• Title/Summary/Keyword: Hospital Service Quality

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Effect of chest compressions on the quality of back pain prevention and chest compressions by applying body stabilization Convergence movement (체간안정화 융합운동을 접목한 가슴압박이 요통예방과 가슴압박 품질에 미치는 영향)

  • Hong, Eun-Jeong;Cho, Byung-Jun;Kim, Gyoung-Young
    • Journal of the Korea Convergence Society
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    • v.10 no.5
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    • pp.85-94
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    • 2019
  • This study was aimed to identify a study on the effect of chest compressions combined with abdominal drawing-in technique on prevention of back pain and chest compression quality. We tested motion analysis, electromyography, and chest compression quality of 15 paramedics. Data were normalized to SPSS 21.0 (Kolmogorov-Smirnov and Shapiro-Wilk test). The paired t-test was used for the pre- and post-test chest compressions, the one-way ANOVA was used for the analysis of the measurement point-in-time differences, and LSD was used for the post-test. The results of the study showed significant difference in muscle activity and chest compression success rate when the chest pressure was applied with abdomen drawing-in. Therefore, it is necessary to study cardiopulmonary resuscitation education which can increase the chest compression success rate while preventing the back pain of the paramedics in the future.

A Study on the Goal-Orientation of QI Performers in the Medical Centers (의료기관 QI 담당자의 목표추구몰입에 관한 연구)

  • Kim, Mi-Sook;Park, Jae-Sung
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.105-124
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    • 2008
  • The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

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Perceptions of Quality Nursing care of Patients and Families (질적 간호에 대한 환자와 가족의 지각)

  • Chi, Sung-Ai;Kwon, Sung-Bok;Park, Eun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.247-275
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    • 1998
  • The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

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호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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Clinical Characteristics of Psychiatric Patients with Military Issues Using MMPI-2-RF (군복무 적합성 평가를 위해 정신건강의학과에 내원한 환자군의 MMPI-2-RF 프로파일)

  • Sung, Gyhye;Park, Ji-Hyun;Kim, Keun-Hyang;Lee, Sang-Hyuk;Park, Eun-Hee;Choi, Ji Young
    • Korean Journal of Psychosomatic Medicine
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    • v.25 no.1
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    • pp.33-45
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    • 2017
  • Objectives : The purpose of this study was to examine psychological characteristics of patients who visited psychiatric clinic for medical certificate for military service using MMPI-2-RF. We compared target group with general psychiatric patients with same age range. Methods : A total of 165 male patients for medical certificate and 154 general psychiatric patients were collected from the Department of Psychiatry of three university hospitals. There were significant differences of age and educational level between two groups. We used independent t-test, ANCOVA, ${\chi}^2$ test to examine differences between two groups. Results : Medical certificate group scored higher on the validity scales, the Higher-Order(H-O) scales, the Restructured Clinical(RC) Scales, the Specific Problems(SP) Scales, and the Personality Psychopathology Five (PSY-5) Scales. Especially, EID, RC7, HLP, SFD, SAV, SHY, DSF, and INTR-r showed significant differences between two groups on all three statistical tests. Conclusions : The present study showed that psychiatric patients who received psychological evaluation for military service have significantly higher emotional distress, helplessness, lower self-confidence, and lower quality of interpersonal relationships. And the difference of validity scales between two groups could be related with psychological burden of compulsory military service in the study sample which causes elevation on scales of infrequent responses. MMPI-2-RF would be helpful instrument to assess these emotional and psychological characteristics.

Trends of Korean Medicine Treatment after Musculoskeletal Disorder Surgery: A Literatural Review (근골격계 질환 수술 후 한방치료 동향(국내 학술지를 중심으로))

  • Lee, Kang-Joon;Park, Chang-Hyun;Lee, Yoon-Jae;Lee, Jung-Han;Cho, Jae-Heung;Park, Tae-Yong;Yang, Na-Rae;Hwang, Eui-Hyoung;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.3
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    • pp.61-70
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    • 2017
  • Objectives The purpose of this review is to analyse the trend in papers related with Korean Medicine Treatment after musculoskeletal disorder surgery. Methods We reviewed Korean Medicine papers by searching Korean web databases 'Korea Traditional Knowledge Portal', 'Scientific and Technological Information Integration Service (NDSL)', 'Academic Research Information Service (RISS)', 'Korea Medical Informati on Portal (OASIS)'. We classified the papers by the year of publishment, the title of journals, the type of study, surgery region, chief complain after surgery, main treatment, periods after surgery, assessment for outcomes. Results 1. Korean Medicine treatment after musculoskeletal disorder surgery has received more attention than in the past and there are attempts to do various studies besides the case reports. 2. 41 research papers were divided in to 3 original articles, 3 review articles, 35 case reports. But almost presented a low level of evidence. 3. Pain was the most common symptom after the musculoskeletal disorder surgery. Pain should be the primary goal of Korean rehabilitation treatment after musculoskeletal disorder surgery. 4. Assessment tools for outcome were concentrated in questionnaries, VAS and NRS. In order to evaluate better, it is necessary to evaluate the overall condition of the patient such as the quality of life evaluation and patient satisfaction. Conclusions In this study, we expect that the development and clinical application of Korean rehabilitation treatment program after musculoskeletal disorder surgery will be actively pursued.

The Trends and Application Prospects of Medical Information System on the Ubiquitous Environments (유비쿼터스 환경에서의 의료정보시스템 동향 및 응용의 전망)

  • Kim, Chang-Soo;Kim, Hwa-Gon
    • Journal of radiological science and technology
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    • v.28 no.3
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    • pp.193-201
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    • 2005
  • We are living in Ubiquitous society now. There is also trend of integration in medical field that is largely affected by outside environment. At this time, it is necessary to rightly understand the abstract, function, expected effect and management method of Integration Medical Information System(IMIS) to use this system effectively for solving many hospital information system problems and disadvantages. It is fact that large-sized hospitals are improving the quality of service for treatment of patients through building integrated Medical Information System. So it is necessary to change this individual system that is previously developed and used for treatment assistance, hospital affair or general management respectively to integrated management system, modify patient information or treatment information data to the data suitable for new system and build the integrated medical information system suitable for the hospital service with treatment data and integrated medical information. This paper suggested and designed abstract of integrated medical information system, the organization of system, the character of system and the plan and materialization of IMIS when building integrated medical information system. And the context of this paper is suggested trend of industry and solution of integration EMR, HIS, PACS. Therefore this paper is suggested development strategy, implemented integration medical information system.

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The comparison of the subjects's oral health state who were benefited from the elderly scaling care service program(From the visitors of 5 public health centers in South Jeolla Province) (노인 스켈링 사업 대상자의 구강건강상태 비교(전남지역 일부 보건소를 방문한 노인 대상으로))

  • Ku, In-Young;Park, In-Suk;Ku, Min-Ji
    • Journal of Korean society of Dental Hygiene
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    • v.9 no.4
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    • pp.593-605
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    • 2009
  • Objectives : In an aging society, as the necessity of the elderly oral health care was increased, the oral health dimensions was a lot more visible important to a community public health service for the quality of life improvement. In oral health care of the elderly, the periodic scaling treatment was required to manage periodontal tissue care. Methods : So, the 319 elderly people were selected by a random sampling method, those who are visitors of 5 public health centers in the South Jeolla Province. based on the findings of personal interview questionnaires and oral health states from these elderly subjects, we made a comparative analysis of oral health states of the elderly scaling program subjects. Results : 1. Among the participants, 52.4% of the elderly benefited from scaling care project otherwise 47.6%, the subjects with periodontal diseases were 78.4%, whereas 21.6% of the ones who don't. 2. In regard to perceptions of oral cavity abnormal symptoms, findings revealed that the teeth smart sensation with something cold was 'yes' 62.7%, 'No' 37.3%, gingival bleeding was 'yes' 61.4%, 'No' 38.6%, oral odor(halitosis) was 'yes' 63.3%, 'No' 36.7%, and dried mouth was 'yes' 63.3%, 'No' 36.7%. 3. The study data showed 73.2% of periodontal disease subjects, and 24.6% of no periodontal diseases responded that they have hyperesthesia and 67.6% of periodontal diseases, 39.1% no periodontal diseases responded that they have gingival bleeding. 4. In comparison of the presence of periodontal disease with scaling service program state, it is show that the elderly scaling service program was significant statistically in Elderly's periodontal disease prevention. according to analysis, 52.4% of the subjects with and 34.8% of no periodontal diseases received the Elderly scaling service program(p<0.05). Conclusions : Therefore, oral health care of the elderly, a community public health service the periodic scaling treatment was required to manage periodontal tissue care.

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Effect of nutrition care process-based nutrition intervention on improvement of intake in the elderly in-patients with malnutrition (영양관리과정에 근거한 영양중재가 노인 영양불량 입원환자의 식사섭취량 증진에 미치는 효과)

  • Park, Ji-Hyun;Kang, Min-Ji;Seo, Jung-Sook
    • Journal of Nutrition and Health
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    • v.51 no.4
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    • pp.307-315
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    • 2018
  • Purpose: This study evaluated the effects of personalized nutrition intervention for increasing hospital meal intake by elderly patients with malnutrition. Methods: The subjects were 30 elderly patients with malnutrition who visited a general hospital located in Daegu. An individual nutrition intervention such as change of meal types or special meal service was given to the patients according to nutrition diagnosis related to inadequate intake of hospital meals. Nutritional intake status of the subjects was assessed by analyzing energy intake, protein intake, index of nutritional quality (INQ), nutrient adequacy ratio (NAR) and mean adequacy ratio (MAR). Results: The causes of inadequate intake in the subjects were poor appetite or preference problems (46.7%), symptom-related problems (30.0%) and mastication problems (23.3%). The INQ of protein in the subjects was significantly increased from $0.81{\pm}0.17$ to $1.41{\pm}0.25$ after the nutrition intervention (p < 0.05). The NAR of protein (before $0.50{\pm}0.21$, after $0.58{\pm}0.17$), iron (before $0.72{\pm}0.30$, after $0.84{\pm}0.29$) and vitamin $B_2$ (before $0.31{\pm}0.16$, after $0.37{\pm}0.14$) was also increased after the nutrition intervention (p < 0.05). The MAR of five nutrients, protein, calcium, iron, vitamin A and vitamin $B_2$, was significantly increased by the nutrition intervention (p < 0.05). Conclusion: Personalized nutrition intervention according to nutrition diagnosis related to inadequate intake of hospital meals may improve the intake amount of elderly patients with malnutrition.

Factors Affecting the Satisfaction and Revisit Intension of Health Promotion Center In A University Hospital (한 대학병원 부속 건강검진센터 이용자의 만족도와 재이용 의사에 미치는 요인)

  • Kim, Hee-Kyoung;Ryu, Hwang-Gun
    • Korea Journal of Hospital Management
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    • v.6 no.3
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    • pp.5-24
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    • 2001
  • The purpose of this study was to serve as a basis for providing quality medical service and mapping out consumer-centered marketing strategies to successfully cope with the rapidly changing medical environment and meet consumer needs, by examining what affected the satisfaction and revisit of health Promotion center Client. The subjects in this study were 186 of visitor to health Promotion center in a university hospital in the city of Busan. A survey was conducted with structured questionnaire from March 2 to 30, 2001. The collected data were analyzed with SPSS for Windows (ver10.0). For more statistical analysis, frequency analysis, component analysis, t-test, ANOVA and correlation analysis procedures were utilized. Results of the study can be summarized as follows: 1. Regarding demographic characteristics, 51.6% of the Client investigated were male, and 48.4% were female. The greatest number of them were in their 40s(38.9%). 86.5% were married, and 34.2% were self-employed. 44% were a high-school graduate, and the monthly mean income of 59.4% was one to three million Won. And, the residential area of 46.8%, the largest percentage, was a half-an-hour distance from health Promotion center. 2. The most common motivation of their selection of the health Promotion center was a recommendation by Staff and neighborhood(59.7%), followed by excellent facilities and services(17.2%), the tradition and reputation of the hospital(7.5%), and its publicity pamphlets(7.5%). 3. 45.9%, the largest percentage, acquired health-related information from their friends or acquaintances. 43.8%, the greatest percentage, visited there because they felt there's something wrong with their body. 53.4% worried about the possibility of being attacked by cancer, and 57.5% wanted to take a precise cancer examination. For health maintenance, 50.1% got regular exercise. Regular exercise was considered most crucial for health maintenance or promotion. 4. The largest reason they used that examination center again was the kindness of employees(52.7%), followed by the tradition and reputation of the hospital(21%) and excellent examination setting and equipment(10.8%). 5. By demographic factor, there was no significant difference between the man and women in satisfaction level with examination and expenses. The women expressed more satisfaction at facilities, and the high-school graduate group were more contented with expenses. 6. As a result of investigating their satisfaction level according to the motivation of selecting that examination center, the group that chose the center due to excellent facilities and services were more satisfied with examination and expenses. 7. As for the relationship of total examination satisfaction to revisit. intention, there was a higher correlational relationship between total health examination satisfaction and expense satisfaction. Especially, the more they were satisfied with examination, the more they were willing to revisit there for another examination.

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