• Title/Summary/Keyword: Medical Service Management

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A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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A Study in an Effective Programs for Emergency Care Delivery System (응급의료 전달체계의 충실 방안)

  • Kwon Sook Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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The Clinical Study of Hemoptysis in Lung Disease (객혈을 주소로 입원한 환자의 임상적 고찰)

  • Lee, Hyang-Ju;Um, Hye-Suk;Kim, Jung-Tae;Cho, Dong-Ill;Rhu, Nam-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.6
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    • pp.760-773
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    • 2000
  • Background : Hemoptysis is a common clinical symptom responsible for 11% of admission to the hospital chest service. In KOREA pulmonary tuberculosis is still the most common cause of hemoptysis and the incidence of hemoptysis due to neoplasia has increased. Bronchoscopy and high resonance CT are essential for diagnosis of the cause of hemoptysis. We studied the causes, diagnostic tools and treament treatment of hemoptysis Methods : We conducted a retrospective analysis of clinical profiles, radiologic and bronchoscopy findings and treatments of hemoptysis for 220 patients who were admitted to our hospital with hemoptysis between 1994 and 1998. Results : The mean age at diagnosis was 49.3 years and male to female ratio was 2.1 : 1. The main causes were active pulmonary pulmonary tuberculosis in 72 cases(32.7%), inactive pulmonary tuberculosis with sequlae in 69 cases(31.4%) lung cancer in 43 cases(19.5%), bronchiectasis in 10 cases(4.5%), and chronic bronchitis in 10 cases(4.5%). The mean amount of hemoptysis for 24hrs was 120cc. The mean duration of bleeding was 25 days. The number of cases with a past history of pulmonary tuberculosis were 128 cases, in which 24 were relapsed tuberculosis cases, 25 chronic tuberculosis cases, 69 inactive tuberculosis cases, and 10 lung cancer cases. High resonance CT was the most useful method for structural etiologic evaluation of hemoptysis developed in patients with inactive tuberculosis, bronchiectasis and aspergilloma. Sputum study and bronchofiberscopy were the confirmative diagnostic tools for active pulmonary tuberculosis and lung cancer. The treatments of hemoptysis medical in 152 cases(71.7%), bronchial arteη embolization in 39 cases(17.8%), and operation in 9 cases(4.0%). The mean following up duration was 22.4 months. The overall outcomes of hemoptysis were controlled in 77 cases(43.5%), rebleeding in 100 cases (56.5%) and expired in 9 cases (4.0%). The outcomes of hemoptysis in pulmonary tuberculosis were controlled in 21.6%, rebleeding in 78.4%, and expire in 14.7%. Conculsion : The most common cause of hemoptysis was related with pulmonary tuberculosis. HRCT was an important diagnostic tool in AFB smear negative active pulmonary tuberculosis and inactive tuberculosis with sequelae. Early, proper management of pulmonary tuberculosis is important for prevention of hemoptysis in Korea.

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Factors Affecting the Negative Perception of Public Hospitals among Local Residents (지역 주민의 공공병원에 대한 부정적 인식에 영향을 미치는 요인)

  • Eun Hye Choi;Jung Hee Cho;Kyoung Eun Yeob;Bo Hui Park;So Young Kim;Jong Hyock Park
    • Health Policy and Management
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    • v.34 no.2
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    • pp.211-221
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    • 2024
  • Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.

A Study on the Effects of Medical service facilities Location strategy on the Customer's Satisfaction : Focused on Mediation Effect of the Location's Marketability (의료서비스시설 입지전략이 고객만족에 미치는 영향 : 입지시장성의 매개효과를 중심으로)

  • Kim, Duck-Ki
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.2
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    • pp.530-547
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    • 2018
  • This study examines the importance of location and transportation in the operation of small- and medium-sized hospitals in the rapidly changing clinical environment. Approximately 350 persons were surveyed for approximately 40 days from July-August 2017, and responses were analyzed using SPSS and AMOS Statistical Package for 335 parts excluding 8 parts of 343.The main research results were as follows: First, a hypothesis was adopted that the attractiveness of building materials will positively affect customer satisfaction. Second, the hypothesis that transport infrastructure has a significant impact on customer satisfaction was rejected. Third, the hypothesis that the building appeal will positively affect the site was supported. Fourth, the hypothesis that transport infrastructure will have a significant impact on location marketability was supported. Fifth, the hypothesis that location marketability will significantly impact customer satisfaction was supported. Sixth, the hypothesis that the relationship between the site and customer satisfaction with the relationship between the client and the client is explained is partly attributable to the fact that there is a partial function. The assumption that the relationship between traffic infrastructure and customer satisfaction was confirmed. The hypothesis that the relationship between traffic infrastructure and customer satisfaction was supported. This research focuses on small- and medium-sized hospitals located in Seoul, which does not include the recognition of patients' awareness of the location and transportation of small- and medium-sized hospitals. Moreover, this study has the limitation in analyzing patient satisfaction, rather than the objective data of the financial management performance of the hospital. The results of this study could provide the basis for selecting the future locations of health care facilities.

The Effect of Salesperson Control System on Customer-oriented Selling Behaviors and Sales Performance in Pharmaceutical Distribution Channel (제약유통채널에서 영업사원에 대한 통제시스템이 고객지향적 판매와 영업성과에 미치는 영향)

  • Jung, Yeon-Sung;Hong, Geum-Pyo;Yi, Ho-Taek
    • Journal of Distribution Science
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    • v.15 no.1
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    • pp.105-114
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    • 2017
  • Purpose - Recently, domestic pharmaceutical market is growing steadily, but top-tier companies are concentrating on sales growth. In this market, SMEs, which account for more than 80% of the entire market, suffer from the problem of lower margins and increasing inventory costs. According to the government's policy changes related to pharmaceuticals, it is pointed out that the management of existing customers and the control of salespeople are important issues for pharmaceutical companies. This study investigates the effect of the control system on the salesperson in domestic pharmaceutical distribution channel on customer-oriented selling behaviors and sales performance. Research design, data, and methodology - To verify the proposed research model and test hypotheses, the authors selected 244 MR(medical representatives)'s responses which have currently relationship with doctors or pharmacists. This study carefully investigated the reliability, content validity, convergent validity, and discriminant validity of the proposed model. Results - The authors find out the following results: capacity control, activity control, and self control have positive effects on customer-oriented selling behaviors and customer-oriented selling behaviors have a positive effect on sales performance. In addition, we present alternative model to check the direct effect between the control systems and the sales performance, but control system factors except self control have no direct influence. Conclusions - First of all, competency control and activity control increases the customer-oriented selling behavior of the salesperson. This means that the salesperson's sales skill, negotiation skill, customer access skill, presentation ability, monitoring, direction and evaluation are important and it is also important to control activities to check the number of visits to customers, report preparation, and customer service etiquette. Second, the fact that self-control of salesperson affects the customer-oriented selling behavior suggests that self-control is not controlled by external factors but rather establishes short/long-term goals. Therefore, it is important for sales organization to create an environment in which members can induce persistent incentives for self-control. Finally, output control did not affect customer-oriented sales behavior, which is less likely to form confidence or motivation to MRs when output control is perceived as a means of monitoring, supervising, or controlling rather than providing information to salespeople.

Model Development of Nursing Care System for Women's Health : Based on Nurse-Midwifery Clinic (여성의 건강을 위한 간호전달체계 모형개발 - 조산원 중심으로 -)

  • Park, Yeong-Suk
    • Women's Health Nursing
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    • v.5 no.1
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    • pp.133-145
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    • 1999
  • The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

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A Study on Unmet Dementia Information of Dementia Caregiver Using Dementia Relief Center and Program Effect Recognition of Workers (치매안심센터 이용 보호자의 미충족 치매정보와 종사자의 프로그램 효과성 인식에 관한 연구)

  • Kim, In-Ok;Koh, Myung-Suk
    • Journal of Convergence for Information Technology
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    • v.10 no.5
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    • pp.75-82
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    • 2020
  • This study is a descriptive research study to identify Unmet Dementia Information Needs (UDIN) for caregivers of dementia patients at Dementia Relief Center and to understand the effectiveness of the program for workers. The subjects were 114 caregivers and 217 practitioners from dementia relief centers in 25 autonomous districts of S city from November 1, 2019 to January 31, 2020. The UDIN questionnaire is a 7-point Likert scale. The Crisis Management Questionnaire is a Likert 5-point scale consisting of 10 questions from 6 categories. As a result of the study, the proportion of depressed caregivers experiencing UDIN was 12.3times higher than those who did not (p<.001). The program effectiveness was 8.98times better than those who perceived the lack of risk management as good (p=.004), and social workers were 2.81times better than nurses (p=.091). It is necessary to conduct interactive operations to meet the needs of the community residents by listening to their diverse opinions rather than simply implementing a one-sided policy to raise the service of a dementia relief center to the highest level in a short period of time.

Clinical Analysis of Death in Trauma Patients (외상으로 인한 사망 환자의 임상적 분석)

  • Kim, Whan Sik;Cho, Min Su;Bae, Keum Seok;Kang, Seong Joon;Lee, Kang Hyun;Hwang, Keum;Oh, Jin Rok;Park, Il Hwan
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.96-100
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    • 2007
  • Purpose: Trauma is the 5th most common leading cause of death in Korea, but there has been no appropriate management system for patients until now. We analyzed the main causes of death in trauma patients by comparing the characteristics of those patients with the characteristics of patients who survived. We feel this analysis should have a positive effect on the development of an appropriate trauma management system in Korea. Methods: We retrospectively reviewed trauma patients who had been admitted to the Department of General Surgery from February 2002 to February 2007. We compared several expected risk factors between the mortality and the survival group. Data on the transportation, arrival time at the emergency center, amount of transfusion, initial shock index, cause of death, and initial physical condition according to RTS (Revised trauma score), ISS (Injury severity score) and TRISS (Trauma and Injury Severity Score) were collected. Patients with ISS lower than 12 were excluded. Results: Three hundred sixty-six(366) patients with multiple injuries were included. There were 40 patients in the mortality group and 326 patients in the survival group. The mean arrival time (minutes) to emergency center was longer in the mortality group (137.6 vs 93.6 p 0.04). The total amount of transfusion (ml) was larger in the mortality group (7139 vs 2470 p 0.01). The initial shock index was higher in the mortality group (1.45 vs 1.17 p<0.01). The RTS, ISS, and TRISS were not statistically different between the groups. In the multivariate analysis, mean arrival time and initial shock index were important factors for survival. Conclusion: If the mortality rate of trauma patients is to be reduced, the arrival time at the emergency center should be minimized. Improvement of the emergency medical transfer service system is very important for achieving that.

Application and Policy Direction of Blockchain in Logistics and Distribution Industry (물류 및 유통산업의 블록체인 활용과 정책 방향)

  • Kim, Ki-Heung;Shim, Jae-Hyun
    • The Journal of Industrial Distribution & Business
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    • v.9 no.6
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    • pp.77-85
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    • 2018
  • Purpose - The purpose of this study is to subdivide trade transaction-centered structure in a logistics/distribution industry system to apply blockchain, to establish and resolve with which types of technology, and to provide policy direction of government institution and technology to apply blockchain in this kind of industry. Research design, data, and methodology - This study was conducted with previous researches centered on cases applied in various industry sectors on the basis of blockchain technology. Results - General fields of blockchain application include digital contents distribution, IoT platform, e-Commerce, real-estate transaction, decentralized app. development(storage), certification service, smart contract, P2P network infrastructure, publication/storage of public documents, smart voting, money exchange, payment/settlement, banking security platform, actual asset storage, stock transaction and crowd funding. Blockchain is being applied in various fields home and abroad and its application cases can be explained in the banking industry, public sector, e-Commerce, medical industry, distribution and supply chain management, copyright protection. As examined in the blockchain application cases, it is expected to establish blockchain that can secure safety through distributed ledger in trade transaction because blockchain is established and applied in various sectors of industries home and abroad. Parties concerned of trade transaction can secure visibility even in interrupted specific section when they provide it as a base for distributed ledger application in trade and establish trade transaction model by applying blockchain. In case of interrupted specific section by using distributed ledger, blockchain model of trade transaction needs to be formed to make it possible for parties concerned involved in trade transaction to secure visibility and real-time tracking. Additionally, management should be possible from the time of contract until payment, freight transfer to buyers through land, air and maritime transportation. Conclusions - In order to boost blockchain-based logistics/distribution industry, the government, institutionally, needs to back up adding legal plan of shipping, logistics and distribution, reviewing standardization of electronic switching system and coming up with blockchain-based industrial road maps. In addition, the government, technologically, has to support R&D for integration with other high technology, standardization of distribution industry's blockchain technology and manpower training to expand technology development.