• Journal of Korean Academy of Nursing
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• v.10 no.1
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• Journal of muscle and joint health
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• v.12 no.2
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• pp.143-154
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• 2005

Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.18
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• pp.7653-7664
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• 2014

Background: Colorectal ranked first among cancers reported in males and ranked second amongst females in Jordan, accounting for 12.7% and 10.5% of cancers in males and females, respectively. Colorectal cancer patients can suffer several consequences after treatment that include pain and fatigue, constipation, stoma complications, sexual problems, appearance and body-image concerns as well as psychological dysfunction. There is no published quantitative data on the health-related quality of life and psychological wellbeing of Jordanian colorectal cancer survivors. Method: This project was a cross-sectional study of colorectal cancer survivors diagnosed in 2009 and 2010. Assessment was performed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the colorectal cancer specific module (EORTC QLQ-CR 29) and the Hospital Anxiety and Depression Scale (HADS). Data on potential predictors of scores were also collected. Results: A total of 241 subjects completed the study with mean age of $56.7{\pm}13.6$. Males represented 52.3% of study participants. A majority of participants reported good to high overall health; the mean Global health score was $79.74{\pm}23.31$ with only 6.64% of study participants scoring less than 33.3%. The striking result in this study was that none of the study participants participated in a psychosocial support group; only 4 of them (1.7%) were even offered such support. The mean scores for HADS, depression score, and anxiety score were $8.25{\pm}9$, $4.35{\pm}4.9$ and $3.9{\pm}4.6$, respectively. However, 77.1% of study participants were within the normal category for the depression score and 81.7% were within this category for anxiety score; 5.4% of participants had severe anxiety and 5.4% of them had severe depression. Discussion: Patients with colorectal cancer in Jordan have a good quality of life and psychological wellbeing scores when compared with patients from western countries. None of the colorectal cancer patients managed at the Ministry of Health received any formal counselling, or participated in psychological or social support programmes. This highlights the urgent need for a psychosocial support programme, psychological screening and consultations for patients diagnosed with colorectal cancer at the Ministry of Health Hospitals.

• Journal of Navigation and Port Research
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• v.42 no.6
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• pp.406-414
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• 2018

The objective of this study was to analyze the effect of characteristics of maritime telemedicine (service quality, recognition or not of service, health counselling service experience or not) on seafarer's satisfaction, and also analyze the effect of seafarer's satisfaction on loyalty. This study's data was collected from the Research Report of Survey of telemedicine service subjects in 2017 conducted in the maritime telemedicine pilot project. However, only 103 seafarers who received maritime telemedicine (Tele-Monitering) services were analyzed statistically. The main results of this study were as follows. ⅰ) Better service quality led to higher levels of satisfaction, ii) High levels of seafarer's satisfaction led to high levels of loyalty, iii) Seafarers whose age is under 50 than 30 years old are less satisfied, ⅳ) In total boarding career, Seafarers with more than 5 years but less than 10 years were more satisfied than seafarers with less than 5 years, ⅴ) Seafarers with more than 10 years but less than 15 years were more satisfied than seafarers with less than 5 years, ⅵ) Seafarers with more than 15 years but less than 20 years were more satisfied than seafarers with less than 5 years, ⅶ) Also, Seafarers in excess of 20 years were more satisfied than seafarers with less than 5 years, In conclusion, ⅰ) Better service quality led to higher levels of satisfaction and loyalty. Accordingly, the improvement of service quality is not only an important factor in improving satisfaction and loyalty, but also plays an important role in forming a positive image of maritime telemedicine. ⅱ) Seafarers with younger age and lower overall total boarding career were more satisfied. It is believed that the seafarer who are willing to use telemedicine and who are willing to refer to others are young.

• Korean Journal of Community Nutrition
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• v.21 no.3
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• pp.284-292
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• 2016

Objectives: This study compared the differences of postmenopausal women's bone mineral density in relation to the degree of obesity, metabolism index and dietary factors that affect bone mineral density. Methods: The subjects included in the study are 39 postmenopausal women of normal weight with body mass index less than $25kg/m^2$ and 32 postmenopausal who are obese. Anthropometry and biochemical analysis were performed and nutrient intakes and DQI-I were assessed. Results: Normal weight women were $56.03{\pm}3.76years$ old and obese women were $58.09{\pm}5.13years$ old and there was no significant difference in age between the two groups. The T-score of bone mineral density was $0.03{\pm}1.06$ in normal weight women and $-0.60{\pm}1.47$ in obese women and this was significantly different between the two groups (p<0.05). Blood Leptin concentration was significantly lower in normal weight women ($6.09{\pm}3.37ng/mL$) compared to obese women in ($9.01{\pm}4.99ng/mL$) (p<0.05). The total score of diet quality index-international was $70.41{\pm}9.34$ in normal weight women and $64.93{\pm}7.82$ in obese women (p<0.05). T-score of bone mineral density showed negative correlations with percentage of body fat (r = -0.233, p=0.05), BMI (r = -0.197, p=0.017), triglyceride (r = -0.281, p=0.020) and leptin (r = -0.308, p=0.011). The results of multiple regression analysis performed as the method of entry showed that with 22.0% of explanation power, percentage of body fat (${\beta}=-0.048$, p<0.05), triglyceride (${\beta}=-0.005$, p<0.05) and HDL-cholesterol (${\beta}=0.034$, p<0.01), moderation of DQI-I (${\beta}=-0.231$, p<0.05) affected T-score significantly. Conclusions: The results of the study showed that obese women have less bone density than those with normal weight women. In addition, the factor analysis result that affect bone mineral density showed that intake of fat is a very important factor. Therefore, postmenopausal women need to maintain normal weight and manage blood lipid levels within normal range. They also need to take various sources of protein and reduce consumption of empty calorie foods that have high calories, fat, cholesterol and sodium.

• Journal of dental hygiene science
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• v.2 no.1
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• pp.1-9
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• 2002

The objection of this present study are (1) measurement of patient's expectation toward quality care of dental services. (2) Analysis of differential expectation of dental service by the patient characteristics and (3) presentation of measurement implication for better dental service at the dental clinic. The data used in the study were collected from April 25 to June 9, 2001 and for 77 patients of university dental hospital and 102 patients of dental clinic. The study found, in general, that patient's expectation on the clinic environmental factor was most highly scored followed by dental human factors. The convenience of transportation from the patient's residence to the clinic was highly concerned as be an important factor in dental service utilization.

• Health Policy and Management
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• v.11 no.2
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• pp.141-168
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• 2001

Healthcare service organizations can apply the cost of quality(COQ) model as a method to evaluate a service quality improvement project such as Total Quality Management (TQM). COQ model has been used to quantify and evaluate the efficiency and effectiveness of TQM project through estimation between cost and benefit in intervention for a quality Improvement to provide satisfied services for a customer, and to identify a non value added process. For estimating cost of quality, We used activities and activity costs based on Activity Based Costing(ABC) system. These procedures let the researchers know whether the process is value-added by each activity, and identify a process to require improvement in TQM project. Through the series of procedures, health care organizations are service organizations can identify a problem in their quality improvement programs, solve the problem, and improve their quality of care for their costumers with optimized cost. The study subject was a quality improvement program of the department of radiology department in a hospital with n bed sizes in Metropolitan Statistical Area (MSA). The principal source of data for developing the COQ model was total cases of retaking shots for diagnoses during five months period from December of the 1998 to April of the 1999 in the department. First of the procedures, for estimating activity based cost of the department of diagnostic radiology, the researchers analyzed total department health insurance claims to identify activities and activity costs using one year period health insurance claims from September of the 1998 to August of the 1999. COQ model in this study applied Simpson & Multher's COQ(SM's COQ) model, and SM's COQ model divided cost of quality into failure cost with external and internal failure cost, and evaluation/prevention cost. The researchers identified contents for cost of quality, defined activities and activity costs for each content with the SM's COQ model, and finally made the formula for estimating activity costs relating to implementing service quality improvement program. The results from the formula for estimating cost of quality were following: 1. The reasons for retaking shots were largely classified into technique, appliances, patients, quality management, non-appliances, doctors, and unclassified. These classifications by reasons were allocated into each office doing re-taking shots. Therefore, total retaking shots categorized by reasons and offices, the researchers identified internal and external failure costs based on these categories. 2. The researchers have developed cost of quality (COQ) model, identified activities by content for cost of quality, assessed activity driving factors and activity contribution rate, and calculated total cost by each content for cost for quality, except for activity cost. 3. According to estimation of cost of quality for retaking shots in department of diagnostic radiology, the failure cost was ￦35,880, evaluation/preventive cost was ￦72,521, two times as much as failure cost. The proportion between internal failure cost and external failure cost in failure cost is similar. The study cannot identify trends on input cost and quality improving in cost of qualify over the time, because the study employs cross-sectional design. Even with this limitation, results of this study are much meaningful. This study shows possibility to evaluate value on the process of TQM subjects using activities and activity costs by ABC system, and this study can objectively evaluate quality improvement program through quantitative comparing input costs with marginal benefits in quality improvement.

• Journal of Korean society of Dental Hygiene
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• v.20 no.5
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• pp.707-716
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• 2020

Objectives: This study aims to provide basic data for high-quality dental services. In addition, we will promote the operation of preventive dentistry that implements preventive measures. It was conducted to study the change of patient's treatment behavior and treatment cost due to the discontinuation of preventive dentistry in university dental hospitals. Methods: This study collected data using the integrated medical information system of the C University Dental Hospital. From September 1, 2017 to August 31, 2019, data were analyzed using frequency, percentage, mean, standard deviation, chi-square test using SPSS version 24.0 statistical program, and T-test. Results: There was a significant difference in the number of preventive dental treatment cases from 58.3% of preventive dental operation periods to 41.7% of preventive dental operation periods. As a result of comparing the medical expenses, the total medical expenses during the preventive dental operation period decreased from 521,308,872 won to 379,724,995 won during the discontinuation period, 141,583,877 won. The number of medical treatments by treatment behavior decreased 3,835 (28.4%) from a total of 13,520 preventive dental operation periods to 9,685. Conclusions: This study is meaningful as the first study to confirm the change in the treatment behavior and the change in the cost of treatment due to the discontinuation of the operation of preventive dentistry at university dental hospitals. In conclusion, it is thought that there is a possibility of the lack of accessibility and the limitation of professional preventive care due to the discontinuation of preventive dentistry.

• Korea Journal of Hospital Management
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• v.22 no.2
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• pp.44-57
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• 2017

The objective of this study is to investigate financial integrity strategies for sustainable development of local public medical centers, and particularly focus on seeking ways to enhance its financial efficiency and publicness. The data which was collected from 33 local public medical centers was analyzed by Data Envelopment Analysis to measure its financial efficiency. Then, Matrix Analysis was used to examine the association of financial efficiency and publicness of local public medical centers with related factors. In the aspects of facilities and location, according to the results, the local public medical centers which have larger number of available hospital beds or located in bigger cities were examined to have higher degree of publicness. In the aspect of human resources, greater number of doctors made both financial efficiency and the degree of publicness decreased, whereas higher participation rate of educational program for doctors affects increasing its financial efficiency and publicness. Lastly, in the aspect of costs, higher labor, material, and administrative cost diminished financial efficiency, but enhanced the degree of publicness. Based on these results, this study concluded that enhancing the publicness of local public medical centers should be pursued by increasing the accessibility with better facilities and location, and also concurrently organizing rational expenditure structure with appropriate cost investment to the resources of local public medical centers. Also, it is necessary to enhance both financial efficiency and publicness simultaneously by improving the quality of health care services through the educational programs for medical staffs.

• The Journal of Korean Academic Society of Nursing Education
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• v.7 no.2
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• pp.275-284
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• 2001

This study was conducted to examine the nurses' role in Oriental medical hospital and the necessity of Oriental medical nursing system. Data were collected from 194 nurses in 14 Oriental medical hospitals located in Seoul, Busan, Daegu, Kwangju, Kangwon Province, Kyungbuk Province from July 1, 2000 to September 10, 2000. The results of this study are summarized as follows. 1. In nurse's level of knowledge of acupuncture point in current Oriental nursing practice, 28.4% of the respondents did not know acupuncture points at all, while 30.9% knew them a little. 40.7% of them did not almost know them. 2. According to nurses' role in Oriental medical hospital, they did a lot of duty for measurement of vitality, medical record, Dr. notifying, communication with medical team and related departments, and observation of patients' conditions. They did a little duty for handling Oriental medical practice. 3. As the subject of curriculum for Oriental medical nursing, 52.1% chose training course for Oriental medical nursing, while 25.8% chose inclusion of the curriculum in the school of nursing. 39.2% replied that they would take the training course for Oriental medical nursing, while 3.6% answered that they would not take it. 68.6% of them thought that Oriental medical nursing system should be introduced, while 4.1% objected to introducing the system. The nurses in Oriental medical hospitals are working with many problems because of their role confusion and low level of knowledge in Oriental medicine. Therefore, systematic curriculum and research related to Oriental medical nursing are necessary. Oriental medical nursing system must be introduced in order to make nurses have professional knowledge and skill in Oriental medicine. The nurses then can provide services of good quality for the patients.