• 보건의료산업학회지
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• 제2권1호
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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.

• 간호행정학회지
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• 제4권1호
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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.

• 호스피스학술지
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• 제1권1호
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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.

• 정신신체의학
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• 제25권1호
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• pp.33-45
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• 2017

연구목적 본 연구는 군복무 적합성에 대한 정밀평가 및 병사용 진단서를 목적으로 정신건강의학과에 내원한 환자군의 심리적 특성을 확인하고자, 일반적인 정신과적 치료를 위해 내원한 환자군과의 비교를 통해 차이를 분석하였다. 방법 정신건강의학과에 내원한 18세에서 27세까지의 남성환자 총 319명을 병사용 진단군 165명과 일반내원군 154명으로 분류하였다. 독립표본 t-test, ANCOVA, 절단점을 초과하는 사례수에 대한 ${\chi}^2$ 검정을 통해 두 집단 간 MMPI-2-RF의 척도들의 차이를 비교하였다. 결과 두 집단 간 연령 및 교육수준의 차이가 유의하였다. 두 집단은 MMPI-2-RF의 타당도 척도, 상위차원척도, 재구성 임상척도, 특정문제척도, 성격병리 5요인척도 모두에서 차이가 있었다. 두 집단 간 차이를 조사하기 위해 시행한 세가지 분석 모두에서 유의한 차이를 보인 척도는 EID, RC7, HLP, SFD, SAV, SHY, DSF, INTR-r이었다. 결론 군복무 적합성 평가가 의뢰된 환자군의 경우, 일반내원 환자군에 비해 정서적 고통의 수준이 유의하게 높았으며, 무력감이나 자신감 저하, 대인관계에서의 어려움이 더욱 현저한 것으로 시사되었다. 더불어 병사용 진단 군에서 보인 타당도 척도의 상승을 고려하여 향후 연구에 대한 제언을 하였다.

• 한방재활의학과학회지
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• 제27권3호
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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.

• 대한방사선기술학회지:방사선기술과학
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• 제28권3호
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• pp.193-201
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• 2005

최근의 정보통신기술(ICT)은 관련기술과의 융합으로 모든 시스템을 통합하는 형태로 발전하고 있다. 이런 시대의 흐름과 마찬가지로 의료산업은 근래에 많은 발전 및 응용에 관한 연구가 활발히 진행되고 있다. 의료정보시스템도 의료 IT의 정보시스템들이 통합되는 방향으로 급변하게 진화해가고 있으며, 앞으로도 그 가속도는 더 할 전망이다. 특히 유비쿼터스 환경에서의 의료정보산업은 최근에 큰 전환기를 맞고 있다. 특히 정부의 정보통신부 IT839 전략으로 핵심기술 및 신규 서비스로 다양한 응용서비스 시범사업과 관련 요소기술 개발이 활발히 진행되고 있다. 따라서 본 논문에서는 의료정보시스템의 최근 동향을 업계 및 시스템적으로 분석하고, 유비쿼터스 컴퓨팅 환경에서의 미래의 통합의료정보시스템의 응용에 대한 발전 방향을 제시하고자 한다. 그리고 국가 주도의 산업성장으로서 유비쿼터스 환경의 구축을 위한 병원 응용 시스템 구축을 제시하며, USN(Ubiquitous Sensor Network) 환경의 IT응용 서비스가 실용화하고 있는 실정에서 통합의료정보를 위한 환자 진료의 서비스 강화를 도모하도록 통합의료정보시스템을 제안 및 설계하였다. 그리고 병원의 실제 EMR, HIS, PACS의 호환을 위한 솔루션을 제시하였다.

• 한국치위생학회지
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• 제9권4호
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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.

• Journal of Nutrition and Health
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• 제51권4호
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• pp.307-315
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• 2018

본 연구는 대구광역시 소재 종합병원에 입원한 노인 영양불량환자의 병원식사 섭취량 증진을 위한 영양중재의 효과를 분석하고자 하였으며, 이를 통하여 입원한 노인 영양불량환자의 영양관리 방안에 대한 기초자료를 제공하고자 하였다. 본 연구에서는 병원식사 섭취량 감소의 원인을 파악하여 각 원인에 따라 개별적인 영양중재를 실시하였다. 그 결과 연구대상자의 에너지 및 단백질 섭취량을 유의하게 개선시켰고 단백질의 INQ를 높였다. 또한 단백질, 철, 비타민 $B_2$의 NAR이 개선되고 MAR도 유의적인 증가를 보였다. 따라서 본 연구는 환자의 식사섭취량 부족의 원인을 정확하게 진단하고 영양진단에 따른 개별적인 영양중재를 통하여 환자의 식사섭취 상태를 개선시킬 수 있었다는 점에서 의의가 있다고 여겨진다.

• 한국병원경영학회지
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• 제6권3호
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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.

• 디지털융복합연구
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• 제18권1호
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• pp.257-263
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• 2020

본 연구는 건강보험심사평가원 자료를 이용하여 조현병 환자의 인구사회학적 특성, 의료기관 특성, 입퇴원 특성이 재원일수에 미치는 영향을 분석하여 국가 보건 정책 질 향상을 위한 기초 자료로 활용하고자 시행하였다. 건강보험심사평가원 2016년 환자 데이터셋(HIRA-NIS)에서 조현병이 주진단인 4,692명의 진료비 명세서를 연구대상으로 하였다. 조현병 환자의 재원일수 영향 요인을 확인하기 위하여 인구사회학적 특성, 의료기관 특성, 입퇴원 특성을 설명변수로, 재원일수를 종속변수로 회귀분석을 실시하였다. 연구결과 재원일수에 주요하게 영향을 미치는 요인은 여자, 연령, 의료 급여, 병원급, 요양병원, 강원도, 정신질환 부진단, 기타 부진단 등으로 밝혀졌다. 공공 데이터를 이용하여 조현병 환자의 재원일수에 영향을 미치는 요인을 찾고자 함에 의의가 있으며, 중증도는 고려하고 있지 않아 향후 중증도에 따른 재원일수의 차이에 대한 연구가 진행되어야 할 것으로 보여 진다.