• 한국병원경영학회지
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• 제10권2호
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• pp.26-44
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• 2005

The purpose of this study was to investigate these major factors on patient satisfaction, and to examine the affecting level of major factors in. The subjects in this study was 70 hospitals that were surveyed the hospital evaluation program containing the survey of patient satisfaction by KHIDI(Korea Health Industry Development Institute) from 1997 to 1999. The collected data was analysed SPSS for Windows(Ver 10.0). On basically, frequency analysis, t-test, and ANOVA was performed and, for more analysis, correlation analysis, factor analysis, multiple regression analysis, logistic regression analysis was utilized. According to this study, the major factors of inpatient satisfaction are divided 3 types facility factor, manpower factor, and service factor. And the major factors of outpatient satisfaction are analyzed 5 types; facility factor related direct medical service, facility factor related indirect medical services, manpower factor, pharmacy factor, and facility factor related utilization convenience. The importance of this study lies in the identification of major factors on hospital patient satisfaction.

• 한국산학기술학회논문지
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• 제15권11호
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• pp.6746-6755
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• 2014

본 논문은 기초생활보장수급자를 대상으로 장기요양서비스 이용 여부가 의료 이용에 미치는 영향을 파악하기 위한 서술적 연구이다. 연구 대상은 장기요양 1등급 판정을 받은 기초생활보장수급자 5,834명을 대상으로 하였다. 기초생활보장수급자의 의료 이용에 미치는 영향을 다중회귀분석으로 분석한 결과 2007-2009년 총 진료비 변화량을 설명하는 $R^2$은 22.6%이었으며, 장기요양 서비스 이용자에 비해 미이용자는 8,297,329원 증가하였다(${\beta}=.29$, p< .001). 입원일 변화량의 $R^2$은 22.4%이었으며, 서비스 이용자에 비해 미이용자는 119.013일 증가하였다(${\beta}=.33$, p< .001). 총 진료비와 입원일 변화량에 영향을 미치는 요인은 장기요양서비스 이용 여부, 수발자 여부, 2009년 일상생활수행능력, 간호처치, 재활기능이 유의한 영향을 미치는 것으로 나타났다. 따라서 장기요양 서비스 미이용자의 의료 이용이 높게 나타남에 따라 미이용자에 대한 적정 의료와 요양서비스 이용을 지원할 수 있는 정책 마련이 필요로 된다.

• 융합정보논문지
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• 제10권1호
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• pp.235-242
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• 2020

본 연구는 실천적 측면에서 궁극적으로 소비자 중심인 고객만족경영을 위한 병원의 경영환경 개선 방향성을 제시할 목적으로 병원이용에 대한 최종적인 충족상태를 기대수준 대비 이용 후 만족도로 측정하여 입원 의료서비스 제공과정과의 관계를 분석하였다. 연구방법은 300병상 미만의 병원 및 종합병원에서 입원진료를 한 환자를 대상으로 2018년 9월 10일부터 9월 30일까지 자료를 수집하여, t-test와 분산분석(ANOVA), 그리고 로지스틱 회귀분석(Logistic Regression)을 실시하였다. 분석결과, 입원이용 결정이유는 병원브랜드가 가장 많았고 그다음으로 의사브랜드이었으며, 입원 의료서비스 제공과정에 대한 만족도는 일반적 특성에 따른 통계학적 차이를 보이지 않았다. 병원이용에 대한 최종적인 충족상태인 기대수준 대비 만족 유무에는 입원 의료서비스 제공과정 중 입원 진행 절차가 유의하게 영향관계가 있는 것으로 확인되었다.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.67-73
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• 2019

Objective: The purpose of this study was to compare the differences in the length of hospital stay between hemorrhage stroke survivors with health insurance and those with medical care after controlling all factors except for the type of medical insurance by using the propensity score matching (PSM) method. Design: Retrospective cohort study. Methods: Data from the Korean National Centers for Disease Control and Prevention's In-Depth Discharge Injury Survey between the years 2006 and 2012 were used for analysis. A total of 4,538 cases were defined as persons with hemorrhagic stroke (I60-I62) based on the block of categories in the International Classification of Diseases (10th). In order to analyze the inpatient period differences depending on the type of health care, which reflects one's socio-economic level, the chi-square and t-test was conducted. Results: Frequency and percentage were presented, and regression analysis was used to determine the factors affecting the inpatient period. Age, severity of disease, treatment outcome, and post-discharge status were no longer statistically significant after matching. The inpatient period of the persons receiving medical aid benefits was found to be significantly longer than those with national health insurance (p<0.05). Conclusions: The factors influencing the inpatient period of hemorrhagic stroke survivors were treatment outcomes, severity of disease, hospital admission process, and the type of health care. It is necessary for systematic and comprehensive governmental management for persons with hemorrhagic stroke to be transferred to long-term care facilities.

• Journal of Hospice and Palliative Care
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• 제25권2호
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• pp.76-84
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• 2022

Purpose: We compared cost-effectiveness parameters between inpatient and home-based hospice-palliative care services for terminal cancer patients in Korea. Methods: A decision-analytic Markov model was used to compare the cost-effectiveness of hospice-palliative care in an inpatient unit (inpatient-start group) and at home (home-start group). The model adopted a healthcare system perspective, with a 9-week horizon and a 1-week cycle length. The transition probabilities were calculated based on the reports from the Korean National Cancer Center in 2017 and Health Insurance Review & Assessment Service in 2020. Quality of life (QOL) was converted to the quality-adjusted life week (QALW). Modeling and cost-effectiveness analysis were performed with TreeAge software. The weekly medical cost was estimated to be 2,481,479 Korean won (KRW) for inpatient hospice-palliative care and 225,688 KRW for home-based hospice-palliative care. One-way sensitivity analysis was used to assess the impact of different scenarios and assumptions on the model results. Results: Compared with the inpatient-start group, the incremental cost of the home-start group was 697,657 KRW, and the incremental effectiveness based on QOL was 0.88 QALW. The incremental cost-effectiveness ratio (ICER) of the home-start group was 796,476 KRW/QALW. Based on one-way sensitivity analyses, the ICER was predicted to increase to 1,626,988 KRW/QALW if the weekly cost of home-based hospice doubled, but it was estimated to decrease to -2,898,361 KRW/QALW if death rates at home doubled. Conclusion: Home-based hospice-palliative care may be more cost-effective than inpatient hospice-palliative care. Home-based hospice appears to be affordable even if the associated medical expenditures double.

• 부모자녀건강학회지
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• 제14권2호
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• pp.69-75
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• 2011

Purpose: This study is descriptive survey research that examined nurses' communication skills perceived by inpatient children's parents for short period due to acute diseases in children's hospital and aimed to make a qualitative improvement of nursing with the basic materials for improving nursing service for inpatient children. Methods: The subjects were 177 parents of children who were hospitalized in a children's hospital in Gwangju from May 1 to June 16, 2009. A structured questionnaire which consisted of a communication and interpersonal skills developed by Yodkowsky et al. (2006). Data collected from them were processed and analyzed with the SPSS/WIN program. Results: Nurses' communication skills as perceived by the parents of inpatients scored an average 4.11, communication scored 4.02, and interpersonal relationship scored 4.18. The scores of interpersonal relationship were mostly higher. Nurses' communication skills as perceived by the parents of inpatients according to general characteristics showed statistically significant differences depending on the number of children and the birth order. Conclusion: it was considered that nurses' emotional characteristics were important for inpatient children. it is thought that the positive communication skills considering the emotional aspects in planning and performing nursing for inpatient children should be achieved.

• 보건의료산업학회지
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• 제3권2호
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• pp.65-75
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• 2009

This study aims at deriving any useful information necessary to strengthen the competitiveness for growth through empirical analyses on a general hospital located in a province in order to countermeasure the opening and competition of medical markets. The characteristics of user were identified on the basis of disease groups under KCD in the research method. In addition, the analysis on the expenses of diagnosis and treatment was divided into the treatment progress and degree of hospital resource utilization. And the regression was carried out to identify the impacts of characteristics of inpatient users on the degree of hospital resource utilization. As a result of major research, the inpatient users of the general hospital located in the provincial area in consideration of inpatient users were formed around the inpatient disease groups representative for Korea. And it was understood that most of residents within a distance of 40 minute by the public transportation were using. Although there are restrictions that the analyses were carried out for a general hospital in a province, the findings of this study can be considered a generalized model for the management of provincial general hospitals when we consider the current circumstance that the diagnosis and treatment are carried out by provincial medical institutions primarily for patients in general within the province, along with implications that any general hospital in Korea should be equipped with the facilities, equipments and human resources under the Medical Treatment Act.

• 보건행정학회지
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• 제23권2호
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• pp.152-161
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• 2013

Korea has a single National Health Insurance program and all citizens are covered under this program, accounting 97% of the population, approximately 50 million people. Claims submitted by Health care providers are reviewed by Health Insurance Review and Assessment (HIRA) for the reimbursement. HIRA database contains not only individual beneficiary's information, but also healthcare service information such as diagnosis, procedures, prescriptions and tests for them. HRA database has gained attention as importance source for research due to its rich healthcare information and the demand of HIRA database has increased. Due to its tremendous size, however, researchers have had problems in accessing the database to conduct research. To meet this demand, we conducted a study to develop the inpatient sample data from HIRA database for research. This study has two purposes: 1) to determine a needed sample size; 2) to test reliability and validity of the sample data. We determined an adequate sample size to ensure representativeness and generality with additional consideration for convenience of calculation. The minimum sample size was 729,904 for the generality, and 488,861 for representativeness. After considering the convenience of calculation, our final sample size was 13% of the population, which was about 7.7 million beneficiaries. Age (5 years interval) and gender were used as stratification variables for sampling. In order to examine whether this sample data appropriately reflect population, we tested the reliability and validity of the sample data. From the sample data, we computed average expenditure of total claims per inpatient for 2011, frequency of top 30 disease, estimation of the number of stroke patients from the sample data, and then compared them to those from the population. Results confirmed reliability and validity of the sample data.

• 보건의료산업학회지
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• 제10권1호
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• pp.39-51
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• 2016

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

• 보건의료산업학회지
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• 제10권2호
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• pp.71-82
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• 2016

Objectives : This study purposed to analyze the productivity trends of regional health care resource uses in South Korea. Methods : Data was provided from the regional health care statistics by the National Health Insurance Service(NHIS) and collected from 2011 to 2014 at the 226 administrative regions such as Si(city in Korean), Gun(county in Korean), Gu(district in Korean). Productivity trend was analyzed with Malmquist Productivity Index(MPI). Input variables were the number of medical personnels, facilities, and major medical equipments. Output variables were the number of inpatient and outpatients in model A, and the amount of inpatient and outpatient reimbursements in model B. Results : In model A, the productivity of 62 regions were increased but it was decreased in 164 regions. In model B, the productivity of 123 regions were increased but it was decreased in 123 regions. Conclusions : If these trends were continued, there will be problems with the efficiency of national regional healthcare resource utilization. Health policy makers will require to focus in solving this phenomenon.