• Journal of muscle and joint health
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• v.26 no.3
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• pp.290-306
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• 2019

Purpose: This study aimed to describe the experiences of health-care providers about advanced practice nurses (APNs) focusing on the perspectives of physicians and APNs in Korea. Methods: Qualitative data were collected with snowball sampling. Six physicians and 13 APNs participated in this study through in-depth interviews or a focus-group interview. Qualitative content analysis was employed. Results: Three themes and seven categories were emerged. Three themes were 1) challenging start and attempts to settle down on unfamiliar system, 2) being positioned as an APN at clinical settings, 3) long journey for social recognition and legal institutionalization of APNs' role. Seven categories were 1) challenges to new area, 2) introduction and conflict of APN system, 3) driving force for stepping toward becoming APNs, 4) dedication and commitment to role development, 5) efforts to prove APNs' competency, 6) approaches to guarantee legal APNs' activities, and 7) filling the gap in health-care service. Conclusion: The findings suggest that health-care providers who have collaborated with APNs are aware of the needs to operate APN system more stably through the legislation of APNs' scope of practices. Further research is needed to provide the evidences of APNs' practice outcomes such as health care quality, patient safety, reduction of medical expenses, etc.

• Journal of Korean society of Dental Hygiene
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• v.12 no.3
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• pp.503-511
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• 2012

Objectives : This research seeks to present the data needed for the development of coping strategy, following medical market opening by identifying dental hygienists' perspective and coping measures towards the opening. Methods : One hundred eighty-eight dental hygienists were targeted to identify their level of perception towards medical market opening, attitude towards medical market opening, question of whether they agree or not with the opening and reasons, and coping measures and benefits of the medical market opening. t-test, chi-square test and cross-tabulation analysis were used for the analysis Results : First, team leaders are more aware of the medical market opening and hold greater sense of crisis towards opening compared to the rank and file. Second, the reasons cited for agreeing with the medical market opening included improvement of medical services' quality and diversification of services. As for the reasons for disagreeing, they cited the increase medical expenses paid by public. Third, limitation of the hospital management technique was cited the most when it comes to the scope of Korean hospitals' management crisis, followed by the limitations of the diagnosis procedure, limitations of the medical services, limitations of the medical techniques and increase in the number of large hospitals, in the order cited. Fourth, team leaders perceive greater need to seek coping measures from the aspect of realizing medical insurance fee from the policy development, service and system level aspects when it comes to the coping measures depending on their ranks. Conclusions : Therefore, Dental Hygienist has a comparatively low awareness of medical market opening, coping measures need to be explored to cope with the medical market opening by ensuring the dissemination of accurate knowledge through the education on the fees for dental hygienist and seminars in relation to the medical market opening.

• Korean Journal of Clinical Pharmacy
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• v.28 no.1
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• pp.57-64
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• 2018

Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was $90,066{\pm}36,959$ thousand KRW and $10,557{\pm}9,668$ thousand KRW for LT and post-LT patients, respectively. Especially, LT patients' costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being $35,983{\pm}18,115$ thousand KRW, $28,246{\pm}9,408$ thousand KRW, and $12,131{\pm}6,604$ thousand KRW, respectively. For inpatients, the average number of hospitalized days was $63.5{\pm}66.0$ days for LT patients and $22.3{\pm}35.1$ days for post-LT patients. Conclusion: Compared to post-LT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

• Journal of Korean Public Health Nursing
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• v.5 no.1
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• pp.70-95
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• 1991

The ageing problem of the population has been emerging in Korea since 1970's so that it is expecting the elderly 65 years and over among the total population from $4.5\%$ in 1988 to be $6.3\%$ in year 2000. This study was conducted to provide secure policy development in coming years for the aged on medical and health care aspects based on the examining current status of the aged problems and health care policies and systems. The study divided into four parts; The first part examined the medical insurance program and public assistance program of the health services in relation to the aged. The second part emphasized on reduction of medical care cost for the aged. The third part studied the regular health check-up program and health education for the aged. The fourth part examined the chronic disease management programs for the aged and strategies of the health care service quality improvement and specialized programs. The following recommendations made as the results of the study. 1. At present, the medical insurance program and public assistance program for the medically indigent is not appropriate to the elderly because it is a part of general medical insurance program so that Health Security Law for the Aged is proposed. 2. Medical cost will be increased due to the high occupancy rate of hospital beds and long stay of the elderly so that it is recommended to develop an early discharge program, home health care program, Health hospice and an althernative programs. 3. At present, a regular health check-ups for the elderly is not included in medical insurance program so that it is recommended to be included in the insurance program and at the same time health education program thoroughly developed for the aged. 4. To make proper medical and nursing services on chronic diseases for the elderly, it is recommended manpower development, specialized clinics or hospitals, nursing homes and an equivalent long term care facilitices should be established on the community based and a research institutions also to be related to supper the care programs.

• The Korean Journal of Emergency Medical Services
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• v.16 no.1
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• pp.91-101
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• 2012

Purpose: This study aims to assess the influencing factors on the level of satisfaction with clinical training and to provide basic data for more efficient clinical training. Method: The study was conducted on 402 paramedic students who have experienced clinical training from September 6 until October 12 in 2011. The questionnaires consisted of 40 questions. We used SPSS 18.0 frequency analysis, technical statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple regression analysis. Result: 1. The level of satisfaction with clinical training showed significant difference between the frequency (F=8.837, p=.000) and clinical training managers (F=5.418, p=.001). 2. The level of satisfaction with clinical training showed the strongest positive correlation with the satisfaction of clinical training hospitals (r=.694, p=.000). 3. Multiple regression analysis revealed the most powerful predictor for satisfaction with clinical training was the satisfaction level of clinical training hospitals(48.2%) and the frequency of clinical training experiences(.8%), the preparation before the clinical training(5.4%), the total duration of clinical training(.7%), and the satisfaction of emergency department education(1.0%). These five variables accounted for 56.1% of the satisfaction of clinical training among paramedic students. Conclusion: As student's satisfaction of the clinical training increases, the quality of paramedics is expected to improve in the future. As a result, the future paramedics can be nurtured to be highly skilled in on-the-scene emergency situations after graduation.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.14 no.2
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• pp.1-14
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• 2019

Objectives : To evaluate the effectiveness of Chuna Manual Therapy for adhesive capsulitis by a systematic review manner. Methods : Five foreign electronic databases (Pubmed, Ovid-medline, Embase, Cochrane library, Chinese Academic Journals (CAJ)) and two Korean medical electronic databases (Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS)) were searched to find all randomized controlled trials (RCTs) using Chuna Manual Therapy as a treatment for adhesive capsulitis. The methodological quality of each RCT was assessed using the Cochrane risk of bias tool. Results : Twenty-one RCTs met our inclusion criteria. The meta-analysis showed positive results on the use of Chuna Manual Therapy combined with acupuncture or exercise therapy in terms of the efficacy rate and pain using the Visual Analogue Scale (VAS), compared to acupuncture or exercise alone [SMD-1.81 (95% CI & -2.54, -1.08), P<0.001, RR 1.19 (95% CI 1.14, 1.23), P<0.001)]. Positive results in terms of efficacy rate were also obtained comparing Chuna Manual Therapy to acupuncture alone [RR 1.10 (95% CI 1.02, 1.18), P=0.01]. Conclusions : Our systematic review found favorable results on the effectiveness of Chuna Manual Therapy for pain and efficacy rate of adhesive capsulitis. However, evidence was limited due to the lack of well-designed RCTs. More qualified clinical trials are needed to obtain stronger evidence.

• The Journal of the Korea Contents Association
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• v.11 no.11
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• pp.338-349
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• 2011

The purpose of this study is to provide an innovative way enhancing patient satisfaction in military hospitals by analyzing the impact of shared-decision making on patient satisfaction. The survey questionnaire has been distributed for a month in two hospitals with similar goals, serving for officers and men of the armed forces, and 514 copies has been collected for the study. The study found a positive association between shared-decision making and patient satisfaction. The results of the study suggest the military hospitals should allocate their resources on the fundamental issues such as improving quality of services they provide rather than reimburse the services to compensate the service the armed forces received from private institutions.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.242-252
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• 2017

Purpose: Given the emergence of a new profession called a palliative care aide, this study aims to develop the scope of its practice using the Delphi consensus method. Methods: This study was participated by a panel of experts comprising 36 members who were involved in either hospice palliative care practice or making relevant policies. Through a four-step Delphi study, the feasibility of the duty, task and task element was examined. Among the results, items that scored over 4.0 out of 5.0 were selected. Results: The analysis of the Delphi study suggested four job duties, 15 tasks and 46 task elements to be included in the practice scope for palliative care aides. Conclusion: This study defined the scope of practice for palliative care aides, which is expected to prevent any conflict or confusion regarding their job and to promote the quality of their service.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.340-350
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• 2016

The Medical Service Act of Korea describes a clinic as providing services primarily to outpatients, while a large general hospital provides specialized medical services requiring a high level of expertise for treating serious diseases. The portion of medical revenue for clinics has been decreasing gradually compared with large hospitals. This article proposes two fundamental medical policies to fix the distorted medical delivery system of Korea. Firstly, uniform additional medical remuneration rates based on the type of medial institution should be divided into outpatient additional rates and inpatient additional rates. Secondly, to normalize the function of clinics and large general hospitals, an outpatient medical target budget system should be introduced. Finally, to properly implement the proposal, it is important to establish healthcare policy-making governance. The success of policy implementation strongly depends on the participation and incentives of the government, suppliers, and patients. Healthcare policy-making governance must be designed to encompass this fact and improve quality of care.

• Journal of Korean Biological Nursing Science
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• v.19 no.2
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• pp.86-97
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• 2017

Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.