• 보건행정학회지
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• 제34권1호
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• pp.78-86
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• 2024

연구배경: 본 연구를 통해 전문병원과 비전문병원에서 인공관절치환술(슬관절)을 받은 입원환자를 대상으로, 전문병원 지정 여부에 따른 입원환자의 의료이용을 비교하여 전문병원제도의 효과성을 파악하고자 한다. 방법: 본 연구는 2021-2022년 건강보험심사평가원(Health Insurance Review and Assessment Service) 요양급여비용 청구자료를 활용하였다. 종속변수는 입원환자의 의료이용으로, 건당 진료비와 재원일수를 선정하였다. 독립변수는 전문병원 지정 여부이며, 통제변수는 환자 단위 변수(연령, 성별, 보험자 유형, 수술 유형 및 Charlson comorbidity index)와 의료기관 단위 변수(설립 구분, 종별 구분, 소재지, 정형외과 의사 수 및 간호사 수)를 선정하였다. 결과: 건당 진료비와 전문병원 지정 여부 간 다중회귀분석 결과, 건당 진료비와 전문병원 지정 여부 간 통계적으로 유의미한 음(-)의 관계가 있었다. 이는 전문병원이 비전문병원에 비해 건당 진료비가 유의하게 낮다는 것을 의미하며, 전문병원과 비전문병원의 입원환자 간 의료이용 결과에 차이가 있음을 시사한다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, 전문병원 지정기준의 완화가 필요하다. 본 연구결과, 전문병원이 비전문병원에 비해 건당 진료비가 유의하게 낮은 것으로 나타났다. 이러한 전문병원의 비용 효과성에도 불구하고 전문병원 지정에 대한 높은 진입장벽으로 인해 수도권 및 대도시 지역에 전문병원이 집중되어 있다. 전문병원의 지역불균형을 해소하기 위해 "준전문병원(가칭)"을 도입하는 등 비수도권 전문병원 지정기준을 완화한다면, 지역간 건강격차 해소 및 의료비 절감의 효과를 불러올 것으로 판단된다. 둘째, 병원 의료인력 규모의 적정성을 판단할 필요가 있다. 본 연구결과, 정형외과 의사 수 및 간호사 수에 따라 건당 진료비에 영향을 미치는 것으로 나타났다. 따라서 병원 의료인력 적정 배분을 바탕으로 의료서비스의 비용 효과성을 극대화함으로써 의료비를 절감하는 효과를 불러올 수 있을 것으로 판단된다.

• 간호행정학회지
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• 제13권1호
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• pp.74-81
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• 2007

Purpose: This study focuses on doctors' role expectation and patients satisfaction with the referral centers to get necessary basic Method: There were 495 subjects in this study. 245 of them were doctors working in the 397 clinics and hospitals which have made contracts with the referral center in Y General Hospital located in J city, and 250 were patients who had been treated in it. The data were collected from Sep. 25 to Oct. 21, in 2006. Data analysis was processed with SPSS/WIN 14.0 electronically. Results: Concluding cooperative treaties with other clinics and hospitals, doctors expect the following effects: First, the improvement of the treatment quality of patients. The patients satisfaction ranking order for using referral centers is as follows: kindness of the staff, treatment reservation, doctor's satisfying explanation. providing one-stop service, reduction of waiting time for treatment, evasion of repetitive tests. Conclusion: Referral centers should provide various services totally and actively which reflect the role expectation and satisfaction of doctors and patients altogether.

• 간호행정학회지
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• 제12권1호
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• pp.23-31
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• 2006

Purpose: The purpose of this study was to test the empowerment structural model based on Kanter's work empowerment theory. Method: A predictive, nonexperimental design was used in a sample of 279 nurses from 3 university affiliated hospitals. Data were collected with self-administered questionnaires and analyzed using mean, standard deviation, pearson correlation coefficient and path analysis. Results: The results showed that the overall fitness of the hypothethical model to the data was good(chi-square=.7751, df=4, p=.942, GFI=.999, AGFI=.996, RMSEA=.000). Both formal power and informal power directly influenced on nurses' perceived empowerment level and empowerment directly influenced on nurses' organizational commitment and indirectly influenced on nurses' intent to stay. Conclusion: The results imply that hospital and nurse managers should provide the empowering working condition for nurses to be stayed in hospitals.

• 간호행정학회지
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• 제8권2호
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• pp.295-308
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• 2002

Purpose: The purpose of this quasi-experimental research is to develop the CP for primary THR patients and verify its effectiveness. Method: The CP is designed for both patients and medical employees to meet the 14-day-long hospitalization with an expert and clinical validity test, and the standardized orders are also created. 21 eligible subjects for the control group(with common care plan) and 27 subjects for the experimental group(with CP service) were assigned. Data were collected from questionnaires to evaluate patients' satisfaction level of nursing care and CP, investigation of physical complications, inspection of LOS(length of hospital stay) and hospital charges from April 2000 to February 2001 at K-hospital in Daegu. The collected data were analyzed by using the SAS program. Results: After implementation of CP, there was a statistically significant reduction in mean length of stay. The hospital charges have no considerable difference between two groups. Frequency of physical complications is reduced considerably. The experimental group scored much higher than the control group on the satisfaction level toward nursing care. And in the analysis of CP satisfaction questionnaires, many subjects have high satisfaction in items of 'I see the treatment process and hospital life', 'I feel that I am participating in my treatment process with health care staff'. The analysis of variances which cause a prolonged LOS supports that it's necessary to strengthen an evaluation of pre-operative outpatients' condition and link the home nursing care system in discharge for more shortening of LOS. Conclusion: The above results show that CP can have a positive impact on satisfaction level of inpatients with primary THR and the hospital.

• 간호행정학회지
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• 제21권5호
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• pp.519-529
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• 2015

Purpose: This study was performed to identify perceptions on fixed night shift system and turnover intention of general hospital nurses and to explore a desirable application plan for a fixed night shift system. Methods: This study was a cross-sectional survey. Participants were 300 nurses working at one general hospital in GyeongGi-Do, Korea. Data were collected from November 3 to 7, 2014, with a structured questionnaires and analyzed using SPSS/PC ver 20.0 programs. Results: Of the participants 73.5% had thought about turnover because of night shifts and the preconditions for desirable fixed night shift system were a payment plan differentiated according to work conditions and an adequate number of nursing staff. Economic and administrative supports like 'raising extra-pay for night shift' and 'increasing the number of paid holidays' were very important for a desirable fixed night shift system. Conclusion: The results indicate that the most important factor for a desirable fixed night shift system to decrease nurses' turnover intention is economic and administrative support according to the needs of the nurses. So nursing managers need to find a desirable fixed night shift system considering nurses' demographic characteristics and organizational characteristics.

• 한국임상보건과학회지
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• 제5권1호
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• pp.825-833
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• 2017

Purpose .This study aims to assess the influence factors on the level of satisfaction with hospital training and to provide basic data for more efficient hospital practice of students' public health administration . Methods . We have conducted a survey on students satisfaction with their hands on practice against 200 students in Busan, Kyeongnam and Kyungbook area, who have completed their practice in public health administration. We have identified the general characteristics of the target respondents, the current training status of the department for the hospital practice and training venue; also analyzed the characteristics composed of the apprentice student's attitude before the practice, satisfaction with the department training program and hospital for practice, as well as their practice at hospital. The general characteristics of the target respondents and clinic practice status at the hospital were measured in percentage and frequency analysis; the average and standard deviations of hospital size were also measured; and the correlations between satisfaction with the department, attitude towards the practice and satisfaction with the hospital were analyzed. Results . Most public health administration students experienced their practice at the hospital after the first semester on the $2^{nd}$year and they have received the foundation training for the practice. The survey allowed multiple responses and the results are as follows: medical terminology 49.5%, medical coordinator 36.7%, Hospital administration 26.5%, Health insurance 17.3%, and medical recording and practice 13.8% respectively. In terms of each individual student's attitude towards the practice at the hospital, the respondents answered as follows: I have completed the obligatory subjects for the practice before the practice 89.5%; I have been fully informed on the hospital for my practice. 74.5%; I responsibly practiced and worked with professionalism and sense of belonging to the hospital as a member of staff 90%; I have actively learned and adopted 95%; My knowledge and skills from the practice was relevant to the theory and practice from my course 83.5%. The findings of satisfaction by size of hospital were in order of a small clinic($3.24{\pm}0.63$), medium sized clinic($3.27{\pm}0.65$), hospital ($3.20{\pm}0.61$), and large sized comprehensive hospital ($2.93{\pm}0.74$). Consequently the satisfaction rate shows no significant difference by size of hospital. In relations between practice attitude and satisfaction with subject, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.04), the matter of a sense of belonging and responsibility at hospital during practice(p=0.33). the matter of active adaptation attitude during practice (p=0.42), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. In relations between practice attitude and satisfaction with the hospital for practice, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.01), the matter of a sense of belonging and responsibility at hospital during practice(p=0.04), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. Conclusion . The most essential subject for the practice in public health administration is medical terminology and there is no significance in satisfaction with the practice by size of hospital. Students were content with the hospital where they can experience as much as possible. Students content with their major show positive attitude towards the practice and so do those content with the hospital. Those with the positive attitude towards the practice show the high correlation of satisfaction with both the major and hospital. As a result, the satisfaction with the major is the significant attribute to the practice in the hospital.

• 보건의료산업학회지
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• 제5권3호
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• pp.157-168
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• 2011

This study was designed to identify satisfaction with Hospital Information System(HIS) and the factors affecting them in hospital administrators. The data was collected for 24 days from Mar. 02 to 25, 2011. Among a total of 82 cases of the questionnaires, only 76 cases were used. From the survey, it was made known that there was statistically significant difference in speed, preciseness and stability of environmental factors depending on the type of hospitals while significant difference was found in stability by number of beds. Among the factors of system operation, the administrational method affected speed, preciseness, stability and convenience statistically significantly whereas, however, preciseness, stability and convenience became significantly different depending on the number of staff members. As for the factors that could exercise influence upon satisfaction with administrative service of the HIS, it was revealed that statistically considerable impact could be caused under management of own EDPS expert as well as under comanagement by the medical institution and professional business entity in case of hospital.

• 간호행정학회지
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• 제13권3호
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• pp.373-383
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• 2007

Purpose: This descriptive study was designed to find out the relation between nurses' perceptions of leadership and organizational effectiveness. Method: The data was collected from nurses in 451, a tertiary hospital located in B city by means of structured questionnaires. The data was analysed by t-test. ANOVA, Pearson correlation coefficient. Results: The average age of the subjects was 29.1. Regarding the marital status, 68.1% were single. Regarding the nursing unit, 42.6% were working for the general surgical wards. The total period of clinical career was on average 73.7 months. Regarding the period in current ward, 51.0% were 1-less than 3 years. There was a positive correlation with transformational leadership, transactional leadership, job satisfaction, and organizational commitment, whereas the turnover intention had a negative correlation with transformational leadership and transactional leadership. Conclusion: The nurses' different perceptions of transformational leadership, transactional leadership, and organizational effectiveness have strong correlative relationships with each other. This finding suggests the importance of the head nurse's leadership in increasing organizational effectiveness.

• 한국병원경영학회지
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• 제12권3호
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• pp.68-95
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• 2007

This research is designed for studying between transformational leadership and behavior of subordinate. We took a practical analysis with conception of leader acceptance to search function between transformational leadership and self-efficacy. For practical proof of this research, we look hypothetical inspection with collected data after posing a question with medical Staff of 459. The practical analysis of this research is as below. First, We could know that transformational leadership affect partially positive effect to self-efficacy of subordinate. That is, as a result for researching into the influence of subordinate to self-efficacy, setting each element which forms transformational leadership as hypotheses, charismatic behavior and intellectual stimulation of leader's have an positive effect on self-efficacy of subordinate. However, there is no relation between individualized consideration and self-efficacy of subordinate. Second, we analyzed effect of subordinate's acceptance of leader between transformational leadership and acceptance degree of leader, we could know that all of them which is Two subordinate purpose of transformational leadership have a controling effects as there must be existed differences on self-efficacy before and after interaction. It is also another suggestion of this research to provide a clue to next research which is related with the importance of acceptance and it, conception, because we find the fact there could be existed the difference according to acceptance degree of leader.

• 한국임상약학회지
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• 제13권2호
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• pp.72-81
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• 2003

Adverse drug reaction (ADR) may increase hospital admission, morbidity and mortality and adding extra cost to healthcare expenditures. AIMS: This study was performed to identify the types of ADR being reported in a tertiary hospital, and to find out the ways to improve current ADR monitoring system. To investigate the attitudes of hospital pharmacists towards, and their understanding of ADR reporting. METHODS: Of 117 reports submitted to the pharmacy department during 3 months survey period, A questionnaire survey of 75 randomly selected hospital pharmacists was conducted. RESULT: Of the report was from patients aged between 60 and 70. The medical department with the high frequency in ADR reporting was Internal Medicines $(60\%)$. The most common ADR manifestations were gastrointestinal complaints $(47.8\%)\;and\;80\%$ of the reported cases were mild in their severity. The most common drugs suspected of causing ADR were CNS drugs which accounted for $38.4\%.\;55.5\%$ of respondent were aware of the need to education and information about ADR monitoring. The important reasons for unreporting ADR were unknown of how to report ADRs $(94.6\%)$. CONCLUSIONS: An ADR reporting system based on reporting by staff pharmacists has been effective increasing the number of reported reactions and pharmacist involvement in monitoring patients for ADRs. Pharmacists have the knowledge and responsibility to contribute to ADR reporting program. A great opportunity exists for pharmacists to contribute in this area of patient care.