• Title/Summary/Keyword: Medical service factors

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Study on the Efficient Integration of Long-term Care Facilities and Geriatric Hospitals by Using NHIC Survey Data (실태조사를 통한 장기요양시설과 요양병원의 효율적 연계방안)

  • Choi, in-duck;Lee, eun-mi
    • 한국노년학
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    • v.30 no.3
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    • pp.855-869
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    • 2010
  • The purpose of this study is to identify how to efficiently integrate long-term care facilities into geriatric hospitals. We conducted a survey on the current operations of facilities and medical services of 2009 of 192 long-term facilities and 168 geriatric hospitals in Korea between October and November. Technical statistics and chi-square test were conducted on the collected data using the SPSS 13.0/Win program. There was a difference between the two facility types in terms of the co-payment levels of the food services. Both types selected the budget deficit as their major management problem. Ease of access and the surrounding environment were critical factors used to select the location of both types of facilities. Facility users benefited from the discounted co-payments of both facility types. However, facility users wanted more frequent visits and support from their family members during their stay at the facilities. It was discovered that users in the long-term care facilities stayed longer, that is until they died, compared to their counterparts in geriatric hospitals. The two types of facilities provided their services totally separately to users. Users of the two types of facilities are poorly supported and cared for by their families. This study suggests that setting reasonable service fees, paying caretakers, introducing an integrated facility, strengthening facility assessment standards, introducing the family doctor system, and introducing the handling of long-term care insurance by geriatric hospitals would allow the integration between long- term care facilities and geriatric hospitals to be beneficial.

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.

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.

A Comparison of the Recognition and Satisfaction for Health Care Service between Internal Customer and External Customer (수도권 소재 병원의 내 . 외부고객의 의료이용에 대한 인지도와 만족도 차이 분석)

  • 구정연;유승흠;이해종;손태용
    • Health Policy and Management
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    • v.10 no.1
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    • pp.111-125
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    • 2000
  • To compare the differences in the recognition on hospital utilization and satisfaction, 368 hospital employees and 485 patients were selected in four hospitals in Seoul and Kyung-gi do. The survey was done using a constructed form of checklist from Apr. 30 to May 10, 1999. And the results are as follows: l. Gaining knowledge of hospitals available among hospital employees differed from that of patients. When finding out about sources of information concerning hospitals, direct visit to the hospital was recognized to be the main factor for the hospital employees in contrast to the patients' recognition which were mass media, personal involvement of job related workplace and recommendations from other hospitals. There was no difference between university and general hospitals. 2. The factors that concern which hospital to choose there was a difference between hospital employees and patients. Hospital employees recommended their own hospital solely based on the reason that it was their work place. On the other hand, the patients made a choice based on the type of medical staff, transportation available and whether it was a university hospital or not. There was no difference between university and general hospitals. 3. The recognition of employees concerning hospital image of a hospital between hospital employees and patients was different. In university hospitals, the employees recognized the name value of university hospital and cooperation as most important, whereas the patients thought convenience, kindness were the main factors. Patients considered general hospitals to be more convenient. There was some difference between university and general hospitals. For university hospitals employees' recognition was higher and for the general hospital patients' recognition is higher on hospital image. 4. The recognition of employees was different from that of patients' on hospital satisfaction. The patients' satisfaction was higher than that of employees'. There was no difference between university and general hospitals. Based on the above findings, the employees' recognition on hospital utilization and satisfaction was different from that of the patients, but there was no difference between university and general hospitals. In both groups choice of hospital was associated with satisfaction. Results showing difference between employees' and patients' recognition can be applied to implement customer-oriented attitude and be used as a baseline data for internal-external marketing planning of hospital management. The study may be limited in that the results cannot be generalized due to its small sample size and not being able to reflect demographic variables and life style. Further studies to investigate the difference of hospital utilization and hospital satisfaction will be necessary to define demographic characteristics and recognition of employees which influences patients' hospital satisfaction.

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The effect of orthodontic treatment and orthodontic treatment effect on dental hygiene students Factor (치위생과 학생의 교정치료 실태와 교정치료 효과에 영향을 미치는 요인)

  • Shin, Myong Suk;Hwang, Ji-Min
    • The Journal of the Convergence on Culture Technology
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    • v.4 no.1
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    • pp.57-65
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    • 2018
  • The purpose of this study was to investigate the factors affecting the actual condition and effectiveness of orthodontic treatment among some dental hygienists and students. This study was carried out from September to December, 2016 to describe the purpose of the study and the method of writing the questionnaire for some dental hygienists and students. The final 430 sections were analyzed and analyzed using PASW Statistics 18.0. First, the duration of orthodontic treatment was 34.4% for college students, 36.9% for orthodontic treatment for less than 2 ~ 3 years, and 62.3% for internal motivation. The factors affecting the orthodontic treatment effect were the patient's cooperativeness and the hospital's scale was the lowest. The higher the grade level, the more the clinical experience and dental part-time experience were, the higher the correlation between dental specialty and dental hygienist's medical service, education and counseling was .521(P<0.001). The higher the level of cooperation, the higher the grade level, the more dental treatment and orthodontic treatment experience, the lower the level of family co - operation. Therefore, it is important to emphasize the importance of cooperation of orthodontic patients and to develop a strategic program for each individual patient.

Study of the Factors Determining Life Satisfaction of Local Residents in Chungbuk Province (지역주민의 생활 만족도에 영향을 미치는 결정요인 연구 -충청북도를 대상으로-)

  • Cho, Taek-Hee;Bae, Min-Ki
    • The Journal of the Korea Contents Association
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    • v.17 no.5
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    • pp.591-601
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    • 2017
  • The purpose of this research was to identify the effects of factors determining life satisfaction (LS) of local residents in chungbuk province. After reviewing the literature, this research selected and developed the 9 categories and specific indicators of LS. This research had obtained data through a face to face investigation using questionnaire, which surveyed 1,619 residents at 11 local governments in chungbuk province. This research analyzed the data using descriptive statistical methods and multiple linear regression method. This research found that 1) the level of overall LS had 4.433 points out of 7, the level of residential environment satisfaction had highest point (4.911), but the level of leisure culture satisfaction had lowest point (4.155), 2) in multiple regression analysis, The effect of income and consumption level on LS was highest. The degree of labor and life-social services was important factor to increase LS. The results of this study were expected to provide many implications for implementing policies to improve LS in the country and local governments.

Increased Readmission Risk and Healthcare Cost for Delirium Patients without Immediate Hospitalization in the Emergency Department

  • Ma, I Chun;Chen, Kao Chin;Chen, Wei Tseng;Tsai, Hsin Chun;Su, Chien-Chou;Lu, Ru-Band;Chen, Po See;Chang, Wei Hung;Yang, Yen Kuang
    • Clinical Psychopharmacology and Neuroscience
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    • v.16 no.4
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    • pp.398-406
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    • 2018
  • Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

The Effects of Supplementary Education Awareness on Interpersonal Communication for Health Care Providers (종합병원 의료인의 교육훈련 인식이 의료인 상호간 커뮤니케이션에 미치는 영향)

  • Jung, Sang-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.411-420
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    • 2018
  • This study was conducted to identify the effects of interpersonal communication between health care providers after receiving supplementary education. The participants of this study were 433 health care providers who work at 29 general hospitals in Gwangju Metropolitan City and Jeollanamdo Province. Data were collected from June 8 to June 25, 2018 and evaluated by t-tests, dispersion analysis, correlation analysis and stepwise regression. The results were produced by investigating interpersonal communications according to socio-demographic and health-related characteristics including age, education level, bed size of the hospital at which the participant worked, job satisfaction, hospital location, personal health status, experience with health care management and experience with depression. There were significant differences in communication observed according to supplemental education awareness regarding age, bed size of hospital, occupation, wage, type of medical institution of employment, job satisfaction, work location, health status, health care education experience and chronic disease. There were positive correlations between supplemental education awareness in health workers and their interpersonal communication. The factors that had positive effects on interpersonal communication were level of education and health-related education experience, while age, hospital bed size and job dissatisfaction had negative effects. Finally, support environment, learning transfer and results were identified as sub-factors of supplemental education. Based on the results above, it was proposed that educational training to enhance results, provide a supportive environment and foster learning transfer be developed to increase communication between health workers and provide a safe health service for patients.

Cognitive Impairments and Its Related Factors Among the Centenarians in Korea (우리나라 100세 이상 고령자의 인지기능장애 수준과 관련요인)

  • Park, Seok-Yong;Bae, Jin-Sung;Cho, Young-Chae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.12
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    • pp.584-591
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    • 2018
  • This study was conducted to determine the levels of cognitive impairment (MMSE-K) among centenarians, and to reveal their association with related variables. The study subjects were 268 centenarians who received medical check-ups from the National Health Insurance Corporation during the period of 2016-2017. The levels of cognitive impairment were significantly reduced among females as well as those living with spouses and children, lower monthly income, lower BMI and individuals who engaged in smoking and alcohol consumption without regular exercise relative to their respective counterparts. The risk of definitive cognitive impairment in study subjects was significantly higher among women (ORs=9.85, 95% CI=2.88-33.59) than men and was lower in obese group (ORs=0.25, 95% CI=0.07-0.86) than in low weight groups, as well as in non-smoking (ORs=0.30, 95% CI=0.10-0.83) than smoking groups. The factors influencing the cognitive impairment of study subjects were sex, living status, monthly income, BMI and smoking status. Taken together, these results suggest that the levels of cognitive impairments among centenarians differed significantly in response to socio-demographic characteristics and health related variables. Especially, the levels of cognitive impairments decreased among those with poor health related variables such as smoking, alcohol consumption and regular exercise.

25-Hydroxyvitamin D level is associated with mortality in patients with critical COVID-19: a prospective observational study in Mexico City

  • Parra-Ortega, Israel;Alcara-Ramirez, Diana Guadalupe;Ronzon-Ronzon, Alma Angelica;Elias-Garcia, Fermin;Mata-Chapol, Jose Agustin;Cervantes-Cote, Alejandro Daniel;Lopez-Martinez, Briceida;Villasis-Keever, Miguel Angel;Zurita-Cruz, Jessie Nallely
    • Nutrition Research and Practice
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    • v.15 no.sup1
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    • pp.32-40
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    • 2021
  • BACKGROUND/OBJECTIVES: Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19. SUBJECTS/METHODS: This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality. RESULTS: The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality. CONCLUSIONS: Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.