• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.163-180
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• 1998

The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

• Korean Journal of Health Education and Promotion
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• v.32 no.4
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• pp.59-65
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• 2015

Objectives: Health screening in Korea is very active in both the public and private sector. However, primary prevention for health promotion has not been activated yet. Quaternary prevention is the prevention of unnecessary medical interventions or the prevention of overmedicalization. Methods: Data was collected after a search of the literature focusing on keyword. The curriculum guidelines for family medicine residents were collected from the homepage of the American Academy of Family Physicians. Results: This quaternary prevention is just beginning. The first step to enhance the health promotion services in the community is to identify the barriers pertaining to the delivering of health promotion activities. These barriers are related to the patient, the physician, attitudes, health promotion programs and the healthcare system. The second step is to establish new changes, such as expansion of insurance coverage, improvement of medical payment system, provision of consumer-oriented services, connection and integration of providers, and the service provider education and training. Conclusions: In order to enhance the health promotion services in the community we need to identify the barriers and to establish several changes to overcome them.

• Health Policy and Management
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• v.23 no.2
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• pp.145-151
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• 2013

Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.

• Health Policy and Management
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• v.19 no.3
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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.

• Health Policy and Management
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• v.23 no.3
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• pp.266-280
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• 2013

Background: Information asymmetry between physicians and patients is one of the most unique characteristics of health care. But as consumerism spreads in health care sector, health care consumers are searching comparative information about quality and cost of providers from many information sources. Providing comparative information to health care consumers not only makes consumers choose hospital rationally, but also invigorates the health care market by providers' competition. However there are few studies regarding information searching behavior of health care consumers, then this study is carried out. Methods: The purpose of this study is to understand the information searching behavior of health care consumers based on their characteristics and the types of medical institutions. For this purpose, 313 spinal patients' data of 11 medical institutions (university hospital, spine specialized hospital, clinic) located in Seoul were collected by self-administered surveys. Results: The results of this study are as follows: 1) t-test/analysis of variance analysis showed that according to various characteristics of health care consumers and the types of medical institutions, the level of information searching of each source and the amount of information searching and searching outcomes are statistically different. 2) Regression analysis showed that influence on searching outcomes are statistically different according to the level of information searching of each source and searching content and the amount of information searching has positive effects on searching outcomes. Conclusion: The significance of this study is to provide empirical basis for establishment of health care policy reflecting information needs and preference of health care consumers.

• Korea Journal of Hospital Management
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• v.18 no.4
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• pp.18-38
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• 2013

This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, indoor environment, admission procedure, hospital image, service quality of physicians nurses medical technicians medical staff that patients perceived. Inpatients and outpatients were selected from three hospital in D city Questionnaire survey was employed to collect data from the subjects. For inpatients, indoor environment, admission procedure, hospital image and service quality of physicians have an effect on perceived value. Admission procedure, hospital image and service quality of physicians nurses medical technicians has an effect on the patient satisfaction. Hospital image and service quality of physicians nurses medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. For outpatients, Admission procedure, hospital image and service quality of physicians medical technicians have an effect on perceived value. Indoor environment, hospital image and service quality of physicians medical technicians medical staff has an effect on the patient satisfaction. Indoor environment, hospital image and service quality of physicians medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve middle hospitals.

• Journal of Society of Preventive Korean Medicine
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• v.10 no.1
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• pp.109-121
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• 2006

The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

• Health Policy and Management
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• v.14 no.4
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• pp.88-113
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• 2004

Starting from April, 2003, new pre-review system has been introduced and implemented to reduce unnecessary conflict with medical care organizations caused by current retrospective claim review system and to enhance efficiency of review system. The main purpose of pre-review system is to educate doctors to contrive adequacy of medical services. This research mainly focuses on effectiveness of pre-review system's influence on physicians' behavior changes. The analysis-participants were drawn from 1,449 clinics which implemented pre-review system, since April of 2003. The research results are as followings. First, the amount per claim has reduced by $\\3,154$, days of visit per claim by 0.1 day, and amount per visit by $\\412$, which were statistically significant. Second, anesthesiologists have decreased in three indicators the most, and the internists had least of changes. Third, the amount per claim and days of visit per claims has dropped significantly on physicians with less periods of practice and physicians with more ages. Fourth, the clinics without the expensive medical equipments, the city clinics showed significant decrease on days of visit per claim. Fifth, in intervention methods, the one-to-one education showed more significant decrease on amount per visit rather than information feedback by paper. In conclusion, the pre-review system have an impact on self-imposed physician behavioral change. The outcome of this research may be utilized for future extension implementation of pre-review system. Furthermore, it is showed that ability of transitions in medical services review system according to the future transition of payment system and context of health service policy.

• Korea journal of population studies
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• v.4 no.1
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• pp.23-35
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• 1981

Health policy is directed to equity in the provision of primary care for rural people before the year of 2, 000. This study aimed to define and identify the need for physician's care by using empirical data, and suggested an alternative of the primary care delivery system in rural areas to the government. 1. Twenty percent of the study population wanted to obtain any form of medical care services. : 9.3 percent of the population was in need for physician's care; 15 percent of the need was met by physicians, while 85 percent remained unmet at the time of survey in 1979. 2. For meeting all the need for physician's primary care, 2.9 annual physician visits per capita are demanded. An alternative, which was devised in some favourable way at reasonable cost in rural settings, was suggested. It was to deploy the physician extender such as community health practitioner in the infrastructure of the health care delivery system, whose supervision is provided by physician, based on experience of the KHDI health demonstration project. 3. One physician, two community health practitioners and two community health aides should be assigned in distant locations for meeting all the estimated need for physician's primary care for 10, 000 rural underserved residents.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9817-9822
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• 2014

Background: Breast cancer is a serious health problem. Early detection is crucial for optimal treatment and reducing mortality. Objective: The aim of this study was to evaluate health beliefs concerning performance of breast self- examination (BSE) and mammography in a sample of Iranian female health workers. Materials and Methods: This cross-sectional study was performed among 441 female health care workers (physicians=88, nurses=163, midwives=38, officers=68, and others=84) in 3 different health centers in Yazd, Iran. Data were collected using a self administered questionnaire which included demographic characteristics and thenPersian version of the Champion's Health Belief Model Scale (CHBMS). Results: The mean age of the participants was $34.7{\pm}13.7$. It was found that 41.9% of the workers performed BSE in the past and 14.9% of them regularly, but only 10.6% of them had undergone a mammogram. Perceived barriers to BSE (F=6.351, P=0.021) and mammography (F=5.214, p=0.022) were significantly higher in officers than physicians, nurses or midwives. Perceived barriers were lower among those who had performed BSE and mammography, but not significant (p=0.34 and p=0.56, respectively). Furthermore, perceived susceptibility and perceived benefits of the workers who had BSE and mammography were significantly higher than who did not (p<0.05). Perceived seriousness was not a significant variable in BSE and mammography (p=0.71 and p=0.43, respectively). Conclusions: The health beliefs of health workers concerning the perceived susceptibility of breast cancer and the perceived benefits BSE and mammography significantly impact their screening practices.