• International Journal of Advanced Culture Technology
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• 제9권1호
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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.

• 한국의료질향상학회지
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• 제9권2호
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• pp.198-208
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• 2002

본 연구에서는 종합전문요양기관과 협력관계를 맺은 병의원과 협력관계를 맺지 않은 병의원을 대상으로 진료의뢰와 관련된 중요고려요인, 그리고 기대요인 및 만족도를 비교하였다. 본 연구 결과 종합전문요양기관과의 협력관계 체결여부에 따라 협력병원 집단군이 협력관계가 없는 병원집단군보다 진료의뢰 중요요인의 평균이 높았으며, 그 중 '환자 의뢰절차의 간편성(p<0.01)' '병원간의 협력병원 체재 구축(p<0.05)'에 대해서는 통계적으로 유의한 차이를 보였다. 협력병원 여부에 따른 진료의뢰후 기대요인에 있어서는 '의료시설 및 장비의 이용' '종합전문요양기관 의료진과의 자유로운 인간관계 형성' '협력기관이라는 간판의 설치' 항목 등이 통계적으로 유의한 차이가 있었다. 그러나 협력병원 관계 여부에 따른 만족도에 있어 두 집단간 통계적으로 유의한 차이가 없었다. 개원의가 진료의뢰 시 중요하게 고려하는 요인과 진료의뢰후의 만족도간의 관계는 협력병원에 있어 '환자의뢰 절차의 간편성' '첨단 의료장비의 보유' '진료의뢰센터 직원의 친절도' 항목이 만족도보다 고려요인에서 높게 고려되고 있다고 조사되었으며 통계적으로 유의한 차이를 보이고 있었다.

• 한국의료질향상학회지
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• 제9권2호
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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.

• 한국산학기술학회논문지
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• 제14권9호
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• pp.4258-4269
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• 2013

본 연구는 부산시내 9개 병의원에 근무하는 근로자 349명을 대상으로 구조화된 설문지를 통하여 자료를 수집하였으며, 의료조직에서 피그말리온 리더십이 종사자의 리더-구성원 교환관계와 조직몰입에 미치는 영향을 파악함으로써 병원의 조직성과 제고방안을 제시하고자 하였다. 수집한 설문자료는 SPSS ver.18.0과 AMOS ver.18.0 프로그램을 이용하여 분석하였으며, 빈도분석, 상관분석, 요인분석, 신뢰도분석, 경로분석 등을 수행하였다. 주요 분석결과는 다음과 같다. 첫째, 병원조직에서도 피그말리온 리더십이 리더-구성원 교환관계의 질에 영향을 미치는 것으로 나타났다. 둘째, 피그말리온 리더십은 병원 종사자의 조직몰입에 직 간접적으로 영향을 미치는 것으로 나타났다. 셋째, 리더-구성원 교환관계는 조직몰입의 정서적 몰입, 지속적 몰입, 규범적 몰입에 각각 직접적인 영향을 미치며 그 중에서도 정서적 몰입에 가장 큰 영향을 미치는 것으로 나타났다. 넷째, 리더-구성원 교환관계는 병원 조직에서 피그말리온 리더십과 조직몰입의 관계를 부분적으로 매개하는 것으로 나타났다. 본 연구는 병원 조직에서 피그말리온 리더십과 리더-구성원 교환관계, 조직몰입 간의 관계를 최초로 연구하였다는 데 의의가 있다.

• 보건교육건강증진학회지
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• 제14권1호
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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.

• 간호행정학회지
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• 제17권3호
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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.

• Journal of Information Technology Applications and Management
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• 제12권2호
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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.

• Safety and Health at Work
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• 제8권4호
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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.

• 통합자연과학논문집
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• 제11권4호
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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.

• 한국의료질향상학회지
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• 제28권2호
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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.