• Journal of The Korea Institute of Healthcare Architecture
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• v.23 no.4
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• pp.67-75
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• 2017

Purpose: This study is for the facility eligibility and improvement evaluation analysis for the patient care environment of 7 facilities which has national inpatient isolation units. Methods: For the evaluation, first of all, the patient care environment of national inpatient isolation units are scrutinized by the checklist which is used on from 2014 with the 4 fields of criteria : architectural planning and layout, general requirement and condition for operating the negative pressured isolated patient room, HVAC system, and waste water discharging system. Finally, the evaluation results are compared with that of 2014. Results: The result shows that the average value of facility eligibility is 89.3 percent and which is 8.9 percent higher than the value before the MERS occurred. Implications: It is clear that facility remodeling of 7 institutions is being performed continuously, and the result of facility eligibility evaluation is reflected on design of a new 21 national inpatient isolation units those are going to be constructed from 2016. Therefore, it is expected that this study is used as a practical reference to establish the criteria of patient care environment management and safety management for both infectious disease outbreak and general service condition.

• Health Policy and Management
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• v.32 no.2
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• pp.125-136
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• 2022

The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Journal of Korean Academy of Nursing
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• v.33 no.1
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• pp.122-129
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• 2003

Purpose: The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient. Method: The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, $X^2$-Test and regression. Result: Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order. Conclusion: The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.16 no.10
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• pp.3313-3332
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• 2022

This study is an investigation into the factors affecting patient dissatisfaction among Saudi hospitals. The selected factors considered for analysis are security of information sharing, operational practices, disruptive technologies, and the ease of use of EHR patient information management systems. From the literature review section, it was clear that hardly any other studies have embraced these concepts in one as was intended by this study. The theories that the study heavily draws from are the service dominant logic and the feature integration theory. The study surveyed 350 respondents from three large major hospitals in three different metropolitan cities in the Kingdom of Saudi Arabia. This sample came from members of the three hospitals that were willing to participate in the study. The number 350 represents those that successfully completed the online questionnaire or the limited physical questionnaires in time. The study employed the structural equation modelling technique to analyze the associations. Findings suggested that security of information sharing had a significant direct effect on patient satisfaction. Operational practice positively mediated the effect of security of information sharing on patient dissatisfaction. However, ease of use failed to significant impact this association. The study concluded that to improve patient satisfaction, Saudi hospitals must work on their systems to reinforce them against the active threats on the privacy of patients' data by leveraging disruptive technology. They should also improve their operational practices by embracing quality management techniques relevant to the healthcare sector.

• Journal of The Korea Institute of Healthcare Architecture
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• v.14 no.1
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• pp.49-58
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• 2008

Considering the rapid growth of elderly population and the increase of medical demand for aged, many of geriatric hospitals are needed in Korea. On the other hand, supplies of hospitals for acute care are considered to be excessive. So many of small and medium hospitals facing management problems have been converged to geriatric hospitals. These attempts are considered resonable for efficient utilization of health care resources in Korea. This paper aims to identify the concept of geriatric hospital and to analyze the problems and then to seek the alternatives for architectural planning on the basis of surveying the geriatric hospitals converged from hospitals for acute care.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.3
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• pp.373-384
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• 2006

Purpose: This is a pilot study to identify patient safety risk factors and strategies for patient safety management perceived by nurses. Methods: Data were collected and analyzed with an open questionnaire from April to May 2005, targeted on 100 nurses working in two hospitals. The issues were 'what are risk factors for patients, nurses, and other medical practitioners? How do they prevent with the aftermath of risk factors, causes of incidents?' For data analysis, types and frequency of risk factors were worked out, using the Australian Incident Monitoring System Taxonomy. Results: The types of patient safety risk factor perceived by nurses were as follows ; therapeutic devices or equipment, infrastructure and services (29.5%), nosocomial infections (16.3%), clinical processes or procedures (15.4%), behavior, human performance, violence, aggression, security and safety (12.2%), therapeutic agents (9.7%), injuries and pressure ulcers (8.7%), logistics, organization, documentation, and infrastructure technology (5.6%). Strategies for patient safety included training of prevention of infection, education about safety management for patients and medical professionals, establishment of reporting system, culture of care, pre-elimination of risk factors, cooperative system among employees, and sharing information. Conclusion: These results will be used to provide evidences for patient safety management and educational program.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.15 no.12
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• pp.4400-4419
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• 2021

In the 4th Industrial Revolution, the healthcare industry is undergoing a paradigm shift from post-care and management systems based on diagnosis and treatment to disease prevention and management based on personal precision medicine. To optimize medical services for individual patients, an open ecosystem for the healthcare industry that allows the exchange and utilization of personal health records (PHRs) is required. However, under the current system of hospital-centered data management, it is difficult to implement the linking and sharing of PHRs in practice. To address this problem, in this study, we present the design and implementation of a patient-centered PHR platform using blockchain technology. This platform achieved transparency and reliability in information management by eliminating the risk of leakage and tampering/altering personal information, which could occur when using a PHR. In addition, the patient-consent system was applied to a PHR; thus, the patient acted as the user with ownership. The proposed blockchain-based PHR platform enables the integration of personal medical information with scattered distribution across multiple hospitals, and allows patients to freely use their health records in their daily lives and emergencies. The proposed platform is expected to serve as a stepping stone for patient-centered healthcare data management and utilization.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.48-79
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• 1999

Background : The clothing is considered as second skin. The patient clothing needs basic clothing demands which are comfortable, functional and aesthetical and special demeands which are associated with medical examination, treatment and management of daily-life inconveniences. The patient is weak and labile to psychic trauma and has limitation of movement. So the help of others is needed. But recent patient clothing does not satisfy above demands. So the design, making and management of patient clothing to satisfy those demands are very important. The purpose of this study' is to develop multipurpose clothing which is comfortable, functional, aesthetical and satisfying patients and medical personnels. Method : The questionnaires of existing patient clothing were tested by patients, medical doctors, and nurses. After analyzing two types of questionnaires, eight types of experimental patient clothing were made. After preference test, shortcomings were removed and merits were adapted. One type of multipurpose patient clothing mixing eight above experimental clothing was made. The state of wearing and moving were videotaped. The videotape-recoding was watched by patient, caregivers(medical doctors, nurses) and clothing specialists. Result : The general reaction for experimental clothing were positive by the group of patients, medical personnels and clothing specialist, there were significant differences among three groups. Conclusion : It was thought that to develop one type of multipurpose clothing is possible. If the studys for patient clothing which are free-size and economic matters that are type of clothes and method of washing are made in depth, the desirable patient clothing will appear.

• Health Policy and Management
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• v.16 no.1
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• pp.17-40
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• 2006

With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

• Journal of Korean Clinical Nursing Research
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• v.27 no.1
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• pp.12-22
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• 2021

Purpose: The purpose of this study is to identify the effects of organizational commitment (OC) and perceived patient safety culture (PPSC) on patient safety nursing activities (PSNA) among nurses in comprehensive nursing care units. Methods: Participants were 173 nurses working at five general hospitals in Chungcheong area. Data were analyzed using descriptive statistics, 𝑥² test, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis with SPSS/WIN 23.0 programs. Results: The mean scores of the OC and PPSC were 3.28±0.50 and 3.85±0.35, respectively. The mean score of PSNA was 4.55±0.41, and PSNA was significantly different by the experience of participating in hospital's safety culture campaigns (t=2.70, p=.008). The results of the multiple regression analysis showed that 'patient safety knowledge and attitudes' (β=.27, p=.006) and 'unpunished environment to error' (β=.22, p=.004) as the sub-categories of PPSC were affecting factors on PSNA with an explanatory power of 26.0% (F=6.40, p<.001). Conclusion: The results of this study suggest that in order to promote PSNA among nurses in comprehensive nursing care units, it is necessary to develop a program to enhance patient safety-related knowledge and attitudes. In addition, the hospital's organizational efforts such as operating safety campaigns and creating an unpunished environment to error should be needed.