• Journal of Korean Clinical Nursing Research
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• v.23 no.3
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• pp.302-311
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• 2017

Purpose: The purpose of this study was to examine nursing organizational culture and resilience and their effects on quality of nursing service. Methods: A cross-sectional study was conducted. A convenience sampling method was used to collect data from 199 participants who worked in a tertiary hospital in G city. Demographic and work related variables, quality of nursing service, resilience, and nursing organizational culture were measured using validated self-report questionnaires. Results: All of the participants were women and the majority were staff nurses and single. A statistically significant difference in quality of nursing service was found for age, marital status, educational level, clinical career, position and perceived health status. Age, educational level, clinical career, position, resilience, innovation-oriented culture, relation-oriented culture, and hierarchy-oriented culture were significant predictors of quality of nursing service, explaining 47% of total variance. Among the predictors, resilience was the strongest predictor, followed by innovation-oriented culture, and hierarchy-oriented culture. Conclusion: Findings indicate that quality of nursing service can be improved by raising individual nurse's resilience and advancing nursing organizational culture. Considering the identified factors, researchers and administrators need to develop and provide clinical nurses with a variety of programs to improve the quality of their nursing service.

• Asia-Pacific Journal of Business Venturing and Entrepreneurship
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• v.7 no.3
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• pp.89-97
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• 2012

The purpose of this study is to examine service quality elements in China Bank Industry and influence on service value, customer satisfaction and reuse intention. This study is composed one parallel comparison of documentary and evidential researches. To verify research model, the survey about medical institution and hospital services were conducted in Daqing of Heilongjiang Province, in China. Collected data was analyzed and the results are introduced in this paper. The findings ar as followed. This study has modified three-dimensional model of service quality: "interaction quality", "outcome quality" and "physical environment quality". Research was focused on investigating the direct effect of every service quality dimension on customer satisfaction. But "outcome quality "has only direct effect on service value, "interaction quality" and "physical environment quality" have not direct effect on service value in this study. Service value has direct effect on customer satisfaction and reuse intention. And customer satisfaction was the significant mediating role in the relationship of the service value and reuse intention.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• Korea Journal of Hospital Management
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• v.27 no.2
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• pp.34-43
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• 2022

Objective: Telemedicine service is gaining importance in remote military areas. This study aimed to explore the mediating effect of user satisfaction on the association between military telemedicine service's quality and customer loyalty. Methods: The research data comprised the results of a satisfaction survey on 1,116 military telemedicine satisfaction surveys conducted from November 1 to November 31, 2021. T-tests and ANOVA were analyzed to confirm the difference in satisfaction and loyalty according to the general characteristics of the study subjects. User satisfaction, customer loyalty, and mediating effects were analyzed using multiple linear regression analysis. Results: Among the study subjects, 458 were affiliated with the Army, 68 with the Navy, and 36 with the Air Force. Among the quality of telemedicine service, tangibility, reliability, and empathy affected user satisfaction while reliability and empathy affected customer loyalty. Since the standardized coefficient beta of empathy was 0.150 (P=0.018), it was confirmed that it significantly affected customer loyalty by mediating user satisfaction. Conclusion: The telemedicine service's quality affects users' satisfaction and customer loyalty. Moreover, there was the mediating effect of user satisfaction on the association between telemedicine service and customer loyalty. Therefore, the reliability and reliability of the current telemedicine service can be improved through the replacement of outdated equipment and performance improvement, expansion of medicines in telemedicine units, and improvement of medical services through periodic CS education to increase the customers' satisfaction and loyalty.

• Health Policy and Management
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• v.7 no.1
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• pp.100-124
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• 1997

In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.87-106
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• 2018

Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

• Progress in Medical Physics
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• v.28 no.3
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• pp.111-121
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• 2017

Verification of dose distribution is an essential part of ensuring the treatment planning system's (TPS) calculated dose will achieve the desired outcome in radiation therapy. Each measurement have uncertainty associated with it. It is desirable to reduce the measurement uncertainty. A best approach is to reduce the uncertainty associated with each step of the process to keep the total uncertainty under acceptable limits. Point dose patient specific quality assurance (QA) is recommended by American Association of Medical Physicists (AAPM) and European Society for Radiotherapy and Oncology (ESTRO) for all the complex radiation therapy treatment techniques. Relative and absolute point dose measurement methods are used to verify the TPS computed dose. Relative and absolute point dose measurement techniques have a number of steps to measure the point dose which includes chamber cross calibration, electrometer reading, chamber calibration coefficient, beam quality correction factor, reference conditions, influences quantities, machine stability, nominal calibration factor (for relative method) and absolute dose calibration of machine. Keeping these parameters in mind, the estimated relative percentage uncertainty associated with the absolute point dose measurement is 2.1% (k=1). On the other hand, the relative percentage uncertainty associated with the relative point dose verification method is estimated to 1.0% (k=1). To compare both point dose measurement methods, 13 head and neck (H&N) IMRT patients were selected. A point dose for each patient was measured with both methods. The average percentage difference between TPS computed dose and measured absolute relative point dose was 1.4% and 1% respectively. The results of this comparative study show that while choosing the relative or absolute point dose measurement technique, both techniques can produce similar results for H&N IMRT treatment plans. There is no statistically significant difference between both point dose verification methods based upon the t-test for comparing two means.

• Journal of the Korea Convergence Society
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• v.13 no.1
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• pp.409-415
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• 2022

The purpose of this study is to identify factors affecting nursing service quality for nursing hospital nurses and An attempt was made to confirm the correlation between nursing work environment, human-centered care, and work stress on nurses in nursing hospital. The data was collected using questionnaire filled out by 129 nurses at nursing hospitals in G city area from August 20 to September 10, 2019. As a result of the study, factors influencing the quality of nursing services among nursing hospital nurses were married, Practice Environment of Nursing Work, and human-centered care. Based on these results, hospital management will need to make efforts to improve the organizational system to create a desirable nursing working environment in nursing hospital.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.2
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• pp.137-144
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• 2008

Positron emission tomography-computed tomography (PET/CT) provides both functional and anatomical images of high quality non-invasively with better precision in localization than PET alone. Increase in the use of PET/CT, coupled with increasing concerns about the quality of medical services accrued the demands for accurate evaluation of system performance and quality assurance. Thus, well designed programs for performance evaluation and quality assurance are needed. Widely used protocols for performance evaluation of PET are the methods proposed by National Electrical Manufacturers Association (NEMA) in 1994 and 2001. In addition, in order to maintain high quality of PET/CT images, quality assurance programs including periodic (daily, monthly, and yearly). Therefore, in this article, the methods and present state of performance evaluation and quality assurance of PET/CT are reviewed.

• Korea Journal of Hospital Management
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• v.11 no.1
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• pp.31-53
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• 2006

The objective of this study is to examine the effectiveness of the strategy of hospital specialization by analyzing the differences in expected and perceived services, perceived service quality, satisfaction, and intentions to revisit and recommend the hospital to others between general and specialty hospitals. Data were collected using self-administered questionnaire from patients admitted to four study hospitals: two speciality and two general hospitals. The questionnaire was developed based on SERVQUAL to measure five dimensions of service quality. Four hundreds questionnaires were distributed to inpatients or their guardians and 282 returned questionnaires were used in the analyses. The significance of the differences in study variables between specialty and general hospitals were tested by t-test and $x^2$-test. The factor analysis result confirmed the construct validity of 28 questions asked to measure service quality and resulted in four dimensions of service quality: reliability, assurance, tangible and empathy/responsiveness. Cronbach's Alpha ranged from .9013 to .9358, that confirmed the internal consistency of answers. The study results indicated that patients who used specialty hospitals had higher levels of expected and perceived service, a higher level of perceived service quality, and higher levels of service satisfaction than patients who used general hospitals. Percents of patients who had the intention to revisit the hospital and to recommend the hospital to others were higher among patients in specialty hospitals. The most frequent reason to choose the hospital was the excellence of doctors in both general(29.9%) and specialty(43.8%) hospitals, that was followed by convenient transportation(15.3%) and someone know works at the hospital(15.3%) in general hospitals and other's recommendation(14.6%), and nice amenities(13.1%) in specialty hospitals. Although there were no significant differences in clinical department, age, and sex of patients between general and specialty hospitals, patients who visited speciality hospitals had higher levels of education and income than their counter part in general hospitals. These results suggested that specialty hospitals performed better than general hospitals. Specialization could be a viable strategy to tide over recent financial difficulties experienced by hospitals, particularly small- and medium-sized hospitals.