• Journal of Korean Academy of Nursing Administration
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• v.3 no.2
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• pp.151-165
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• 1997

A cost analysis for hospitalized patients was performed based on the KDRG classification in order to determine an appropriate nursing fee under the PPS(Prospective Payment System). The data was collected from 20 nursing units of three tertiary hospitals and two secondary hospitals from August 26 to September 15, 1996. The study consisted of 148 inpatients diagnosed for lens procedures(KDRG 03900), tonsillectomy &/or adenoidectomy(KDRG 16100), Cesarean section(KDRG 37000), or vaginal delivery(KDRG 37300) without any complications. The direct or indirect nursing hours of each patients were measured. Then, direct or indirect nursing expenditures of four nursing units, operating room and delivery room were computed. Finally, the resources used including average total nursing hours, average length of stay and average nursing cost of each KDRG were estimated as follows; 1) The average total nursing hours were 640 minutes for lens procedures, 403 minutes for tonsillectomy &/or adenoidectomy, 934 minutes for appendectomy with complicated principal diagnosis, 1,094 minutes for Cesarean section and 631 minutes for vaginal delivery. Significant differences were found in average total nursing hours among hospitals. 2) The average length of stay in lens procedures were 5 days, 4 days for tonsillectomy &/or adenoidectomy, 6 days for appendectomy with complicated principal diagnosis, 8 days for Cesarean section and 3 days for vaginal delivery. All results were within normal determined by the Ministry of Health and Welfare although significant differences existed among hospitals, especially with average length of stay for leng procedures between tertiary hospitals and secondary hospitals which was greater than for those of others. 3) The average nursing cost were 87,146 Won for lens procedures, 69,600 Won for tonsillectomy &/or adenoidectomy, 128,337 Won for appendectomy with complicated principal diagnosis, 151,769 Won for Cesarean section and 85,403 Won for vaginal delivery. These costs were 7.6%, 13.0%, 13.0%, 16.0% and 22.0%, respectively, of the official price fixed by the Ministry of Health and Welfare under the prospective payment system. Research for the analysis of nursing costs according to the severity of illness for those KDRGs shoud be carried out within the period of the PPS pilot project. In addition, a proper nursing fee schedule for a new reimbursement system based upon the result of the above research should be prepared in the near future.

• Journal of Korean Academy of Nursing
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• v.27 no.2
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• pp.253-263
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• 1997

This second study on the effectiveness of nursing organization was designed to test the relationships between effectiveness of nursing organizations and structural variables that had been significant variables in the first study, the group design variable and the personal characteristic variables that had not been analyszed in the first study based on personal resource productivity model. The data were collected through self-reported questionnaires completed by 605 nurses working in hospitals in seoul and 782 patients being hospitalized in 5 tertiary hospitals in Seoul. The results showed that according to the canonical correlation analysis, the managing job design, nursing delivery system. nurse's age, career. and formalization were revealed as predicting variables of a nurses' job satisfaction and patients satisfaction among the five hospitals. Hospitals in which the team nursing method was used showed a higher score in nurses' job satisfaction and patient satisfaction than in hospitals which used the functional nursing model.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.696-705
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• 1994

This study was done to provide a basis for home health care management for women following Cesarean delivery. Furthermore it was initiated as an possible application of home health care in the future. In this study, client selection criteria was developed by the researcher and assessment tools for home health care, recording system and problem oriented recording system were revised from Jun's(1993) methods. The selection criteria tool for home health care for women who had a Cesarean delivery was structured and consisted of five areas : physical status, functional status, psychological-emetional status, educational needs status and environmental status. The structured assessment tool consisted of general items, obstetric history, past medical history, methods of feeding, medications taken before ad-mission, laboratory results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of women and their newborns. The visit note consisted of the date : nursing problems : nursing process including initial assessment : nursing goals : visit plan : health status of the postpartum women and their newborn : nursing diagnoses : nursing implementation evaluation : summary : next visit plan and revision. The problem oriented recording system consisted of the date, problem numbers, nursing diagnoses, problem appearance date, problem resolution date. The results of the research are as follows : The seven cases having had a Cesarean delivery were discharged on an average on the 5th day after the Cesarean birth. The total number of home visits was 13. According to Cordon's functional health patterns the total possible nursing diagnoses was 34 diagnoses for the methers and their newborns. Among the 34 diagnoses, there were 13 diagnoses in the health perception /management pattern, 7 in the psychosocial health perception / management pattern, 8 in the psychosocial self-perception, 2 in the nutrition / metabolism pattern of physical function, 2 in the knowledge deficit of newborn management, anxiety related to newborn management, knowledge deficit related to disease process of new-born, anxiety related to disease process of newborn anxiety related to prognosis of baby's condition, knowledge deficit related to newborn jaundice each appeared once. The changes in the number of nursing diagnoses was related to not the number of visits but to the number of nursing diagnoses decreasing. The con-tent of the home health care was categorized ac-cording to assessment, direct care, counseling, education, family care. The recommendation based on the results of this research are Home health care nurses for Cesarean postpartum women and their neonates requires comprehensive knowledge of pregnancy, delivery, and the postpartum period and of the neonate so that they can provide appropriate care and holistic views. Most of cases terminated after the second visit, this outcome may be related to the subjects being discharged on the 5th day after delivery. Therefore, study done with earlier discharge after delivery may have different outcome. It is very hard to assess psychological aspects that need follow-up and to develop communication channels.

• Journal of Korean Academy of Nursing Administration
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• v.19 no.2
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• pp.217-226
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• 2013

Purpose: Purpose of this research was to identify effects of application of a modified primary nursing system. Methods: Measurement was done of direct nursing time and satisfaction of nurses and patients before and after one month of the modified primary nursing system in a surgery unit in C university hospital, Seoul. Results: There was no statistically significant difference between average for patient satisfaction (4.24) before and (4.11) after application of the modified primary nursing system. Total average for nurse satisfaction with the nursing delivery system was 2.89 before application and, 3.34 after, indicating some significant differences (t=-4.06, p<.001). The KPCS-1 was 10.19 before application of the modified primary nursing system and 9.52 after application. Recalculated into direct nursing time, the average direct nursing time for one patient was 92 minutes before application, and 85.98 minutes after, indicating no significant difference. Conclusion: Through this research an attempt was made to build and test a modified primary nursing system. Results indicate that the most important thing is to clearly regulate office work and safely implement the new system.

• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.3
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• pp.252-267
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• 2017

Purpose: This study aimed to investigate clinical nurses' perception on nursing managerial competencies. Methods: This was a descriptive study. The data were collected from 198 nurse managers who had worked in six general hospitals using a self-reporting questionnaire. Data were analyzed by descriptive statistics, t-test, ANOVA, and Importance-Performance Analysis. Results: Only 32% of the participants had experienced nursing managerial competency training. The mean score for perceived performance of nursing managerial competency was lower than that for perceived importance. There were significant differences in perceived importance, performance, and importance-performance gaps among head, charge, and staff nurses. Importance-performance analysis showed that three of the 30 nursing managerial competencies require further development: staffing, human resources development and education, and nursing standard development competency. There were significant differences in importance-performance gaps according to age, career years in current hospital, work shift, position, nursing delivery system, and nursing managerial competency-education experience. Conclusion: A training program for developing and improving nursing managerial competencies which is focused on the gaps in importance and performance level is needed for clinical nurses. In addition, it should be considered to improve nursing work conditions such as nursing delivery system and formal appointment in order to increase the performance of nursing managerial competencies.

• Women's Health Nursing
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• v.5 no.1
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• pp.5-20
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• 1999

This study was conducted to examine primiparas' perception of delivery experience and identity as the mother("Myself as the Mother" and "My Baby") according to delivery methods such as normal delivery and cesarean section. The result of this study summarized as follows. 1. The primiparas' perception of delivery experience according to delivery methods showed that the primipars who had normally delivered perceives the delivery experience more positively than those by cesarean section(t=4.88, p=0.000). This fact supported hypothesis 1 that "the primiparas group by normal delivery should perceive the delivery experience more positively that by cesarean section." 2. The primiparas who had delivered by cesarean section were more positive in the SD-Self score than those who had normally delivered at the time when four weeks passed after delivered, and there was a significant difference(t=-4.21, p\0.000). Therefore, hypothesis 2-1 that "the primiparas group who had normally delivered should be more positive in the SD-Self 1-2 days and 4 weeks after delivery than one who delivered by cesarean section" was rejected. 3. It was shown that the primiparas who had delivered normally were more positive in the SD-Baby 1-2 days 4 weeks after delivery than those who delivered by cesarean section(after-delivery 1-2 days : t=3.10, p=0.002 and after-delivery 4 weeks : t=2.15, p=0.034). Based on this fact, hypothesis 2-2 that "the primiparas group who had delivered normally should be more positive in the SD-Baby 1-2days and 4 weeks after delivery than those who had delivered by cesarean section"was supported. 4. Primiparas who had delivered by cesarean section appeared to have a positive identity as the mother by showing a more significant difference (t=7.96, p=0.000) 4 weeks after delivery than 1-2 days after delivery. In conclusion, we see that primiparas' perception of delivery experience and identity as the mother were different according to delivery methods. Thus, it is required to devise a nursing in tervention strategy to expand support from the health care system and opportunities to provide pre. post-delivery programs so that primiparas can have a positive perception of delivery experience and a positive identity as the mother. Based on conclusion stated above, the following suggestions are made. 1. As this study compared the perception of delivery experience and identity as the mother between prmiparas who had delivered normally and ones who had delivered by cesarean section, the further study on comparison between multiparas who had delivered normally and ones who had delivered by cesarean section is needed. 2. According to the results of this study, longitudinal study is needed to examine the difference and change in the formation of maternal identity. 3. According to the result of this study, a study is also needed to determine interaction between time for maternal identity and delivery methods.

• The Korean Nurse
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• v.22 no.1 s.119
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• pp.34-46
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• 1983

This study is an investigation of nursing students'' attitudes towards the health care dilivery system. The purpose of the study is to contribute to nursing education based on the new health concept. Special Objectives Were: 1. To find out the acceptance

• Perspectives in Nursing Science
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• v.17 no.1
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• pp.49-60
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• 2020

Purpose: The purpose of this study is to describe women's concern for pregnancy and child birth in the internet community. Methods: One representative in the internet community was selected and questions regarding pregnancy and child birth were collected for 2 weeks in October 2019. A total of 8,005 questions were analyzed by frequency and proportion after categorizing theme into pregnancy, delivery, and postpartum care. Results: The most frequent questions were on preparedness for pregnancy (26.2%), followed by questions on infertility (23.3%), and on postpartum care (20.2%). Among the questions on preparedness for pregnancy, the most frequent questions were related to the follicle and ovulation. More than half of the questions on infertility (68.3%) were about diagnosis and treatment. Questions on abortion included symptoms, abortion procedure, post abortion care, and the support system. Among the questions on delivery, the most were about the delivery method (67.2%). Finally, questions on postpartum care were related to the physical changes/symptoms, daily life after delivery, postpartum care support, etc. Conclusion: As these results reflect women's need for information and support, it is suggested that more specific and targeted nursing practices for pregnancy and child birth should be developed.

• Health Policy and Management
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• v.33 no.4
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• pp.479-488
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• 2023

Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion: In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

• Korea Journal of Hospital Management
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• v.14 no.2
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• pp.60-74
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• 2009

This study purports to verify managerial effectiveness of the integrated delivery system(IDS) of Japanese health care institutions through comparing the managerial performance between hospital groups providing with both acute and nursing care and those with acute care only. Data on the managerial performance of 697 hospitals providing with nursing care together and 819 hospitals providing with acute care only were collected from Japanese Central Social Insurance Medical Councils 2001, 2003, 2005, and were analyzed using mean comparison test(t-test) between the two groups. The results revealed that there were significant differences between the two groups in such indicators as ratio of material cost, labor cost, depreciation rate, total margin, operating margin, average number of outpatient per day, average revenue of an inpatient per day, total amount of labor cost, gross revenue per employee, and labor productivity. However, we could not find out any consistent evidence which support the effect of integrated delivery system on the hospital managerial performance. Further discussion was made on the limitation of the study and future research agenda relevant to the topic.