long-term Care Insurance Act (2000-). Currently, visiting rehabilitation is provided through hospitals, clinics, visiting nursing stations, etc. The following issues came to the fore in the process of the institutionalization of the system: (1) the complexity of the system, (2) the necessity of changing perceptions into a life model approach, (3) insufficient service provision by therapists, (4) the lack of human resources and an education system, (5) the lack of awareness of care managers and doctors about visiting rehabilitation, and (6) the necessity of quality enhancement through a team approach. Conclusion: It is deemed worthwhile to refer to the visiting rehabilitation system in Japan and the issues that emerged in the process of institutionalizing the system while seeking a policy direction for a similar system in South Korea.

• Health Policy and Management
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• v.2 no.2
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• pp.112-130
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• 1992

Patient care services are provided to individual patients in response to their health needs produced by illnesses or injuries. The services are often addressed to very serious conditions, and also they constitute the most expensive component of health care services. Therefore, the importance of quality is emphasized, but there are many indications that patient care quality is far from a satisfactory state in most of the countries. Based upon this observation, it is attempted to examine obstacles and approaches to quality improvement in patient care services. In doing so, following Taguchi's(1986) definition of product quality, quality of patient care services is conceived of as better when the less is the sociental loss attributalbe to variability of intended function and harmful side effects they emhibit after being delivered. Some distinguishing features of medical care sector pose difficulties in implementing effective quality improvement programs in patient care services. Nevertheless, newly proposed method of quality management, based on industrial quality management approach, seems to have a great deal of potential to effectively cope with such difficulties. This method, unlike the traditional approach to quality assurance, focuses on total organisational processes, not individuals, as the obproach to quality assurance, focuses on total organizational processes, not individuals, as the objects of quality improvement; variation, not comparison with standards, in quality measurement; and continuous improvement, not removing only bad quality care, as an ideal. Prerequisite to a successful use of any quality mangement method is motivating providers to improve quality. Conceivable approaches for such motivation are self-regulation, external controls and promotion of competition. Since these approaches are not mutually exclusive, they may be employed in an appropriate combination. In Korea, medical care providers are now functioning under the circumstances where they have little reason for making efforts to improve quality of their services. Once these circumstantial conditions are changed to exert pressures on providers to improve quality, the use of adequate quality management method becomes an issue. In this connection, much attention shoould be directed to the newly proposed method described above. In all these efforts for improving quality of patient care services, health insurance would be able to play a pivotal role. Poviders of medical care, buth indiciduals and organizations, are usually very responsive to the measures that affect their financing, and thus health insurance can be a strong instrument for motivationg providers to improve quality. Also, the insurance continuously acquires data on patient care, which could be processed to produce information required to effective quality control.

• Health Policy and Management
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• v.9 no.1
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• pp.30-71
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• 1999

There has been a dramatic increase in public awareness regarding dementia during recent years. However, dementia remains a family affair and patients do not receive adequate care in Korea. This study aims to assist patients and their caregivers by establishing Home and Community based Long-Term Care in a city. The data collected for analysis include five main categories: dementia prevalence, limitations of daily activities of patients, burden of caregivers, the services that patient's family want to utilize, the resources that handle dementia in the community. Major findings can be summarized as follows: 1)The prevalence rate of dementia for elderly people is 13.1 per 100 persons. Alzheimer's disease amount to 38.9% of dementia patients and vascular dementia account for 36.7% of them 2)Eight out of ten patients have mild dementia. Almost all patients have normal ADL. IADL, however, shows different picture. In every items of IADL, about 60% of patients reveals some limitations. 3)The proportion of patients who had medical diagnosis is as low as 20%. Families of patients think dementia as normal aging process and medical doctors in the community do not give special concern to dementia patients. 4)Caregivers does not have proper social support. They suffer from long care time, experience large obstacles in respect of health, daily living, and social activity. 5)Health center and Community welfare center have launched some programs-consultation, home-visiting nursing, day care center, voluntary force mobilization and so on-for dementia patients. But they do not perform expected roles and functions because of lack of skilled personnels and inadequate coordination of relevant organizations for dementia care. 6)Families of dementia patients prefer home helper and home-visiting nurse to hospitalization. For the future, however, demand for institution-based long-term services will increase. We develope community dementia care model based on above findings as follows: 1)Health center execute community cardiovascular control program for the prevention of vascular dementia. 2)Refer to epidemiologic characteristics of patients and preference of family, the most urgent task for dementia care in this city is to expand and organize Home and Community based Long-Term Care. 3)For the continuous and comprehensive care, care plan for a patient must be prepared. Case management team should be builded to prepare this plan and coordinate relevant resources. 4)Special long-term care unit for dementia will be needed in a near future. This unit should have multiple functions, such as day-care center, short stay facility, training center for relevant personnels, besides long-term nursing home considering effective care of dementia and efficient operation of the facility. 5)Voluntary workers deserve their due efforts. Incentive mechanisms must be developed to activate voluntary activities.

• Korean Journal of Health Education and Promotion
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• v.8 no.1
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• pp.14-21
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• 1991

In accordance with the rapid industrialization in Korea, there have been remarkable changes in the health environment. The major changes are ; the change of disease structure, the aging of population structure, the diversification of health needs and the increase of health care costs. Because most of health problems stems from the environment, national health policy should be conducted according to the environmental changes. It is necessary for the voluntary organizations as well as the government ones to plan and participate the national health promotion movement on a national level so as to make the people form the attitude that health promotion is better than cure. Also, it is desirable that national health promotion movement be implemented gradually especially by four steps, 1) preparation step; 2) enlightenment step: 3) implementation step: 4) evaluation step.

• Journal of Preventive Medicine and Public Health
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• v.43 no.1
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• pp.26-34
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• 2010

Objectives: The purpose of this research is to analyze the impact of shared-decision making on patient satisfaction. The study is significant since it focuses on developing appropriate methodologies and analyzing data to identify patient preferences, with the goals of optimizing treatment selection, and substantiating the relationship between such preferences and their impact on outcomes. Methods: A thorough literature review that developed the framework illustrating key dimensions of shared decision making was followed by a quantitative assessment and regression analysis of patient-perceived satisfaction, and the degree of shared-decision making. Results: A positive association was evident between shared-decision making and patient satisfaction. The impact of shared decision making on patient satisfaction was greater than other variable including gender, education, and number of visits. Conclusions: Patients who participate in care-related decisions and who are given an explanation of their health problems are more likely to be satisfied with their care. It would benefit health care organizations to train their medical professionals in this communication method, and to include it in their practice guidelines.