• Title/Summary/Keyword: Medical service quality outcome

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Customers' Utilization and Satisfaction in Oriental Medical Clinics (한의원 환자들의 한방의료 이용 행태 및 만족도 실태)

  • Seo, Young-Joon;Kang, Shin-Hee;Kim, Yeon-Hee;Choi, Dae-Bong;Shin, Hyun-Kyu
    • The Journal of Korean Medicine
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    • v.31 no.2
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    • pp.124-136
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    • 2010
  • Objective:: This study aimed to examine the customers' utilization of and satisfaction with oriental medical clinics in South Korea. Method: The data for this study were collected from 1,208 patients of 391 oriental medical clinics through a mail questionnaire survey from September to December 2008. The collected data were analyzed by the frequency analysis and $X^2$-test. Results: The results of the study were as follows. First, the most important reason that patients used oriental medical services was to get both oriental and western medical services simultaneously, because they thought such approach would be more effective for treating their diseases. Second, two important reasons that patients visited oriental medical clinics were "the reputation of and trust in the oriental medical clinics" and "the recommendation of their family and friends". Third, many patients of the oriental medical clinics have concerns about the "high prices and the outcome of oriental medical services". Fourth, the most preferred oriental medical service was "acupuncture". Fifth, it was found that 75% of the respondents were satisfied with the services they had received. They told that the outcome of the care and the kindness of the clinics' staff were very important factors that have an impact on their satisfaction. Conclusion: The study results imply that oriental medical clinics have to make an effort to strengthen their reputation and trust in the community through the scientific validation of oriental medicine, differentiated services mixed with traditional value, customer relationship management, reasonable and acceptable price of the services, staff education, and continuous quality improvement.

Outcome Assessment of a Demonstration Project on Integration of Home Visiting Health Care and Social Welfare Services (보건소 중심의 방문보건.재가복지 통합시범사업 성과)

  • Ahn Yang-Heui;Jang Sei-Jin;Choi Gyun
    • Journal of Korean Public Health Nursing
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    • v.20 no.1
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    • pp.5-15
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    • 2006
  • Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.

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Development the Nursing Productivity Conceptual Framework (간호생산성 개념틀 개발에 관한 연구)

  • Park, Jung-Ho;Park, Kwang-Ok;Lee, Byung-Sook
    • The Korean Nurse
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    • v.32 no.1
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    • pp.47-60
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    • 1993
  • This study was performed to develop the conceptual framework of the nursing productivity. The study efforts were made (1) to define the concept the nursing productivity, (2) to identify the elements of the productivity, and (3) to determine the relationship among the elements. With the aim, the study employed a descriptive analysis by way of reviewing various references related w the subject. The nursing productivity consists of such elements as the nursing efficiency and Lhe nursing effectiveness which are complememary Lo each other. The nursing efficiency is the quantative input/output ratio, while the nursing effectiveness represents the integrated outcome of sch sub-elements as the degree of accomplishing nursing goals, the quality of nursing service, consumer's satisfaction, and the degree of improvement of nurse's attitude toward the quality care. The nursing prodiccivity can be estimated by summing up the nursing efficiency and the effectiveness. By employing the system theory model, the elements of the nursing producTivity consist of three elements; the input, the process, and the output. By the process elements, the system inputs are transformed to the system outputs nursing efficiency and nursing effecitveness which are input 1.0 the system, in turn, through feedback mechanism(Figure 4).

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A Research on Inpatient Perception of Kindness on Nurse (입원환자가 지각하는 간호사의 친절에 관한 연구)

  • Kang Hyun-Sook;Kim Il-Won;Kim Won-Ock;Jang Kwang-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.3 no.2
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    • pp.259-271
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    • 1996
  • This reserch has been done in order to improve quality of nursing and medical service. In order to improve those qualities the study has been done to know inpatient perception of kindness and meaning of kindness which patients receive from nurse and also what effect inpatient have when they experience kindness from nurse. The subjects were 454 people who admitted in K Hospital. Time period was from October to December 1995. This survey has been done by personal interview with a written questionnaire. Analysis of data has been done by $X^2-test$ and percentage. The results of the research may be summarized as follows. 1. The inpatients perception of kindness on nurse were explanation(26.8%), tolerance(16.3%), warm-heartedness(12.8%), interest(9.5%), ability(8.4%), confidence(6.4%), respect(4.0%), support(2.65%). 2. In order to find out general moaning of kindness, study classified by age, sex, education, job, experience of hospitalization, inpatient ward. As a result of $X^2-test$, no special meaning of kindness was presented in inpatient perception of kindness. 3. Contents kindness which inpatient experienced were, warm-heartedness(23%), understanding(18.1%), interest(17.8%), ability(12.8%), tolerance(5.7%), confidence(2.6%), 4. Over half of subjects(59.1%) answered stability to effect on kindness of Nurse. Next are self-confidence(7.9%), respect(5.3%), confidence(4.6%), warm-heartedness(3.5%), understanding(2.6%). According to above results inpatient feels that meaning of kindness were explanation, tolerance, warm-heartedness. This meaning has no distinctive difference other than consistent meaning. Likewise, inpatient experience about contents of kindness is similar to meaning of kindness. As a result of this research, which show that kindness of nurse gives patient stability, respect and confidence, we would kindness is important for recovery of inpatient. Therefore, this research outcome could be able to help to improve quality of nursing and medical service.

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Occupational Health Protection for Health Workers in China With Lessons Learned From the UK: Qualitative Interview and Policy Analysis

  • Xu, Huan;Zhang, Min;Hudson, Alan
    • Safety and Health at Work
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    • v.12 no.3
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    • pp.304-310
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    • 2021
  • Background: Healthcare settings have been recognized among the most hazardous places to work. Based on the five categories of occupational hazards that were identified by the ILO and WHO, this study aimed to analyze policy framework relevant to occupational health protection of health workers (HWs) in public health service in China, then discussed how to share the experience of the National Health Service (NHS) England for improvement. Methods: Based on policy learning theories, policy analysis and qualitative interview were used in this study. Results: In the Chinese public health service, at least five laws related to the regulation of occupational health protection for HWs; however, enforcement of relevant laws was separated and multi-centered; the national monitoring system, which targeted to occupational hazards and health outcome for HWs in China, had yet to be developed; the top three priorities were workplace violence, bloodborne pathogens, and musculoskeletal disorders; national strategies included Security Hospital, and Healthy China 2030. In NHS England, three laws were fundamental; several monitoring systems had been set up, including NHS Staff Survey, Commissioning for Quality and Innovation incentive scheme; mental health, musculoskeletal problem, and nutrition disorder and overweight were raised great concern; Health and Safety, and NHS Healthy Workforce Program were critical nationwide strategies. Conclusion: There were several similarities as well as differences between the Chinese public health system and NHS England, which laid foundation of learning by China. Recommendations of improving occupational health policies in China were provided, based on the lessons learned from the NHS England.

Prehospital Care of 119 Emergency Medical Technician to Trauma Patients (119구급대원의 외상환자에 대한 병원 전 응급처치와 업무수행현황)

  • Yun, Seong-Woo;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.2
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    • pp.27-42
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    • 2011
  • Purpose: This study intended to improve quality of prehospital emergency care for trauma patients by figuring out its current situations and problems based on run-sheets and questionnaires of 119 emergency medical technicians (EMTs). Methods: This study conducted a research of 425 trauma patients transferred to the 3rd hospital in G-city by 119 ambulances from July 1, 2008 to June 30, 2009. We aslo utilized 114 copies with questionnaires of 119 EMTs working in J-province. The data were analyzed with SPSS 18.0. Results: There were 425 trauma patients including 272 men and 137 patients with traffic accident. When it comes to types of 119 EMTs who delivered cares to patients, there were 206 (48.5%) advanced EMTs, 101 (23.8%) basic EMTs, 50 (11.8%) nurses and 43 (10.2%) rescue education receivers. The most frequent measured vital sign was pulse rate (54.1%). Regarding assessment of systolic blood pressure, pulse rate and respiration rate, there were some significant differences in accordance with type of 119 EMTs. Among the 317 patients evaluated 'emergency' in field, 137 patients returned to their home. Prehospital emergency cares accounted for 861, around 2.0 treatments per a patient. In view of questionnaire, the 74.6% of 119 EMTs hoped supplement of man power for proper prehospital care to trauma patients. Conclusion: This study suggested that it is necessary to develop detailed guidelines for trauma patients so as to improve quality of trauma patient evaluation and prehospital care. Furthermore, improvement of emergency care systems will reduce mortality of trauma patients and lead to their good outcome.

The Medial Sural Artery Perforator Flap versus Other Free Flaps in Head and Neck Reconstruction: A Systematic Review

  • Yasser Al Omran;Ellie Evans;Chloe Jordan;Tiffanie-Marie Borg;Samar AlOmran;Sarvnaz Sepehripour;Mohammed Ali Akhavani
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.264-273
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    • 2023
  • The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.

Difference of Prescription Services between the Health Center and the Private Clinic (일부 보건소와 일반의원에서의 투약서비스 비교연구)

  • 이선희;조공민;손명세;김한중
    • Health Policy and Management
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    • v.2 no.2
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    • pp.131-151
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    • 1992
  • The contents of prescription service were comparatively analysed between health centers(HC) and private clinics(PC). Medical chart review was done for 330 otu-patients diagnosed with upper respiratory tract infection(UR) of 120 adults and 90 children, and gastritis or duodenitis of 120 adults. Emphasis on comparison was the prime cost of medication which used in prescription service. The results were as follows; 1. The prime costs fro the medication per visit of HC group were significantly higher than PC group in all three diseases, and the out of pocket payments of patients per visit were significantly lower in the HC group than PC group. 2. The reason for high prime costs of medication per visit of HC in adult case of URI were due to the idverse use of medication and long prescription period per visit. And high medication costs in children cases of URI in HC group were due to the longer prescription day. In cases of gastritis, the prime cost of medication was also higher because of longer prescription period and the higher prime cost of medication. The proportions of medications for injection in the HC and PC groups showed similar features. 3. In depth analysis of the prescription services showed the differences of the contents of medication. In adults cases of URI, the averaged cost of oral medication was significantly lower in HC group, but that of medication for injection was higher in HC group. In children cases of URI, the averaged cost of oral medication and medication for injection was lower in HC group than in PC group. But in the cases of gastritis it was was higher in HC group than in PC group. The prescription periods were longer in HC group than in PC group in all three diseases. As a conclusion prime medication cost and quality of prescription services of HC group were higher than PC group. In terms of health care the cost containment and quality assurance in physician visit for common disease, public sector utilization is good option for those perspectives. But it should not be generalized unless future study about structure and outcome research for quality assurance.

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Client Services Evaluation in Dentistry Sector (치과의료기관 방문시 불만처리서비스에 대한 의료소비자의 평가)

  • Han, Ji-Hyoung;Kim, Jin
    • Journal of Korean society of Dental Hygiene
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    • v.3 no.2
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    • pp.209-220
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    • 2003
  • The purpose of this study was to examine how clients who visited dental institutions perceived client services, what sorts of client services were provided to them and to what extent they were satisfied with them. It's ultimately meant to seek ways to enhance and enlarge client services. A survey was conducted on 379 residents who used dental institutions in Seoul and Gyeonggi provinces, and the findings of this study were as follows: 1. 64.6 percent of the people investigated weren't aware of client services, and 33.0 percent viewed them as part of medical services. 77.5 percent had grievances about dental institutions they'd ever used. 2. The biggest complaint was that the dental treatments they received weren't covered by the dental insurance. As for how to solve their grievances, the largest group of them told the employees of the dental institutions about their complaints or didn't use them again. When asked whether the dental institutions took any steps to get rid of their grievances, the greatest group replied they had no idea. and the second largest group answered they took no measure. 3. By age and educational level, those who were in their 60s and up and stopped at elementary school were best cognizant of client services. Among client service variables, they were most satisfied with how the employees handled their complaints, and as to overall satisfaction, their willingness to revisit ranked highest. 4. Concerning connections among client service awareness, service variables and overall satisfaction level, their awareness of client services had a positive correlational relationship with every service variable and satisfaction level. Among the service variables, prompt client services and employee attitude were positively correlated to overall satisfaction level, but service procedure, facilities and information services exercised little impact on that. 5. As for what factors affected their content with client services, their client service awareness was identified as one of the important factors to influence their use of dental institutions, the outcome of their visit and their willingness to revisit. The above-mentioned findings suggested that dental institutions should strengthen publicity activities to inform people of client services, and encourage them to express their grievances. In addition, they should take an immediate action to remove their complaints, and try to get a successful feedback to offer higher-quality medical services and customer-oriented services.

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A Taxonomy of Geriatric Hospitals Using National Health Insurance Claim Data (건강보험청구자료로 본 요양병원의 기능 유형)

  • Min Kyoung Lim;Sun-Jea Kim;Jeong-Yeon Seon
    • Korea Journal of Hospital Management
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    • v.28 no.2
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    • pp.9-20
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    • 2023
  • Purpose: This study classified the actual functions of geriatric hospitals and examined the differences in their characteristics, in order to provide a basis for discussions on defining the functions of geriatric hospitals and how to pay for care. Methodology: This study used various administrative data such as health insurance data and long-term care insurance data. Cluster analysis was used to categorize geriatric hospitals. To examine the validity of the cluster analysis results, we conducted a discriminant analysis to calculate the accuracy of the classification. To examine cluster characteristics, we examined structure, process, and outcome indicators for each cluster. Findings: The cluster analysis identified five clusters. They were geriatric hospitals with relatively short stays for cancer patients(cluster 1; cancer patient-centered), geriatric hospitals with relatively large numbers of patients using rehabilitation services(cluster 2; rehabilitation patient-centered), geriatric hospitals with a high proportion of relatively severe elderly patients(cluster 3; severe elderly patient-centered), geriatric hospitals with a high proportion of mildly ill elderly patients with various conditions(cluster 4; mildly ill elderly patient-centered), and geriatric hospitals with a significantly higher proportion of dementia patients(cluster 5; dementia patient-centered). The largest number of geriatric hospitals were categorized in clusters 4 and 5, and the structure and process indicators for these clusters were generally lower than for the other clusters. Practical Implications: We have confirmed the existence of geriatric hospitals where the medical function, which is the original purpose of a geriatric hospital, has been weakened. It has been observed that the quality level of these geriatric hospitals is likely to be lower compared to hospitals that prioritize enhanced medical functions. Therefore, it is suggested to consider the conversion of these geriatric hospitals into long-term care facilities, and careful consideration should be given to the review of care-giver payment coverage.

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