• Title/Summary/Keyword: Outpatient clinic

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Investigating the Level of Competition between Public Health Centers and Private Clinics in Korea

  • Kim, Hyun Joo;Lee, Jin Yong;Jo, Min-Woo;Eun, Sang Jun
    • Korea Journal of Hospital Management
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    • v.21 no.2
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    • pp.37-49
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    • 2016
  • The purpose of this study is to investigate the level of competition between Public Health Centers (PHCs) and private clinics (PCs) by examining the number of patients that used PHCs vs. PCs, estimating the total amount of revenue generated from outpatient services at both PHCs and PCs, thereby analyzing the financial impacts on PCs derived from the PHCs. We utilized 2011 National Inpatient Sample data (NIS). Using the 20 table containing general information on each individual claims, we integrate it with the 40 table which contains all the diagnostic codes for each claim. Then, we disaggregate the bundled claims into the original individual claims. Overall, 3.1% of outpatient visits are made at PHCs while the rest was made at the PCs (96.9%). Among the total claim costs of 6.34 billion USD (as of 2011), PHCs occupy 2.0% (124 million USD), and 98.0% are contributed to PCs (6.21 billion USD). The estimated economic losses of PCs due to PHCs are summarized as follow; the maximum potential loss is estimated at 198 million USD in total and 7,099 USD per clinic when we include all patient types; the minimum loss is estimated at 71 million USD in total and 2,540 USD per clinic where Medical Aid recipients and the elderly (aged 65 and over) are excluded. Our results confirm the potential economic effect on PCs due to PHCs providing outpatient services. PCs and PHCs are the most important players providing primary care in Korea. Unnecessary competition between PCs and PHCs is not desirable. Health authorities should carefully examine the healthcare services currently provided by PHCs and their impacts on PCs.

A Chronological Study on the Transformation and the Spatial Characteristics of Ambulatory Care Facilities in the United States (미국 외래진료시설의 시대적 변천과 공간적 특성에 관한 연구)

  • Lee, Sukyung;Choi, Yoonkyung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.25 no.2
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    • pp.51-62
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    • 2019
  • Purpose: This study aims to examine spatial characteristics of ambulatory care department Chronologically through case studies; and to consider the social implication of these spatial changes. Methods: In this study, a total of eight ambulatory care departments, one or two for each period, were selected in order to analyze the spatial characteristics. Results: First, since the 1990s, the outpatient department of the US has been changed into a patient-centered space by providing high quality outpatient medical services through individual exam room planning. Second, the exam room has been changed from open/semi-open/group exam room to individual exam room since 1990, and the trend is shifting from the cluster type to the modular type consisting of universal exam rooms in order to achieve the flexibility of exam room. Third, the diagnostic/testing area has been deployed to the ambulatory clinic to enable 'one-stop shopping' for patients-centered care since 1990s, however, it has been disappearing since 2000 due to Reduce medical expenses. Fourth, the Central Nursing Station type first appeared in the outpatient department In the 2000s, followed by the type of decentralized nursing station type since 2010s. And fifth, the area of medical support has been placing to be concentrated on one place due to the Lean Design strategy since 2010. Implications: In the future, it is expected that Korea will be more focused on efficiency, visual control, and flexibility in the planning of the ambulatory care department as in the case of the United States.

A study on the productivity of physicians operating clinic in Kyeongsangnamdo (경상남도(慶尙南道) 개원의(開院醫)의 진료생산성(診療生産性)에 관한 조사연구(調査硏究))

  • Kim, J.H.;Jeong, K.W.;Chun, J.H.;Lee, C.U.;Pae, K.T.;Kim, K.H.;Shin, H.R.;Park, H.J.
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.171-180
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    • 1991
  • Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The mar results were as follows. First, physicians were more prevalent $35{\sim}44$ group (30.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization,'city (78.0%) in geographical location. Age group of 35-54 and specialist were mere prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatients load of all physician were 77.1 persons on average. Age group of $35{\sim}44$ had the most outpatient load (90.3 persons) among all age group, $6{\sim}10$ years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factors-number of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.

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SATISFACTION OF PATIENTS WITH DISABILITIES ABOUT OUTPATIENT GENERAL ANESTHESIA AND NURSING CARE FOR DENTAL TREATMENT (외래전신마취 하 치과치료를 시행한 성인 치과장애인의 치과마취과 간호사에 대한 만족도 조사)

  • Kim, Hye-Jung;Han, Jin-Hee;Han, Hee-Jeong;Kim, Hyun-Jeong;Yum, Kwang-Won;Seo, Kwang-Suk
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.2 no.2
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    • pp.136-141
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    • 2006
  • The purpose of this study is to survey the status of oral care of adult patients with disabilities and satisfaction degree of outpatient general anesthesia for dental treatment. 30 adult patients who underwent general anesthesia for dental treatment at clinic for the disabled in Seoul National University Dental Hospital enrolled for telephone survey. Many patients (83.3%) had mental problems to do social communication. And someone of family members (mainly mother) had cared for the patient but there was only one patient who got regular oral care. The satisfaction level of outpatient general anesthesia and nursing care for dental treatment was very high(100%).

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Research on the Design Guidelines and Implementations of Barrier-free Space for Children - Focused on the Common Spaces of the Outpatient Clinics in Pediatric Rehabilitation Hospitals - (어린이를 고려한 무장애공간 계획기준 및 적용실태 연구 - 어린이 재활병원의 외래부 공용공간을 중심으로 -)

  • Cho, Min-Jung
    • Korean Institute of Interior Design Journal
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    • v.25 no.4
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    • pp.113-124
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    • 2016
  • This research examines domestic and oversea's barrier-free design guidelines provided exclusively for children and their implementations in the common spaces of the outpatient clinics in two pediatric rehabilitation hospitals in Seoul. Based on literature review, a checklist was developed to compare various barrier-free design guidelines in consideration of children's accessibility in space. In addition, four spatial areas in the outpatient clinics of the two hospitals were investigated based on the checklist. As a result, the domestic and Japanese guidelines were aiming primarily to all user groups regardless of ages. Whereas in other oversea's guidelines, a number of barrier-free design standards exclusive for children were found in the facility items such as handrail, sink, urine, toilet, water fountain, chair, table, shelve, and so on, throughout the indoor waiting and sanitary spaces. Concerning implementations, most of the items in the indoor passage, waiting, and sanitary spaces of the two hospitals were not sufficiently facilitated enough to meet with the barrier-free design standards exclusive for children. As such, it is recommended to review and improve the current domestic barrier-free design guideline to accommodate various physical and spatial needs of children in all age groups and regardless of disability types, in the design of a pediatric rehabilitation hospital in the future.

The effect of change of mandatory referral system in an ophthalmology of tertiary care medical institution (의료전달체계 변경이 3차 의료기관 안과에 미친 영향)

  • Kim, Yang-Soo;Yu, Seung-Hum;Oh, Hyohn-Joo;Kwon, Oh-Whoong
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.88-104
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    • 2002
  • According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

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Impact of Life Style Characteristics on Prevalence Risk of Metabolic Syndrome (생활습관 요인이 대사증후군 유병 위험에 미치는 영향)

  • Yoo, Ji-Soo;Jeong, Jeong-In;Park, Chang-Gi;Kang, Se-Won;Ahn, Jeong-Ah
    • Journal of Korean Academy of Nursing
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    • v.39 no.4
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    • pp.594-601
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    • 2009
  • Purpose: The goal of this study was to evaluate the impact of life style characteristics on the prevalence risk of metabolic syndrome (MS). Methods: A total of 581 adults were recruited from a cardiovascular outpatient clinic. A newly developed comprehensive life style evaluation tool for MS patients was used, and patient data related to the MS diagnosis were reviewed from the hospital records. Results: The overall prevalence of MS was 53.2%, and the mean of MS score was 2.6 for patients at a cardiovascular outpatient clinic (78% of the patients had hypertension). Dietary habits among the life style characteristics had significant influence on the prevalence risk of MS and MS scores. And also interestingly, the classification and regression tree (CART) model suggested that the high prevalence risk groups for MS were older adults (61.5$\leq$age<79.4), and adults between 48.5 and 61.5 yr of age with bad dietary habits. Conclusion: This study indicates that nurses should focus on dietary habits of patients (especially patients classified as high prevalence risk for MS) for improvement and prevention of MS prevalence risk.

A Study on Applying a Korean Medical Integrative Program for Sleep Disorder (수면장애에 대한 한방통합프로그램의 적용 연구)

  • Lee, Jae-Eun;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.1
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    • pp.103-108
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    • 2013
  • Objectives : Korea's average life expectancy is getting longer and longer and the pace of change in society has increased every year as people experience stress more easily. Under this situation, chronic sleep disorder is increasing, but there is no specific program for the treatment of sleep disorder in Korean medicine. Therefore, we studied a Korean medical treatment program for sleep disorder to apply to outpatient clinic patients. Methods : For this study, we evaluated the Insomnia Severity Index (ISI), BDI, STAI, FSS on 29 insomnia patients who visited Kyunghee Korean medical hospital from July 2010 to May 2012. Herbal medicine, acupuncture, herbal acupuncture, moxibustion, sleep hygiene, and medical qigong were applied. We compared ISI scores before treatment and after 4 weeks of treatment. Results : ISI score was improved after Korean medical treatment for sleep disorder. Before the treatment ISI score was 18.1, which means clinical insomnia. After the Korean medical treatment, the score was 7.5, which means no clinically significant insomnia. Conclusions : The study showed a significant effect on the Korean medical treatment program for sleep disorder to apply to outpatient clinic patients. ISI score was improved and the patients were satisfied with the treatment, so it would be more helpful to apply in sleep clinics.

Determination of the type-2 diabetes risk status of the individuals who applied to the internal diseases outpatient clinic

  • Emine, Kiyak;Nermin, Olgun;Cigdem, Inan
    • CELLMED
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    • v.4 no.3
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    • pp.21.1-21.5
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    • 2014
  • The purpose of this study is to determine the type-2 diabetes risk status of the individuals applying to the internal diseases outpatient clinic and the affecting factors. This descriptive study was conducted on 500 individuals who applied to the internal diseases department of a hospital in Ordu Turkey, between May and June 2010 without diabetes diagnosis. The questionnaire form and Type 2 Diabetes Risk Assessment Form are used to collect the data. For the evaluation of data; independent samples t-test and One-Way Anova are used to evaluate the data. It is determined that the type-2 diabetes risk an score of the individuals participating in the study is $10.4{\pm}5.5$ and 32.4% of them have low type-2 diabetes risk score, 26.6% have slightly elevated score, 18% have moderate score, 16.6% have high and 6.4% have very high type-2 diabetes risk score. It is found that the type-2 diabetes risk mean score of the women participating in the study who are adults, are married, have low education level, are unemployed, are non-smoker, do not drink alcohol and do not have any information about type-2 diabetes is statistically significantly high (p < 0.05). It is determined that 16.6% of the individuals participating in the study have high type-2 diabetes risk and 6.4% have very high type-2 diabetes risk.