• Health Policy and Management
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• v.19 no.3
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• pp.125-141
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• 2009

The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.46-58
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• 2000

Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

• Journal of dental hygiene science
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• v.22 no.4
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• pp.206-214
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• 2022

Background: This study analyzed the practice of dental medical dispute prevention rules of dental hygienists to present an improvement plan for improving perceived importance and practice and provide data for the development of effective medical dispute prevention programs. Methods: A self-administered questionnaire survey was conducted targeting dental hygienists who were providing assistance at dental hospitals and dental clinics in Seoul and Gyeonggi-do regions from March 22 to April 28, 2022. The questionnaire collected from 273 dental hygienists consisted of eight questions on general characteristics, 30 questions on medical dispute experience, and 14 questions on medical dispute prevention. Results: Complaints showed a high experience rate in 'Consultation & reservation', medical disputes in 'Patient handling (unkind) related', and 'Prosthesis installation and cement removal'. In both the importance and practice of medical dispute prevention rules, 'Preservation of medical records and other medical-related data' was high, and 'Management of patients on standby for a long time' was low in terms of practice. 'Lack of time' and 'Lack of manpower' were cited as reasons for not resolving dental treatment disputes. The importance of dental dispute prevention rules was found to be significant according to age and position, and it was also found to affect the level of practice. Conclusion: Seventy-six-point six percent of the respondents said that education on the prevention of medical disputes was necessary, although they lacked recognition of prevention rules compared to their perceptions and experiences. This study suggested specifying prevention rules in dental hygiene subjects and expanding education, improvement of dental treatment system, revise the law on the range of work to improve the recognition and practice of prevention rules.

• Journal of Korean Neurosurgical Society
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• v.61 no.2
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• pp.127-166
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• 2018

Despite advancements in treating ruptured cerebral aneurysms, an aneurysmal subarachnoid hemorrhage (aSAH) is still a grave cerebrovascular disease associated with a high rate of morbidity and mortality. Based on the literature published to date, world-wide academic and governmental committees have developed clinical practice guidelines (CPGs) to propose standards for disease management in order to achieve the best treatment outcomes for aSAHs. In 2013, the Korean Society of Cerebrovascular Surgeons issued a Korean version of the CPGs for aSAHs. The group researched all articles and major foreign CPGs published in English until December 2015 using several search engines. Based on these articles, levels of evidence and grades of recommendations were determined by our society as well as by other related Quality Control Committees from neurointervention, neurology and rehabilitation medicine. The Korean version of the CPGs for aSAHs includes risk factors, diagnosis, initial management, medical and surgical management to prevent rebleeding, management of delayed cerebral ischemia and vasospasm, treatment of hydrocephalus, treatment of medical complications and early rehabilitation. The CPGs are not the absolute standard but are the present reference as the evidence is still incomplete, each environment of clinical practice is different, and there is a high probability of variation in the current recommendations. The CPGs will be useful in the fields of clinical practice and research.

• Korean Journal of Adult Nursing
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• v.20 no.3
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• pp.375-385
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• 2008

Purpose: This study is to identify factors affecting on the level of practice on nosocomial infection management of operating room nurses. Methods: The subjects of this study were 155 nurses who worked in operating rooms of six medical centers in located Gwangju and Chonanam area. Data were collected during October, 2006 by the questionnaire including a total of 124 questions. Data collected were analysed with use of SPSS 12.0 program. Results: There was a significant difference of the level of practice by marital status(t=3.957, p=.048), education level(F=3.691, p=.027), position(F=6.588, p=.002), type of hospital(t=4.857, p=.029), number of nurse(F=4.243, p=.007), education about nosocomial infection management(F=3.069, p=.030), management council(t=6.397, p=.012) and management manual(t=6.961, p=.009). There were significant correlations between knowledge and practice (r=.389, p=.000), and between awareness and practice(r=.389, p=.000). Knowledge on nosocomial infection management, awareness of hands washing and positions were affecting factors on the level of practice. Conclusion: This study suggests that knowledge and awareness on nosocomial infection prevention and management of operating room nurses should be improved through consistent education. and support of administrator's of hospitals is needed.

• Journal of Korean society of Dental Hygiene
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• v.12 no.2
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• pp.379-389
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• 2012

Objectives : The purpose of this study was to improve the practice level on dental hygienists'infection prevention by examining the actual condition of dental hygienists'infection control and analyzing factors of having influence upon this. Methods : A questionnaire survey was carried out from July 18, 2011 to August 26 targeting dental hygienists who work at medical institutions where are located in Daegu, Busan and Ulsan Metropolitan Cities and Gyeongsangnam buk-do. After then, the following conclusions were obtained. Results : 1. As a result of surveying practice by item in the practice level of infection prevention, the items with high practice level in the management of infectious diseases were surveyed to be 12 months(89.6%) for health-checkup cycle and to be having experience of vaccination(78.0%) for hepatitis type B. The items with high practice level in the management and practice of washing hands were indicated to be in order of regularly paper towel(87.7%) and hands cleaning after regular medical examination(80.5%). In the item of the practice on wearing and managing individual protection equipment, regularly wearing(93.1%) rubber globes given washing implements was indicated to be high. 2. As a result of analyzing working career, working institution, working region, and practice level of infectious-disease management, the appearance of fulfilling infection control guidelines at medical institution and the experience of education for infection control were indicated to have difference depending on working institution. Regularly health checkup was indicated to have difference depending on respondents' working career and working institution. 3. The whole average in the practice level of infection prevention according to working career, working institution, and working region was indicated to be 2.55 out of 3-point perfection. 4. Wearing latex gloves was indicated to have statistically significant difference depending on working institution(p<0.001) and working region(p<0.001). The exchange of latex gloves every patient and the use of paper apron had statistically significant difference depending on working region(p<0.001). 5. As a result of comparing the frequency of using protection equipment for preventing infection according to the management of infectious diseases, the statistically significant difference was shown depending on the appearance of infection control guidelines at medical institution(p<0.001), the appearance of having experience of health checkup(p<0.01), and the appearance of having experience of vaccination for hepatitis type B(p<0.05). Conclusions : The above-mentioned findings showed that the denture satisfaction of the denture-wearing senior citizens was linked to their subjective oral health awareness. Therefore it will be possible to improve denture-wearing elderly people's quality of life when oral health plans geared toward boosting their denture satisfaction are carried out.

• The Journal of Korean Academic Society of Nursing Education
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• v.13 no.2
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• pp.246-256
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• 2007

Purpose: The purpose of this study was to explore the role of nurse specialist in the general hospital, and to provide basic data for the role management of nurse specialist. Method: The subjects were 38 staff nurses who worked in a medical, surgical, or other department in one general hospital. Survey tools were developed with criteria for a clinical nurse specialist by American Nurses Association(1986), Korean Nurses Association(2001), Kim(2005)'s research, and the nurse specialists' self job description. Validity of the tool was examined by 5 clinical nursing experts and nurse specialists. Data analysis was done by using SPSS Win 12.0 program. Result: The results of domains for the job of nurse specialists were 61.6% for direct clinical practice, 21.7% for education, 5.7% for consultation, 5.2% for management, 5.2% for research, and 1.1% for other domains. The results for the large classifications in nurse specialists domains were 57.6% for direct nursing practice in direct clinical practice domain, 89.1% for patient education in education domain, 57.5% for medical consultation in consultation domain, 57.5% for medical research in research domain, and 39.2% for documentation in management domain. Conclusion: This research revealed that direct clinical practice domain was higher than the other domains of research, education, and management. Discussion and development about the nurse specialist's various roles needs to be addressed on a continual basis.

• Journal of Korean Society for Quality Management
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• v.46 no.2
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• pp.211-224
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• 2018

Purpose: It can easily be understood that more rules and regulations need to be imposed on the medical device industry due to its impact on public health and hygiene. Domestic medical device manufacturers are thus required to comply with the requirements specified in the good manufacturing practice (GMP) system, and it is essential to abide by the international standards as well to sustain their global competitiveness. The main purpose of this study is to review the guidelines of the medical device GMP system in Korea and propose future directions for further enhancement of the GMP system. Methods: Specific requirements prescribed in international standards, such as ISO 9001:2015, ISO 13485:2016, ISO 14971:2012, and ISO 14155:2011, are analyzed and compared with the domestic GMP system. Results: It has been observed that the generic international standard related to quality management system, ISO 9001:2015, lays out the foundations for the development of quality management system relevant to medical device industry, ISO 13485:2003, with which the domestic GMP system is fully compatible. Further, several important aspects of risk management and clinical trials of medical devices are also recognized and included in the domestic medical device GMP system. Conclusion: Even though specific requirements of individual ISO standards are slightly different from each other, their overall structure and framework may contribute to the development and enhancement of globally competitive GMP system of the domestic medical device industry.

• Korean Journal of Adult Nursing
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• v.25 no.3
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• pp.250-262
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• 2013

Purpose: This study was designed to develop, to implement and evaluate a fever management nursing protocol for adult patients. Methods: This study was conducted through seven steps following both the guideline development procedures of the Scottish Intercollegiate Guidelines Network and the Model of the Asan Medical Center Evidence-Based Practice, as follows: 1) identifying the clinical needs and composition of the protocol development group; 2) identifying and evaluating the evidence; 3) assessing the level of evidence and grading recommendations; 4) forming a protocol; 5) evaluating the protocol using an expert group validity test and identifying barriers to its implementation; 6) protocol development; and 7) evaluation of practical improvement measures following implementation of the protocol. Results: The evidence-based protocol for fever management in adult patients was completed and includes five domains and 15 items. The protocol had good content validity (CVI=.90) and nursing practice could be improved after implementation of the protocol. Conclusion: This nursing protocol can be used as a guide for nursing in febrile adult patients. We recommend that further guidelines be updated in an interdisciplinary manner in order to foster local adaptation of the best clinical practices.

• Journal of Haehwa Medicine
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• v.23 no.1
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• pp.79-92
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• 2014

Objectives : This study aimed to investigate the medical contents of Korean medical textbooks and intervention usage in clinical practice. Method : We conducted an email survey of Doctors of Korean Medicine(DKMs) registered with the Association of Korean Medicine and analyzed the 259 responses that we received. Results : 1, The study showed that most DKMs used western medical knowledge concerning "history taking and diagnosis"(96.5%), "management and prevention"(95.8%), "causes and overview"(91.9%), and "prognosis"(90.3%). DKMs did not usually use western medical knowledge with regard to "diagnosis and treatment evaluation tools"(40.9%) or "western medical treatments"(25.1%) in their clinical practice. 2. Of the DKMs surveyed, 39.0% usually used traditional and western medical terms at similar levels of frequency in explaining their patients' conditions, while 35.9% used western medical terms more often and 20.8% used Korean traditional medical terms more often. 3. Most DKMs usually used acupuncture, herbal medicine, cupping therapy, Moxibustion in their practice and used herbal prescriptions presented in Dongeuibogam(57.1%), Bangyakhappyeon(52.9%), and Sa-Sang Constitutional Medicine(36.7%), although 27.8% used their own herbal prescriptions in creating for patients. In practice, DKMs usually used meridian acupuncture(64.1%), needling myofascial trigger points(54.8%), sa-am acupuncture(42.1%), dong-shi acupuncture therapy(24.7%), and constitutional acupuncture therapy(8.5%). Conclusions : We found that most DKMs use western medical contents as well as Korean medical contents in clinical practice. New Korean medical contents should be establish based on these results.