• Title/Summary/Keyword: Medical service performance

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The appropriate scope of work of EMT-paramedics in emergency medical institutions according to expert opinion (전문가들이 생각하는 응급의료기관 내 종사하는 1급 응급구조사에 대한 인식과 적정 업무 범위는)

  • Kang, Hyo-Young;Kim, Yong-Seok;Kim, Jin-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.3
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    • pp.77-90
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    • 2018
  • Purpose: This study aimed to assess and improve the work scope of emergency medical technicians (EMT)-paramedics in emergency medical centers. Methods: Data were collected from February 1 to 14, 2018. The questionnaire comprised a total of 56 questions: eight general questions, six questions about the recognition of EMT-paramedics in emergency medical centers, and 42 questions about their work. Data were analyzed via frequency and correlation analysis using SPSS version 18.0. Results: Regarding the work of EMTs in emergency medical centers, positive opinions were found in 23 items, negative opinions in 4 items, and both positive and negative opinions in 9 items. Regarding the questions about the necessity, work importance, professionalism, and the need for an increase4 in EMR-paramedics, depending on respondents' career, there was no statistically significant difference between the group of beginners and the group comprising beginners and that of experienced workers (p>.200). Conclusion: The expert survey revealed that the work performance of EMT-paramedics in regional emergency medical centers was trusted and showed positive results of improvement and expansion.

Innovative approaches to the health problems of rural Korea (한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案))

  • Loh, In-Kyu
    • Journal of agricultural medicine and community health
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    • v.1 no.1
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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The Differences in Quality Perceptions, Expectations, Evaluation, and Satisfaction for Nursing Service between Patients and Nurses: Small-medium Sized General Hospitals (중소 종합병원 입원환자와 간호사의 간호서비스에 대한 기대와 지각, 질 평가와 만족도 차이)

  • Kim Jeong-Hee;Lee In-Sook
    • Journal of Korean Academy of Nursing
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    • v.34 no.7
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    • pp.1243-1254
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    • 2004
  • Purpose: This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds. Method: The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale. Result: There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was 'the responsiveness', and in the perceived performance, the highest was the 'assurance'. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction. Conclusion: To improve the nursing service quality at small-medium hospitals, strengthening the 'assurance' factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.

The Primary Care Performance of Three Types of Medical Institutions: A Public Survey using the Korean Primary Care Assessment Tool

  • Jung, Hye-Min;Jo, Min-Woo;Kim, Hyun-Joo;Jang, Won-Mo;Lee, Jin-Yong;Eun, Sang-Jun
    • Quality Improvement in Health Care
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    • v.25 no.2
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    • pp.16-25
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    • 2019
  • Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

The Modifying Effect of Switching Barriers in Customer Loyalties in Medical Services (의료서비스에서 고객충성도에 대한 전환장벽의 조절효과 분석)

  • Lee, Sun-Hee;Kim, Hyun-Mi;Chae, Yoo-Mi
    • Health Policy and Management
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    • v.17 no.3
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    • pp.68-86
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    • 2007
  • This study was performed to explore the effect of customer satisfaction and switching barriers on customer royalties in medical services. 900 households, 1% sample were randomly selected from K city located in Kangwon province. Interview survey was performed with structured questionnaire for the entire people, 923 persons who experienced medical service utilization during one year before survey on time, september, 2002. In comparison of switching barriers by sociodemographic characteristics, lower income group and lower educated group showed the higher level of recognition level on availability of changing the service provider significantly. In terms of economic loss as one of switching barriers, the group of over aged 61, the lower income group and the lower educated group felt higher than other groups. Also, the time loss of switching barrier was recognized in 41-60 aged group and employee in service industry highly. For the perceived risk factor as another switching barrier, the high educated group showed the higher recognition level in performance risk and felt higher social risk than other groups. In analysis of customer satisfaction and loyalty levels by switching barrier components, the lower level of availability of changing the service provider and the higher level of recognition for economic and time loss, they showed the higher satisfaction and loyalty levels. In final step, multiple regression analysis showed the positive relationship between customer satisfaction, switching barrier and customer loyalties. Besides, the moderating effect of switching barrier in relationship between customer satisfaction and loyalties was significant and this results suggests that the influence of customer satisfaction to customer loyalties might be weakened in high level of recognition for switching barrier. In conclusion, perceived risk of economic and time loss as switching barrier is an important factor and should be considered in planning of marketing strategy carefully in terms of defensive marketing.

The Effectiveness of Quality Control of 119 Emergency Medical Services on Survival Rate of Cardiac Arrest Patients (119구급서비스 품질관리가 병원 전 심정지 환자의 생존율에 미치는 영향)

  • Jung, Eun-Kyung;Yun, Hyeong-Wan
    • The Korean Journal of Health Service Management
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    • v.7 no.1
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    • pp.21-34
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    • 2013
  • Hospitals in Korea are enforcing a quality control over 119Emergency Medical Services to increase the survival rate of Out of Hospital Cardiac arrest patients. This study is to analyze the factors that effect the survival rate of Out of hospital Cardiac arrest patients by comparing the results of before and after the quality control enforcement. Cardiac arrest patients can be assorted into pre-decision group and decision group. The study analyzed the survival factors which was based on the adequate use of 119 BLS and ACLS usage rates, response time of 119EMS, qualification of ambulance worker, number of EMS team members, and adequate use of AED according to ECG diagnosis. The analyzation was done over total 1,233 of Cardiac arrest patients from January 1, 2010 to December 31, 2011 After the enforcement of the quality control, the usage of Vital sign check and BLS showed a big difference. Especially, as the usage of ECG showed a significant difference, Shockable rhythm, which is the most important to Cardiac arrest patients, also showed a significant difference. After the enforcement of quality control, the performance of ACLS showed a significant difference in IV. The study showed 119 ambulance workers provided better service in Vital sign and BLS and ACLS after the enforcement of quality control. It is considered a 119 ambulance service effects the survival rate of Cardiac arrest patients. Therefore, it can increase the survival rate and it is necessary to continue a quality control.

Analysis of New Patient's Willingness to Pay Additional Costs for Securing Satisfactory Consultation Time (외래 초진환자의 만족진료시간과 관련 추가 비용 지불 의사)

  • Lee, Chan Hee;Lim, Hyunsun;Kim, Youngnam;Yoon, Soojin;Park, Yang Sook;Kim, Sun Ae;Park, Eun-Cheol;Kang, Jung-Gu
    • Health Policy and Management
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    • v.27 no.1
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    • pp.39-46
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    • 2017
  • Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

The Variation of HbA1c Examination Performance Rates among Diabetic Patients Using Ambulatory Care in South Korea (우리나라 외래서비스 이용 당뇨환자의 특성에 따른 당화혈색소(HbA1c)검사 시행률 변이 분석)

  • Hong, Jae-Seok;Kang, Hee-Chung;Kim, Jai-Yong
    • Health Policy and Management
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    • v.19 no.1
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    • pp.49-61
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    • 2009
  • Background: The appropriate management of diabetes mellitus(DM) can help reduce its relapse and economic burden, but the level of management of DM in Korea is reported to be insufficient. This study aims to identify the management level of DM by figuring out the HbA1c examination performance rate of the diabetics and analyzing the variation according to the characteristic of a diabetic. Methods: This study used the Korean National Health Insurance Database which includes E10-14(ICD-10 code) as a primary or secondary disease as of 2006. Study population is 1,892,062 diabetics excluding 393,784 patients with the first attack of DM in 2006, 33,440 diabetics who died in 2006, and 21,299 patients with DM having no record of ambulatory care among the 2,340,585 DM patients in total. Results: The HbA1c examination performance rate of all DM patients in our country is estimated to be 41.5% as of 2006 and shows variation according to the characteristic of individual DM patients. The highest performance odds was shown by the patients who were below 19 of age, insured for health insurance, attended more than 3 ambulatory care providers, made ambulatory care visits more than 10 times annually, attended a specialized general hospital as their main attending medical institution, had a record of hospitalization or had co-morbidity. Conclusion: This study propose that is necessary to make politic preparations for the appropriate management of diabetes at a national level, and particularly, the patients with advanced age, the ones dependent on Medical Aid, and the ones using hospitals or clinics, whose appropriate management seems vulnerable, demand a careful management.

Core competency in disaster management of 119 paramedics (119구급대원의 재난관리 핵심역량에 관한 연구)

  • Kim, Jin-Hyeon;Choi, Eun-Sook
    • The Korean Journal of Emergency Medical Services
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    • v.21 no.3
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    • pp.35-48
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    • 2017
  • Purpose: The purpose of the study was to investigate the core competency of disaster management of 119 paramedics. Methods: A self-reported questionnaire was completed by 242 paramedics in C area from April 28 to May 12, 2017. The study instrument included general characteristics of the subjects (4 items), disaster experience, recognition, and preparedness (20 items), and importance and performance of disaster management core competency (24 items) by Likert 5-point scale. Data were analyzed using t-test, ANOVA, Pearson's correlation coefficient using IBM SPSS 24.0. Results: The seriousness of personal disaster was 4.02 points and the importance of disaster-related education was 4.28 points. The importance to core competency of disaster management was 4.39 points and the ability to perform core competency was 3.58 points. The seriousness of personal disaster and the importance of disaster-related education were positively correlated (r=.600, p=.000). The importance and ability to perform core competency were positively correlated (r=.389, p=.000). Conclusion: It is necessary to strengthen core competency of disaster management in paramedics who are the first defense line of disaster.

Feasibility to Expand Complex Wards for Efficient Hospital Management and Quality Improvement

  • CHOI, Eun-Mee;JUNG, Yong-Sik;KWON, Lee-Seung;KO, Sang-Kyun;LEE, Jae-Young;KIM, Myeong-Jong
    • The Journal of Industrial Distribution & Business
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    • v.11 no.12
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    • pp.7-15
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    • 2020
  • Purpose: This study aims to explore the feasibility of expanding complex wards to provide efficient hospital management and high-quality medical services to local residents of Gangneung Medical Center (GMC). Research Design, Data and Methodology: There are four research designs to achieve the research objectives. We analyzed Big Data for 3 months on Social Network Services (SNS). A questionnaire survey conducted on 219 patients visiting the GMC. Surveys of 20 employees of the GMC applied. The feasibility to expand the GMC ward measured through Focus Group Interview by 12 internal and external experts. Data analysis methods derived from various surveys applied with data mining technique, frequency analysis, and Importance-Performance Analysis methods, and IBM SPSS statistical package program applied for data processing. Results: In the result of the big data analysis, the GMC's recognition on SNS is high. 95.9% of the residents and 100.0% of the employees required the need for the complex ward extension. In the analysis of expert opinion, in the future functions of GMC, specialized care (△3.3) and public medicine (△1.4) increased significantly. Conclusion: GMC's complex ward extension is an urgent and indispensable project to provide efficient hospital management and service quality.