• Title/Summary/Keyword: Hospital Service Quality

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Veterans Hospital Medical Expenses Increase & Decrease Characteristics and Convergence Phenomenon-Focusing on the implications of the medical support system for national veterans-

  • Yu, Tae Gyu
    • International Journal of Advanced Culture Technology
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    • v.9 no.1
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    • pp.16-21
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    • 2021
  • As the average age of national veterans has increased from 69 years old(2011) to 71 years old(since 2015) over the past five years, the overall medical service cost of veterans has increased by about 20%. The main cause of this phenomenon is 'ultra-aging', which accounts for 67% of veterans, while the proportion of health insurance patients aged 70 or older is 9%. Therefore, it is judged that the analysis of the trend of use of medical services at veterans hospitals in each region that is in charge of severe medical services of national veterans can serve as an opportunity to seek countermeasures for the severe medical system of national veterans. First of all, based on the details of major medical expenses (hospitalization, outpatient, pharmaceutical expenses) by region for the last 10 years(2010-2019), data significance was performed through a chi-square test, and the Central Veterans Hospital and Non-Central Veterans Hospital using EXCEL. 'Expected frequency' was calculated by year. By applying the CHITEST(observation frequency, expected frequency) function again, the p-value(p<0.05) was calculated, and the profit bias of each region's veterans hospital could be determined. The specific research method is for the last 10 years(2010-2019) for state-sponsored patients_outpatient treatment income, state-sponsored patients_hospitalization income, exempt patients_outpatients at the Central Veterans Hospital, Busan Veterans Hospital, Gwangju Veterans Hospital, Daegu Veterans Hospital, and Daejeon Veterans Hospital. A one-way analysis of variance was conducted to verify the significance of the difference between group averages on the status of 5 medical revenues of veterans hospitals in each of the 5 regions, including medical treatment income, reduced patients_hospitalization income, and reduced patients_medicine expenses. It was found to be significant(p<0.05) at all levels, including region and type. Finally, the bias in the profit structure of regional veterans hospitals was the highest in 2017(p=0.0004) and the lowest in 2013(p=0.0349). In addition, in the profit structure of the Veterans Hospital, the year in which the'regional' variable worked the most was 2019, and the year with the least affected was 2010. The order of the former is Jungang(=31,674,713), Busan(=12,314,614), Gwangju(=11,957,038), Daegu(=10,168,015), and Daejeon(=6,991,034), and the order of the latter is Jungang(=57,868,791), and Busan(=19,183,194). Gwangju(=17,904,712), Daegu(=15,656,034), and Daejeon(=14,377,395). In conclusion, the profit bias of veterans hospitals repeatedly raced the lowest(p=0.01986) and highest(p=0.03499) for the past five years(2010-2014) year by year, with the 'regional' variable being the most in the veterans hospital's profit structure It was identified as a major influence factor. On the other hand, for the last 5 years (2015-2019), the influence factors of the'regional' variable every year were in 2015(p=0.02015), 2016(p=0.01741), 2017(p=0.00045), and 2018(p=0.00394). in 2019(p=0.00227), a significant difference was confirmed at a very low level.

A Study on Anticipating Factors and Satisfaction of Local Clinics to 2nd Referral Hospitals based on Collaboration Hospital System (개원의의 진료의뢰시 기대요인 및 만족도에 관한 연구 - 협력병원체제 여부를 중심으로-)

  • Kim, Dong-Il;Kim, Hae-Joon;Yoon, Seok-Jun;Mun, Yeong-Bae
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.198-208
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    • 2002
  • Background : This research, as a part of improving management process of college hospital in this rapidly changing circumstances, is searching for the actual state of private clinics referring patients to referral center including college hospitals. Methods : This research examined the sense of satisfaction and requesting degree in using referral center and by analyzing the correlation and differences among factors such as primary factors regarded as selecting ones in referring patients to a referral center in college hospital and expecting factors expected to be supported to patients and cooperative hospitals. Results : The main researched results are as follows. First, as for the primary factors, the differences between cooperative and uncooperative hospitals revealed the fact that choosing target hospital in accordance with cooperative relation and convenient process in referring patients are important. Second, satisfaction rates, analyzed from the paired t-test revealed kindness and convenience as the top priorities, while sending patients back again and benefit of supporting such as the use of facilities were revealed as the least satisfactory aspects, despite the fact that they should be fulfilled through actual service. Conclusion : The recognition of the practitioner is examined and analyzed in this research by examining primary factors in selecting college hospitals, expecting factors expected to be supported to patients and satisfaction degree, which are expected to be used as basic materials for the development of referral center of college hospitals.

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An Analysis of Fall Incidence Rate and Its Related Factors of Fall in Inpatients (입원환자 낙상 발생 실태와 원인에 관한 분석 연구)

  • Kim, Chul-Gyu;Suh, Moon-Ja
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.210-228
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    • 2002
  • Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

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Effect of Pygmalion Leadership on the Organizational Commitment and the Mediating Effect of Leader-Member Exchange among Hospital Employees (피그말리온 리더십이 병원 종사자의 조직몰입에 미치는 영향과 리더 - 구성원 교환관계의 매개효과)

  • Hong, Byoung Ho;Bae, Sung Yoon;Kim, Misuk
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.9
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    • pp.4258-4269
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    • 2013
  • This study attempted to examine the relationship between pygmalion leadership and the organizational commitment among hospital employees, and the mediating effect of the leader-member exchange (LMX) on their relationship. For this purpose, we designed structured self-response survey questionnaires, and collected data from 349 employees working at 9 hospitals and ambulatory clinics in Busan area. Frequency analysis, correlation analysis, factor analysis, and reliability analysis were performed using SPSS ver.18.0 program, and the path analysis was performed using AMOS ver.18.0 program. Major findings are as follows. First, some factors of pygmalion leadership were found to directly influence the quality of LMX, while some had both direct and indirect influences on organizational commitment. Second, the quality of LMX was found to partly mediate the relationship between pygmalion leadership and the organizational commitment in hospital organizations. This is the first in kind which was conducted in the hospital setting.

A Study on Improvement of Health Education in Hospitals (병원의 보건교육 활성화 방안에 관한 고찰 -지역사회와 병원의 연계방안을 중심으로-)

  • 홍인정
    • Korean Journal of Health Education and Promotion
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    • v.14 no.1
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    • pp.1-9
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    • 1997
  • The health education in hospitals has many problems including lack of the division specialized in health education, lack of implementation system of health education, insufficient professional health education and insufficient health education materials. Despite these restraints, hospitals should reinforce health education program as a part of active response centered on disease prevention and health promotion targeting healthy people who have potential health risk before the onset of disease, rather than passive approach emphasizing the treatment. Accordingly, health education team should be organized in a hospital, in which health educators can provide the following education services. First of all, hospitals themselves should provide active community services in collaboration with community organizations. In addition, multi-disciplinary approach in cooperation with schools, work places should be reinforced to establish the comprehensive health education system. The establishment of medical service referral system with other medical institutions and the linkage system for medical information exchange are also needed. The utilization of education materials obtained through these system should be open to community residents as well as patients. Finally, medical staff working in hospitals should try to provide the high-quality health education that is as high as the level of medical services. The high-quality health education is possible when its level is based on one required by community residents and the county rather than the international or arbitrary standard.

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The Effects of Medical Staffing Level on Length of Stay (의료 인력의 확보가 환자 입원일수에 미치는 영향)

  • Lee, Han-Ju;Ko, Yu-Kyung;Kim, Mi-Won
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.3
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    • pp.327-335
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    • 2011
  • Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

An Implementation of Intefrated Database for Electronic Medical Record System in East-West Medical Collabration (${\cdot}$양방 협진 전자의무기록 시스템 구축을 위한 통합 데이터베이스 구축)

  • Ahn, Yo-Chan;Oh, Sang-Bong
    • Journal of Information Technology Applications and Management
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    • v.12 no.2
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    • pp.129-143
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    • 2005
  • In recent years, two major streams in medical information systems are:1) system integration among OCS(Order Communication System), EMR(Electronic Medical Record), PACS(Picture Archiving and Communication System), and ERP(Enterprise Resource Planning) and 2) system integration through medical collaboration between East and West medical service providers. One of the characteristics which differentiate the Korean medical industry from the western medical industry is the East-West medical collaboration. In many respects there are many differences between East and West medical treatment. Although East and West medical treatment have developed from different medical philosophies and standards, we assume that the better medical care can be provided by integrating their medical procedures effectively. The two possible approaches to the integration of East and West medical information systems are suggested in this paper:One is loosely coupled model and the other is tightly coupled model. EMR improves the quality of medical record which reflects the quality of clinical practice. It provides more efficient and convenient way of input, retrieval, storage, communication and management of medical data. We abstracted the standard medical procedures from the two medical procedures performed in Daejeon Oriental Hospital and Hehwa Clinic at Daejeon University and also abstracted database schema by analyzing the characteristics of information needed in East-West medical collaboration. Our EMR is composed of two types of data:one is structured data and the other is unstructured data, which are formalized by SOAP(Subjective, Objective, Assessment, Plan) format. Currently the integrated system is implemented and operated successfully for six months.

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Long Working Hours in Korea: Based on the 2014 Korean Working Conditions Survey

  • Park, Jungsun;Kim, Yangho;Han, Boyoung
    • Safety and Health at Work
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    • v.8 no.4
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    • pp.343-346
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    • 2017
  • Background: Long working hours adversely affect worker safety and health. In 2004, Korea passed legislation that limited the work week to 40 hours, in an effort to improve quality-of-life and increase business competitiveness. This regulation was implemented in stages, first for large businesses and then for small businesses, from 2004 to 2011. We previously reported that average weekly working hours decreased from 2006 to 2010, based on the Korean Working Conditions Survey. Methods: In the present study, we examine whether average weekly working hours continued to decrease in 2014 based on the 2014 Korean Working Conditions Survey. Results: The results show that average weekly working hours among all groups of workers decreased in 2014 relative to previous years; however, self-employed individuals and employers (who are not covered by the new legislation) in the specific service sectors worked > 60 h/wk in 2014. Conclusion: The Korean government should prohibit employees from working excessive hours and should also attempt to achieve social and public consensus regarding work time reduction to improve the safety, health, and quality-of-life of all citizens, including those who are employers and self-employed.

The Disaster Preparedness and Professional Quality of Life among Nurses in Emergency Rooms of Regional Emergency Medical Center

  • Lee, Min-Hee;Kim, Kye-Ha
    • Journal of Integrative Natural Science
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    • v.11 no.4
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    • pp.184-191
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    • 2018
  • The purpose of this study was to investigate the disaster preparedness and professional quality of life among nurses in emergency departments. The participants in this study were 56 nurses in emergency departments in two cities. The data were collected by questionnaires survey from January to August 2016. All statistical analyses were performed using SPSS ver. 23.0 program. Participants' disaster preparedness was different according to position (t=-2.32, p=.004), type of working (t=-2.32, p=.004), and frequency of traumatic events (F=5.26, p=.009). There were significant differences by gender (t=2.88, p=.006), desire for continuous work in the emergency room (t=2.95, p=.005), and job satisfaction (F=10.81, p < .001) in compassion satisfaction. Burnout was different according to gender (t=-2.05, p=.045), choice of an emergency department (t=-2.37, p=.021), desire for continuous work in the emergency room (t=-2.31, p=.025), and job satisfaction (F=11.99, p < .001). Disaster preparedness and compassion satisfaction had positively significant correlations. Compassion satisfaction of nurses in emergency department was an important variable that should be considered to improve their disaster preparedness.

Patient Understanding of Patient Safety: Based on Results from Focus Group Discussion (환자안전에 대한 환자의 이해: 초점집단토의 결과를 중심으로)

  • Jeehye Im;Minsu Ock
    • Quality Improvement in Health Care
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    • v.28 no.2
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    • pp.50-60
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    • 2022
  • Purpose: To examine the degree of recognition regarding the concept of patient safety, as perceived by the patient, using a focus group discussion. Methods: A focus group discussion was conducted with a patient group comprising seven patients. Results: When the participants heard the term "patient safety" they seemed to understand it to be related to the hospital environment or satisfaction with the overall hospitalization experience. The participants emphasized communication between the medical staff and the patients in relation to the explanation of treatments, as well as the provision of information regarding prevention, experience, and the treatment of incidents with patient safety. They agreed on the need for indicators reported by patients. However, they emphasized that additional items and a questionnaire method that considers the patients' point of view are needed. Conclusion: It is necessary to establish and implement various strategies that can raise the awareness of patient safety using patient safety indicators and increase participation in patient safety activities.