• 대한치과기공학회지
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• 제28권1호
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• pp.67-81
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• 2006

This research has been attempt to examine closely factors that high cost and value to overall satisfaction state for dental implant prosthesis, re-utilization intention, inducement intention of the general hospital dental service user and provide basis data necessary to establish competitive general hospital dentistry management strategy. Collected data using own recording way questionnaire from April 17, 2004 to May 15, 2004 choosing 142 people that agree on this research and question of 361 people that dental implant prosthetic treatment finished from March 1, 1999 to March 1, 2004 for this. Major analyzation consequences are as follows : First, general satisfaction, re-utilization intention, inducement intention for implant prosthesis that highly correlation variables are kindness, explanation, medical treatment level and appreciation of the aesthetic. Second, correlation is high relatively between re-utilization intention, inducement intention in the 3 variables such as general satisfaction re-utilization intention, inducement intention. Third, the result of multiple regression analysis showed that most significant effective factors are satisfaction with explanation of dental implant prosthesis between the 3 dependant variables such as general satisfaction, re-utilization intention, inducement intention. In looking into these consequence, how to improve that raise satisfaction about dental implant prosthetic treatment and to establish patient focused care service system for dental implant prosthesis, it is consider that explain enough about implant prosthesis and raise quality of medical examination and treatment level, including satisfied with fabrication of good esthetic dental implant prosthesis.

• 임상간호연구
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• 제23권3호
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• pp.376-387
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• 2017

Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

• Journal of Acupuncture Research
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• 제35권3호
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• pp.108-114
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• 2018

Background: The purpose of this survey study was to understand how utilization of X-rays as an adjunct to Chuna manual therapy (CT) supports treatment, as assessed by Korean medicine doctors (KMDs). Methods: A survey was emailed to all 18,289 members of the Association of Korean Oriental Medicine (AKOM)to determine the implications of X-ray use in CT. Surveys were collected from September 22, 2017 to October 15, 2017. Results: Of the 18,289 KMDs 562 completed the survey. The implications of a radiological diagnosis (X-ray) with CT was assessed using 5 items in a questionnaire: time to diagnosis, accuracy of treatment, patient comprehension and satisfaction, CT effect, and safety of CT. Survey participants identified improvement in patient comprehension and satisfaction as the most important factor for X-ray use with CT, followed by increased safety of CT. From the determinant factors for selection of CT intensity and specific techniques, severity of clinical symptoms was shown to be the most influential factor. Degenerative changes of the spine and degree of spinal malposition were also reported to be highly influential. Conclusion: The KMDs' that participated in this study indicated that utilization of X-rays in conjunction with CT administration improved patient comprehension and satisfaction, and CT safety. Installation of radiological equipment in Korean medicine clinics where CT is provided may increase safety and patients' satisfaction.

• 한국임상약학회지
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• 제28권1호
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• pp.57-64
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• 2018

Background: Patients experience significant differences in aspects of mortality, quality of life, and costs between during the year of receiving liver transplant (LT) and the subsequent years (post-LT). This study aimed to estimate the medical utilization and cost of LT for patients compared to post-LT patients by using a recent National Patient Sample (NPS) data provided by the Korean Health Insurance Review and Assessment Service (HIRA). Methods: This study used a subset of the 2015 HIRA-NPS. Patient claims data that included Z944 (Korean Standard Classification of Diseases code for LT status) were selected. Within the selected data, LT patients were identified based on whether the national health insurance number code of Q80 (procedure code for LT surgery) was included, and they were compared to post-LT patients. Results: In the analysis, 330 patients were included. The average cost per patient was $90,066{\pm}36,959$ thousand KRW and $10,557{\pm}9,668$ thousand KRW for LT and post-LT patients, respectively. Especially, LT patients' costs for injection/procedure, surgery/treatment, and examination were higher than other costs, being $35,983{\pm}18,115$ thousand KRW, $28,246{\pm}9,408$ thousand KRW, and $12,131{\pm}6,604$ thousand KRW, respectively. For inpatients, the average number of hospitalized days was $63.5{\pm}66.0$ days for LT patients and $22.3{\pm}35.1$ days for post-LT patients. Conclusion: Compared to post-LT patients, LT patients had higher costs, especially for injection/procedure, surgery/treatment, and examination. Additionally, the LT group had longer hospitalization duration and higher costs for their hospital admission, whereas they did not show a significant difference in number of visits and medical costs for outpatient-care.

• 임상간호연구
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• 제24권1호
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• pp.23-33
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• 2018

Purpose: The purpose of this study was to investigate the effect of SBAR communication program on nurse's perception about communication and attitudes toward patient safety. Methods: A single-group pre-post experimental study was conducted. A SBAR education program was provided to 167 nurses working in 9 general wards of a hospital in Seoul. A total of 153 questionnaires were included for the final analysis. Statistical analysis included analysis of variance, paired sample t-test, and Cochran-Mantel-Haenzel test. Results: After applying SBAR communication education, nurses perceived significant improvement in three of the five categories of communication between nurses and doctors; satisfaction (p=.001), accuracy (p=.001), and understanding (p=.002). The indicators of communication between nurses were also improved significantly in the order of accuracy (p=.001), satisfaction (p=.001), shift communication (p=.001), and openness (p=.016). The scores of nurse's attitudes toward patient safety demonstrated a significant increase in the five categories out of the six; perception of management (p=.001), working condition (p=.001), safety climate (p=.001), teamwork climate (p=.001), job satisfaction (p=.012). Conclusion: It is recommended that nurses and doctors use SBAR communication in their practice. Developing education programs and utilization methods is required for the effective establishment of SBAR communication.

• Molecules and Cells
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• 제39권2호
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• pp.77-86
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• 2016

Cancer is a heterogeneous disease caused by diverse genomic alterations in oncogenes and tumor suppressor genes. Despite recent advances in high-throughput sequencing technologies and development of targeted therapies, novel cancer drug development is limited due to the high attrition rate from clinical studies. Patient-derived xenografts (PDX), which are established by the transfer of patient tumors into immunodeficient mice, serve as a platform for co-clinical trials by enabling the integration of clinical data, genomic profiles, and drug responsiveness data to determine precisely targeted therapies. PDX models retain many of the key characteristics of patients' tumors including histology, genomic signature, cellular heterogeneity, and drug responsiveness. These models can also be applied to the development of biomarkers for drug responsiveness and personalized drug selection. This review summarizes our current knowledge of this field, including methodologic aspects, applications in drug development, challenges and limitations, and utilization for precision cancer medicine.

• 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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• 제19권4호
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• pp.57-68
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• 2014

Since the introduction of National Health Insurance(NHI) in 1977, it has grown rapidly and contributed to extend patient's access to the health care services. However, limited coverage for health care services of NHI has been ongoing challenge and private health insurance(PHI) has been rising as an alternative source of enhancing coverage and saving out-of-pocket(OOP) expenditure for patients. In this study, after controlling for socio-demographic, economic, health related variables, we identified the patients' healthcare utilization and subsequent OOP expenditure depending on their PHI enrollment and their enrollment types(fixed benefit, indemnity, fixed benefit plus indemnity). Data were collected from the 2010 Korean Health Panel. The unit of analysis was a member of household(n=13,324). Of the 13,324 cases, 70.7% of patients held PHI, in detail, fixed benefit(47.0%), indemnity(3.6%), fixed benefit plus indemnity(20.1%). Major findings showd that patients who enrolled in PHI used more outpatient services(outpatient visit, number of physician visit, number of examination) and spent more OOP expenditure than non-PHI patients. There were also differences of healthcare utilization and OOP expenditure among the types of PHI. In addition, PHI patients used more inpatient services(inpatient use, number of hospitalization, LOS), but there was no significant difference between PHI and non-PHI patients with regard to the OOP expenditure. Thus, we could not find any distinct relationship between the types of PHI and patients' tertiary hospital use. Policy-makers should need careful political deliberation for monitoring the effect of PHI on health care utilization and subsequent expenditure not only to improve patients' coverage but also to save their OOP expenditures.

• 한국의료질향상학회지
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• 제4권1호
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• pp.64-80
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• 1997

Background : An important issue in health care today is in trying to center service around the hospitalized patient. There is a "Kindness Movement" developing now, where in the focus of Health Care is being changed from simply treating the basic physical needs of the patient with sophisticated technology, to keeping emotional well being healthy with more humane and attentive treatment. In our attempt to reach the goal of a completely satisfied patient, we undertook a study of the common complaints of patients, and the subsequent nature of the interventions. Method : The study was carried out in two stages, first the patients made known their complaints by filling out questionnaires, then we collected data on the attempts to alleviate the complaints. The questionnaire provided 19 different complaints, which were then analysed for such variables as content, source of complaint, persons treating the complaint, and length of time and method used to solve the complaint. Results : 1. The Chief complaints made by patients(99.1%) were of physical discomfort, such as pain, nausea, vomiting, indigestion, diarrhea and constipation. 2. The complaints were voiced primarily by either of the patient's family, or by the patients themselves(78.4). 3. The complaints were intervened by nurses alone(53.5%), physicians alone(25.5%), or by nurses and physicians together(19.25%). 4, The method by which the complaints were resolved included the utilization of prescriptions(55.7%), further explanation and education(25. 5%) and notification after treatment(13.2%). 5. Most complaints were voiced during the dayshift(42.6%, 7:00-15:00), followed by the evening shift(36.0% 15:00~22:00), and then the nightshift(21.3 %, 22:00-07:00). 6. The time required for successful resolution of the patient's problems varied from 10~88.9min, according to the nature of the complaint. Conclusion : Hopefully by knowing beforehand the nature of both complaint and intervention, we can anticipate problems and shorten reaction time, in order to provide for a more satisfied patient.

• 농촌의학ㆍ지역보건
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• 제22권1호
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• pp.75-83
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• 1997

The medical insurance system has been adopted in 1989. Since then, the utilization of medical care services has increased rapidly. It appears that the medical institution needs more nursing manpower such as nurses and nurse aides to meet an increased demand for medical care for the residents. However, the medical care clinics run by a medical practitioners has a more shortage of nursing manpower than hospitals. The purpose of this survey was to analyze the current employment status and to obtain an opinion on the improvement of utilization such as recruitment and retention of nursing manpower. The questionnaire sent to the private physician and the response rate was 28.7% ; 87 out of 300 physicians. 82.6% of the respondents employed nurses aides rather than nurses and an average number of employees per clinic was 2.5 persons. Most physicians had difficulties in recruiting nursing manpower. It took more than one month for replacement on average, therefore, they were suffering from giving good continual care for the patient and also high resignation of nursing personnel. The low wage, long working hours, hard work and lack of incentives are the biggest reasons for the difficulty in recruiting and retaining of the nursing personnel obtained for the clinics survey. The above mentioned problems would be solved in the near future by changing those difficulties. In the meantime, the private physicians are marking an effort to retain the nursing personnel by keeping a relationship of the private physician's cooperatives.