• 대한한의학방제학회지
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• 제18권2호
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• pp.135-158
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• 2010

The purpose of this survey was to find out the actual condition and the problems of combined medications of patients who have general diseases, respiratory diseases. The objects of this survey were 1,769 outpatients who visited 8 Oriental hospitals and Seoul national university hospital respiratory clinics. SPSS program was used to analyze the survey data. The mean age of patients was lower in oriental hospital than in western hospital. The monthly family incomes were higher in oriental hospital patients than in western hospital patients. The condition of patients was better in oriental hospital than western hospital and self-assessed health status was more positive in oriental hospital patients than in western hospital patients. The percentage of having experienced of treated in oriental and western hospital at the same time was 21% in western hospital patients and 45% in oriental hospital patients. In patients with respiratory diseases, the percentage of having taken combined medications was 40.2% in oriental hospital and 13.7% in western hospital. In patients with non-respiratory diseases, the percentage of having taken combined medications was 27.4% in oriental hospital and 8.3% in western hospital. And in the patients with two different diseases, the percentage of having taken combined medications was 27.9% in oriental hospital and 6.3% in western hospital. The percentage of having experienced synergistic effects was 33.0% in western hospital and 56.3% in oriental hospital. The percentage of side effects was 12.6% in western hospital and 12.2% in oriental hospital. This survey was meaningful in that it reported the actual condition of combined medications of patients who have general diseases, respiratory diseases. For the deep study on synergistic and side effects of combined medications, it is necessary to collect many cases of synergistic and side effects by doctors in western and oriental hospitals.

• 한국임상약학회지
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• 제25권3호
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• pp.159-165
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• 2015

Objective: Polypharmacy is one of the main causes of inappropriate medication use, adverse drug-related events and cost. It aimed to investigate the status of polypharmacy and potentially inappropriate medication (PIM), the factors affecting polypharmacy and cost in elderly outpatients. Method: A pharmacy claim data were retrospectively analyzed with elderly patients prescriptions at a pharmacy located near a top tier general hospital. The numbers of medications per person, prevalence of polypharmacy and PIM according to the 2012 Beers criteria and Korea PIM list, medication cost and the factors affecting polypharmacy were investigated. Results: Forty-six percentages of the elderly outpatients received polypharmacy and over 21% of them had medications listed in Beers or Korean PIM. In multiregressional analysis, we found that age, gender and insurance types were affective factors of polypharmacy. (p < 0.001, 0.047, 0.009, respectively). The cost of polypharmacy with PIM in elderly outpatients was increased with age. Various approaches of interventions would be further required.

• Journal of Community Nutrition
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• 제1권2호
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• pp.133-139
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• 1999

The purpose of this survey was to investigate eating habits, life styles and nutritional care of diabetic outpatients and to provide basic data for developing individualized nutritional care and diabetic education programs. This survey was carried out by nutritional counseling with a questionnaire and checking medical record. Information about the general characteristics of the subjects, eating habits, health-related life styles and attitude and perception of subjects to diet therapy was gathered from 200 randomly-sampled diabetic outpatients at a University Hospital located in Inchon. All data were analyzed by Statistical Analysis System(SAS) software. The results are summarized as follows : Female subjects were 63.5% of total subjects and 65.5% of total subjects were 50 years or more. The average Body Mas Index(BMI) of male and female subjects were 23.06kg/㎡ and 25.02kg/㎡ respectively and 44% of all subjects wee obese. Among subjects, type II diabetic patients were 81.0% and 82.5% of subjects had suffered from diabetes for more than one year. Also 41% subjects had diabetic history in their family. More than half of the subjects had nutrition education concerning diabetes. Also 75.5% of them thought that nutrition education was effective. The most important guideline in diet therapy was to eat cooked rice with dietary fiber-rich grains. Therefore, it might be necessary to develop nutrition education program adjusted according to diabetic patient's needs and life styles, which may increase feasibility of self-care and implementation of management guidelines.

• 한국병원경영학회지
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• 제8권2호
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• pp.49-69
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• 2003

This study purported to evaluate the performance of the appointment system for outpatients in primary care dental clinic. The data of patients' time flow for 1,245 patients in Y Dental Clinic were collected for one month in 2002 and then analyzed. Specifically, the time periods of treatment and patients' waiting as well as rates of appointment and it's failure are estimated. The accuracy of expected treatment time period was also evaluated. The results showed that 72% of patients visited the clinic with appointments, and only 56% kept their appointments. The patient's waiting time period turned out to be 11 minutes in Y clinic. The expected treatment time period is turned out to be very important because they influence significantly on patient's waiting time period. Practically, the expected treatment time period should be overestimated about 9 minutes in general, and the characteristics of dentist, each patient's diagnosis and age need to be especially considered. Hospitals and clinics also need to make the systematic and detailed critical pathways for a variety of patient cases by analyzing the patients' treatment pattern. With the improved appointment systems, healthcare institutions will approach the goal of effective and efficient management of the institution and also satisfy their customers.

• 대한한방부인과학회지
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• 제24권4호
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• pp.163-173
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• 2011

Purpose: To show the clinical aspects in outpatients who visited Oriental Obstetric & Gynecology Clinic Methods: We studied 7141 patients who visited Oriental Obstetric & Gynecology Clinic from 2008 to 2010. Results: 1. The total patients and the percentage of new patients increased every year. 2. The age distribution showed over 60% in 20~49. 3. The percentage of Oriental Ob&Gy patients decreased with 55% in 2008, 28% in 2009, 29% in 2010. 4. The distribution of oriental diagnosis showed 55.4% in Ob&Gy, 19.2% in musculoskeletal system, 6% digestive system and respiratory system neuropsychiatry in 2008. And 30.6% in musculoskeletal system, 28.5% in Ob&Gy, 10.9% neuropsychiatry in 2009. And 29% in musculoskeletal system, 28.1% in Ob&Gy, 11.1% in heart system in 2010. 5. The most commonly used herbal medicine was Ikgibohyeltang. Conclusions: We hope these results could be helpful to diagnosis and treatment of oriental Ob&Gy patients.

• 한국병원경영학회지
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• 제20권2호
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• pp.39-56
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• 2015

This study calculated the potential customer satisfaction improvement index (PCSI index) and average satisfaction coefficient (ASC) by categorizing quality attributes based on the Kano analysis for medical service quality. This study seeks to suggest ways to increase the efficiency of medical business management by determining priority to improve after applying the indexes to IPA. To achieve such purposes, this study conducted a survey on 150 outpatients of a premium general hospital and 200 workers in four different sections in the same hospital. As a result of the analysis, there was a difference in the awareness of service quality to improve patient satisfaction between the outpatients and workers. Therefore, the focus should be put on those items deemed important by the patients rather than those that the workers called attention to in order to effectively improve service quality. Along with efforts to alleviate or eliminate inconveniences experienced by patients, it is necessary to provide training programs for workers on customer reception and management such as delivering services with a kind manner and giving explanations in a proper and professional manner and exhibiting the right attitude.

• 대한한방소아과학회지
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• 제19권2호
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• pp.197-213
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• 2005

Objective : The purpose of this study was to investigate chief complaints of pediatric outpatients .Fin the oriental hospital and search for a trend of patients and their symtoms. Method : The study was composed of 2,915 new patients aged between 0 and 20 who had been visited pediatrics in ${\bigcirc}{\bigcirc}$ university oriental hospital from 2001 to 2004. Results : The percentage of new patients decreased every year with 30.7% in 2001, 25.5% in 2002, 24.1% in 2003, 17.8% in 2004. The age distribution showed 9.9% in infancy patients, 62.6% in early childhood, 16.8% in late childhood, 10.6% in adolescence. The percentage of infants decreased every year with 13.3% in 2001, 9.4% in 2002, 8.8% in 2003, 7.1% in 2004. The percentage of adolescents increased every year with 8.0% in 2001, 9.6% in 2002, 12.8% in 2003, 13.5% in 2004. Systemic division of chief complaints was respiratory symtoms(37.6%), general symtoms(26.1%), digestive symtoms(19.2%), skin symtoms(6.8%), nervous and mental symtoms (6.1%), urinary symtoms(2.2%), musculoskeletal symtoms(1.3%) and others(0.7%) in order of frequency. The main chief complaints were nasal mucus/obstruction(17.5%), weakness(16.9%), cough(12.8%), loss of appetite(9.8%), inappropriate growth(4.3%), atopic skin problem(3.4%), repeated common cold(2.4%), abdominal pain(2.4%), vomiting (2.2%), diarrhea(2.0%) and fever (1.9%). Loss of appetite, inappropriate growth and repeated common cold increased every year. Diarrhea and convulsion decreased every year. Conclusions : The two main causes of visit of patients were respiratory problems and improvement of general condition. More data of patients should be accumulated for further study. Not only analysis according to chief complaint, but also analysis according to diagnosis will accomplish more aaccurate information about disease of childrens in the future.

• 한국병원경영학회지
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• 제28권4호
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• pp.73-89
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• 2023

Purposes: The purpose of this study was to empirically analyze the effect of the attitude of medical staff providing medical services on the treatment satisfaction of the patients who experienced outpatient care at the hospitals and clinics. In particular, it was verified whether the courtesy of the medical staff to the outpatients has moderated the effect of the medical staff's explanation on the treatment satisfaction. Methodology: After controlling the socio-demographic factors of the outpatients with their treatment and waiting time, multiple regression analyses were conducted to figure out the effect of the attitude of the medical staff on the treatment satisfaction. And the covariance analyses were adopted to verify the moderating effect of the variables of the medical staff. Findings: At both hospitals and clinics, all attitudes of medical staff such as the way they explain to and communicate with the patients, and their courtesy showed positive effects on treatment satisfaction. Among them, the courtesy of the medical staff was the most influential variable on the satisfaction of the treatment, and it only had the control power over the effect of the way they explain on the treatment satisfaction. Practical Implication: Among the medical staff's attitudes toward patients at hospital or clinic level, the courtesy of doctors and nurses is an important factor in improving treatment satisfaction. In particular, if the level of their courtesy is low among the medical services rendered at the clinics, the satisfaction level will decrease even if the level of explanation of the medical staff is high. Therefore, in terms of hospital management, treatment satisfaction can be improved when doctors and nurses provide medical services to visitors with polite, humble and friendly manner in explaining to and communicating with the patients.

• 간호행정학회지
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• 제8권1호
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• pp.151-167
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• 2002

Purpose : The purpose of this study is to present the direction of service marketing for improving customers' satisfaction by comparing the difference in medical and nursing service satisfaction between internal and external customers. Method : The subjects were outpatients and inpatients as the external customers and nurses, doctors, and staffs as the internal customers, in a university hospital. Data were collected from April 25 to May 2, 2001 through questionnaires. The 2 structured instruments were used for collecting the data: Customer Satisfaction Measurement 2000 developed by Korean Society of Quality Assurance in Health Care(1999) and nursing service satisfaction questionnaires by the researcher. Data were analyzed using SPSSWIN 9.0 with t-test, one-way ANOVA, scheffe test.Result : 1. In overall medical service satisfaction scores, external customers' satisfaction showed significantly higher than internal customers'(p=.000) and there was no significant difference between external customers(p>.05). But there was significant difference between internal customers(p<.05). 2. There was no significant difference in nursing service satisfaction between the external and internal customers (p>.05). In the external customers, inpatients' nursing service satisfaction showed significantly higher than outpatients' (p<.001). And there was significant difference in nursing service satisfaction between internal customers(p<.05). Conclusion : To increase external customers' satisfaction with medical and nursing service, hospital should carry out internal marketing strategies for improving internal customers' satisfaction. Also to increase outpatients' satisfaction, it should conveniently improve procedures of use and provide more information and education for outpatients.

• 약학회지
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• 제54권6호
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• pp.455-460
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• 2010

We evaluated the inappropriateness of metformin use in patients with type 2 diabetes and chronic medical conditions to identify the frequency of the prescription metformin in violation of the food and drug administration (FDA) black box warning. We reviewed medical records of 307 outpatients who received metformin at endocrinology department in a hospital setting between January 1, 2005 and August 30, 2009. Of the 307 outpatients, 25 discontinued treatment of metformin due to elevated serum creatinine level (Scr${\geq}$1.5 mg/dl in male, Scr${\geq}$1.4 mg/dl in female), cancers, and/or liver disease. 5 were lost to follow-up. 89 (29.0%) of the patients had cardiovascular disease, 54.1% for hypertension, 9.8% for liver disease, and 60 (20.8%) for chronic kidney disease. 12 patients (3.9%) with chronic kidney disease and/or elevated serum creatinine level, and 1 patient (0.3%) with lactic acidosis were contraindicated to metformin use. Metformin should be avoided in 7 outpatients (2.3%) with active hepatitis and 1 patient (2.6%) with liver cirrhosis. Of the 307 outpatients, 13 (4.2%) patients who received metformin at the first visit and 16 (8.7%) patients who received metformin at the last visit violated to black box warning. 8 (2.6%) of the patients were in precautionary conditions to metformin use. Adjusted mean difference of serum creatinine was -0.16 mg/dl [95% CI: -0.22 to -0.11 (p<0.05)] and adjusted mean difference of alanine aminotransferase was 4.46 IU/l [95% CI: 2.47 to 6.44 (p<0.05)] between the first visit and the last visit. Critical number of elderly patients who are at the high risks of drug-disease and drug-laboratory interaction is exposed to the inappropriate metformin use in violation of black box warning. The periodic evaluation of metformin use and monitoring prescription through drug utility review (DUR) system is needed to improve patients' safety and to reduce adverse drug events.