• Title/Summary/Keyword: Nurses, Public health

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An Analytic Case Study on the Management of an Upper-level General Hospital(2010-2012)

  • Park, Hyun-Suk;Lee, Jung-Min;Baek, Hong-Suck;Lee, Jun-Ho;Park, Sang-Sub
    • Journal of Korean Clinical Health Science
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    • v.2 no.1
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    • pp.1-16
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    • 2014
  • Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

A Study on Factors Influencing Dementia Management Strategies and Their relationships with Primary Caregivers' Burden (치매주간호자의 치매관리전략 영향요인과 부양부담 관계 연구)

  • Lee, Hyeon-Sun;Oh, Jin-Joo
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.629-638
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    • 2002
  • The impact of chronic diseases on patients and their families depends on how well the family members cope with it. Therefore, research on strategies for facilitating the coping of the families in a desirable manner is very important. Dementia management strategies refer to specific means families of dementia patients use to cope with dementing illness of their family members. This study was designed to examine type of dementia management strategies utilized by families and to identify factors influencing them. The subjects in this study were 103 conveniently selected demented patients and their primary caregivers who were registered to a public health center located in Chungcheong Province. The subjects were visited by 20 home visiting nurses, and the data were collected using a structured questionnaire. The data were collected form May 2, 2001 to June 2, 2001. The findings of this study were as follows. 1. The most frequently used types of dementia management strategies were active management (M=3.36, S.D=.96), and encouragement (M=2.94, S.D=.99). Criticism was least used type of dementia management strategy (M=2.71, S.D=.99). 2. The factors influencing each management strategy were as follows; 1) The criticism management strategy was most frequently used by the primary caregivers who graduated elementary school (F=3.21, p<.05). 2) The encouragement strategy was most frequently used by the primary caregivers in a case when the patients were in the mild stage of dementia (F=2.76, p<.05), when the patients never had any treatment experiences (F=2.01, p<.05), when the family could afford the provision of treatment for the patients (F=-2.44, p<.050), and when the primary caregiver had a job (t=2.90, p<.01). 3) The active management strategy was most widely used by the primary caregivers who could afford the provision of treatment for the patients (F=-2.31, p<.05) and were in their 70s (F=3.04, p<.05). This type of management strategy was significantly more used by those who discussed the difficulties of caring with their family members (F=3.46, p<.05). 3. The use of criticism management strategies was significantly correlated with the total level of burden of the primary caregivers. But the types of encouragement and active management strategies had negative correlations with the caregivers' burden although they were not significant. Since the findings of this study showed that the criticism management strategy had a significant positive relationship with caregivers' burden, those who are more likely to use the negative management strategy should be identified in future studies. The primary caregivers who are more likely to use negative strategy should be more closely monitored and be focused as the group who should be intervened in future studies.

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The Health and Welfare Service Delivery System and It's Effectiveness: Operation of An Interdisciplinary Team Approach for Model Development (보건복지서비스 전달체계의 효율적 운영방안에 관한 연구 I: 모델 개발을 위한 사례관리 적용)

  • Kim, Jung-Woo;Woo, Ju-Yul;Um, Myung-Yong
    • Korean Journal of Social Welfare
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    • v.35
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    • pp.107-131
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    • 1998
  • This study tried to formulate and operate an interdisciplinary case management team in Eun-Pyung Gu, Seoul. This was a part of an effort to promote efficiency of service delivery system for low-income elderly or the handicapped by linking. coordinating. and integrating various health and human services providers. In-depth qualitative analysis described the process of which the interdisciplinary case management team was formed, along with the process of the team operation. The interdisciplinary team consisted of home helpers, visiting nurses, and social workers from Health Center and Social Welfare Centers. Issues dealt with by the team include: 1) information exchange of clients' social, economic, and medical situations; 2) identification of types of service provision to clients; 3) clients' needs assessment and its prioritization; 4) assignment of a leading case manager for each case; 5) identification of problems and issues regarding integration of service delivery system The team approach to case management contributed to the systematic delivery of services to the elderly and the handicapped by avoiding service duplication and fragmentation. This study argued that public agency played a key role in constituting and operating the interdisciplinary case management team Suggestions for further studies were presented.

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Association between Sleep and Loneliness in the Elderly Living Alone (독거노인의 외로움과 수면의 관계)

  • Choi, Yu Jung;Lee, Kyung Kyu;Lee, Seok Bum;Kim, Kyung Min;Kim, Dohyun;Lee, Jung Jae
    • Korean Journal of Psychosomatic Medicine
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    • v.28 no.2
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    • pp.168-176
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    • 2020
  • Objectives : Loneliness and poor sleep quality are common phenomena in old age and are associated with negative physical and mental health. However, little is known regarding the relation between loneliness and sleep quality. The aim of this study was to examine the association of loneliness and sleep quality among the elderly living alone. Methods : This is a cross-sectional study that enrolled 1,090 subjects who are the community-residing elderly living alone. Sociodemographic status, medical condition, cognition, mood disorder, sleep quality and levels of loneliness were collected using a self-administered questionnaire and a specific semi-structured interview conducted by trained nurses. Descriptive statistics were used to analyze data regarding sociodemographic variable and loneliness. Univariate and Multivariate regression analyses were applied to examine the association between loneliness and sleep quality after adjustment for multiple confounding variables. Results : The Pittsburgh Sleep Quality Index (PSQI) mean score of "lonely group" (9.2±4.2) was significantly higher than that of "not lonely group" (7.3±3.7) (student-t test, p<0.001). Loneliness was significantly associated with PSQI (standardized β=0.065, p=0.025), sleep disturbance (standardized β=0.086, p=0.005), use of sleep medication (standardized β=0.065, p=0.034) after adjustment for possible confounding variables including sex and mood disorder. Conclusions : Loneliness was associated with sleep disturbance and this finding implied negative impact of loneliness on sleep quality of older adults. Public health promotion efforts to reduce loneliness may improve sleep quality and mental health in the elderly living alone.

Global Convergence for Healthcare ICT Services (헬스케어 ICT 서비스의 글로벌 컨버전스)

  • Won, Dal Soo;Lee, Sang San;Jung, Yong Gyu
    • The Journal of the Convergence on Culture Technology
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    • v.2 no.2
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    • pp.45-49
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    • 2016
  • It may be summarized to four kinds of innovation through global convergence, and the convergence of adjacent areas according to mega-trends in medical services market and actively introduced ICT technologies, public and private partnership. Health care is no longer a local industry, it is becoming Global Convergence. In the case of developed countries, it is increased to income levels, the development of new medical technologies, while the increase in specialized medical services and need of aging population. It increases migration of foreign medical personnel, geographical proximity and choice of the best medical technology, regardless of the cost. The increasing demand for high quality yet relatively low foreign prices of medical services. Hospitals are especially spread of international certification such as the US JCI standards. Hospital exports are being evaluated and opened the way for the export industrialization as ICT convergence hospital that can be exported to the fusion-related technologies more efficiently. Current local hospital has already reached saturation, globalization of Korean hospital is being the time necessary. Thus, unlike a strategy for each country, as well as technology transfer it is also possible, such as total exports provided the building, medical equipment procurement, local medical personnel (doctors and nurses) selection and training, PR and marketing. In the current medical law and need to be revised prospectively maintained for publicity and abroad, there is a need for further legal dragons and actively support a more flexible policy on the application of national law overseas medical services.

A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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A Study for the Nursing Curriculum and educational environment in 3-year college (전문대학 간호과의 교과과정 및 교육여건에 관한 조사 연구)

  • Kim Sook-Young;Son Haeng-Mi;Lee Hong-Ja;Lee Hwa-In;Jun Eun-Mi;Cho Kyung-Mi;Joo Hye-Joo;Han Young-Ran
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3 no.2
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    • pp.125-149
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    • 1997
  • The role of nurses in Korea is undergoing significant change because of the economic development, medical insurance and the change of family structure. It will be predicted that the nurse's role is extended more and more in the 21C. So the nursing curriculum in nursing education is the most important thing to prepare a good quality of nursing. Furthermore qualified curriculum calls for the development of desirable attitudes in nursing students. The purpose of this descriptive study was to collect data which can be used to facilitate the process of encouraging every college to assume greater responsibility for needed curriculum and educational conditions related to preperation of nursing students for various developed society toward 21C. A total sixty one nursing college were surveyed by mail during August and October 1997. Thirty six college(59%) responded. The data was analyzed by using SAS program. The results are as follows : 1) 32 college(88.9%) answered that they have Nursing educational philosophy and goal. 2) Total credits are 136credits, and the students who don't have teacher's course need 128 credits. 3) Nursing essential subjects comprise 84 credits, and nursing clinical practice subjects are 19 credits. 4) 15 colleges(41.7%) have their own hospital for student's clinical practice, 36 college(100%) take the community nursing practice in public health center, 34college(94.4%) take the school health nursing practice. 5 college(13.9%) have industrial nursing practice. 5) 3-year nursing college have 6.4 professor, 3.5 assistent professor, 1.9 and 3.4 full faculty and 7.4 part time faculty. We sugest that 3-year college have to have nursing educational philosophy and goal in terms of nursing educational standard. To improve the quality of nursing education every college should try to increase the number of professor and to contact qualified hospital for students clinical practice.

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The Study of Comparison Satisfaction and Re-use Intention between Central and Ward Reception Desk Users (입.퇴원 수속창구 중앙화와 분산화에 따른 이용자의 만족도와 재이용 의사)

  • Ham, Tae-Hoon;Lee, Kyung-Woo;Sohn, Tae-Yong;Yu, Seung-Hum
    • Korea Journal of Hospital Management
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    • v.14 no.4
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    • pp.149-162
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    • 2009
  • The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.

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Physicians' Knowledge about Hereditary Breast Cancer in South Korea (국내 임상 의사의 유전성 유방암에 대한 지식도)

  • Choi, Kyung-Sook;Tae, Young-Sook;So, Hyang-Sook;Lee, Woo-Sook;Hur, Myung-Haeng;Kang, Mi-Young;Son, Song-Yi;Lee, Mi-Hi;Lee, Young-Lan;Choi, In-Soon;Jang, Eun-Sil;Kim, Seong-Jae;Jun, Myung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.13 no.1
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    • pp.105-113
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    • 2007
  • Background: Cancer genetics have gained public attention dramatically. Everyday physicians and nurses use the knowledge of cancer genetics in their practices. Despite the importance of the knowledge of the health care providers on cancer genetics, there is a paucity of literature investigating the levels of knowledge about cancer genetics among health care providers. Purpose: This study aimed to describe the Korean physicians' current knowledge level about hereditary breast and ovarian cancer (HBOC). Method: This nation-wide survey used a 15-item questionnaire which is modified from the Breast Cancer Genetic Counseling Knowledge Questionnaire originally developed by Erblich et al.(2005). One hundred and forty-four physicians participated in this survey from October 1, 2006 to March 31, 2007. Result: Physicians' knowledge level about hereditary breast cancer was 11.94 (S.D=2.46). Physicians with short-term careers (less than one year), the position of Intern, or who were involved in breast or ovarian cancer care demonstrated the highest knowledge about HBOC. Conclusion: Genetic courses in medical education seemed to contribute to the high level of physicians' genetic knowledge. Also, nursing discipline needs to incorporate genetics or genetic counseling courses into the formal educational curriculum in order to deliver up to date cancer care services which are sensitive to ever-changing cancer genetic information.

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The Effects of Self-Management Program and Its Measurement for the Elderly with Chronic Illness in the community (국내 지역사회 거주 만성질환 노인 대상 자기관리 프로그램의 효과 및 측정도구에 대한 고찰)

  • Shin, Ga-In;Park, Hae Yean
    • 한국노년학
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    • v.40 no.2
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    • pp.257-267
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    • 2020
  • The purpose of this study is to identify the effectiveness of self-management programs and the measurement used for elderly people with chronic illness living in the community. Databases used for study search were Google Scholar, RISS, and Dbpia. And research questions were selected based on the PICO framework. We searched the study published from January 2010 to September 2019 and selected the final six studies by applying inclusion criteria and exclusion criteria. As a result, the selected study had qualitative level of Level 1-2. In general characteristics of the program, nurses conducted the most programs, and the program was operated for 50 elderly people or less. In addition, the program was conducted mainly in public health centers, senior centers. The subjects were the most studies for chronic patients with hypertension. The dependent variables of the program covered the cognitive domains in all the studies, and many of the studies measured the physical domains as the dependent variables. The results of this study provide the effectiveness of self-management intervention for the elderly with chronic diseases living in the community, and highlight the need for the development of programs for chronic diseases in the community. In addition, this study suggests measuring tools related to various cognitive, physical, mental, social and quality of life of the elderly, and suggests the necessity of multidisciplinary research.