• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.1
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• pp.9-21
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• 2014

This study aims to help utilize the dental treatment institutions for the disabled and provide high quality of medical services in the future by identifying the satisfaction factors for the patients of the dental clinics for the disabled. As a study method, surveys were completed 200 patients who visited the dental hospital for the disabled. Among these, the surveys from 187 patients were statistically analyzed. The main findings of this study are as follow. Since the study showed that there were differences in the satisfaction factors between the disabled and non-disabled people, subsequent studies needs to be done to develop measuring tools to accurately accommodate the satisfaction factors of the disabled. In addition, as the low spatial accessibility in terms of distance and location was found in this study, more dental treatment institutions for the disabled are required. In the meantime, the survey results found that the most satisfactory aspect was the lower treatment cost compared to other clinics, and that the most important factor when choosing a clinic was also treatment. In addition, given the fact that the group that took a prosthetic treatment, which was non-insured treatment, showed higher satisfaction compared to the group that did not, it suggests that the economic burden plays an important role for the dental treatment of the disabled.

• Journal of Hospice and Palliative Care
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• v.2 no.2
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• pp.91-100
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• 1999

Purpose : This study was performed to investigate the satisfaction in the hospice services provided for inpatient families and bereaved families whose members had been admitted to the hospice unit at Kangnam St. Mary's Hospital to improve the quality of care for the terminally ill patients and their families. Methods : This sample consisted of 33 families of hospice patients during the period of April to lune, 1998 and 30 bereaved families whose patients had died from March, 1993 to March, 1998. The data were collected through a self-report questionnaire and analyzed using t-test and ANOVA. Results : 1) The satisfaction level of inpatient families and bereaved families showed the mean value of 3.5 where the highest value is 5.0. 2) According to age, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management(P=0.0001). The level of satisfaction of bereaved families showed significant differences in the field of support for the family, medical management, nursing management, and facilities of the hospice unit(P=0.0001). 3) By family relationship, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family, medical management and nursing management (P=0.0001). 4) According to religion, the level of satisfaction of inpatient families had significant differences in the fields of hospice philosophy, support for the family and nursing management (P=0.0001), but there was no significant difference for the bereaved families. Conclusions : The findings of this study showed that hospice services had positive influence on families with terminal disease such as cancer. To improve the level of satisfaction in the hospice services for families with hospice patients, we need to provide care by an interdisciplinary hospice team approach, and to assess needs of the families according to their socio-psychological characteristics. Further studies need to be conducted with large samples.

• Korean Journal of Clinical Pharmacy
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• v.29 no.3
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• pp.193-201
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• 2019

Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

• Journal of Korean Academy of Nursing
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• v.16 no.3
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• pp.108-122
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• 1986

Changing concepts of health care, are stimulating the demand for health care, thereby orienting society to health care rights to such an extent that they are deemed as fundamental ones inalienable to man. Concomitantly, qualitative as well as quantative improvement is being sought in the nursing service field. Today, efforts are being made in various areas, especially to qualitatively improve nursing services. A second issue concerns proper staffing. It is important to study staffing, in as much as it continues to be the most persistent and critical problem facing hospital nursing administrators today. It involves quantity, quality, and utilization of nursing personnel. A great deal of attention has been focused on this problem since mid 1930's when nursing services began to be felt as an important segment of hospital operation representing the largest single item of hospital budgets. Traditionally, the determination and allocation of nursing personnel resources has relied heavily on gloval approaches which make use of fixed staff-to-patient ratios. It has long been recognized that these ratios are insensitive to variations between institutions and among individual patients. Therefore, the aim of this thesis is to point to the urgent need for the development of methodology and criteria suited to the reality of Korea. The present research selected one place, the W Christian Hospital, and was conducted over a period 10 days from January, and nurses who were them on duty in their unit. The total num-her of patients surveyed was 1,426 and that of 354. The research represents many variables affecting the direct patient care time using the result from the direct observation method, then using a calculation method to estimate the relationship between the patients care time and selected variables in the hospital setting. The amount of direct patient care time varies with many factors, such 89 the patients age. diagnosis and time in hospital. Differences are also found from hospital, clinic to clinic, ward to ward, and even shift to shift. In this research, the calculation method of estimating the required member of nursing staff is obtained by dividing the time of productive patient care activity(with the time of patient care observed), by the sum of the productive time that each the staff can supply, i.e., 360 minutes, which is obtained by deducting the time for personal activities. The results indicate a substantial difference between the time of productive patient care observed directing and the time of the productive patient care estimated using calculating method. If we know accurately the time of the direct patient care on a shift, there required number of staff members calculated if the proper method can be determinded should be able the time of the direct patient care be estimated by the patient classification system, but this research has shown this system to be in accurate in Korea. There are differences in the recommended time of productive patient care and the required number of nursing staff depending upon which method is used. The calculated result is not very accurate, so more research is needed on the patient classification system.

• Quality Improvement in Health Care
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• v.2 no.1
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• pp.58-67
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• 1995

Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05. Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

• Journal of the Korean Society of Radiology
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• v.1 no.2
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• pp.13-22
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• 2007

The purpose of this study was to survey a development of the wireless transmission system of medical images for ubiquitous medicine. There have been many changes in medical equipments and medical record medical treatment and medical record within hospital and PACS(Picture Archiving Communication System) which is picture management system for patients can be typical cases. It is difficult to use these automated medical systems unless they are within hospital and in case of rapid image reading in the emergency cases or in absence of doctor, it is difficult to perform it immediately. The present study implemented an image transmission system using CDMA connection so that images in the server can be viewed at any time and in any place. Remote wireless diagnosis based on medical images using PDA is applicable to medical areas that require mobility, and the use of PDA can be an ideal alternative for point of care. The use of PDA enables prompt and accurate access to digital medical images, which in turn reduces medical accidents and improves the quality of medical services through high productivity and efficiency of medical practitioners' works. It also enables quick response to patients' demands and high-quality medical services and, consequently, patients' high satisfaction.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.387-403
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• 1998

These days our nation is standing on tiptoe of welfare nation. so hospital in authority have done reformation to provide quality medical services. This effective nursing work to provide quality nursing by keeping pace with the reformation of management of hospital for quality medical function might be well said to be depending on the degree of function of nursing management of nursing department. This essay has been aimed to prepare the data to build the position of nursing organization which can elevate the quality of nursing by clarifying the difference of the degree of the function of nursing management according to the position of nursing department in hospital organization. 135 nurses of 1 general hospital in Seoul which has independent nursing organization of the hospitals of over 600 beds and 155 nurses of 1 general hospital in Seoul which has the nursing organization under the management of medical department have been the objects of this study. The tool of Yoon. Young Ae(1988) has been used by having it amended and complemented and the degree of reliability of the tool was resulted in Cronbach's Alpha .9155. The collected data have been analysed by SPSS program as mean. frequency, chi-square. t-test. F-test(ANOVA) and the results are as the follows; 1. Compared result of general characteristics of the two groups by $x^2$-test showed statistically significant difference between religion ($x^2$=10.375, p=.015) and educational background($x^2$=51.222. p=.000) 2. The t-test aimed to compare the degree of function of nursing management according to the position of nursing department is as the below: Compared result of the degree of the function of nursing management according to the areas has shown higher point in independent type(M=3.22) than in the type under the management of medical department(M=2.85) in the personnel and administrative activities of nursing department. the standard and regulation of nursing duty also showed higher point in independent than in the type under the management of medical department (M=3.37) and the education of nursing showed higher point in independent type(M=3.53) than in the type under the management of medical department(M=3.19) and the evaluation of nursing quality has shown higher point in independent type(M=3.33) than in the type under the management of medical department(M=3.05), The area which showed the highest difference of the degree of the function of nursing management between the two organizations was in the activities of personnel and administration management of nursing department (independent type M=3.22. the type under the management of medical department(M=2.85). The degree of function of general nursing management showed higher in independent type nursing organization than in the type under the management of medical department by 3.41 in independent type and 3.11 in the type under the management of medical department. The items which showed the lowest degree of function of nursing management of both organizations have been suitable nursing man power and distribution and the reflection of the opinion of nursing department. In conclusion. the degree of function of nursing management to be able to provide quality nursing for the hospital goal of quality medical works showed visibly higher in independent nursing organization than in the nursing organization under the management of medical department. Therefore it is desirable for the hospital to operate the nursing department in hospital organization by independent type rather than the type under the management of medical department and the chief of nursing department of the nursing organization of the type under the management of medical department should make effort to reform its structure to be able to establish the position of performing independent nursing management. And also the chief of the nursing organization of independent type should endeavor to build substantial independent type organization more than ever under the viewpoint of securing suitable nursing man power and the low degree of management in the reflection of the opinion of nursing department.

• Journal of Hospice and Palliative Care
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• v.5 no.1
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• pp.31-42
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• 2002

Purpose : The purpose of this study was to evaluate the present status of hospice palliative care programs in Korea as a basic database for standardization of hospice palliative care. Method : The data was collected from July to October, 2001. The instrument used for this study was the questionnaires which was consisted of the general characteristics of organization, recipient of service, manpower, contents of service, financial conditions and facilities. Sixty-four hospice palliative care programs answered the questionnaires, confirmed by telephone. Results : They were 40 hospital-based hospice palliative care programs and 24 nonmedical hospice palliative care programs. 11 Hospital-based hospice palliative programs have isolated unit or hospital affiliated free standing hospice. 6 Non-hospital hospice palliative programs have a free standing hospice. Major subjects of hospice palliative program were terminal cancer patients but patients with non-terminal illness were also included. Only 24 of 64 hospice palliative programs had all of the essential professionals : physicians, nurses, social workers, and clergies. Home hospice palliative care programs have a referral system in hospital based (89.7%) and nonmedical programs (73.7%). 24hr hospice are were provided in 26 hospital-based (65.0%) and 9nonmedical programs (37.5%). There were rooms for family in half of hospital-based programs. 73.9% of hospice palliative care programs have financial problems. 62.0% of Hospice palliative care programs need financial support from government. Conclusion : 64 Hospice palliative care programs provided hospice palliative services but had many problems in manpower, quality of care and facility. For improving the quality of terminal patients' life and promoting the cost effectiveness of health care resources, it is necessary to consider the standardization and institutionalization of hospice palliative care.

• Journal of Korean Academy of Nursing
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• v.34 no.3
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• pp.449-457
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• 2004

Purpose: The aim of this study was to analyze economical efficiency of home care service by comparing a cost-utility ratio(CUR) between home care and hospitalization. Method: The analytic framework of this study was constructed in 5 stages: Identifying the analytic perspectives, measurement of costs, measurement of utility, analysis of CUR, and sensitivity test. Data was collected by reviewing medical records, home care service records, medical fee claims, and other related research. Result: The mean of the annual total cost was 23,317,636 Won in home care and 73,739,352 Won in hospital care. QALY was 0.389 in home care and 0.474 in hospital care, so CUR was 299,712,545 QALY in home care and 777,841,266 QALY in hospital care. Conclusion: The findings affirmed that home care had an economical efficiency in the aspect of utility compared to hospitalization. Therefore, the findings of this study can be used to develop a governmental health policy or to expand the home care system. In addition, the cost-utility analysis framework and process of this study will be an example model for cost-utility analysis in nursing research. Therefore, it will be used as a guideline for future research related to cost-utility analysis in nursing.

• Journal of Digital Convergence
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• v.10 no.3
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• pp.233-240
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• 2012

This study aimed to clarify any factors that may have effect on the appropriateness of hospital admission and hospitalization with the intention of facilitating more efficient occupancy of hospital beds and better medical services in the aspect of their quality, minimizing unnecessary occupancy of beds, and ultimately helping patients requiring acute treatments to use immediately hospitals. This paper selected 154 Stroke patients who left neurology department of one general hospital from March, 1, 2006 to September, 31, 2010 as targets to meet the rate according to medical care security and to see the trend of recent 4 years. As study method, this paper analized medical treatment record with AEP to evaluate the appropriateness of hospital admission and stay and the collected data was computerized through SPSS 12.0. Based upon the results above, the conclusion was drawn that the higher appropriateness of hospital admission and the shorter length of hospital stay will lead to the higher appropriateness of hospitalization. In other words, it is required to provide hospitalized patients with all kinds of behaviors including medical treatments and nursing care service, management of pharmaceuticals, tests, rehabilitation and symptoms, as well as instructions and information for patients. Meanwhile, as it was found that the length of hospital stay may affect the appropriateness of hospitalization, the longer length of hospital stay may result in reduced bed turnover rate. In this light, it is necessary to organize a task force team responsible for evaluation and control of the appropriateness of hospitalization and hospital stay length to improve the quality of medical service in a medical center, so that patients can leave the center timely. Ultimately, governmental supports such as expansion of long-term care facilities will reduce the necessary length of hospital stay so that patients with stroke can receive rehabilitative treatments and long-term care service shortly after completion of acute treatments.