• Quality Improvement in Health Care
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• v.3 no.1
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• pp.104-124
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• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• Korean Journal of Construction Engineering and Management
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• v.19 no.1
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• pp.21-31
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• 2018

The rapid increase of the elderly living alone is a critical issue in worldwide as it leads to a rapid increase of a social support costs (e.g., medical expenses) for the elderly. In early stages of dementia, the activities of daily living (ADL) including self-care tasks can be affected by abnormal patterns or behaviors and used as an evidence for the early diagnosis. However, extracting activities using non-intrusive approach is still quite challenging and the existing methods are not fully visualized to understand the behavior pattern or routine. To address these issues, this research suggests a model to extract the activities from coarse-grained data (spatio-temporal data log) and visualize the behavioral context information. Our approach shows the process of extracting and visualizing the subject's spaceactivity map presenting the context of each activity (time, room, duration, sequence, frequency). This research contributes to show a possibility of detecting subject's activities and behavioral patterns using coarse-grained data (limited to spatio-temporal information) with little infringement of personal privacy.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.33-49
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• 2017

Background: Health care utilizations and costs of the patients with degenerative lumbar spine disease in Korea increased dramatically. We analyzed whether hospital market competition is associated with charges and length of stay for patients with degenerative lumbar spine disease. Methods: We used Medical claims data of 2002 and 2010 from the nationwide representative sample of National Health Insurance Service of Korea. The study subjects were inpatients with degenerative lumbar spine disease (N=24,768) in 2002 and 2010. We employed a multilevel linear mixed model that included patient- and hospital-level variables in hierarchical data. Results: Higher hospital competition was associated with lower charges (${\beta}=57.5$, p<.0001 in 2002; ${\beta}=353.7$, p<.0001 in 2010) and shorter length of stay (${\beta}=0.3$, p<.0001 in 2002; ${\beta}=0.9$, p<.0001 in 2010) in both 2002 and 2010. Compared to 2002, the magnitude of such association became greater in 2010. However, subgroup analyses show that the influence of competition on charges and length of stay differed by hospital size. Conclusions: This study showed that hospital market structure (e.g., hospital competition) affects hospital efficiency (i.e., hospital charges and length of stay). It is necessary to continue to monitor how changing market structure influences hospital outcomes, including more detailed outcomes such as patient satisfaction.

• Archives of Plastic Surgery
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• v.34 no.4
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• pp.466-470
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• 2007

Purpose: Active prevention is an essential component in reducing the development of pressure sores. For the high-risk patient group, following the certified pressure sore screening scale as well as educating the patient and the nurses who care for them can lead to optimal management of these patients. Applying a risk assessment scale along with a prevention strategy can reduce medical costs and length of stays at the hospital. The purpose of this study is to evaluate the efficacy of a new pressure sore risk assessment scale based on the universally recommended Braden scale and our prevention program. Methods: From June to August, 2003, our pressure ulcer risk assessment scale was applied to a total of 1882 patients admitted to the experimental group (intensive care unit, neurosurgery, general surgery, and oncology units). It was based on Braden scale. We analysed sensitivity, specificity, positive and negative predictive value and ROC curve to evaluate its efficacy. Pressure ulcer prevention program was composed of patient's education using protocol and specific nursing care. The incidence of pressure ulcers was also measured during the 3 months period, and those were compared to the control group of 1789 patients from March to May, 2002. Results: 118(6.27%) of the experimental group were high-risk with an incidence of pressure ulcers measuring 4 (0.21%). Sensitivity, specificity, positive and negative predictive value of our scale were 100%, 94%, 4%, 100%, respectively, and AUC(area under the curve) was 0.992. In the control group, the incidence of pressure ulcers was 11(0.61%). Statistical analyses using chisquared tests with a significance level of 5%, the results were such that ${\chi }^2=3.6482$(p=0.0561). The results proved to be statistically significant in borderline. Conclusion: The results from this study proved that pressure sore risk assessment scale based on Braden scale has an excellent efficacy, and shows that our pressure ulcer prevention program is partially effective in reducing pressure ulcer incidence.

• Pediatric Infection and Vaccine
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• v.22 no.3
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• pp.136-142
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• 2015

The Korean Society of Pediatric Infectious Diseases (KSPID) has participated in the task force team consisting of government authorities as well as civil medical experts and facilities to block the spread of Middle East Respiratory Syndrome in 2015. KSPID posted the "Middle East Respiratory Syndrome (MERS) Pop-up" in the homepage of The Korean Pediatric Society and The Korean Society of Pediatric Infectious Diseases. KSPID also released the "Guidelines for testing for MERS in children and adolescents" and the "Instructions for the Operation of National Safe Hospital" for children and adolescents in a timely manner. Such actions were aimed to prevent unnecessary anxieties, studies and isolation of pediatric patients with respiratory symptoms and signs caused by other common microbial etiologies as being suspected for MERS patients. This strategy relieved the doctors and parents from unnecessary fear and prevented the loss of unnecessary health care costs, and has proven to be a well-judged guideline and management protocol as evaluated after the final end of MERS outbreak. KSPID and its members should support the presence of pediatric infectious disease (PID) specialists in every medium size hospitals in Korea by developing the need for consultation fees for PID consultation in the hospital based practice and promoting the potential for cost savings related to prevention of health care associated infections and optimal prescription of antimicrobial agents. KSPID and its members need to approach and develop a communication plan to political decision makers to demonstrate and convince them of the importance of a PID specialist service.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.23 no.1
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• pp.199-214
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• 2010

Objective : Atopic dermatitis (AD) may profoundly affect patient's quality of life (QOL), and also cause economic impact. The aim of our study was to evaluate the quality of life and the economic impact of adult atopic dermatitis patient in Seoul. We also evaluate the relationship of QOL and economic impact with severity of AD. Methods : 30 adult atopic dermatitis patient were included and evaluated by using the SCORAD Index and EASI. Patients were asked to fill in the questionnaires about their quality of life and financial costs during the past year by AD. Data about sleep disturbance and pruritus were also obtained. Pearson's correlation were used for statistical analysis. Results : 1. Among 30 patients, women were 19(63.3%), men were 11(36.7%). The mean age of the patients were 27.3 years old, patients between the ages of 17 and 30 years were 23, over 30 were seven. 2. The mean score of Objective SCORAD was $32.89{\pm}7.30$, Subjective SCORAD was $8.13{\pm}3.53$ and EASI was $9.15{\pm}6.90$이었다. 3. The mean score of Skindex-29 was $28.26{\pm}7.58$, DLQI was $10.17{\pm}5.55$. 4. By analyzing the questionnaire, a monthly average cost of 583,200 won for each patient was determined. Direct cost was 236,800 won and indirect cost was 346,300 won. 5. By analyzing the correlation between the severity of AD and QOL, Objective SCORAD and EASI were positively correlated with QOL(Skindex-29, DLQI) but not significant, meanwhile subjective SCORAD were significantly and positively correlated with QOL(Skindex-29, DLQI). 6. By analyzing the correlation between the severity of AD and economic impact, Objective SCORAD were significantly and positively correlated with direct cost and indirect cost. Also, EASI were significantly and positively correlated with direct cost and oriental medical hospital visits. Conclusions : The above results show that the QOL of the patients with atopic dermatitis is significantly related to their disease severity. Atopic dermatitis patients pay 583,200 won a month, and the economic impact of the patients is significantly related to their disease severity.

• Journal of Physiology & Pathology in Korean Medicine
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• v.35 no.3
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• pp.104-116
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• 2021

In order to reduce the social and economic costs due to the increase in dementia patients, which is a representative senile disease in an aging society, it will be important to prevent dementia and to detect and treat early in high-risk groups. This study reported the results of treatment for the elderly with high risk of dementia and depression who received Korean medicine (KM) treatment in 9 KM clinics. Medical charts were surveyed on 116 patients with high risk of dementia and depression who received KM treatment at 9 KM clinics in Gangseo-gu from September 1, 2020 to December 31, 2020. The majority of the patients were female(76.72%), the average age was 71.66±7.18 years old, and the average education level was 8.96±3.91 years. The average treatment period was 61.47±10.30 days, the average number of treatments was 15.38±1.06 times, and both acupuncture and herbal medicine were administered. After receiving KM treatment, cognitive assessment scores such as MMSE-DS and MoCA-K, depression-related GDSSF-K score, dementia knowledge, attitude, and preventive behavior, blood debilitation scale, and GQOL-D score were improved compared to before. There was no specific adverse reaction except that one patient with elevated AST and ALT levels was observed. This study showed improvement in cognitive function, depression, dementia-related scale, and quality of life in high-risk groups for dementia and depression over 60 years old who received KM treatment. More systematic and large-scale planned clinical studies will be needed.

• Journal of the Korea Convergence Society
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• v.12 no.5
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• pp.373-383
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• 2021

Our society is aging rapidly. In this super-aged society, the increase in healthcare costs are considered a national problem that undermines the sustainability of social security. Various services for healthcare for the elderly have been promoted to address this. However, most of them have focused on healthcare after the outbreak of chronic diseases and lack preventive healthcare. Most of the preventive healthcare projects are only pilots. In this paper, the current status of health care services for senior citizens at home and abroad was analyzed and based on this, the limitations and improvements were analyzed to propose the establishment of IoT-based Total Silver Care Center. IoT-based Total Silver Care Center may be conveniently monitored the health status of the elderly through various sensors, medical devices, and smart bands. And based on this, it can improve the quality of nursing services through time-saving and work efficiency of nursing providers. In addition, health care interventions may be provided in a timely manner if there is a change in the health status of users. And real-time imaging systems can help overcome mental difficulties.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.398-406
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• 2018

Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

• Journal of the Korean BIBLIA Society for library and Information Science
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• v.30 no.2
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• pp.117-144
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• 2019

Today, interest in health information has risen overall due to the aging society, increased public interest in the quality of life, and the increased state's interest in reducing medical costs. Accordingly, efforts have been made across the library and information science in terms of academic research, libraries in terms of providing health specialized services, and the state, yet policies and strategies for providing the health related information in an integrated and systematic manner through the libraries have not been proposed with clarity to date. Thus, this study aimed to propose a method to provide the health information in an integrated manner by the libraries through the previous studies, policy studies, and case studies. Consequently, it proposes to build a system to integrate the health information, build an overall database of the health related information, develop and operate a health specialized library program, operate a general support center for the health information service, and build a cooperative network among the related departments and institutions for the health information service. The details proposed by this study is likely to contribute to developing services for improving the health of the citizens of this country.