• The Korean Journal of Pain
• /
• 제12권1호
• /
• pp.101-107
• /
• 1999

Background : In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods : We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results : Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alterative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients' suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions : Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.

• 대한한의학회지
• /
• 제31권2호
• /
• pp.124-136
• /
• 2010

Objective:: This study aimed to examine the customers' utilization of and satisfaction with oriental medical clinics in South Korea. Method: The data for this study were collected from 1,208 patients of 391 oriental medical clinics through a mail questionnaire survey from September to December 2008. The collected data were analyzed by the frequency analysis and $X^2$-test. Results: The results of the study were as follows. First, the most important reason that patients used oriental medical services was to get both oriental and western medical services simultaneously, because they thought such approach would be more effective for treating their diseases. Second, two important reasons that patients visited oriental medical clinics were "the reputation of and trust in the oriental medical clinics" and "the recommendation of their family and friends". Third, many patients of the oriental medical clinics have concerns about the "high prices and the outcome of oriental medical services". Fourth, the most preferred oriental medical service was "acupuncture". Fifth, it was found that 75% of the respondents were satisfied with the services they had received. They told that the outcome of the care and the kindness of the clinics' staff were very important factors that have an impact on their satisfaction. Conclusion: The study results imply that oriental medical clinics have to make an effort to strengthen their reputation and trust in the community through the scientific validation of oriental medicine, differentiated services mixed with traditional value, customer relationship management, reasonable and acceptable price of the services, staff education, and continuous quality improvement.

• 농촌의학ㆍ지역보건
• /
• 제21권2호
• /
• pp.231-241
• /
• 1996

The estimation of medical care status and the planning of health service program should be done according to each community resident's socio-medical background and public health service. In this point, it is most necessary to be set the exact and new socio-economic statistics data in Nepal, one of the worst countries in national health status. We surveyed 668 house, 3,425 residents in Dolka area, Nepal from January 25th to February 1st, 1995. 1. In personal characteristics, the ratio of men and women was similar, the person who were below 19 years old were 28.1% and the single were 52.4%. The illeterate person were 50.3% and the lower group in economic status which had been estimated by interviewers were 46.9%. 2. In sanitational characteristics, the person who used stream water or rainwater to drink were 42.2% and the person who always boiled water to drink were only 8.3%. The person who had not toilet in their house were 67.3% and the lower group in sanitational status which had been estimated by interviewers were 61.8%. 3. The prevalence rate of illness during the last one month were 8.6% and the chronic were 26.1% and the acute were 72.5%. The distribution of sickness symptom were headache, fever and joint pain in order and the person who took no medical treatment among the sick were 37.0%. The patterns of medical utilization were public health center, hospital and pharmacy in order. 4. Illness prevalence was significantly related to sex, age, merital status and educational experience. The residents who were women, 40 years old or more, married and had not educational experience were apt to take illness. 5. Medical utilization was significantly related to educational experience, job, distance from home to medical facilities and economic status. The person who had educational experience, were officer workers or merchants, lived near by medical facilities and had higher economic status took medical treatment very well.

• 보건교육건강증진학회지
• /
• 제28권1호
• /
• pp.81-92
• /
• 2011

Objectives: The purpose of this study is to evaluate the influence of depression symptom on the self-rated health status(SRHS), the outpatient health service utilization and quality of life(QOL) also the relationship depression symptom with socio-demographic and health related factors. Methods: We selected 9,550 participants without chronic diseases from a total of 18,104 in the '2009 community health survey in Gyeongnam. They were assessed by using a Korean version of the Center for Epidemiological Studies-Depression Scale(CES-D). Those with CES-D scores of 21 or greater were defined as having probable depression. Results: A probable depression were associated in bivariate analysis with gender, age, educational status, monthly household income, marital status, current smoking status, drinking habit, physical activities and body mass index. After adjustment for covariates, probable depression groups predicted a lower status in SRHS. Likewise probable depression groups predicted a higher utilization in outpatient health service. Also probable depression groups predicted a lower score in QOL. Conclusions: Probable depression influence SRHS, outpatient health service utilization and QOL even after adjusting for the socio-demographic, health related factors and chronic medical illness. Programs for prevention and management of depression will be helpful to promote health and QOL.

• 한국콘텐츠학회논문지
• /
• 제17권5호
• /
• pp.366-375
• /
• 2017

본 연구는 의료급여환자와 가족 3인, 요양병원에 4년 이상 근무한 경험이 있는 종사자 5인에 대한 심층면접조사를 통하여 도덕적해이가 우려되고 있는 의료급여환자의 요양병원 이용과정과 입원, 의료서비스, 퇴원과 전원 등에 대하여 분석하였다. 주요 분석결과와 함의는 다음과 같다. 첫째, 요양병원 입원은 의료급여환자의 선택보다는 의료기관간의 연계와 유치를 위한 경쟁적 홍보에 의해서 이루어지고 있었다. 둘째, 의료급여환자의 요양병원 장기입원의 원인은 본인부담이 적어서 도덕적 해이를 유발할 수도 있었지만 거주지 부재, 간병인 부재 등 퇴원 후 사회적인 보호수단이 없는 것도 주요 원인이었다. 셋째, 대다수 의료급여환자들이 치료가 필요한 상태이지만, 건강보험환자에 비해 필요성이 높지 않음에도 입원을 유지하는 경우가 있었다. 넷째, 요양병원의 의료서비스는 재활서비스가 주를 이루고 있으며, 간호인력과 간병인의 역할이 중요하였다. 다섯째, 의료급여환자들은 요양병원 의료비를 수급비와 가족지원 등으로 부담하고 있지만, 일부 환자들은 병원에서 간병비나 본인부담을 면제 혹은 감면받고 있었다. 여섯째, 공공기관과 사회복지기관은 요양병원에 환자를 의뢰한 이후 지속적인 관리를 하지 않고 있으며, 퇴원 후 지역사회서비스 연계가 필요한 것으로 나타났다.

• 농촌의학ㆍ지역보건
• /
• 제25권2호
• /
• pp.413-425
• /
• 2000

1. 도시지역과 농촌지역의 특성과 각 주민들의 요구를 고려한 서비스를 제공하여야 한다. 도시지역 주민의 경우 보건소의 업무 중에서 질병예방이 우선이라고 하였으며 농촌지역 주민들의 진료 서비스가 우선이라고 하였다(부표 1 참조). 2. 보건소의 역할에 대한 중요성을 재인식할 뿐만 아니라 지역사회 정보화에 맞추어 지역의료체계의 핵심적인 중추기관으로서의 기능을 재정립해야 한다. 따라서 순천시 역시 주민의 보건소에 대한 의존도가 상당히 높다는 것을 감안하여 보건소에서 지역주민이 원하는 정보화 서비스를 구체적으로 파악하여 지역보건의료 서비스의 정보화에 관련된 계획을 수립하는데 이 연구의 결과를 기초로 삼아야 한다(부표 2와 부표 3 참조).

• 융합정보논문지
• /
• 제9권2호
• /
• pp.1-6
• /
• 2019

본 논문에서는 의료용 빅 데이터를 활용하여 비즈니스와 연계하여 새로운 서비스를 창출하기 위한 프레임 워크를 설계하였다. 단순한 데이터 분석 단계를 나타내는 것이 아니라 데이터의 활용 목적을 명확히 하고, 이에 대한 분석을 수행하여 그 속에서 가치를 추출하고 실제 사업이나 서비스를 운용할 때까지의 과정을 설계한다. 설계된 프레임워크는 기본 아키텍처, 사회 시스템 모델까지 커버할 수 있도록 하였다. 설계된 프레임 워크를 참조하여 사회 시스템에 적용될 수 있도록 디자인하였으며, 기본 데이터로는 의료용 빅 데이터를 중심으로 하였다. 의료용 기본 데이터를 적용한 프레임 워크 설계로 여러 의료용 사업 제휴 및 서비스 창출을 실현할 수 있을 것으로 기대하고 있다.

• 대한한의학회지
• /
• 제36권3호
• /
• pp.98-110
• /
• 2015

Objectives: The purpose of this study was to analyze the medical cost of facial paralysis in payer perspective and to estimate the practice pattern of patient using 2011 Health Insurance Review & Assessment Service-National Patients Sample(HIRA-NPS). Methods: Basic statistical system was used for descriptive analysis of NPS dataset. A table for general information (table20) was extracted by disease code, and social demographic characteristics, distribution of the use among inpatients and outpatients, utilization of each kind of medical care institutions, medical cost were analyzed. Subgroup analysis was conducted for assuming the practice pattern of korean medicine and western medicine. Results: A total of 8,219 people and 64,345 claims data were identified as having facial paralysis. Proportion of outpatient was 95.23%, inpatient 0.84% and patient using both services 3.93%. Mean patient charges was 44,229 won per outpatient, 178,886 won per inpatient and 523,542 won per patient using both services. Utilization of korean medical care institutions was 68.81%(claims), 40.46%(patients), utilization of western medical care institutions was 31.19%(claims), 59.54%(patients). The amount charged by korean medical care institutions was 52.61% and western medical care institutions was 47.39%. Cost per claim was higher than those of the korean treatment and cost per patient of western treatment was lower than those of the korean treatment. Conclusions: The research assessed the medical cost and practice pattern associated with facial paralysis. These findings could be used in health care policy and subsequent studies.

• 한국임상약학회지
• /
• 제31권2호
• /
• pp.153-159
• /
• 2021

Background: With increasing economic evaluation studies on the treatment of or screening tools for liver diseases that cause hepatocellular carcinoma (HCC), interest in the analysis of the medical utilization and costs of HCC treatment is increasing. Therefore, we aimed to estimate the medical utilization and costs of HCC patients, and calculate the cost of main procedures for HCC treatment, including liver transplant (LT), hepatic resection (HR), radiofrequency ablation (RFA), and transarterial chemoembolization (TACE). Methods: We analyzed claim data from January to December 2018 from the Health Insurance and Review and Assessment Service-National Patient Sample (HIRA-NPS-2018) dataset, including data of patients diagnosed with HCC (Korean Standard Classification of Diseases code C22.0) who had at least one inpatient claim for HCC. Results: A total of 715 HCC patients were identified. In 2018, the yearly average medical cost per HCC patient was ₩18,460K (thousand), of which ₩14,870K was attributed to HCC. Among the total medical costs of HCC patients, the inpatient cost accounted for the largest portion of both the total medical and HCC-related costs. The major procedures of HCC treatment occurred most frequently in the order of TACE, RFA, HR, and LT. The average medical cost per treatment episode was the highest for LT (₩87,280K), followed by HR (₩10,026K), TACE (₩4,047K), and RFA (₩2,927K). Conclusion: By identifying the medical costs of HCC patients and the costs of the main procedures of HCC treatment, our results provide basic information that could be utilized for cost estimation in liver disease-related economic evaluation studies.

• 품질경영학회지
• /
• 제41권4호
• /
• pp.555-566
• /
• 2013

Purpose: The purpose of this study is to develop innovation index of hospital service integrating 6 sigma and SERVQUAL. Methods: This study used DMA(Define, Measure and Analysis) from 6 sigma and 5 Factors from SEVQUAL. To test data, chi-squire text, association analysis and behavior analysis was conducted. Results: This study indicated the management index through CTQ (Critical to Quality) and Chosen few X using 6 sigma process. Finally, And this study developed 5 Factors; Equipment Utilization in Tangibility, Ratio of Patients/Disease/Behavior/Treatment in Reliability, Survival RAte, Canselation Rate of Reservation, Churn Rate, Interval of Treatment and Confidence in Responsiveness, Frequency of Patients/Disease/Behavior/Treatment in Assurance and Contrast to Best Department/Best Doctor/Best Doctor in Faculty/Average of Mine in Empathy. Conclusion: This study developed innovation index of hospital service. Managing this index, hospital is able to achieve the decline of total treatment cycle, adjustment of patients behavior and increase of equipment utilization. Ultimately, hospital is able to accomplish innovation of healthcare service.