• 보건행정학회지
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• 제30권3호
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• pp.277-285
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• 2020

Chronic diseases as well as a growing population of older adults are currently the leading cause of ill health and economic burden worldwide. Managing those diseases in one-on-one medical consultations poses substantial challenges due to limited time and resources in the current health care system. Various approaches have been taken to manage these conditions, most with limited success. Shared medical appointments (SMAs) are an innovative care delivery option to make the testing of alternative care modalities a prime concern. SMAs are individual medical consultations carried out in a group of patients with similar diseases by providing education, medication management, and disease monitoring. SMAs, since their initial conceptualization in 1998, have gained much popularity and adopted as one of the standard processes in many countries. Accumulated evidence-based studies show outcomes for increasing access to care, behavioral change facilitated through self-management education, maintained/better outcomes, physician productivity, and enhanced resource management. This review summarizes current evidence regarding the existing status of SMAs abroad. An extensive literature search was conducted on major electronic databases including PubMed and Google Scholar. This study suggests to explore and exploit the SMAs which have unique potential as a healthcare delivery innovation in Korea.

• 한국병원경영학회지
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• 제spc호
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• pp.51-60
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• 2016

The forms of healthcare service delivery emerges from the interaction between technological progress and institutional changes. Building a healthcare system which enables effective and efficient patient care is a imperative to a sustainable operation of a society. Identifying of a promising medical technologies and diffusing them consists of the basic tasks of a good healthcare system. Inducing of a promising innovation in healthcare and utilization of the innovation requires a deep understanding of healthcare innovation system and delicate governmental intervention to the effective functioning of the system. Therefore, the support for R&D in healthcare field should be given to social and institutional technologies for the better organization of healthcare delivery and consumption system as well as basic and applied medical sciences.

• 지역사회간호학회지
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• 제28권2호
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• pp.129-143
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• 2017

Purpose: The purpose of this study is to explore factors which influence adoption, implementation and continued use of tele-healthcare systems. Methods: Qualitative research was conducted by in-depth interviews with 17 professionals from various fields of organizations involved in developing and implementing tele-healthcare systems. Data were analysed thematically, using a conceptual model of diffusion of innovations. Results: The system users were reacted positively to the 3 attributes out of 9 which decided the adoption of innovation. In addition, it is required to redesign the tele-health care system simpler and easier so that the system users can access to the system much more easily regardless of space and time limitations. From the design stage on an individual level, it is necessary to conduct detailed needs analysis and listen to users who are at the center of innovation diffusion. On an organizational level, it is necessary to actively prepare for possible problems during system implementation, educate the users and build communication channels continuously. Conclusion: This study has identified the factors affecting the innovation of tele-health care systems and contributed to the understanding of the operation of tele-health care systems by the diffusion of innovation theory in community health posts.

• 셀메드
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• 제6권2호
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• pp.9.1-9.6
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• 2016

Traditional healers in Ghana are so near to the health needs and aspirations of the majority of people who live mostly in the rural areas, yet have been excluded from the formal health care delivery system. Medical systems in Africa and around the globe have broad-ranging ties to the cosmology and the way of life of a people. However, in Ghana, colonialism and external orientation have had a negative influence on Traditional Medicine (TRM). Thus, in Ghana, Traditional healers can be described as a marginalized group and yet their roles in effective delivery of primary and mental health care cannot be overemphasized. This paper elucidates advocacy work toward medical pluralism in Ghana. First, the influence of colonialism on TRM is briefly examined, followed by highlights on advocacy work intended to include TRM in the health care system. Based on "small wins", challenges, successes, and prospects of our advocacy are discussed.

• 보건행정학회지
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• 제32권3호
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• pp.247-257
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• 2022

The presidential election and the inauguration of the new government are a period of the policy window opening. The newly launched government is expected to improve the quality of life of the people. The Yoon Suk-yeol Government is also launched with new expectations with a transitional period in health care. The sustainability of health care in Korea is threatened. The environment of health care and the main policy issues of health care are difficult to secure the necessary finance for health care in spite of the increasing health care burden. Accordingly, the Yoon Suk-yeol Government's health care policy aims to provide intensive support to those in need of health and welfare and to improve the health of the people through investment in health. And for integrating fragmented health care and welfare services and creating people-centered community-based health care, a health care innovation center will be established for the evaluation platform of new delivery and payment systems, a health care development plan will be established for the blueprint of health care, and reorganizing the central & local government should be reviewed. Although we are facing unfavorable situations such as the distribution of the National Assembly, inflation, and the possibility of economic recession, we expect that announced health care policies will be implemented, recognizing that health care innovation is the only way to improve health care sustainability.

• 여성건강간호학회지
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• 제29권2호
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• pp.137-145
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• 2023

Purpose: This non-randomized study was performed to evaluate the effects of music therapy on labor pain, the childbirth experience, and self-esteem in women during vaginal delivery. Methods: In total, 136 primiparous women over 37 weeks of gestation receiving epidural analgesia during vaginal delivery were recruited via convenience sampling. To minimize diffusion effects, data from the control group (n=71) were collected first (April 2020 to March 2021), followed by data from the music group (n=65; April 2021 to May 2022). Participants in the music group listened to classical music during labor, while the control group was offered usual care (no music). Labor pain was measured using a numeric rating scale (NRS), and self-esteem and childbirth experience were collected using self-report questionnaires. Data were analyzed using the independent t-test, chi-square test and Cronbach's α coefficients. Results: The overall pain level (NRS) at baseline was 0 in both groups. Mothers in the music therapy group had lower levels of latent pain (t=1.95, p=.005), active pain (t=3.69, p<.001) and transition-phase pain (t=7.07, p<.001) than the control group. A significant difference was observed between the two groups, and the music therapy group expressed more positive perceptions of the childbirth experience (t=-1.36, p=.018). For self-esteem, the experimental group's score was slightly higher, but without a statistically significant difference from the control group. Conclusion: Using music therapy during labor decreased labor pain and improved the childbirth experience. Music therapy can be clinically recommended as a non-pharmacological, safe, and easy method for nursing care in labor.

• 문화기술의 융합
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• 제8권3호
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• pp.405-413
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• 2022

COVID-19 이후 원격진료, 스마트 병원, AI 진단 등 ICT 기술과 데이터사이언스를 활용한 새로운 의료서비스모형의 활용이 크게 증가하고 있다. 본 연구에서는 최근 미국에서 원격진료와 대면진료의 혼합 모형 운영, 소비자 중심의 온라인의약품 배송, 가정용 진단기기 개발, 그리고 진료 및 처방, 의약품 배송, 진단기기의 활용이 통합적으로 제공되는 새로운 모형 제시 등 미국 헬스케어산업에서 파괴적 혁신을 선도하는 아마존의 헬스케어 사업 모형을 살펴보았다. 특히 아마존 기존 사업분야와의 시너지 효과 등으로 인해 적극적 시장 확대 및 소비자 가치 증대가 발생함을 다품목시장에서의 시장확대 모형을 통해 보였고, 또한 소비자 선택 유도 확대 시 의료서비스 시장에서의 경쟁이 활성화됨을 호텔링의 공간경쟁모형을 통해 보였다. 분석 결과 소비자 가치 증대의 장점과 함께 공급기반 감소에 따른 경쟁 약화의 부작용이 있을 수 있으므로 장기적으로 공정경쟁 관리 차원의 정책적 관심이 필요할 것으로 보인다.

• Journal of Information Science Theory and Practice
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• 제11권2호
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• pp.82-103
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• 2023

The Zimbabwean healthcare sector faces huge challenges due to increased demands for improved services for a growing number of patients with fewer resources. The use of information and communications technologies, prevalent in many industries, but lacking in Zimbabwean healthcare, could increase productivity and innovation. The adoption of health management information systems (HMISs) can lead to improved patient safety and high-level patient care. These technologies can change delivery methods to be more patient focused by utilising integrated models and allowing for a continuum of care across healthcare providers. However, implementation of these technologies in the health care sector remains low. The purpose of this study is to demonstrate the advantages to be attained by using HMISs in healthcare delivery and to ascertain the factors that influence the uptake of such systems in the public healthcare sector. A conceptual model, extending the technology, organization, and environment framework by means of other adoption models, underpins the study of adoption behavior. A mixed method methodology was used to conduct the study. For the quantitative approach, questionnaires were used to allow for regression analysis. For the qualitative approach, thematic analysis was used to analyse interview data. The results showed that the critical success factors (namely, relative advantage, availability, complexity, compatibility, trialability, observability, management support, information and communication technology expertise, communication processes, government regulation, infrastructure support, organizational readiness, industry and competitive support, external support, perceived ease of use, perceived usefulness, attitude, and intention to use) influenced adoption of HMISs in public hospitals in Zimbabwe.

• 대한산업공학회지
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• 제41권6호
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• pp.530-539
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• 2015

A business model (BM) can be developed based on a business model framework (BMF) consisting of key components such as value proposition, customers, and resources. To systematically generate and analyze emerging BMs such as healthcare BM, an integration of diverse BMF components is needed. The present study is to establish a comprehensive BMF and evaluate its applicability to healthcare BMs. Based on a review of eight BMF studies, ten BMF components were identified and classified into five major components (value proposition, resources, organizing model, customers, and revenue model) and five minor components (technology, service platform, delivery, competitive strategy, and growth/exit) by analyses of frequency and functional importance. Lastly, the BMs of three emerging healthcare companies (WellDoc, Inc., CFW Shops, and Aravind Eye Care System) were analyzed and compared in terms of the proposed BMF components. The comprehensive BMF components presented in the study can be of help for developing new BMs and analyzing the strengths and weaknesses of BMs.

• 대한간호학회지
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• 제11권2호
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• pp.5-8
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• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.