• 한국산학기술학회논문지
• /
• 제10권1호
• /
• pp.209-214
• /
• 2009

병원 산업계의 경영관리 환경 변화에서 인터넷의 정보 제공 수준이 높아짐으로써 고객의 의료 지능이 높아지고, 병원선택(Hospital Shopping)과 의사선택(Doctor Shopping)을 스스로 하고 있어서, 병원의 경영도 고객(환자)접점 관리가 사업성과를 중요한 결정 요인으로 작용하고 있다. 이러한 결과로 환자와의 접점관리를 위한 고객관계관리(CRM) 시스템을 구축하고 운영하는 병원이 점차 늘어가고 있다. 그러나 이러한 병원CRM시스템 투자 노력에도 불구하고 그 성과는 미미한 수준에 머물고 있거나 대부분의 CRM 시스템이 실패함에 따라 CRM의 적극적인 도입의 지가 줄어들고 있다. 본 연구에서는 병원CRM시스템의 도입 의도에 어떤 영향 변수들이 주요한 변수로 작용하고 있는지에 대하여 연구하였다. 이러한 문제를 해결하기 위해 병원CRM시스템의 구축에 있어서 영향을 많이 끼치는 분야로 병원정보시스템을 선택했고, 이를 위해 구조방정식모형을 이용하여 연구 가설을 검증하고 연구 모형의 유효성을 증명한 독립변수의 측정 변수를 도출하여 향후 CRM 도입을 하고자 하는 병원에게 지식정보를 제공하고자 하였다.

• 한국산학기술학회논문지
• /
• 제13권1호
• /
• pp.236-246
• /
• 2012

지역 환자의 역외유출 현상이 갈수록 심화되고 있다. 특히 중증질환을 가진 암 환자는 거리와 상관없이 양질의 의료서비스를 받기 위해 수도권 의료기관을 많이 찾는다. 하지만 이러한 환자의 역외유출은 진료 연속성 저하와 함께 불필요한 물적, 인적 이동을 야기 시킨다. 이에 본 연구는 부산지역 암환자들이 부산과 수도권에서 진료를 받는 경우에 환자의 만족도에 영향을 미치는 요인을 체계적으로 비교, 분석하여 지역 병원의 이용도를 제고시킬 수 있는 방안을 마련하고자 수행하였다. 부산지역 암환자를 대상으로 부산 의료기관에서 수술을 받은 암환자 223명과 수도권에서 수술을 받은 암환자 187명을 대상으로 2011년 3월 21~3월 30일까지 설문조사를 실시하였다. 자료 분석은 SPSS및 SAS 프로그램을 이용하여 접근성, 의료진 만족도, 이용편의성이 의료서비스 전반적 만족도 요인으로 나누어 접근하였다. 연구 결과, 이용편의성과 의료진 만족도는 수도권 의료기관 이용자가 높은 것으로 나타났으나, 접근성과 의료서비스의 전반적 만족도는 부산지역 의료기관을 이용한 암환자가 높았다. 이에 부산지역 의료기관은 의료진의 질적 향상을 위한 우수 의료진 유치 및 양성, 환자 중심의 의료 시설 제공을 위한 노력이 필요하다. 본 연구를 토하여 향후 환자의 수도권 집중현상 완화를 위한 정책개발 시 유용한 기초자료로 활용할 수 있을 것으로 기대된다.

• Journal of Preventive Medicine and Public Health
• /
• 제31권4호
• /
• pp.814-827
• /
• 1998

In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital (45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of care. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of rare was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area.

• 한국간호교육학회지
• /
• 제7권2호
• /
• pp.245-253
• /
• 2001

The aim of this study is to describe degree of fatigue and factors related to fatigue in patients with rheumatoid arthritis. The subjects of the study consist of one hundred fifty-eight outpatients with rheumatoid arthritis at three university hospitals in Taegu between July 10 and August 30, 1999. The instrument used in this study was the Multidimensional Assessment of Fatigue developed by Belza et al.(1995) and revised by Jung, Bok Hee. Kim, Myung Ae(1998). Analysis of data was done by using the descriptive statistics, t-test, ANOVA and Duncan with SPSS program. The major findings can be summarized as follows: 1. Degree of fatigue in patient with Rheumatoid Arthritis was shown the average 22.91 out of the total scores 40. Four subscales of fatigue scores are common fatigue degree 6.37, fatigue timing at the last week 5.92, distress due to fatigue 5.40 and degree of daily activity fatigue 5.22. Among the realms of daily activity fatigue, outdoor activity(6.00), sexual life(5.84), doing the household(5.66), shopping(5.61), other exercise except stroll(5.54) were shown the high degree of fatigue and cooking(4.97), a stroll(4.48), recreation(4.35) showed the low degree of fatigue. 2. There were no significant differences on the total degree of fatigue according to demographic variables. But there were some significant differences on the subscale fatigue scores according to demographic variables. Degree of daily activity fatigue according to sex was shown significant difference (t=-2.358, p=.020), and according to education level was shown significant difference(F=3.938, p=.005) and common fatigue degree according to age was shown significant difference(F=2.853, p=.026). Conclusively fatigue is one of difficult problems for patients with rheumatoid arthritis. Therefore it is necessary to develop some nursing intervention for reducing fatigue of rheumatoid arthritis patients.

• 근관절건강학회지
• /
• 제6권1호
• /
• pp.22-36
• /
• 1999

The purpose of the study was to identify disease characteristics and behavior pattern of treatment for patients with Fibromyalgia. This study was carried out between May to Aug. in 1998 through direct interview in Rheumatism clinic at H. University Hospital and subject in this study were 125 outpatients diagnosed with Fibromyalgia. Collected data were analyzed by descriptive statistics and t-test, ANOVA using SPSS Window program. The results of this study are as follows. 1. General Characteristics : All of the persons with Fibromyalgia were female who were mostly in their forties(37.5%). A third of them(38.4%) were graduated from high school. The greatest part of them(54.4%) were christians but little part of them(16.8%) were employed 2. Disease Characteristics : They have struggled with Fibromyalgia for 10 years on an average. About half of them(56.9%) suffered from Fibromyalgia only but the others had another diseases which were in greatest part occupied by Osteoarthritis. The number of tender point which is a feature of Fibromyalgia differed according to measuring criteria. Yunus criteria. however, was proved to be the most proper measuring criteria than any other method as it showed high correlations between symptoms and physical activities. The most serious symptoms that complained the patients among subjective symptoms are pain, sleep disorder, and fatigue in sequence, and activities most hard to do among physical activities are washing by hand, scrubbing by hand, and shopping in sequence. 3. Behavior Pattern of Treatment : The largest part of them(42.4%) had received medical treatment after they were determined to have the disease and most of them were taking medicine as prescribed by physician(88.8%) or other medicines(16.8%), Of them, two thirds stated that the medicine they took were effective. Around a third of them took exercises mostly composed of swimming. The medical institution they visited in the past were orthopedic surgical department, Oriental hospital, physical therapy department in sequence and, in a slight percent(11.4%), psychiatric department. 4. Relations between Disease Characteristics and Behavior pattern of Treatment : It shows that number of tender point and level of symptom are significantly different according to duration of disease and medical intervention. As a results, it can be suggest that persons with Fibromyalgia need to take exercises and medicine continually regardless of medical treatment as it is a chronic disease whose symptoms are hardly mitigated.

• 근관절건강학회지
• /
• 제6권2호
• /
• pp.253-277
• /
• 1999

Patients with chronic disease have various treatment patterns because it shows a progressive degenerative feature. Especially various physical and emotional problems of the rheumatoid arthritis patients leave them shopping around various types of treatment. According to previous studies, over 70% of patients with arthritis experienced the traditional oriental medicine or folk remedies simultaneously with medical treatment within one year after the onset of disease. The purposes of this study are 1) to compare the patterns of treatment-seeking behaviors between Korean arthritis patients and Americans ; and 2) test two models of treatment-seeking behaviors by path analysis, one for early treatment-seeking behavior model(ETBM) and the other is chronic treatment-seeking behavior model (CTBM) in Korean sample. The interview survey was performed to 133 RA patients with structured questionnaire at out-patient clinic or public health center. Patients characteristics such as age, duration of disease were similar in two countries except higher educational background in Americans. There were no patients using only alternative therapies or no medical treatment in the US. Most of the American patients have chosen both medical treatment and alternative therapy, while the Koreans less than American. In Korea, combined treatment group usually consists of the people who are younger, more educated and higher economic status than the characters of other groups in early or chronic stages. In early stage, they tend to have strong belief of curing from the disease, satisfy the relationship with their physicians and comply with direction of the medical professional. The paths of two models were explained by 70% in ETBM and 33% in CTBM. When the models were modified, almost all paths of the CTBM were the same as the previous one, but direct determinant factor was changed from the relationship with physicians to the lay referral system in chronic model. These two models' explanation powers became 94% and 88%, respectively. The attitude or perception of disease, lay referral system and the relationship with medical personnel are the main determinants of treatment-seeking behaviors.