• 보건행정학회지
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• 제27권2호
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

• 보건행정학회지
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• 제19권3호
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• pp.125-141
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• 2009

The purpose of this study was to examine the role of provider practice patterns in the difference in health expenditure between the two types of patients: Health Insurance and Medical Aid type 1. The study used the outpatient claim data for all Medicaid and health insurance patients of hypertension who received medical services from 8,454 primary care physicians during the first half of 2006. The data were stratified by patient's gender and age for the two groups of patients who received care from the same physician. The dependent variables were the differences in medical expenditure per case, patient days per case and medical expenditure per patient day between Medicaid patients and health insurance patients. Empirical results showed that physician characteristics, such as physicians under age 50, greater proportion of pediatric Medicaid patients, lower proportion of new Medicaid patients and the greater number of comorbidity of Medicaid patients are associated with the greater difference between the two types of patients (i.e., greater expenditure of Medicaid patients relative to health insurance patients). This study shows that factors associated with provider practice patterns need to be taken into account in Medicaid policy.

• 간호행정학회지
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• 제16권3호
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• pp.219-228
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• 2010

Purpose: The purpose of this study was to explore the degree of delay in waiting time, and the relationships of waiting time, patient satisfaction, and revisiting intention of outpatient in general hospitals. Methods: The data were collected from June 22 to July 4, 2009. A total of 536 outpatients who visited 21 clinics of a general hospital were subjected to evaluate the waiting time. The survey tools used were the Korea Health Industry Development Institutes (2008) tool for patient satisfaction and Reichheld & Sasser (1990) for revisiting intention. The data were analyzed by SAS version 9.1, descriptive statistics, t-test, ANOVA, and Pearson correlation coefficient. Results: The mean patient's waiting time was $28.3{\pm}30.7\;min$, the revealed mean score of patient's satisfaction was 2.92, and the revisiting intention showed was 4.56. The waiting time was negatively correlated with patient's satisfaction (r=-.10, p<.019). Patient's satisfaction was positively correlated with revisiting intention (r=-.51, p<.001). Conclusion: Waiting time management is an important factor of increasing patient's satisfaction and revisiting intention in general hospitals. It is mandatory that reservation management systems take into account the patient's characteristics of visiting outpatient department in order to shorten the real waiting time.

• 보건의료산업학회지
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• 제6권1호
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• pp.77-86
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• 2012

Objective of the study represents experiences of medical utilization of Psychiatric Outpatients. This research draws on information obtained from the 2008 National-wide sampling study of the Korean Healthcare Panel(KHP) conducted. The results of our study suggest the significance of variables such as the gender(p<.001) in the social demographical characteristics, the medical security type(p<.016), medical institution utilization(p<.012) treatment type(p<.004) in the utilization factors. In the case of medical utilization cost, the financial support factor(p<.018) showed a significant relationship. Depending on the particularities of gender, medical security type, financial support, medical institution utilization, treatment type were determined through a multiple logistics regression analysis. Gender showed that, among Psychiatric outpatient age of 30-59 level was 5.358 times and 60 years and older, their the second medical examination level was 4.490 times higher than Psychiatric outpatients under the age of 29. Health insurance type showed for the others medical allowance was 6.712 times higher than job health insurance and the other treatment was 0.395 times lower than drug treatment. Psychiatric outpatients utilization are rooted in the thoughts and factor levels of the Psychiatric patients and must be understood from the Psychiatric outpatients's perspective. The point is not only to gauge the patients research during Psychiatric medical utilization. The important of social community mental healthcare services levels goes beyond the goal of enhancing healthcare.

• Journal of Dental Anesthesia and Pain Medicine
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• 제20권1호
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• pp.39-44
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• 2020

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

• 보건행정학회지
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• 제12권3호
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• pp.23-35
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• 2002

Fiscal crisis in the medical insurance system has put the pressure upon hospitals by increasing the rate of curtailment, since the implementation of the separation of prescription and dispensing of medicine. The purpose of this study is to analyse the curtailment of mdical and drug expenditure before and after the system of separation between prescribing and dispensing and to suggest the problems about current inspection system. Data were obtained from 13 general hospitals and used for analysis of trends on medical & drug expenditure, and curtailment in 1999-2000 at three months intervals. The results were as follows; The scale of curtailment for drug expenditure has been increased on outpatient and inpatient since 2000. For the curtailed drug cost with outpatient, the ratio of curtailed drug expenditure has been increased in the case of prescription within the hospital. These results suggest that review system in social insurance were over-focused to control the cost and it might to impede the validity of review function in insurance system. Therefore, it' s needed to develope the scientific and reasonable criteria for Inspection and evaluation of durg expenditure.

• 한국병원경영학회지
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• 제10권2호
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• pp.26-44
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• 2005

The purpose of this study was to investigate these major factors on patient satisfaction, and to examine the affecting level of major factors in. The subjects in this study was 70 hospitals that were surveyed the hospital evaluation program containing the survey of patient satisfaction by KHIDI(Korea Health Industry Development Institute) from 1997 to 1999. The collected data was analysed SPSS for Windows(Ver 10.0). On basically, frequency analysis, t-test, and ANOVA was performed and, for more analysis, correlation analysis, factor analysis, multiple regression analysis, logistic regression analysis was utilized. According to this study, the major factors of inpatient satisfaction are divided 3 types facility factor, manpower factor, and service factor. And the major factors of outpatient satisfaction are analyzed 5 types; facility factor related direct medical service, facility factor related indirect medical services, manpower factor, pharmacy factor, and facility factor related utilization convenience. The importance of this study lies in the identification of major factors on hospital patient satisfaction.

• 한국병원경영학회지
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• 제21권4호
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• pp.45-54
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• 2016

The purpose of this study is to identify patient and hospital characteristics with pulmonary tuberculosis and to analyze factors which were influencing length of stay and treatment. The Korean National Hospital Discharge In-depth Injury Survey database from 2006 to 2012 was used for analysis. Study subjects were 4,704 patients and analyzed by using frequency, chi-square and logistic regression through using STATA 12.0. To avoid selection bias, we used propensity score matching. Analysis results show that the length of stay and treatment of pulmonary tuberculosis was different between insurance types. Patients characteristic(female, comorbidity, admission by outpatient department, medical insurance type) and hospital characteristic(500-999 beds, over 1000 beds) significantly influence length of stay. Admission by outpatient department and over 1000 beds are significantly influence treatment. Based on these findings, it is necessary to clarify between length of stay and treatment outcome by medical aids beneficiaries and audit hospitals follow discharge guidelines in pulmonary tuberculosis patients.

• Safety and Health at Work
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• 제10권3호
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• pp.341-346
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• 2019

Background: Although the concept of workload is important to nursing practice, only a few nursing researchers have focused on the issue of workload within the nursing context. Knowledge of how the dynamics of workload affects the job stress of nurses working in a specific unit or department in a hospital setting, and the influence of coworker support on this relationship, still remains limited. This study, therefore examined the effect of workload on job stress of Ghanaian outpatient department nurses and the moderating effect of coworker support on this relationship. Methods: A cross-sectional survey design was used, and questionnaire was used to collect data from a sample of 216 outpatient department nurses from four major hospitals in Ghana. The data collected measured workload, job stress, and coworker support using National Aeronautics and Space Administration (NASA) Task Load Index, job stress scale, and coworker support scale, respectively. Data were analysed using descriptive statistics, correlation, and hierarchical regression. Results: High levels of workload were associated with high levels of job stress of the nurses. Also, higher levels of workload were related to higher levels of job stress for nurses who received high levels of coworker support, but this was not the case for those who received low levels of coworker support (reserve buffering effect). Conclusion: The finding reiterates the adverse effect of workloads on employees' health, and the reverse buffering effect implies that supporting a colleague at work should be conveyed in a positive manner devoid of negative appraisal.

• 간호행정학회지
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• 제11권4호
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• pp.361-369
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• 2005

Purpose: The purpose of the study was to analyze the present status of community health practitioner activities and efforts to improve the job performance. Method: This study employed descriptive exploratory design. The sample consisted of 1,892 community health practitioners which was 90 % of population of community health practitioners. The data was analyzed by using SPSS Windows 10.0. Result: The most popular activities of community health practitioners were women's health, chronic degenerative disease management, elderly health, and outpatient care of primary health care. The activities that community health practitioners want to strengthen were outpatient care, disease prevention, rehabilitation, health promotion, and counseling. The efforts to improve the job performance were consult to other health care professionals, discussion with patient and families to choose effective treatment options. Community health practitioners knew that they were exposed to malpractice and hould try to make many efforts to improve their performance. Conclusion: The roles and activities of community health practitioners should be changed to the shift of health care environment and systems.