Purpose: The purpose of this study was to investigate the view on old age of nurses working at general hospitals, geriatric hospitals, oriental hospitals and public health centers. Methods: Data were collected using a self-report questionnaire from 461 nurses working at 3 general hospitals, 8 geriatric hospitals, 7 oriental hospitals and 6 public health centers located in Seoul, Gyeonggi-do and Chungcheong-do from June 20 to September 6, 2012. Results: The mean score of the nurses' view about old age was 3.38 out of 5 points. The details show that the 'society character' was the highest at 4.58, followed by the 'capacity character' 3.94, the 'psychology-economical character' 3.02 and the 'physical-cognitive character' 2.71. As for workplace, oriental hospitals had the highest points on the view about old age, while geriatric hospitals had the lowest. Conclusion: The results of this study indicated that the nurses' view about old age were above the moderate level. As for workplace, geriatric hospital nurses had the lowest view about old age. Therefore, it is recommended to develop an educational program that may promote the nurses' view about old age and provide the better elderly care service.
International Journal of Internet, Broadcasting and Communication
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제10권3호
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pp.115-120
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2018
Current medical tourism is focused on the services of large hospitals and it is hard to find ways to attract the users. Users collect information for medical tourism through various paths in order to receive the medical consultations and customized tour services. To expand medical tourism to small and medium sized hospitals, it is necessary to have the customized medical consultations, tours and interpreter services, which are the key elements of medical tourism. This study suggests ways to provide the services based on information on medical consultations, tours and interpreter services that users had experienced directly, and also based on the platform for the essential items integrated from users, hospitals and guides' viewpoints. With information on hospitals that provide medical consultations and guides who are able to provide professional services in translation, interpretation and customized tour, users may accumulate and share the information about hospitals and customized tours verified by other users from the integrated platform. To match the contents provided by hospitals and guides with information experienced by users into a system, this study suggests the construction plan for the service model that can match the experience information between users and hospitals, between users and guides and between hospitals and guides systematically by operating the data in the universal container.
The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE III scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE III score rised (p<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. When the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. When we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (p<0.05).
Purpose: We examined the relationship between operating income and volume of medical services provided at general hospitals in 2018 according to characteristics of general hospitals and measured as operating income(net income) and volume(adjusted inpatient days) covered or non-covered by National Health Insurance(NHI). Methodology: Finance data from income statement reports in 212 general hospitals and the national health insurance claim data of these hospitals were used. The characteristics of the general hospital were divided into structural, operational, financial, and patient aspects. Operating income and volume were divided into covered and non-covered by NHI. Findings: The results showed high volume hospitals tended to be more profitable than low volume hospitals, especially in non-covered services. Operating income was more likely to be sensitive to non-covered services volume than to covered services volume. Practical Implications: It is necessary to understand the volume of services in non-covered, in order to obtain reliable cost information to be used for the fee schedule. Researches on small size hospitals(<160 beds) are needed, with a large variation in the volume of services and a strong tendency to compensate for the loss in the covered part in non-covered part.
Purpose: This study analyzed the architectural planning factors of the ward in infectious disease hospitals, such as functional unit planning, ward configurations, spatial compositions & circulation, and detailed architectural planning. Through these, the facility guidelines of infectious disease hospitals are summarized, focusing on the differences from the wards of non-infectious hospitals. Methods: This study was conducted by literature review of research reports, papers, design cases, and guidelines, based on the experiences of field surveys for infectious disease hospitals. Results: The result of this study can be summarized into a few points. 1) Infectious disease hospitals need to establish an operation plan with the concept of continuity of care, as an extension of existing facilities. 2) The types of ward configuration for infectious disease hospitals has many variables, so an appropriate type should be selected according to the hospital's operating policy. 3) Various spatial composition types of the ward can be planned by the arrangement of traffic cores and areas of patient groups. At this time, the main planning considerations are safety, efficiency, and comfort. 4) As elements of the detailed plan, It is necessary to consider the types & dimensions of patient rooms, the relationships between nursing stations & sub-stations, and supplementations of medical support functions & convenience facilities. Implications: Since there are many differences in function from the ward of non-infectious hospitals, appropriate facility guidelines for infectious disease hospital are required.
The purpose of this study was to find out the restructuring strategy for five provincial hospitals through the business analysis and survey of the service area. Through the survey of the service area of 5 hospitals. service area was classified into three groups, such as underserved area, adequate area, and overserved area. The strategy for the restructuring the clinical departments was set up based on the result of the business analysis and characteristics of the service area. The result of the study was as follows; 1) Whether or not a provincial hospital has specialized in specific area according to the circumstances and the needs of the community was the major factor influencing on the operating result of the hospital. 2) Provincial hospitals at the underserved area has to invest according to the changes of the occupancy rate and increasing pattern of the number of patients while maintaining the status as a general hospital. 3) Provincial hospitals at the adequate area has to lower the grade from the general hospital down to the hospital first and has to upgrade the competency through the restructuring the clinical departments and investment in specific area. 4) Provincial hospitals at the overserved area has to lower the grade from the general hospital down to the hospital first and has to seek ways to change the hospital fundamentally into geriatric hospital, pneumoconiosis hospital or psychiatric hospital etc. Provincial hospitals incapable to compete with private hospitals and clinics has to lower the grade from the general hospital down to the hospital first, to specialize in specific area and to restructure some clinical departments into rental base or self-operating basis. In case such methods are judged not so good solution, provincial hospitals has to find out ways such as shut-down of several departments or operating under the attending system.
According to the increase of the proportion of aged people, the medical demand for a senile chronic disease has been increased; therefore, aged people call for a geriatric hospital for special geriatric medical service. The main purpose of this study was to analyze the general characteristics and financial status of geriatric hospitals. For the study, a questionnaire was designed and sent to the geriatric hospitals to fill out the patient statistics, number of headcount by department, etc. to find out the stability, profitability, activity and so on financial statements of the hospitals were analyzed. The major findings of this study were as belows. 1. The ratio of the medical expenses to the revenue of the geriatric hospitals is much lower than acute care hospitals. But the probability of bankruptcy is higher due to the high ratio of the liabilities therefore it is required to stabilize the financial position by donating more money. 2. Government budget for the elderly people is not enough. To support the geriatric hospitals by going subsides, government should increase the budget. 3. Portion's of the patient of the geriatric hospitals are government support patient. Since the government doesn't pay the medical charges quickly, geriatric hospitals have a serious cash flow problem. Therefore, it is required that government is to prepay the bill. 4. Since geriatric hospitals treat elderly patient and most patients are government support patients, geriatric hospitals can be said to operate under the strict. 5. When we introduce the daily medical charge, the self-liability will be reduced on approximately 50% of current. This affection will bring a huge progressing financial structure to the medical profit of the geriatric hospital, and also patient family will feel less economical burden.
Objectives: Korean medicine hospitals, since they first emerged in the early 1970s, have rapidly become a new member of the hospital population. As it was a new organizational frame for traditional medicine, we tried to analyze the changes of Korean medicine hospitals coping with institutional environment and their relative positioning in the whole health care sector. Methods: On the basis of Scott and his colleagues' identification of the three components of institutional environments, changes in organizational logics, actors, and governance of Korean medicine hospitals during the period from 1971 to 2010 were analyzed. Results: First, Similar to previous literature on institutional eras of Korean health sector, three distinct periods were characterized: the foundation of Korean medicine hospitals to consolidate the legal status(1971~1986), a rapid increase of entrepreneurial hospitals through cultural-cognitive legitimacy(1987~2001), and the reinforcement of specialization and competition(2002~present). Conclusions: Results suggested that: (1) changes in institutional environments hada heavy impact on structural and behavioral changes among Korean medicine hospitals, but the pace was slower than that of western medicine hospitals. (2) In structure, Korean medicine hospitals have positioned themselves as unofficial long-term care hospitals, focusing on chronic diseases(e.g. cerebrovascular disease). Our study demonstrated that organizational theories can provide useful framework for the analysis of Korean medicine and related policies. Indeed, one of the most important implications of this study is that understanding changes in institutional environments is important to understand the process of how members of the health care sector live, grow, change, decline and survive.
Park Chang-Seo;Kim Kee-Deog;Park Hyok;Jeong Ho-Gul
Imaging Science in Dentistry
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제34권4호
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pp.175-178
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2004
Purpose: Picture Archiving and Communication System (PACS) is difficult to implement in the best of situations, but evidence is growing that the benefits are significant. The aims of this study are to analyze the current status of full PACS and establish successful installation standard of dental PACS. Materials and Methods : Materials and methods were based on the investigation of current working status and installation standard of PACS, and observation of variable issues to installation of dental PACS. Results: By September 30,2004, full PACS implementations in their facilities were 88.1 % in specialized general hospitals (37 installations out of total 42 hospitals), 59.8% in general hospitals (144 installations out of total 241 hospitals), 12.3% in medical hospitals (116 installations out of total 941 hospitals) and 3.6% in dental hospitals (4 installations out of total 11 0 hospitals) Only 4 university dental hospitals currently have installed and are operating full PACS. Major obstacle to wide spread of dental PACS is initial high investments. Conclusions: Clinical environments of dental PACS differed from medical situation. Because of characteristic dental practice, the initial investments for dental PACS are generally much greater than those of medical PACS. Also new economic crisis makes users scruple. The best way to overcome these limitations is to establish an economic installation standard for dental PACS. Also the clear technical communication between the customer and the supplier before both sides are committed to the obstacles are critical to its success.
Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.
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