• Title/Summary/Keyword: Quality of Health Care

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Factors associated with Health-related Quality of Life among Family Caregivers of Elders Receiving Home Care Services (재가 장기요양노인 가족수발자의 건강 관련 삶의 질 영향요인)

  • Kim, Eun-Young;Yeo, Jung Hee
    • Research in Community and Public Health Nursing
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    • v.23 no.2
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    • pp.117-126
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    • 2012
  • Purpose: The purpose of this study was to identify the factors associated with the health-related quality of life of family caregivers. Methods: A cross-sectional study was conducted. This study included 191 primary family caregivers of elders who used home care services (home-visit nursing, home-visit care, daycare) covered by the public long-term care insurance. Data were collected using self-report questionnaires from December 2010 to June 2011. These data were analyzed by using hierarchical multiple regression. Results: The majority of the family caregivers were female (79.6%) and daughters-in-law (28.8%). The mean depression score was $6.33{\pm}6.49$ and the mean health-related quality of life score was $0.69{\pm}0.39$. It was found that the factors affecting the health-related quality of life of family caregivers included depression (${\beta}$=-.406, p<.001), home-visit nursing use (${\beta}$=.296, p<.001), and daycare use (${\beta}$=.178, p=.015), which accounted for 36.6% of their health-related quality of life. Conclusion: Using home-visit nursing and daycare services has a positive effect on the health-related quality of life of family caregivers. To improve health-related quality of life of family caregivers, South Korea needs to fully activate the home-visit nursing and daycare services, and to strengthen family support programs.

Effects of an Empowering Program on Health Quality of Life, Decision Making Self-efficacy, Self-care Competency, and Reasonable Medical Care Utilization among Low Income Women Households (일 지역 저소득층 여성가구주를 위한 임파워링 프로그램이 건강 삶의 질, 의사결정 자기효능, 자가관리 능력 및 합리적 의료이용에 미치는 효과)

  • Ahn, Yang-Heui;Kim, Ki-Kyong;Kim, Gi-Yon;Song, Hee-Young
    • Journal of Korean Public Health Nursing
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    • v.24 no.2
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    • pp.237-248
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    • 2010
  • Purpose: The study assessed the effects of a 12-session empowering program to promote health quality of life, decision making self-efficacy, self-care competency, and reasonable medical care utilization among low income women households in one rural area. Methods: A quasi-experimental, one-group pre-posttest design was employed. A total of 28 women enrolled as medicaid recipients in the Public Health Center of W city agreed to participate. The empowering program consisted of 12 sessions addressing health education for self-care of disease, medication management, and counseling for psycho-social support. The intervention was delivered by five nurses and one social worker. Women completed a structured questionnaire measuring the study variables with demographic characteristic before and after the intervention. Data were analyzed by PAWS Statistics 17 utilizing descriptive statistics and paired t-test. Results: After the intervention, significant increases were evident in participant health quality of life (t=-5.83, p<.001), decision making self-efficacy (t=-4.86, p<.001), self-care competency (t=-8.16, p<.001), and reasonable medical care utilization (t=-3.97, p<.001). Conclusion: The 12-session empowering program on health quality of life as well as self-care competency was effective when delivered to low income women households. Further studies with larger numbers of participants and a control group are necessary to validate the results.

A Study on the Service Quality in Radiological Health Care Services (방사선과 보건의료의 서비스 품질 평가척도 개발에 관한 연구)

  • 강보철;조재립
    • Journal of Korean Society for Quality Management
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    • v.26 no.4
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    • pp.189-201
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    • 1998
  • Quality of radiological services can be assessed by various agents, so called medical doctors, radiologists, patients and others. However radiological services are provided by radiologists to patients and medical doctors. This study was based on data which were collected from assessment of 142 radiologists working in the health care services organization and 149 patients who visited the same organization about radiological services, with self-administered structured questionnaire. This study was planned to analyze of radiological services factors and to develop a methodology for measuring the level of quality in the radiological health care services.

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Application of the SERVQUAL Scale to Health Care Services (의료서비스에서 SERVQUAL 활용에 대한 고찰)

  • 조우현;이선희;최귀선;문기태
    • Health Policy and Management
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    • v.9 no.4
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    • pp.140-156
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    • 1999
  • The purpose of this article was to review the basic concept of the SERVQUAL scale and to evaluate its usefulness in health care settings. The SERVQUAL scale was developed by Parasuraman et al. in 1988. Its purpose was to provide an instrument for measuring the quality of service that would apply across a broad range of services with minor modifications in the scale. The SERVQUAL scale is based on gap theory, which indicates the difference between consumers' expectations and their assessment of the actual performance of a specific firm. It has five dimensions to define service quality. These dimensions include: (1) tangibles' (2) reliability' (3) responsiveness' (4) assurance' (5) empathy. While the SERVQUAL scale has been tested in a number of health care settings. the findings have been mixed. So. health care marketers should be cautious in their use of the SERVQUAL scale. However, it is rare to find instruments that are as well validated as SERVQUAL appears to be. As well the SERVQUAL scale provides valuable information about the quality of health care service.

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Analysis of Hospital Services for Elderly Inpatients (노인 입원환자 병원서비스 분석)

  • Chang, Hyun Sook
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.18-31
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    • 2000
  • Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.

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Designing an Effective Pay-for-performance System in the Korean National Health Insurance

  • Jeong, Hyoung-Sun
    • Journal of Preventive Medicine and Public Health
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    • v.45 no.3
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    • pp.127-136
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    • 2012
  • The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

The Physical Environment and Behavioral·Psychological Health and Quality of Life for the Elderly People with Dementia - A Follow-up Study of Empirical Research, conducted on the Context of Long-term Care Facilities for the Elderly People with Dementia, to Identify Healing Environmental Factors and to Expand the Understanding of Related Clinical Outcomes (물리적 환경과 치매거주노인의 행동·심리적 건강과 삶의 질 - 노인요양시설 치유환경 디자인 요소 도출과 연계된 중재적 의료성과의 이해확장을 위한 후속연구)

  • Choi, Young-Seon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.29 no.4
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    • pp.7-20
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    • 2023
  • Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of physical and environmental factors on behavioral·psychological health and quality of life for the elderly people with dementia who reside in long-term care facilities. This follow-up study of the previous literature review aims to further identify physical and environmental factors, that improve health and quality of life for the elderly people with dementia, published in recent five years and to expand the understanding of clinical outcomes as mechanism that mediate the effect of physical environmental factors on improving behavioral·psychological health and quality of life for the elderly people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies that link the design of dementia care facilities to health- and quality of care(QOL)-related outcomes and this follow-up review scrutinized peer-reviewed articles published in recent five years (from January 2018 to December 2022), filling the gap between the previous literature review and the current state of research. Results: The review identified a growing body of literature that articulates environment-related factors that improve behavioral·psychological health and quality of life for the elderly people with dementia living long-term care facilities. Implications: The findings of the review can be translated to design implications and design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

Developing a Composite Quality Indicator to Assess The Quality of Care for US Medicare End-stage Renal Disease Patients (미국 Medicare 투석환자 치료의 질 지표 개발 : 4가지 주요 치료영역을 바탕으로)

  • Kang, Hye-Young
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.204-216
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    • 2000
  • Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

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Evaluation of Health Care Services of Public Health Centers: SERVQUAL (SERVQUAL을 적용한 일 보건소 이용자의 보건의료서비스 질적 수준 평가)

  • Joung, Hye Young;Byeon, Do Hwa
    • Journal of Korean Public Health Nursing
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    • v.28 no.3
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    • pp.553-564
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    • 2014
  • Purpose: The aim of this study is to identify the expectations and perceptions of health center users as to the services. SERVQUAL scale was used for measurement of service quality. The purpose of this study is to offer baseline data for improving the quality of health care services. Methods: The subjects were users of a health center in S City in Kangwon-do; 170 people participated in this study. Results: Regarding service quality depending on general characteristics, the following results were obtained. First, there were statistically significant differences depending on the gender, purpose of visit, and satisfaction in the health center. Second, the services fell short of the expectations. Third, the quality of 'safe, accurate services' scored the highest, while 'empathy and friendliness' scored the lowest. Fourth, 'internal, external environment of the health center' scored the highest, while 'courtesy of staff' scored the lowest. There were no statistically significant differences. Conclusion: Based on the findings, the following are suggested. First, employee education should be provided for development of empathy and interaction with patients; those are the weakest areas in the health care services. Second, a system allowing patients to understand and participate in their treatment should be developed.