Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.
Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.
Purpose: This is a comparative study using secondary data from the Korean national long term care (LTC) insurance. Methods: Visiting nursing (VN) service users (n=666) and non-users (n=4,375) were extracted and compared in terms of medical expenditures, length of hospitalization, and annual number of ambulatory care visits to investigate effects of VN services in LTC. Results: Total health care expenditures were compared between the two groups and it was found that VN service users spent about $ 1700 than non-users for their medical costs between 2009 and 2011. The average length of in-hospital stay for VN service users was 19.4 days shorter than that of non-users. However, using VN services did not significantly influence the annual number of ambulatory care visits. Conclusion: The study has found that VN services are effective ways of providing community-based LTC services. We recommend LTC policy makers to further utilize VN services to deliver cost effective health care services.
Objectives : The aim of this study was to investigate the satisfaction determinants of rehabilitation care group inpatients in rehabilitation long-term care hospitals. Methods : A survey was conducted with 262 patients from 6 rehabilitation long-term care hospitals located in Busan Kyungnam. Data were collected from June 2016 to July 2016 with a structured questionnaire and analyzed with SPSS 23.0. Results : The significant factors affecting the overall satisfaction score were disease group and 5 quality indices of medical services(Medical service quality, Rehabilitation services quality, Hospital reputation, External physical environment, and Internal physical environment). Additionally, the significant factors affecting intention to revisit were age, disease group, length of hospital stay and the 5 quality indices of medical services. Conclusions : The results of this study indicate that rehabilitation long-term care hospitals should try to improve the overall satisfaction of inpatients, especially focusing on the internal physical environment and the quality of the rehabilitation services and medical services, which will lead to a high level of intention for patients to revisit.
The aim of this study is to suggest theoretical foundations on which hospital employees could estimate medical care services not in the position of providers but consumers. For this purpose this study compares satisfaction of providers but consumers. For this purpose this study compares satisfaction of patients with medical care service with that of hospital employees. 287 patients and 261 employees in three university hospitals in Daegu were selected as samples of investigation and asked questions. Statistical analysis was taken using SAS package. The result of this study are as follows. 1) Among the five fields of medical services patients and hospital employees have different views in doctor hospital staff(except doctor) treatment system availability service but parking service 2) Hospital employees overestimate the level of medical care services compared with patients 3) Demographical variables make a difference in medical satisfaction 4) In satisfaction-evaluation after r ceiving treatment medical system service is influential variables in both patients and hospital employees. And in patient group doctor service is following variables while availability and parking service is influential variables in employees.
There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.
Purpose : The purpose of this study is to provide the basic data to improve pre-hospital phase emergency care for acute myocardial infarction (AMI) patients by analyzing AMI patients' clinical characteristics and emergency care situations. Methods : Data were collected through medical records of 385 AMI patients including ambulance records of 107 AMI patients transferred to the emergency medical center for three and a half years. Results : Regarding emergency care for AMI patients in pre-hospital phase, 47% of the care revealed moderate level or higher, and appropriateness of pre-hospital phase emergency care for cardiopulmonary complaints practiced by paramedics showed statistically significant improvement in recent years (p<.001). The time from onset of symptom to ballooning intervention by 119 emergency services was shorter than that in other cases. However, emergency care by paramedic was mainly basic life support. Conclusion : Since prognosis of AMI shows vast differences depending on prompt detection and medical intervention, cooperation between pre-hospital and in-hospital phase is highly required. 119 paramedics should be trained focusing on the accurate assessment and emergency care, and medical direction should be activated. In addition, regulation on 12-lead EKG, cardiac enzyme analysis, use of analgesics and thrombolytic agents should be legally implemented.
Quality of radiological services can be assessed by various agents, so called medical doctors, radiologists, patients and others. However radiological services are provided by radiologists to patients and medical doctors. This study was based on data which were collected from assessment of 142 radiologists working in the health care services organization and 149 patients who visited the same organization about radiological services, with self-administered structured questionnaire. This study was planned to analyze of radiological services factors and to develop a methodology for measuring the level of quality in the radiological health care services.
Purpose: This study was a retrospective survey to examine economic feasibility of home care services for patients with diabetic foot. Methods: The participants were 33 patients in the home care services (HC) group and 27 in the non-home care services (non-HC) group, all of whom were discharged early after inpatient treatment. Data were collected from medical records. Direct medical costs were calculated using medical fee payment data. Cost-effectiveness ratio was calculated using direct medical costs paid by the patient and the insurer until complete cure of the diabetic foot. Effectiveness was the time required for a complete cure. Direct medical costs included fees for hospitalization, emergency care, home care, ambulatory fees, and hospitalization or ambulatory fees at other medical institutions. Results: Mean for direct medical costs was 11,118,773 won per person in the HC group, and 16,005,883 won in the non-HC group. The difference between the groups was statistically significant (p=.042). Analysis of the results for cost-effectiveness ratio showed 91,891 won per day in the HC patients, and 109,629 won per day in the non-HC patients. Conclusion: Result shows that the cost-effectiveness ratio is lower HC patients than non-HC patients, that indicates home care services are economically feasible.
Purpose: The purpose of this study was to analyze married immigrant women's utilization of health care and their demand for public health care services. Methods: This study was conducted through descriptive survey with 102 married immigrant women in 2 cities, and survey was done from November, 2010 to May, 2011. Results: The results were as follows. Of respondents, 70% were using medical services in Korea and only 38.2% of them were satisfied with services. Major difficulties in using health care services were 'access problem' (35.7%), 'communication problem' (27.7%), and 'medical cost' (19.8%). The respondents' main sources of health information were family (56%), health care center (15%). The types of health information and education demanded by respondents were children's health care (22.1%), pregnancy and delivery (21.1%), and common disease care (20.0%). The most wanted services from public health care institutions were vaccination (24.5%), health promotion (21.5%), and leisure activity programs (20.6%). There was a statistically significant difference in period of immigration and public health care demands. Conclusion: For married female immigrants, it is recommended to provide tailored public health care services such as outreach service and visiting nursing care service, and to set up different language signs for common disease patients.
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