• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.46-55
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• 2017

Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

• Journal of the Korean Operations Research and Management Science Society
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• v.37 no.4
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• pp.139-151
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• 2012

This paper introduces an Internet-based generic simulator for outpatient clinics, named PIOS (Postech Internet-based Outpatient Simulator). Unlike other simulation tools, PIOS is operated on the Internet, is straightforward to use for outpatient process analysis, and is open to public via http://logistics.postech.ac.kr/pios with free of charge. Therefore, non-simulation expert users such as hospital administrators and managers can easily access to PIOS and conduct simulation study by themselves. In this paper, we describe the main components and programming logic of PIOS, and demonstrate its validity by comparing the output results of PIOS and a commercial software package.

• IE interfaces
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• v.23 no.1
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• pp.1-11
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• 2010

There are various ways to manage the patient flow of the hospital outpatient system. However, it is difficult to apply many implementation solutions to the real outpatient system at once. Because first, the expected effects of each different solution are very much depend on the real situation of the system and applied other solutions, and second, owing to the limited resources, each solution should be implemented according to the priority. In order to overcome these difficulties, this paper focuses on proposing the comprehensive subset of implementation solutions, which is one of the most effective among various kinds of subsets, and verifying the effects of it. The comprehensive subset of solutions is derived from conducting design of experiments and simulation which determine the optimum set of different solutions and analyze the particular interactions and priority order among them. This implementation strategy can solve the difficulties of applying different kinds of various solutions to the hospital outpatient system.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.2
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• pp.45-53
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• 2015

Purpose: This study is to derive the behavioral characteristics of the users appear in the outpatient department of psychiatry. Methods: By referencing John Zeisel's Tools for environment-behavior research, observation of user behavior and expert interviews as a method of the study has been carried out. Results: The results of this study are as follows. First, adjacent placement among children, youth and regular the outpatient department of psychiatry is necessary and easy access to internal medicine department and family medicine department is required in order to allow cooperated treatments. Secondly, depending on the characteristics of the outpatient department of psychiatry treatment, adjustment of space requirement or the change of kinds of necessary space is required. Third, considering the psychological and behavioral characteristics of mental illness and guardians, various search for the environment that can support this. Implications: This study is a basic research for space improvement and evaluation of the outpatient department of psychiatry, and need to be followed by further study using various perspectives and methods.

• Journal of The Korea Institute of Healthcare Architecture
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• v.12 no.2
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• pp.31-39
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• 2006

Much has changed in the healthcare field since the beginning of the industrial age. In the healthcare field changes are occurring so rapidly and dramatically that yesterday's paradigm will not be tomorrow's paradigm, creating the need above all else to stay fluid and flexible as strategies(included healthcare architecture planning) for the future are developed. The purpose of this study is to analyze the latest architectural trends of general hospital outpatient department based on the healthcare environment changes in Korea. The major healthcare environment change is to change the object of hospital's healthcare services from inpatient to outpatient. In conclusion, the first, medical faculties of outpatient department are subdivided specialized small faculty. The second, clinic systems for medical examination and treatment of specific disease are activated in the most outpatient department. The third, specialized medical centers for chronical disease(Cancer, Cardiac etc.) control are arranged in existed outpatient department or freestanding facility. Specialized medical center for preventive medicine is regionally decentralized for corresponding with the healthcare paradigm shifts.

• Health Policy and Management
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• v.31 no.2
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• pp.207-216
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• 2021

Background: Good patient experience is positively associated with adherence to treatment recommendations, better clinical effectiveness, and health outcomes. This study aims to find out the key factors affecting positive patient experience to improve the quality of care using nationally representative survey data. Methods: The data was collected from the 6th National Health Nutrition Survey in 2015. Four patient experience items were investigated for patients with visiting outpatient care over the past year. Positive patient experience was defined as a case of responding always or usually yes. The t-test, chi-square test, and multiple logistic regression were performed to determine the key factors affecting the outpatient experience. Results: More than 80% of the respondents reported their care experience as positive excluding doctor spending enough time during the consultation. Male, poor health status, and single/divorced, and the longer time interval between outpatient care visit and survey were found to be significantly correlated with negative care experiences in the multiple logistic regression. Patients who received outpatient care at the oriental medicine clinic had a positive experience compared to those received outpatient care at the general hospital. However, patient factors including age, income, job, and insurance type had no significant association with patient experience. Conclusion: Health care providers should prioritize patients who report negative patient experiences and implement management decisions to improve the patient experience.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.27 no.3
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• pp.259-270
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• 2020

Purpose: This study aimed to identify nursing competencies of outpatient nurses, to develop a tool to assess the same, and to verify the validity and reliability of the tool. Method: Preliminary items of the scale were developed based on a literature review and nurses' interviews. The tool's content validity was verified by an expert panel and by conducting a pilot study. Subsequently, to verify the validity and reliability of the scale, data were collected from 233 outpatient nurses from 7 certified tertiary hospitals. Data were analyzed using exploratory factor analysis, independent t-test, and internal consistency and correlation analysis. Result: The factor analysis revealed the following 9 factors for the 48 items of the scale: organizational management, customer orientation, personality and ethics, problem solving, nursing practice, interpersonal relationships, communication, crisis management, and professionalism. The Cronbach's α coefficient of the final instrument was .97. Conclusion: The tool developed in this study exhibited adequate validity and reliability. It was effective in reflecting the changing roles of outpatient nurses. Therefore, in future, this tool is expected to help improve outpatient nurses' competencies and nursing quality.

• The Journal of Korean Medicine
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• v.35 no.3
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• pp.93-102
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• 2014

Objectives: This study aimed at revising the Korean Out-patient Groups for Korean Medicine (KOPG-OM, version 1.0) based on clinical similarity and resource use, by using the accumulated claims data, and evaluating the validity of the revised classification system. Methods: A clinical specialist panel involving 19 specialists from 8 Korean medicine (KM) specialty areas reviewed the classification tree, diagnosis groups and procedure groups in terms of clinical similarity. Several models of outpatient grouping were formulated, with the validity of each tested based on the $R^2$ coefficient of determination for the treatment costs of all visits. To add age splits, the variances of treatment costs by age groups were also analyzed. These statistical analyses were performed using KM claims data of National Health Insurance from 2010 to 2012. Results: The classification tree designed via panel discussions was used to allocate outpatient cases to 26 diagnosis groups, with cases involving procedures such as acupuncture, moxibustion and cupping, then allocated to 9 procedure groups in each diagnosis group. The cases without procedures were categorized into the visit index - medication group. This process resulted in 298 outpatient groups. The $R^2$ values for treatment costs of all visits ranged from 0.38 to 0.69 depending on the providers' types. Conclusions: The revised model of KOPG-KM has a higher validity for outpatient classification than the current system and can provide better management of the costs of outpatient care in KM.

• Journal of Korean Clinical Nursing Research
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• v.14 no.2
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• pp.31-45
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• 2008

Purpose: The purposes of this study were: (a) to identify role definition, tasks, and duties of the nurses who work in outpatient department (OPD), (b) to do Development a Curriculum(DACUM) chart, and (c) to compare duties and tasks among nurses, nurse's assistants, and doctors. Method: The DACUM committee was organized with 10 nurses who worked in OPD. The committee derived the duties and tasks of OPD nurses from what they had done at workplace. Validity of the derived duties and tasks was tested by 23 nurses at 15 university hospitals. Results: Eleven kinds of duties were identified: preparation for outpatient's medical examination; support for outpatient's medical examination; management of outpatients; outpatient education; outpatient counseling; special examination of outpatient; OPD administration; management of OPD supplies; management of facilities and environments of OPD; management of OPD personnel, and self-improvement. Ninety-two tasks were classified. Conclusion: The abilities for education and emergency care of OPD nurses should be empowered. The results of this study would not only contribute to the effective OPD nursing care, but also be useful as basic data in hospital management.

• Health Policy and Management
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• v.21 no.3
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• pp.397-413
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• 2011

Purpose: The purpose of this study is to examine the relationship between the income level and the healthcare utilization by health insurance type in all cancer patients in year 2005. Methods: The target population was cancer patients with health insurance who used healthcare as a diagnosis code (C00-C97) from January 1 to December 31 of 2005. The Korea Central Cancer Registry Center's Cancer Patient Registry Data, the list of cancer patients of the National Health Insurance Corporation, and the claim data of the Health Insurance Review & Assessment Service were used. The I was the wealthiest, followed by II, III, IV. The V was the poorest in this study. For the analysis, the $x^2$-test, ANOVA (and Kruskal-Wallis test), and regression were used. Results: Outpatient and hospitalization medical expenses, and outpatient visit days of cancer patients with self-employed health insurance were highest in I (p<.001, respectively), and the hospitalization days were the highest in II (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days of cancer patients with occupational health insurance were the highest in I (p<.001, respectively). Outpatient and hospitalization medical expenses, and outpatient visit and hospitalization days in cancer patients were higher in I compared to V, and higher in II and III, IV compared to V (p<.001, respectively). Conclusion: Supporting plan for cancer patients' outpatient healthcare utilization are necessary. Moreover, we should make specialized strategy for low income cancer patients with self-employed health insurance when we develop quality improvement policy for inpatient service.