• 제목/요약/키워드: Outpatient clinics

검색결과 179건 처리시간 0.025초

일 종합병원 외래간호단위의 효율성 평가 -자료포락분석법(Data Envelopment Analysis)의 적용 (Evaluation of Efficiency of Outpatient Clinic in a General Hospital using Data Envelopment Analysis (DEA))

  • 임혜빈;임지영
    • 가정간호학회지
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    • 제19권1호
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    • pp.11-18
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    • 2012
  • Purpose: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.

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Impact of the Outpatient Prescription Incentive Program on Reduction of Pharmaceutical Costs of Clinics in South Korea

  • Kwon, Seong Hee;Han, Kyu-Tae;Park, Sohee;Moon, Ki Tae;Park, Eun-Cheol
    • 보건행정학회지
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    • 제27권3호
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    • pp.247-255
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    • 2017
  • Background: South Korea has experienced problems with excessive pharmaceutical expenditures. In 2010, the South Korean government introduced an outpatient prescription incentive program to effectively manage pharmaceutical expenditures. Therefore, we examined the relationship between the outpatient prescription incentive program and pharmaceutical expenditures. Methods: We used data from the Korean National Health Insurance claims database, which included medical claims filed for 22,732 clinics from 2011-2014 to evaluate associated pharmaceutical expenditures. We performed multiple regression analysis and Poisson regression analysis using generalized estimating equation models to examine the associations between outpatient prescription incentives and the outcome variables. Results: The data used in this study consisted of 123,392 cases from 22,372 clinics (average 5.4 periods follow-up). Clinics that had received outpatient prescription incentives in the last period had better cost saving and Outpatient Prescribing Costliness Index (OPCI) (received: proportion of cost saving, ${\beta}=6.8179$; p-value < 0.0001; OPCI, ${\beta}=-0.0227$; p-value < 0.0001; reference = non-received). Moreover, these clinics had higher risk in the provision of outpatient prescription incentive (relative risk, 2.772; 95% confidence interval, 2.720 to 2.824). The associations were higher in clinics that had separate prescribing and dispensing programs, or had professional staff. Conclusion: The introduction of an outpatient prescription incentive program for clinics effectively managed problems with rapid increases of pharmaceutical expenditures in South Korea. However, the pharmaceutical expenditures still increased in spite of the positive impact of the outpatient prescription incentive program. Therefore, healthcare professionals and health policy makers should develop more effective alternatives (i.e., for clinics without separate prescribing and dispensing programs) based on our results.

외래환자 진료 프로세스를 위한 인터넷 기반 Generic 시뮬레이션 모델 (Internet-based Generic Simulation Model for Outpatient Clinics)

  • 구정인;이기호;이종성;이홍;김병인
    • 한국경영과학회지
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    • 제37권4호
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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.

어린이를 고려한 무장애공간 계획기준 및 적용실태 연구 - 어린이 재활병원의 외래부 공용공간을 중심으로 - (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 -)

  • 조민정
    • 한국실내디자인학회논문집
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    • 제25권4호
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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.

1차 의료기관의 급성 상기도 감염 질환자 의약품 처방특성 - 가정의학과, 내과, 소아청소년과, 이비인후과, 일반의 중심으로 - (Characteristics of Prescription Drugs for Acute Upper Respiratory Tract Infection in Outpatient Clinics - Centered on Family Medicine, Internal Medicine, Pediatrics, Otorhinolaryngology and General Practitioner Clinics -)

  • 공미진;황병덕
    • 보건의료산업학회지
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    • 제11권3호
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    • pp.37-49
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    • 2017
  • Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

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

  • 김현주;이진용;조민우;은상준
    • 한국병원경영학회지
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    • 제21권2호
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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.

건강보험과 의료급여 노인환자의 의료이용량 : 요양기관종별 분석 (Medical Care Utilization between National Health Insurance and Medical Assistance in Elderly Patients)

  • 이용재
    • 한국콘텐츠학회논문지
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    • 제17권4호
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    • pp.585-595
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    • 2017
  • 본 연구는 의료급여와 건강보험환자의 의료이용량의 차이를 분석하여 의료급여환자의 도덕적 해이로 인한 진료비 증가문제를 평가하고 합리적 의료급여 정책결정의 근거를 제시하기 위한 것이다. 이를 위하여 서울시민대상 건강보험과 의료급여 급여자료를 성별 연령별 의료기관 종별로 비교 분석하였다. 분석결과는 다음과 같다. 첫째, 상급종합병원의 입원 외래이용 모두 의료급여환자가 건강보험환자에 비해서 적어서 도덕적 해이가 존재하지 않았다. 오히려 의료급여환자들이 고비용 의료서비스를 이용하고 못하고 있었다. 둘째, 종합병원의 입원이용은 건강보험환자가 많은 반면 외래이용은 의료급여환자가 많아서 의료급여환자들이 본인부담이 적은 외래서비스 이용을 많이 이용하고 있었다. 셋째, 병원 의원은 의료급여환자의 이용이 입원과 외래이용 모두 건강보험환자에 비해서 많았다. 따라서 의료급여환자들은 병원 의원의 입원과 외래이용, 종합병원의 외래이용시 적은 본인부담으로 인해 불필요한 의료이용을 할 가능성이 있는 반면에 상급 종합병원 입원과 외래이용, 종합병원의 입원이용시 비급여 의료비 등 과도한 의료비 부담으로 인해 필요한 의료서비스 이용을 하지 못할 가능성도 있었다. 따라서 중증질환을 가진 의료급여환자들의 의료비 부담을 경감시키기 위한 정책은 지속하고, 의원 병원을 이용하는 의료급여환자들이 불필요한 의료서비스를 이용하지 않도록 관리해야 할 것이다.

Predictors of Mammography Screening among Iranian Women Attending Outpatient Clinics in Tehran, Iran

  • Ahmadian, Maryam;Samah, Asnarulkhadi Abu;Redzuan, Ma'rof;Emby, Zahid
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.969-974
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    • 2012
  • Mammography utilization is low in Iran compared with other countries. Here a cross-sectional survey design was used to investigate psycho-social and individual factors associated with mammography among 400 women asymptomatic of breast cancer. The study was carried out at the four outpatient clinics of Tehran during the period from July through October, 2009. We found that mammography screening was related to higher self-efficacy and women's occupation. Future tailored interventions on potential psycho-social determinants and specific demographic factors are critical in increasing mammography screening rates among Iranian women.

30세 이상 한방의료기관 외래환자 중 비복합 및 복합만성질환자의 의료이용과 결정요인 - 2011년 한방의료이용 및 한약소비실태조사보고서(보건복지부)자료를 중심으로 - (The Use and its Affecting Factors of patients aged 30 and over with single and multiple chronic diseases and their usage outpatient Korean medicine clinics - Based on the Ministry of Health and Welfare's 2011 Report on usage of Korean medicine -)

  • 윤진원;최성용;이선동
    • 대한예방한의학회지
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    • 제19권1호
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    • pp.95-107
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    • 2015
  • Objective : To use and its affecting factors of patients' outpatient treatment that have single and multiple chronic illnesses Method : We used the 2011 study by the Ministry of Health and Welfare, "Report on Usage and Consumption of Korean Medicine." This report was conducted on outpatients and inpatients that visited Korean traditional medicine, from August 25th, 2011, to September 30th, 2011. Our research was based on 1729 patients with chronic diseases aged 30 and over who received outpatient treatment during the last three months. Results : There were 1365 patients with non-complex chronic diseases, while there were 364 patients with complex chronis diseases. Patients had 1 - 8 chronic diseases, and the average number (standard deviation) was 1.26 (0.59). There were statistically significant differences by sex(P<0.0001), age(p=0.0045), marriage (p=0.0060), education level(p<0.0001), income level(P=0.0063), and types of health insurance(p=0.0023). The diseases most common among patients with non-complex chronic diseases were: low back pain, arthritis, gastrointestinal disorder, frozen shoulder, side effects from motor accidents, high blood pressure, fracture, stroke, diabetes, cancer, atopic dermatitis, and asthma. The diseases most common among patients with non-complex chronic diseases were: arthritis+low back pain, low back pain+gastrointestinal disorder, low back pain+side effects from motor accidents, low back pain+frozen shoulder, arthritis+gastrointestinal disease, gastrointestinal disease+frozen shoulder, arthritis+low back pain+gastrointestinal disease, high blood pressure+arthritis, arthritis+low back pain+frozen shoulder, arthritis+fracture, and arthritis+side effects from motor accidents. There were statistically significant differences among the usage of medical clinics by: frequently used clinic (p<0.0001), number of treatment (p<0.0001), the cost of outpatient treatment (p=0.0073), the satisfaction rate (p=0.0171), whether the clinic is the preferred clinic (p=0.0040). In model 1, men than women, people who had local benefits instead of type 1 medical aid, and patients with complex chronic diseases were more likely to use Korean medical clinics. In model 2, men than women, people who had local benefits than people with types 1 and 2 medical aids, people who went to pharmacies and Korean medicine pharmacies than people who went to hospitals, people who went to get treatment 1-10 times than people who visited 11-20 times and more than 41 times, and people who spent less than ten thousand Korean won than people who spent 1 to 2 million Korean won, and people without complex chronic diseases were more likely to use Korean medical treatment. Conclusion : There were differences in sociodemographic characteristics and the usage of medical clinics between patients with non-complex chronic diseases and patients with complex chronic diseases. Among patients with complex chronic diseases, women, patients with types 1 and 2 medical aid, patients who used Korean medical clinics, patients who were treated 11-20 times and more than 41 times, and patients who spent 1 million to 2 million Korean won on outpatient treatment used less treatment than patients with non-complex chronic diseases. However, patients with complex chronic diseases used pharmacies and Korean medicine pharmacies more.

종합병원 외래진료부의 공간구성과 규모계획에 관한 조사연구 - 최근 계획된 500병상 이상 규모의 종합병원을 중심으로 - (A Study on the Spatial Organization of Outpatient Department in General Hospital - Focused on the Latest Planned General Hospital of Scale more than 500 Beds -)

  • 손재원;이특구
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제13권2호
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    • pp.53-60
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    • 2007
  • Various changes in medical environments including growing elderly population, chronic diseases, deepening competition among hospitals since opening to foreign medical service, economic strategy for improvement of profit system have caused hospitals to be specialized. In this backgrounds, the purpose of this study is to receive basic data for architectural planning on the spatial organization of outpatient department in general hospital. The results of this study were as follows; First, major changes of outpatient department in general hospital are composed of 'co-work in medical examination and treatment', 'decentralization of diagnosis and treatment(D/T)' and 'patient-oriented medical service'. Changes by co-work system include appearance of medical offices for co-work, activation of specialized clinics, grouping of E/T section for outpatient and various types of specialized centers. Second, the grouping of E/T sections means the modification of E/T system and organization in general hospitals, and a new spatial organization will be needed. Third, the types of specialized centers are getting varied. they are classified into several types including disease-resource, social stratum-resource, human organ-resource, health-resource, rehabilitation-resource, alternative medical center and so on.

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