• 보건행정학회지
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• 제31권2호
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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.

• 디지털융복합연구
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• 제18권7호
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• pp.299-306
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• 2020

본 연구는 환자중심성 의료문화 변화에 따라, 데이터마이닝 기법을 이용한 융복합 외래 의료서비스 환자경험조사 연구를 시행하여 환자중심성 의료기관 경영전략에 도움이 될 수 구체적 방안을 모색하고자 하였다. '2018 의료서비스경험조사' 원시자료를 이용하여 외래 의료서비스 환자경험이 있는 만 15세 이상 8,843명을 분석하였다. 의사결정나무분석을 수행하였다. 외래 의료서비스 환자경험에 대한 전반적 만족도 결정요인은 의사와 환자 권리보호였으며 추천의사 결정요인은 의사와 시설의 안락함과 편안함이었다. 여성이 남성에 비해 전반적 만족도에서 경험을 긍정적으로 평가했으며 60세 이상이 전반적 만족도와 추천의사에 대한 경험을 긍정적으로 평가했다. 외래 의료서비스 환자경험 의사결정예측 모형을 제시하고 의사 영역과 환자권리보호 영역, 시설의 안락함과 편안함이 중요한 요인임을 확인한 점이 의의가 있다. '의료서비스경험조사'에 대한 종단적 연구가 필요하며 입원 의료서비스경험에 대한 연구가 필요하다.

• 한국융합학회논문지
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• 제7권3호
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• pp.111-120
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• 2016

본 논문의 목적은 종합병원에 근무하는 비정규직 외래간호사가 겪는 경험 세계를 주관적이고 총체적으로 통찰하여 그들의 삶을 이해하는 것이다. 연구 대상자로 자신의 경험을 풍부히 나타낼 수 있는 종합병원 비정규직 외래간호사 7명을 임의 표출하였으며, Colaizzi의 현상학적 질적 연구 방법으로 분석하여 4개의 주제 묶음과 8개의 하위 범주로 도출되었다. 연구결과 비정규직 외래간호사는 계약직이라는 특수한 고용방법으로 인해 표면적으로는 근무환경에 만족한 것으로 나타났으나, 그 이면에는 보상이나 발전에 대한 불만이라는 양가감정을 느끼고 있음을 발견하였다. 이상의 결과들은 비정규직 외래간호사들의 근무경험에 대한 본질을 이해하는데 유용한 자료를 제공할 것이며, 이를 통해 비정규직 외래간호사들이 직면하고 있는 현실적인 문제에 관심을 갖고 접근할 수 있는 근거를 뒷받침할 수 있는 계기가 되기를 기대한다.

• 보건의료산업학회지
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• 제14권1호
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• pp.15-30
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• 2020

Objectives: This study investigated outpatient health care satisfaction and influential factors using data from the "2018 Health Care Experience Survey". Methods: Data on 6,705 participants in the Health Care Experience Survey were statistically examined using a t-test, ANOVA, and multiple regression analysis. Results: First, the level of satisfaction among outpatients was generally positive, and satisfaction among older people was high. Second, the significant factors of outpatient overall satisfaction were gender, consultation time, waiting time, reason for choosing institution, satisfaction with doctors, nurses, institutions, and the therapeutic result. Third, influential factors of intention to recommend were education, institution type, reason for choosing institution, satisfaction with doctors, nurses, institutions, and the therapeutic result. Conclusions: In order to improve the overall satisfaction of outpatients, the treatment method should be improved. For example, the doctor should devote more time for and engage in sufficient conversation with the patient, the nurse should be polite, and patients should be given easy-to-understand explanations.

• 동서간호학연구지
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• 제28권2호
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• pp.179-189
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• 2022

Purpose: Based on the results of Grandey's Emotion Regulation Process Model and previous studies, this study was conducted to identify the relationship between emotional labor, communication competency, emotional intelligence, social support, and burnout, and to identify factors affecting burnout of nurses in outpatient department. Method: The participants were 190 nurses with more than six months of experience working at the outpatient department of a general hospital in Seoul. Data were collected from April 5 to May 28, 2021, and analyzed using SPSS/WIN 25.0. Results: Significant variables affecting burnout were emotional labor, communication competency, emotional intelligence, education, and total clinical experience. Social support showed a statistically significant negative correlation with burnout, but did not affect burnout. Burnout showed a statistically significant a positive correlation with emotional labor, and showed a negative correlation with communication competency, emotional intelligence and social support. We found a negative correlation between burnout and subjective health status. Emotional labor had a positive effect on burnout. Emotional intelligence, clinical experience for more than 10 years, communication competency, and education for masters or higher negatively affected burnout, respectively. They accounted for 49.2% of the total variance of burnout. Conclusion: Based on the results of this study, it is necessary to reduce emotional labor, one of the major predictors of burnout for outpatient care. In order to prevent emotional labor that results in burnout, an integrated program that improves emotional intelligence and communication competency should be developed.

• 성인간호학회지
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• 제24권6호
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• pp.588-596
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• 2012

Purpose: The purpose of this study was to identify factors that influence depression in stomach cancer patients receiving chemotherapy at outpatient clinic. Methods: A cross-sectional design was used. Ninety two subjects diagnosed with stomach cancer and receiving chemotherapy agreed to participated in the study. Subjects completed a survey which included questions about depression, symptom experience, social support and self-efficacy. Results: The level of depression was $13.45{\pm}6.92$. Reported depression differed according to patient's perceived health status. Depression was significantly correlated with symptom experience, social support and self-efficacy. The most important factor related to depression was symptom experience, followed by social support and self-efficacy. These three factors could explain about 47% of depression in stomach cancer patients receiving chemotherapy. Conclusion: Although the level of depression in stomach cancer patients receiving chemotherapy was relatively low, 34.8% of patients reported to have depression. It is important to apply nursing intervention including screening of depression level in stomach cancer patients receiving chemotherapy that focused on symptom experience and to consider about social support and self-efficacy at outpatient clinic.

• 보건행정학회지
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• 제18권1호
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• pp.21-42
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• 2008

This study investigates economies of scale, cost complementarity and economies of scope for healthcare organizations using econometric approaches. The economies of scale appear to exist in each service provided by a hospital such as inpatient treatment services, outpatient treatment services, and other patient treatment services, respectively. When we test all services in aggregate level, it also indicates that the healthcare industry on average exhibits the economies of scale of 6 percent, which implies that scaling up hospital sizes will bring substantial cost savings to them Evidence shows that cost complementarity exists between outpatient services and other services for patients and, i.e., these other services for patients experience the reduction in marginal costs as the outputs of the outpatient services increase. For the economies of scope, they are present in most service areas; aggregate level services, outpatient services, and other services for patients, respectively. Inpatient treatment services, however, do not show any evidence of the economies of scope. Results show that the economies of scope are achieved by the general hospital type that provides all service areas such as inpatient treatments, outpatient treatments, and other services for patients. The existence of the economies of scope provides the rationale for extending the existing line of business in a hospital into more diverse areas of services where its benefit comes in the form of cost savings. In sum, it overall provides evidence that the M&As in this industry are encouraged to achieve cost reductions from the economies of scale and scope by changing the size and the output mix.

• 의료커뮤니케이션
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• 제13권2호
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• pp.159-166
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• 2018

Background: It is important to investigate patient satisfaction to improve the quality of healthcare. Among the many factors that affect patient satisfaction, perceived health status has been considered as one of the major factors. Therefore, we investigated patient satisfaction through patient experience in outpatient settings according to perceived health status. Methods: This cross-sectional study using questionnaires of patient experience and perceived health status from the Korean National Health and Nutrition Examination Survey 2015 included 4267 people aged over 19 years who met the inclusion criteria. Perceived health status was classified into three: good, fair, and poor. Questions about patient experience consisted of four items: doctor spending enough time with patients, doctor providing easy-to-understand explanation, doctor giving opportunity to ask questions or raise concerns, and doctor involving patient in decisions about care or treatment. Patient experience was classified into two: satisfied and non-satisfied. A multivariate regression model was used to analyze the data. Results: In the good perceived health status group, level of satisfaction was 79.2%, 88.5%, 83.3% and 87.2%, respectively for the four items targeting patient experience. In the poor group, level of satisfaction was 76%, 84.9%, 79.5%, and 83.1%, respectively for the four items. In multivariate logistic regression analyses, the odds ratios of good perceived health status group were 1.775 (1.347-2.338), 1.946 (1.356-2.793), 1.652 (1.218-2.240), and 1.665 (1.193-2.323) compared with the poor group. Conclusion: Perceived health status is associated with patient satisfaction. In particular, the better the perceived health status, the better the patient satisfaction through patient experience.

• 동서간호학연구지
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• 제27권1호
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• pp.61-69
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• 2021

Purpose: This study aims to determine the association between fear of falling, falls efficacy, and fall prevention behaviors in older adults in outpatient and identify the factors affecting fall prevention behaviors. Methods: This was a descriptive study. A total of 137 older adults aged 60 or older with more than one disease in an outpatients setting were recruited from a university hospital in Seoul. Data were collected from March 11 through April 8, 2016. Results: The experience of a fall was significantly associated with age (t=-2.71, p=.008), gender (𝛘²=14.32, p<.001), education (𝛘²=6.05, p=.049), income (𝛘²=9.93, p=.019), physical activity status (𝛘²=16.84, p<.001), and the number of diseases (t=-2.89, p=.004). Fall experience was not significantly associated with marital status (𝛘²=3.79, p=.285). Multiple regression analysis revealed that the most influential factor of fall prevention behaviors was the fear of falls (β=-.37, p<.001), followed by the number of diseases (β=-.20, p=.013). Conclusion: It is necessary to provide preventive fall education with older adults in outpatients settings considering the fear level of falling and the numbers of accompanying diseases.

• 한국콘텐츠학회논문지
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• 제13권5호
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• pp.342-353
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• 2013

의료서비스 이용의 대부분을 차지하고 있는 만성퇴행성질환은 생활습관과 연관되어 있다. 의료서비스를 이용하게 되는 원인으로는 흡연, 음주, 식이, 운동 등의 개인의 올바르지 못한 건강행태가 주요 요인이며, 사회경제적인 요인인 월 평균 가구 소득, 의료보험의 종류, 거주 지역, 인구 1,000명 당 의사 수, 직업의 유무 등이 의료서비스이용 선택에 영향을 미치는 요인이 될 수 있다. 본 연구의 목적은 외래서비스 이용에 영향을 미치는 요인을 파악하고자 한다. 최근 2주간 외래서비스 이용 횟수가 2회 이상인 응답에 대한 로지스틱 회귀분석 결과, 도시지역에 거주할수록, 소득이 높을수록, 과체중 이상일수록, 문제음주자일수록 2회 이상 의료서비스를 이용할 확률이 높았다. 반면에, 민간의료보험 보유자, 직업 보유자, 2주간 몸이 불편했던 경험자, 고혈압 환자, 당뇨 환자, 고혈압과 당뇨 환자, 흡연자들은 2회 이상 의료서비스를 이용할 확률이 낮았다. 지역을 임의효과로 한 혼합모형으로 다수준 분석을 실시한 결과는 고졸 이상자와 사고 중독을 당한 사람들이 그렇지 않은 사람들보다 외래서비스 이용횟수가 더 많았다. 앤더슨 모형과 다수준 분석기법을 함께 사용하여 국내 실정에 맞는 의료서비스 이용 요인을 체계적으로 규명하고자 하는 측면에서 이 연구의 의미가 있다.