• Research in Community and Public Health Nursing
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• v.26 no.2
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• pp.89-99
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• 2015

Purpose: The purpose of this study was to demonstrate the effects of visiting nursing services in long-term care (LTC) insurance on changes in health status and physical functions among the elderly. Methods: We analyzed survey data on the living status and welfare needs of the elderly from 2008 and 2011 using the difference-in-difference method with propensity score matching. Results: The subjects were 76 elders including 38 visiting nursing service users(intervention group) and 38 home-based LTC service users (control group). Results from DID analysis confirmed that the subjective health status level of the intervention group was 2.2 points higher (p=.044) and the depression level was 0.3 point lower (p=.039) than the control group. In addition, the intervention group's ADL score was 1.9 (p=.027) and IADL 3.9 (p=.030), showing that their health was deteriorated less. Conclusion: Visiting nursing service in LTC insurance was associated with delayed deterioration of subjective health status, depression, ADL and IADL. These findings suggest the need of rebuilding visiting nursing service programs focusing on prevention services, which will be more contributive to elderly health care and the reduction of social costs.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.3
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• pp.317-326
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• 2015

Purpose: The purpose of this study was to identify factors related to the loyalty of Chinese customers who use Korean medical and tourism services. Methods: Participants were 158 Chinese who visited plastic surgery clinics in Korea. Data were analyzed using descriptive statistics, One-way ANOVA, $Scheff{{\acute{e}}$ test, Pearson Correlation and Hierachical Multiple Regression. Results: Medical service quality, tourism service quality and medical and service satisfaction were positively correlated with customer loyalty. Medical service quality and medical and tourism service satisfaction had significant influence on customer loyalty. The explained variance for customer loyalty was 84.9%. Conclusion: These results suggest the need to improve the tourism service and medical and tourism service satisfaction to retain loyal customers.

• Journal of Korean Academy of Nursing
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• v.42 no.7
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• pp.928-935
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• 2012

Purpose: The current study was done to identify individual- and group-level factors associated with health care service utilization among Korean medical aid beneficiaries by applying multilevel modeling. Methods: Secondary data analysis was performed using data on health care service reimbursement and medical aid case management progress from 15,948 beneficiaries, and data from 229 regions were included in the analysis. Results: Results of multilevel analysis showed an estimated intraclass correlation coefficient (ICC) of 18.1%, indicating that the group level accounted for 18.1% of the total variance in health care service utilization, and that beneficiaries within the region are more likely to share common features with regard to health care service utilization. At the individual level, existence of disability and types of medical aid beneficiaries showed a significant association, while, at the group level, social deprivation index, and the number of beneficiaries and case managers within the region showed a significant association with health care service utilization. Conclusion: The significant influence of group level variables in health care service utilization found in this study indicate a need for group level approaches, such as policy change and/or promotion of community awareness.

• Research in Community and Public Health Nursing
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• v.25 no.3
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• pp.159-169
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• 2014

Purpose: The purpose of this study was to evaluate the effectiveness of case management for patients with hypertension on their health status and medical service utilization. Methods: This study was a secondary analysis of data collected for a larger study of chronic disease management in 2008 using the National Health Insurance Corporation database. A total of 12,944 patients who received case management for hypertension were included in this analysis. The subjects of case management were classified into subgroups, namely, over-use, under-use, and non-use groups according to the amount of medical service utilization. To compare the medical service utilization, a control group was selected randomly. The data were analyzed through descriptive statistics, McNemar test, and ANOVA. Results: All the subgroups displayed significant differences in blood pressure, self-management, social support, and their characteristics of medical service utilization. The total medical expense of the under-use and non-use groups increased after case management. However, there was no decrease in the medical expense of the over-use group. Conclusion: This finding suggests that there is a need to re-examine why patients overuse medical services and to supplement specific strategies for encouraging appropriate medical service utilization, and enhancing case management efforts for the over-use group.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.19 no.2
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• pp.139-149
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• 2012

Purpose: The purpose of this study is to provide the basic data required for quality improvement of home health care nursing and development of nursing services for cancer patients by examining the frequency of practices, level of service needs and satisfaction for nursing services. Methods: The subjects were 231 patients who agreed in participating on this study and were receiving home health care nursing services by the home health care advanced practice nurse from two national hospitals and four subsidiary general hospitals, located in Seoul from September 30, 2008 to February 28, 2009. Data were analyzed by frequency, percentage, t-test and ANOVA, using SPSS WIN 12.0 program. Results: The most frequent practices were 'checking vital sign' and 'explaining what patient want to know.' Total service need had an average of 3.03 point and emotional domain showed the highest average of 3.44 point. Total satisfaction had an average of 4.23 point and satisfaction along diseases had the highest average of 3.65 point in case of non-metastasis cancer. Conclusion: The subjects were highly satisfied with home health care nursing services which gave positive effect to them. It will be helpful to give cancer patients physical and spiritual care complementally when home health care nurses provide nursing services.

• Journal of Korean Public Health Nursing
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• v.16 no.2
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• pp.354-377
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• 2002

Aging population is a global trend and Korea is no exception. Due to the progress of the medical and scientific sectors, increase in the average lifetime incurred increase in the number of elderly people. Meanwhile, the family function of supporting the elderly has become a major issue in a society due to the changes in the society's structure and increased entry of the women into the workforce. As a means to substitute the protection of the elderly who are not protected at their respective homes and to replace the tending needs, weekly protection centers and short-stay centers for the elderly were established and operated in Seoul since 1992. However, structured and satisfactory services are not yet to be provided, thus this research intends to understand the current situation at the short-stay centers for the elderly, to identify users' characteristics and to conduct study on nursing need for the health reasons so that the results of the research can be utilized as basic data for the development of nursing care program. Towards this end, this research targeted 142 elderly people who were undergoing treatment at the 11 short-stay centers for the elderly out of total of 13 located in Seoul that were willing to cooperate. The research was conducted from April to May 2002, with the measurement tool developed by Rhee, Seon-ja (2001) to measure the level of nursing need. Then data was collected and analyzed using SPSS program. The results are as follows. The general characteristics of users of the short-stay centers for the elderly were: 123 females $(86.6\%)$, 19 males $(13.4\%)$ and 72 elderly were over the age of 80 $(50.7\%)$. Among these, 24$(16.9\%)$ were living by themselves. Among the illnesses that the subjects were inflicted with were: dementia $(54.2\%)$, stroke $(54.1\%)$ and high blood pressure $(50.7\%)$, in the respective order. Despite the fact that they were diagnosed with illnesses, $47.2\%$ responded that they do not undergo special treatment due to financial reasons. When the level of needs for nursing care among the elderly who use the short-stay centers is divided into informational. physical. and emotional need levels and scored between zero to two, the level of emotional need is the highest with 1.80, followed by physical (1.45) and informational (1.44) need levels. As for the realities of services at the centers and improvement areas, restriction on term was cited as the greatest inconvenience with $38.7\%$, followed by lack of budget (24 respondents, $16.9\%$). Wishful services were financial assistance $(46.5\%)$, medical and nursing services $(40.1\%)$, meal provision service $(8.5\%)$ and counseling service $(4.9\%)$, in the respective order. Based on the above mentioned results, the research identified the need to develop nursing program for the patients of dementia that can be applied onto the short-stay centers and the need to develop volunteer service, backed by societal support. Also, placement of specialized cadre of professionals is needed so that medical and nursing service functions can be provided in a complementary manner.

• Child Health Nursing Research
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• v.12 no.2
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• pp.160-169
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• 2006

Purpose: This study was to explore the child's health and learning needs of mother of children with leukemia in a children school of a hospital and to describe the basic material for intervention program development. Methods: Participants in this study was 7 mother of children with leukemia. Data collection consisted of in-depth focus group interviews done from April 21 to 30 in 2005. Results: 3 categories emerged from 9 theme clusters. The categories was 'tutorial service', 'emotional service' and 'disease control'. Conclusion: The results of this study show that pediatric nurses need to pay attention to the learning needs of mother and children in the children school of hospital and develop the program to support the children with leukemia and chronic disease.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.405-418
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• 1998

The purpose of this study was to describe patients satisfaction with nursing care in the emergency department and factors influencing satisfaction rates. 1. The mean score of patient satisfaction with nursing care in the emergency departments was 2.70. The mean scores of patient satisfaction with different aspects of nursing care services were 3.05 for nursing services for psychological safety: 2.67 for technical competence: 2.49 for information giving: and 1.35 for discharge teaching. 2. Patient satisfaction with nursing care services provided. according to the general characteristics of the patients. was revealed as being significantly high for the groups of patients made up of those who were male. those over 51years of age. married subjects. those with an education level of high school or below level. housewives. Buddhists. and those in the middle economic level. Patient satisfaction with nursing care according to their service utilization in the emergency departments revealed that satisfaction was significantly high for patients who were in internal medicine. neurology or psychiatry. those admitted for the first time. those for whom the distance from the department to home was less than 30 minutes. patients who visited between monday and Friday and between 8AM and 4PM. patients who did not have to wait to be seen and those who stayed in the department less than 24 hours. 3. The correlation between the patients' general characteristics. nursing service utilization of the patients in the department and their satisfaction with nursing care showed that patients with longer waiting time had lower satisfactory scores for nursing service. 4. The registered nurses working in the emergency department reported that the main reasons for low satisfaction rates included 'over worked nurses' and 'too many patients' in the emergency department. In conclusion. the results of this study suggest the necessity of developing relevant nursing interventions for discharge teaching to increase patient satisfaction with nursing care services in emergency departments: and the need for adequate support from hospital administrators to improve patients' service utilization.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.307-319
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• 1998

This study is an empirical investigation and study on the measurement of nursing service quality as perceived by patients. A series of H1. H2. H3 alternative hypotheses were tested using a sample of 250 patients in Taegu City. Korea. HI hypothese were tested for application of five component of service quality (SERVQlTAL and SE RPERF : tangiblity. reliability. responsiveness. accessibility. understandability) in Taegu area Hospitals. Validity test - the five components of service quality were rearranged into two components of service quality (personal factor. nonpersonal factor). Although SERVQUAL was verified in USA. application for five components of service quality in Korea indicated that it need more analytical studies. Nobody can deny the fact that the recent growth of the nursing service quality is one of the most important driving forces of hospital management. In many hospitals. the nursing quality charges more than 50% of the medical service quality. As a result. many hospital managers should be enormous interests in the investment potentiality of the nursing service. However. doesn't many researchers invest their time and effort on the research of the quality control in nursing service. Nursing service management is the process to satisfy customer's desires and expectations through the various service activities. Presently nursing service are being faced with three Common tasks of improving quality of nursing service. competitively differential advantage and productivity because of quantitative expansion of Nursing service. Such a phenomenon is also found in our medical service industry. resulting from increasing demands for medical service owing to national medical insurance policy and consumer's attitude change emphasizing prevention of illness. excessiveness of medical facilities in large cities and increasing medical lawsuits due to influence of consumerism. Therefore. under such circumstances. this research on nursing service is conducted from nursing managements to improve the nursing service quality problems faced by medical institutions. The results of this theoretical/empirical research are as follows: 1. Nursing service Quality is regarded as patients' perceived quality and evaluated on the basis (5 dimension) of technical and functional quality. 2. Nursing service Quality is a concept of patients evaluation on the measurable multi-dimensions intrinsic and extrinsic attributes of service. 3. Nursing service Quality is conceptually defined as the difference between the perceived service and the expected service. 4. Korean consumers trend to evaluate nursing service quality based on such dimensions as responsiveness and reliability. understandability. accessibility. tangibility. 5. After analyzing whether or not there are some differences in respective medical institution. it was found that there are significant difference on understandability. reliability. communicability. courtesy. competence. 6. After analyzing the difference between the expected nursing service and the nursing perceived service, it was found that the expected nursing service is higher than the perceived service in every medical institution. 7. HI hypothesis was tested with regard to the validity test between SERVQUAL and SERVPERF in nursing service quality. The result of validity test between SERVQUAL and SERVPERF was found to have differential result. That is the R2 of SERVPERF is higher than that of SERVQUAL. Therefore. HI was verified in nursing management. H2. H3 hypotheses were tested whether or not the nursing service quality and patient satisfaction is the preceding variable. The result of H2 hypothes is that the nursing service quality is the preceding variable of patient satisfaction and the patient satisfaction is that of revisiting intention. After analyzing whether or not there is any differences on the demographic variable of five nursing service quality factor. it was found that there are statistically significant differences on communicability and courtesy at the sex. understand ability. accessibility and tangibility at the age. understandability at the academic background respectively.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.7 no.1
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• pp.26-38
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• 2000

The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.