• 제목/요약/키워드: Practice management

검색결과 4,345건 처리시간 0.056초

지불보상체계가 의사의 진료행태에 미치는 영향 : 미국사례 분석 (The Effect of Doctor's Payment Method on Practice Behavior)

  • 임재영
    • 보건행정학회지
    • /
    • 제14권4호
    • /
    • pp.48-74
    • /
    • 2004
  • Considering the existence of asymmetric information between doctor and patient, the doctor's reimbursement method has been considered as a desirable policy device of improving efficiency of patient's use of medical care in terms of its affecting doctor's practice pattern by determining doctor's practice revenue. By using the Community Tracking Study (CTS) physician data set, which includes not only various information on doctors practice arrangements and sources of practice revenue, but also vignettes of various clinical presentations, this paper investigates doctor's reaction to the financial incentive under the control of patient's specific medical situation. Under the econometric model for exploring the effect of doctor's reimbursement method on his/her practice patterns; referring patients, recommend doctor-visit or medical tests, the Hausman's specification test was used for checking out the possibility of the doctor's reimbursement method being endogeneized explanatory variable. In the case where the endogeneity problem of doctor's reimbursement method exists, the 2SLS method was used for correcting that problem, and the multiple regression method was used in the case where the problem is found to be nonexistent. Based on the empirical results, this paper finds that doctors do appear to respond to financial incentive. The empirical results show that the doctor's reimbursement method statistically significantly affects doctor's practice pattern and are coincident with the theoretical result proposed by previous researches, This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would more refer their patients to specialists, and hesitate in recommending doctor-visit or medical exam.

지역사회 의료공급자의 지불보상체계상의 특징이 지역사회 주민의 의료이용에 미치는 영향: 미국사례분석 (The Effect of Payment Method of Community Medical Provider on Medical Care Use of Community Residents)

  • 임재영
    • 보건행정학회지
    • /
    • 제15권2호
    • /
    • pp.16-36
    • /
    • 2005
  • Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

간호원의 스트레스 관리교육 효과에 관한 실험연구 (An Experimental Study on the Effects of the Stress Management, Education Program for Nurses)

  • 안황란;구미옥;최미혜;정면숙
    • 대한간호학회지
    • /
    • 제16권1호
    • /
    • pp.40-48
    • /
    • 1986
  • The purpose of this study was to identify the effect of the Stress Management Education Program (SMEP) on the nurses stress and stress management ability, and to identify the main factors affecting them. The subjects were 72 nurses who participated in the In-Service education program of the Jin-Ju District, Kyeong-Nam Branch of the Korean Nurses Association during the period from Oct. 1 to Nov. 30, 1985. The book of“The stress management education program”was developed by the investigators. With this book, we executed the 1st education through the lecture & showing an example, After 15 days from the 1st education, we mailed a reminding booklet to the individuals. (2nd education). Then, we mailed a questionnaire on 15th day from the 2nd education. Before and after the SMEP We measured the stress management ability & stress, and identified the affecting factors. Findings of this study are as follows ; 1. The 1st hypothesis that“the SMP will increase the. knowledge about the nurses' stress management”was supported (t= -6.60, p <.001) 2. The 2nd hypothesis that“the SMEP will increase the nurses' practice about the stress management”was rejected. 3. The 3rd hypothesis that“the SEMP will decrease the nurses' stress”was rejected. 4. The 4th hypothesis that“the higher the know-ledge about the stress management, the lower the nurses' stress”was rejected. 5. The 5th hypothesis that“the higher the degree of the practice about the stress management, the lower the nurses' stress”was supported. (r= - .2859, p<.05). 6. There were significant correlations between the knowledge about stress management and age (r= -.3717, p<.01), between the knowledge about stress management and the period of her work. (r= -.2897, p<0.5). There was significant difference in the knowledge about stress management between those who had married and those who had not. (t=2.82, p<.01) 7. There was significant difference in the practice about the stress management between those who had religion and those who had not. (t=2.7, p< .01) 8. There was significant difference in the stress according to the type or work. (t=6. 127, P <.05) There was significant correlation between the stress and supportive system. (r=-.2647, p<.05).

  • PDF

치과위생사 통합교육과정 모형 접근에 관한 연구 (A Study on Approach toward Integrative Dental-Hygienist Curriculum Model)

  • 황미영;이춘선
    • 한국치위생학회지
    • /
    • 제7권4호
    • /
    • pp.595-609
    • /
    • 2007
  • The purpose of this study was to classify the courses of the dental-hygiene curricula into several categories by field, to incorporate the subjects in the same category into an integrated course, and to suggest how to ensure the successful phase-in application of integrative education according to Ronald M. Harden's 11-stage integrative ladder model. The findings of the study were as follows: 1. When the existing curricula were analyzed, it's found that many credits were provided to the courses in the area of basic dentistry that offered both theory and practice. In particular, the subjects tested by the national examination were offered by every college. In the field of public oral health, the largest number of credits was allocated to theory of oral prophylaxis and practice courses. In clinical area, clinical practice, in the area of dental office management, dental insurance course was given the largest credit. There were 31 to 61 major subjects in the colleges, which indicated that the major subjects were segmented in detail. 2. It seemed necessary to incorporate the subjects in the field of basic dentistry into oral biology, and theory of oral prophylaxis/practice, preventive dentistry/practice, preclinical stage, emergency treatment and introduction to dental hygiene should be integrated in to clinical dental hygiene. The courses in clinical area should be combined into clinical dentistry, and in the field of medical management, dental insurance, hospital management and medical relation law should be incorporated into management of dental clinic. 3. In the 11-stage integrative ladder, the subjects in the same field could perfectly be incorporated as the stages advanced. Each of the subjects was less emphasized, and communication and joint plans among teachers who were respectively in charge of the courses were increasingly considered important. Specifically, there should be a consensus among the teachers in regard to the outline of teaching programs, order of education. objects and objectives of programs and what and how to evaluate.

  • PDF

전문대학 식품영양과의 실험실습 및 현장실습 운영실태에 관한 연구 (A Stidy on the Real Management of Experimental-practice and Spot-practice at Department of Food and Nutrition of Junior College in Korea)

  • 윤성식;소명환;남궁석
    • 한국식품영양학회지
    • /
    • 제2권1호
    • /
    • pp.61-72
    • /
    • 1989
  • This study was conducted to gather the baseline data on realities of experimental-practice and opinions toward spot-practice, and to examine how to cope with the problems raised at the Department of Food and Nutrition of Junior Technical College in Korea. Questionnaires were gathered from 42 chairmans of the Department of Food and Nutrition and 140 Present dieticians worked in Seoul, Bucheon am Seongnam area. The results are as follows, First, as a whole, each college had 2~3 experimental laboratory (Lab), in which Cooking Science Lab. Chemistry Lab and Microbiology Lab were occurred at higher frequency as Lab's name. Second, the numbers per experimental-practice class were more than 40 at most colleges. 85% of Present dieticians have answered to feel too much numbers per the class during their college days, whereas professors' opinions toward the numbers per class were suitable at 20~30 persons per class. Third, professors' opinion toward the adquate ratio of the theory subject classes to experimental subject classes was suitable at 60 : 40. Dieticians answered to take the theory subject classes partly or mostly on behalf of the experimental-practice classes. Fourth, the main reasons which inhibited normal experimental-practice class were the class for emphasis on examination, the shortage of experiment budget, the excess of class members, the shortage of experimental Lab Also, this results showed same propensity to present dieticians' opinion toward the same question above. Fifth, among the experimenta1-practice subjects established at the Department of Food and Nutrition, Diet Therapy Lab was highest frequency class emphasized on theory followed by Nutrition Counselling Lab, Food Processing and Storage Lab, Food Hygiene Lab and Food Microbiology Lab in that order. Here, Basic Chemistry Lab, Biochemistry Lab, Food Microbiology Lab were pointed as subjects far from the present task of dieticians. Sixth, Department of Food and Nutrition, as a whole, has conferred with spot-practice arrangement About 50% (all who want to join spot-practice) of second year students took part in spot-practice. In the other way, all colleges except for 2 colleges didn't give the credit for the spot-practice system. Seventh, according to the on analysis on spot-practice places, manufacturing company was at highest frequcney followed by hospitals, elementary school having group feeding system in that order. Especially, 16.7% (5 colleges) of the total colleges sent the students to the research institute related to food industry for spot-practice experience. Eighth, Professors' opinions toward the spot-practice time and period were preferable on summer vacation of second year and for 1~2 weeks, respectively. On the contrary, 74 dieticians answered to the adquate period as for 4 weeks. Ninth, 86 dieticians of the total 140 answered to complete the spot-practice during their college days, which helps the present task of them. Lacks of spot-practice program, Lacks of comprehension of upper personals and lacks of group feeding equipments ranks higher as difficulties in spot-practice management.

  • PDF

지역별 건강생활 실천율의 영향요인: 시군구 단위 접근 (Determinants of Healthy Living Practice: County Approach)

  • 정초록;김지만;박종연;신의철;최병호
    • 보건행정학회지
    • /
    • 제30권3호
    • /
    • pp.376-385
    • /
    • 2020
  • Background: The purpose of this study is to investigate the factors affecting the healthy living practice rate such as non-smoking, moderate drinking, walking, and low-salt diet by elementary municipality (so called, 'si-gun-hu'). Methods: The 2016 Korean Community Health Survey was used for the analysis. The theoretical model is founded upon the Anderson model, and both the multiple linear regression analysis and the beta regression analysis was performed for estimation. Results: As a result of the beta regression analysis, healthy living practice rate was found to be significantly higher in the areas with a less number of cigarette retailers, participating in healthy city projects, a low proportion of people who perceive their body type as obesity, a higher proportion of women, and a lower proportion of spouses. Conclusion: In order to improve healthy living practices, the regulations on health risk businesses, the spread of Healthy City project, and policy efforts awaring obesity are recommended.

Perception and practice regarding allergen labeling: focus on food-related employees

  • Park, Si-Eun;Kwon, Yong-Seok;Paik, Jin-Kyoung;Kwak, Tong-Kyung;Hong, Wan-Soo
    • Nutrition Research and Practice
    • /
    • 제10권4호
    • /
    • pp.424-432
    • /
    • 2016
  • BACKGROUND/OBJECTIVES: Most consumers are able to recognize allergenic foods. However, the frequency of checking such foods is reportedly low, resulting in higher prevalence of food-related allergic reactions in Korea compared to other countries. Thus, this study was performed to investigate the overall perception of allergenic food labeling and its practice level in food manufacturing company employees. SUBJECTS/METHODS: The survey was administered to food safety employees and food development teams at food companies located in metropolitan areas. A total of 399 (93.8%) valid samples were used in the final analysis. Statistical analyses, including Frequency Analysis, t-test, Anova, PCA (Principal Component Analysis), and Pearson Correlation Analysis using SPSS ver. 21.0, were performed. RESULTS: The correct answer rate in the analysis of allergy-related knowledge level ranged from 15.0% to 89.7%. Analysis of differences in allergy-related perception by knowledge level showed significant differences in introduction of a food recall system, strengthening of relevant laws and regulations, content labeling, description of substitutional food, and differentiated package by age. CONCLUSIONS: It can be concluded that labeling of allergenic foods should be made easier and more convenient for checking by employees, developers, and consumers, and it is necessary to provide contents through the development of publicity, guidelines, or APP along with labeling.

아동의 발열관리: 현황 및 과학적 근거 (Childhood Fever Management: Current Practice vs Evidence)

  • 김진선
    • Child Health Nursing Research
    • /
    • 제22권2호
    • /
    • pp.126-136
    • /
    • 2016
  • Purpose: The purposes of this review were to address misconceptions of childhood fever and fever management practice among parents and health care providers, and to identify the scientific evidences against such misconceptions and practices. Methods: Journal databases and clinical guidelines from 2000 to 2015 were searched. The search terms were fever, fever management, misconception, myth, fiction, fact, fever phobia, child, antipyretics, tepid bath, alternating use/combined use of antipyretics, and physical cooling method. Results: There are significant gaps between current concepts and practices, and the scientific evidence. Misconceptions and unrealistic concerns about childhood fever still exist among parents and even health care providers, worldwide. The evidences suggest that antipyretics should be given carefully with the aim of relieving discomfort or pain rather than decreasing the temperature itself. Alternating use of antipyretics should be discouraged due to the risk of confusion and error. Antipyretics do not prevent febrile convulsions. Moreover, the scientific evidence does not support tepid sponge massage. Conclusion: Evidence-based childhood fever management interventions should be targeted toward parents and health care providers. By adopting an evidence-based approach to nursing interventions, pediatric nurses can ensure children receive appropriate and safe fever management.

아동의 발열과 발열관리: 문헌고찰 (Fever and Fever Management in Children: A Literature Review)

  • 정용선;김진선
    • Child Health Nursing Research
    • /
    • 제16권1호
    • /
    • pp.30-40
    • /
    • 2010
  • Purpose: The purposes of this review were to identify whether available evidence supports the nursing interventions that are commonly used to reduce fever in children and to introduce research findings into practice. Methods: Journal databases and clinical guidelines from 1990 to 2009 were searched. The search terms were fever, febrile convulsion, fever management, fever phobia, child, antipyretics, temperature, external cooling, tepid sponge bath, and physical treatment. Results: Evidence suggests that uncomplicated fever is relatively harmless, but it is an important immunological defense. Antipyretics should not routinely be used with the sole aim of reducing body temperature in children with fever who are otherwise well. Currently a lack of evidence supports the practice of alternating acetaminophen and ibuprofen, and the routine use of tepid sponge bath. Conclusion: Currently, fever management in children does not reflect research evidence. Pediatric nurses can play an important role by encouraging clinical research in this area and also by enhancing research utilization in their practice. Moreover, pediatric nurses can educate parents about evidence-based fever management. Evidence-based educational interventions for pediatric nurses need to be developed and evaluated to improve the quality of nursing care in the management of childhood fever.

Risk Assessment in Finland: Theory and Practice

  • Anttonen, Hannu;Paakkonen, Rauno
    • Safety and Health at Work
    • /
    • 제1권1호
    • /
    • pp.1-10
    • /
    • 2010
  • The Finnish risk assessment practice is based on the Occupational Safety and Health (OSH) Act aiming to improve working conditions in order maintain the employees' work ability, and to prevent occupational accidents and diseases. In practice there are hundreds of risk assessment methods in use. A simple method is used in small and medium sized enterprises and more complex risk evaluation methods in larger work places. Does the risk management function in the work places in Finland? According to our experience something more is needed. That is, understanding of common and company related benefits of risk management. The wider conclusion is that commitment for risk assessment in Finland is high enough. However, in those enterprises where OSH management was at an acceptable level or above it, there were also more varied and more successfully accomplished actions to remove or reduce the risks than in enterprises, where OSH management was in lower level. In risk assessment it is important to process active technical prevention and exact communication, increase work place attraction and increase job satisfaction and motivation. Investments in OSH are also good business. Low absenteeism due to illness or accidents increases directly the production results by improved quality and quantity of the product. In general Finnish studies have consistently shown that the return of an invested euro is three to seven-old. In national level, according to our calculations the savings could be even 20% of our gross national product.