• Title/Summary/Keyword: Medical Services Value

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Factors affecting the turnover intention of hospital employees by job category (병원직종별 이직의도에 관련된 영향요인)

  • Kim, Young-Bae;Kim, Won-Joong;Hwang, In-Kyung;Lee, Key-Hyo;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.4 no.1
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    • pp.21-40
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    • 1999
  • This study attempts to analyze the relationship between various job-related factors and the intent to turnover of employees working at different types of hospitals/clinics in urban and rural areas. The data was compiled from 1,506 employees in 21 hospitals and 10 clinics located in Kyung-gi Do. Korea, using a self-administered questionnaire. Major findings are as follows: 1) The intent to turnover was higher for the employees of small hospitals located in rural areas. It was also higher when the employees were less than 30 in age, female, single, had not received college education, and had worked for 2-5 years in their hospitals. 2) An important factor affecting the intent to turnover was job satisfaction, which in turn had a strong correlation with the job itself(opportunity of utilizing abilities and skills, subjective value attached to the current job, sense of accomplishment) and had a rather weak correlation with salary, supervision, promotion and co-worker relationship. 3) In the analysis by job category, it was found that, besides job satisfaction, the intent to turnover was significantly affected by the job itself in case of administrative personnel and by the level of salary in case of nurses. 4) For a successful management of turnover, hospitals need to develop (a) programs for improving adaptive abilities of 'new' employees(who have worked for less than 2 years), and (b) for the other employees(who have worked for more than 2 years), strategies for enhancing job satisfaction by providing the environment where they can show their maximum abilities.

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Clinical application of chromosomal microarray for pathogenic genomic imbalance in fetuses with increased nuchal translucency but normal karyotype

  • Lee, Dongsook;Go, Sanghee;Na, Sohyun;Park, Surim;Ma, Jinyoung;Hwang, Doyeong
    • Journal of Genetic Medicine
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    • v.17 no.1
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    • pp.21-26
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    • 2020
  • Purpose: To evaluate the additive value of prenatal chromosomal microarray analysis (CMA) in assessing increased nuchal translucency (NT) (≥3.5 mm) with normal karyotype and the possibility of detecting clinically significant genomic imbalance, based on specific indications. Materials and Methods: Invasive samples from 494 pregnancies with NT ≥3.5 mm, obtained from the Research Center of Fertility & Genetics of Hamchoon Women's Clinic between January 2019 and February 2020, were included in this study and CMA was performed in addition to a standard karyotype. Results: In total, 494 cases were subjected to both karyotype and CMA analyses. Among these, 199 cases of aneuploidy were excluded. CMA was performed on the remaining 295 cases (59.7%), which showed normal (231/295, 78.3%) or non-significant copy number variation (CNV), such as benign CNV or variants of uncertain clinical significance likely benign (53/295, 18.0%). Clinically significant CNVs were detected in 11 cases (11/295, 3.7%). Conclusion: Prenatal CMA resulted in a 3% to 4% higher CNV diagnosis rate in fetuses exhibiting increased NT (≥3.5 mm) without other ultrasound detected anomalies and normal karyotype. Therefore, we suggest using high resolution, non- targeting CMA to provide valuable additional information for prenatal diagnosis. Further, we recommend that a genetics specialist should be consulted to interpret the information appropriately and provide counseling and follow-up services after prenatal CMA.

Interior Location Services Based Emergency Call System (실내 위치 서비스 기반 긴급 호출 시스템)

  • Kim, Doan;Kim, Yongkuk;Jung, Hoekyung
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.23 no.2
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    • pp.149-155
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    • 2019
  • In this paper, we propose an emergency call system which makes a call to an institution or a guardian when an urgent case occurs to a user based on the indoor location service. In addition, it establishes indoor location service infrastructure assuming welfare institutions and hospitals. The proposed system receives the sensor value from the device that is in the form of a clock on the wrist and determines the emergency situation and delivers emergency information to the terminal. The location terminal transmits location and emergency information to the server, and the server accesses the database and stores the data. This enables the caregiver to communicate with the server through the application, monitor the user's status, receive notifications, and respond to emergency situations by using the emergency call function. If the proposed system is applied to the fields requiring urgent action such as medical field and welfare field, it will provide more stable and prompt emergency service to users and carers.

A Study of the Ethical Values of EMT students (응급구조과 학생의 윤리적 가치관에 관한 연구)

  • Kim, Mi-Seon
    • The Korean Journal of Emergency Medical Services
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    • v.5 no.1
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    • pp.37-51
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    • 2001
  • This study is aimed at examining the ethical values of EMT students. The results below are based on the revised questionnaires, which can be applicable to EMT from the original questionnaires developed by Lee(1990), with a sample of 124 students consisting of 63 first and 61 second year students, conducted November 2-8, 2001. Data were analyzed using SPSS in terms of means, standard deviations, t-test, ANOVA, Pearson's correlation coefficient. The results are as follows: 1. In the area of Human life, all subjects showed utilitarian disposition. All respondents perceived the item "When patients recognizing there is no hope for survival ask for euthanasia, it is ethically right to accommodate their opinions." as the most utilitarian item, whereas they perceived the item "When an hopeless patient is on cardiac arrest, it is ethically right to do CPR as the most deontoogical item. 2. In the area of patient relationship, all students of two groups took on deontoogical characteristics, but there were no statistically significant differences between two groups. All students perceived an item "EMT have to keep it secret if patients disclose their suicide intentions and ask for absolute secrecy" the most utilitarian item, whereas they perceived an item "Even though patients act and speak in a very rude manner, EMT people should do their best to provide care for patients." as the most deontoogical item. 3. In the area of task relationship, first year students perceived an item "Given time limitations, it is ethically right to give priority to the patients who can be rehabilitated over the patients who can't be fully recovered." as the most utilitarian item, whereas second year students perceived an item "Under no circumstances should any placebo be administered to patients." as the most utilitarian item. All students perceived an item "When EMT students see an unconscious person lying in the street, they have to give him/her emergency treatment." as the most deontoogical item. 4. In the area of coworker relationship, all students of two groups took on deontoogical disposition, but there were no significant differences between two groups. All students of two groups perceived an item "Suppose you are regarded as the person who would be promoted. However, you think that your coworker is more competent than you. In that case you should tell your supervisor about your coworker." as the most utilitarian item. First year students perceived an item, whereas second year students perceived an item "When you observe coworkers' misconduct at work, it is ethically right to ignore their misdeeds." as the most deontoogical item. 5. This study demonstrated that for the first year students, there is a correlational relationship between areas of human life and task relationship, and between areas of task relationship and coworker relationship, whereas for the second year students, there is a correlational relationship between areas of human life and task relationship. 6. In areas of human life and task relationship, there are significant differences according to attitudes toward EMT and attendance at ethics training sessions. In the area of coworker relationship, there are significant differences according to religion, attendance at ethics training sessions, and a code of ethics. Recommendations for future research, 1. Sample items to measure ethical values and the instrument tailored to the needs of EMT should be developed. 2. A longitudinal study to track ethical value changes according to the amount of work experience is needed. 3. A code of ethics and/or ethics training, which could apply in actual situations, should be implemented.

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Roles of Cancer Registries in Enhancing Oncology Drug Access in the Asia-Pacific Region

  • Soon, Swee-Sung;Lim, Hwee-Yong;Lopes, Gilberto;Ahn, Jeonghoon;Hu, Min;Ibrahim, Hishamshah Mohd;Jha, Anand;Ko, Bor-Sheng;Lee, Pak Wai;MacDonell, Diana;Sirachainan, Ekaphop;Wee, Hwee-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.4
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    • pp.2159-2165
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    • 2013
  • Cancer registries help to establish and maintain cancer incidence reporting system, serve as a resource for investigation of cancer and its causes, and provide information for planning and evaluation of preventive and control programs. However, their wider role in directly enhancing oncology drug access has not been fully explored. We examined the value of cancer registries in oncology drug access in the Asia-Pacific region on three levels: (1) specific registry variable types; (2) macroscopic strategies on the national level; and (3) a regional cancer registry network. Using literature search and proceedings from an expert forum, this paper covers recent cancer registry developments in eight economies in the Asia-Pacific region - Australia, China, Hong Kong, Malaysia, Singapore, South Korea, Taiwan, and Thailand - and the ways they can contribute to oncology drug access. Specific registry variables relating to demographics, tumor characteristics, initial treatment plans, prognostic markers, risk factors, and mortality help to anticipate drug needs, identify high-priority research area and design access programs. On a national level, linking registry data with clinical, drug safety, financial, or drug utilization databases allows analyses of associations between utilization and outcomes. Concurrent efforts should also be channeled into developing and implementing data integrity and stewardship policies, and providing clear avenues to make data available. Less mature registry systems can employ modeling techniques and ad-hoc surveys while increasing coverage. Beyond local settings, a cancer registry network for the Asia-Pacific region would offer cross-learning and research opportunities that can exert leverage through the experiences and capabilities of a highly diverse region.

A Study on Mental Health of Single Aged Persons in Home Perceived by Daughter-in-law (재가 독신노인을 부양하는 주부가 인지하는 노인의 정신건강에 관한 연구)

  • Yun Suk-Rye
    • Journal of Korean Public Health Nursing
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    • v.7 no.1
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    • pp.31-48
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    • 1993
  • Nowaday, there have a lot of changes in the demands of the aged persons. Their problems also came to the fore with diverse forms under the influences of industrialization, urbanization and nuclear family. To make the matter worse, the aged population is mounting rapidly. Also, such structure as nuclear family is widely disseminating uncomfortable to the aged. People is mainly being guided by self interest above everything else. Indeed, they had, all together, bad effects on our traditional value system regarding 'respect for the aged and devotion to patients'. It seems unfortunately obvious that the family responsibility is gradually weakening to support the old who is a dependent family. The result is that the aged must have suffered all sorts of hardships in lightenning psychological, physical and economical difficulties. First, to grasp the situations and conditions supporting for single aged persons from each view of psychological, emotional, family-relational, healthy, social and economical standpoints, and second, to analyze their own recognition levels thinking of their health conditions and the relationships between the supporting environments of old family dependants and their psychological healths and then finally, to propose suggestions being able to be helpful for living comfortably in an old age and thereby, building up good family relation. The statistical techniques used to analyze 115 respondents living in Puchun city are frequency, $x^2$ test, t-Jest, ANOVA, Pearson's Correlation Coefficiency and Regression analysis (SPSS package), pertnent to prove the hypothesis suggested in this paper. Of course, it is needless to say that more data are needed on this point. However, several main research findings can be summarized as follows: First, the better single aged persons may be in the habit of eating a meal and the higher they may think of their physical health conditions and movement, the more they want to participate in economic activities to be free from economical dependence upon their children and to overcome lonliness. Second, single aged women appear to have had higher ability to take care their health for themself than single aged men do. It is why signle aged women do not, in general, have big problems to manage their health. But, as shown in this paper, single aged person"s were more liable to the diseases of the aged and, thereby, requiring special medical treatment badly to be healthy. Third. single aged persons revealed potential desires to free themself from socio economic dependence upon their children even in simple labor Job which can draw a monthly salary of about W200, 000. Fourth, they are generally satisfied with their children's filial piety toward them. Nonethless, most of them appear to be reluctantly dependent upon their children and live lonly lives very much. Fifth, they seem to have some hesitation in expressing their candid opinions as that then are some others along with family environmental factors for psychological and emotiona stability. Accordingly, it is safe to conclude by saying that much attention should' be paid no only to socio-economic supports and better medical services for the aged but also to political supports of the society and towards their children for the aged's emotiona support, for improving the quality of their lives in old age and promoting efficiency in suporting for old family dependants.

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Factors Associated with Place of Death in Korean Patients with Terminal Cancer

  • Hyun, Min Kyung;Jung, Kyung Hae;Yun, Young Ho;Kim, Young Ae;Lee, Woo Jin;Do, Young Rok;Lee, Keun Seok;Heo, Dae Seog;Choi, Jong Soo;Kim, Sam Yong;Kim, Heung Tae;Hong, Seok-Won
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7309-7314
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    • 2013
  • Aim: To investigate factors that affect the place of death (POD) of terminal cancer patients. Materials and Methods: We recruited 702 consecutive patients (${\geq}18$ years) from 12 centers during July 2005 to October 2006, and 481 completed the questionnaire. In April 2011, we linked the data for 96.0% (n=462) of the deceased patients to the POD using the 2005-2009 death certificate data of Korea's National Statistical Office. The primary outcome variable was POD, and the predictive value of variables pertaining to patients and caregivers was evaluated using univariate and multivariate analyses. Results: Most patients died in a hospital (91.5%, n=441) and age, education, preference for place of terminal care, wish to use hospice/palliative care services, terminal cancer awareness, time between diagnosis and death, and global quality-of-life subscale of the EORTC QLQ-C30 of patients, and education and preference for place of terminal care of caregivers were significant predictors in univariate analyses. On multivariate analysis, patients and caregivers who preferred hospital/palliative care as the terminal care option over home care [adjusted odds ratio (aOR), 2.68; 95% confidential interval (CI), 1.18-7.04 and aOR: 2.65; 95%CI: 1.15-6.09 for patient and caregiver preferences, respectively] and caregivers who were highly educated (aOR, 3.19; 95%CI, 1.44-7.06) were predictors of POD. Conclusions: Most of the terminal cancer patients died in a hospital. Our findings indicate that major predictors of hospital deaths are preference of both the patient and caregiver for hospital/palliative care as the terminal care option and higher education of the caregiver.

A Study on the Reasonable Personnel Management of Radiology Department -Centering around the General Hospitals in Seoul- (진단방사선과(診斷放射線科)의 적정인력(適正人力) 관리(管理)에 관(關)한 연구(硏究) -서울시내 종합병원(綜合病院) 중심(中心)으로-)

  • Chung, Soon-Kuy
    • Journal of radiological science and technology
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    • v.11 no.2
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    • pp.27-64
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    • 1988
  • Most hospital administrators in our country have doubted whether or not the size of their hospital personnel staffs, and the personnel management styles implemented are efficient or not. Actually, increased personnel expenditures due to sophisticated specialization of medical practices has become the biggest hospital expense. Therefore, it is said that hospitals can be run move efficiently by implementing reasonable management strategies for hospital personnel management. In this paper, the departments of diagnostic radiography in 16 general hospitals in Seoul, which were classified into 4 groups by the scale of hospital beds, were used as sample cases. Then, the data for the number of X-ray examination by diagnostic item was collected from sample hospitals. The unit hour spent on X-ray examinations in each diagnostic service was quoted from "A Study on setting-up of the relative value units of medical services and on the structure of current fee schedules" written by Mr. Ik Je Seong. The data analysis results are as follows; First, the number of hours per day spent on X-ray examinations in 13 hospitals out of 16 hospitals, was shorter than the general daily working hours (8 hours). Second, in the morning there was not enough time to work for X-ray examinations required, with the available manpower. In the afternoon, however, the situation was diametrically opposed to that in the morning. Third, in light of above results, though most hospitals employ sufficient personnel for the quantity of the actural work, they were always short-handed where their works were performed Fourth, this study tells us that there is a maldistribution of the work in the schedule : too much work for the available personnel in the morning. The following recommendations are resulted from the data analysis described above. First, it is recommended that all out-patients coming again, except specific patients(G. B. or I.V.P. etc) who have to have their X-ray examinations on an empty stomach in the morning among out-patients, be required to visit the hospital in the afternoon. Second, it is recommended that all new out-patients be required to make a reservation in order to equalize the number of patients throughout the day. Third, it is recommended that all in-patients, except specified patients, be arranged to have their X-ray examinations in the afternoon. Fourth, it is recommended that part time workers be employed during peak hours. This recommendation, if applied in a wider scale, would allow hospitals to overcome the problem of the maldistribution of work and personnel, and then more efficient hospital management through the appropirate personnel management procedures could be expected.

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Dosimetric Comparison of Three-Dimensional Conformal, Intensity-Modulated Radiotherapy, Volumetric Modulated Arc Therapy, and Dynamic Conformal Arc Therapy Techniques in Prophylactic Cranial Irradiation

  • Ismail Faruk Durmus;Dursun Esitmez;Guner Ipek Arslan;Ayse Okumus
    • Progress in Medical Physics
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    • v.34 no.4
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    • pp.41-47
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    • 2023
  • Purpose: This study aimed to dosimetrically compare the technique of three-dimensional conformal radiotherapy (3D CRT), which is a traditional prophylactic cranial irradiation method, and the intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT) techniques used in the last few decades with the dynamic conformal arc therapy (DCAT) technique. Methods: The 3D CRT, VMAT, IMRT, and DCAT plans were prepared with 25 Gy in 10 fractions in a Monaco planning system. The target volume and the critical organ doses were compared. A comparison of the body V2, V5, and V10 doses, monitor unit (MU), and beam on-time values was also performed. Results: In planned target volume of the brain (PTVBrain), the highest D99 dose value (P<0.001) and the most homogeneous (P=0.049) dose distribution according to the heterogeneity index were obtained using the VMAT technique. In contrast, the lowest values were obtained using the 3D CRT technique in the body V2, V5, and V10 doses. The MU values were the lowest when DCAT (P=0.001) was used. These values were 0.34% (P=0.256) lower with the 3D CRT technique, 66% (P=0.001) lower with IMRT, and 72% (P=0.001) lower with VMAT. The beam on-time values were the lowest with the 3D CRT planning (P<0.001), 3.8% (P=0.008) lower than DCAT, 65% (P=0.001) lower than VMAT planning, and 76% (P=0.001) lower than IMRT planning. Conclusions: Without sacrificing the homogeneous dose distribution and the critical organ doses in IMRTs, three to four times less treatment time, less low-dose volume, less leakage radiation, and less radiation scattering could be achieved when the DCAT technique is used similar to conventional methods. In short, DCAT, which is applicable in small target volumes, can also be successfully planned in large target volumes, such as the whole-brain.

The Influence of Dental Service Qualities on The Patient Satisfaction and Royalty in Dental Clinics and Hospitals (치과 병.의원의 의료서비스품질이 고객만족과 충성도에 미치는 영향에 관한 연구)

  • Kim, Yang-Kyun;Jung, Ki-Teak;Ann, Young-Song;Lee, Sang-Eun;Jang, Young-Hwa;Han, Bo-Ra
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.49-71
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    • 2003
  • The purpose of the study is exploring the relationship among patient perceived quality of dental care, satisfaction, and royalty in dental clinics and hospitals. The observation of the study is outpatient visiting dental clinics and hospitals located in Seoul and Kyung-Gi Do area, and surveyed the outpatients. The contents of the survey are consisted with questions including quality of care perceived by the patients, costumer satisfaction, and royalty, and measurement for each question is using five point Likert scale. According to result of bi-variate analysis, there was the significant relationship among specialized care, value of the care, and kindness in quality of dental services, level of care in dentists significantly influenced on costumer satisfaction and costumer royalty, and there was the significant relationship between costumer satisfaction and royalty. According to result of regression analysis on the costumer satisfaction, the costumer satisfaction positively related with the convenience of facility, specialized care, value of care, patient age, number of visit, and spend time for treatment, and housewives and self-employees were likely to satisfy on care than regular employees. By result of full regression model and reduced model on costumer royalty, satisfaction could explain 86% on the costumer royalty such as re-visit and promoting other people, and increase of explain power is not significant when other independent variables joined model (full model). Considering efficiency of model, costumer royalty could be explained by satisfaction only rather than other independent variables used. Finally, This study shows that the social-demographic variables of patient influenced the patient satisfaction, and the patient satisfaction influenced patient royalty directly.

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