• Title/Summary/Keyword: Quality of Hospital Services

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Study on Precedents about Sex Offense Cases by Medical Practitioners (의료인 성범죄 사건에 관한 판례 고찰 : 대법원 2016. 12. 29. 선고 2015도624 판결을 중심으로)

  • Jeon, Byeong-Joo
    • The Journal of the Korea Contents Association
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    • v.17 no.8
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    • pp.610-618
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    • 2017
  • Sex offense by medical practitioners has been occurring continuously in Korea leading to not only patients but the general public expressing anxiety and increased distrust in the medical field. The government has been pushing ahead with the legislation or revision of law to increase the penalties on sexual offenders in response to requests for a stricter legal framework to address sex offense cases and has expressed a strong commitment to actively resorting to administrative corrective measures towards sexually offending medical practitioners. Unlike such an overall social atmosphere, the Judiciary that is in charge of applying the law seems not to perceive the seriousness of sex offense cases committed by medical practitioners. A doctor who had sexually assaulted a middle school female student during medical treatment at a pediatric hospital was found innocent by the supreme court, which was a ruling in direct contrast to overall public sentiment. As such, this study seeks to analyze the precedent on cases involving sex offense by medical practitioners with a focus on the above-mentioned case and present implications. The study seeks to dispel distrust in the overall medical field by addressing the gap in legal interpretation towards sex offense committed by medical practitioners and thus provide basic data that can help the general public receive quality medical services in a safer environment.

The Analysis of Research Trend about Hospice in Korea ($1991{\sim}2004$) (국내 호스피스 논문 분석($1991{\sim}2004$))

  • Kim, Sang-Hee;Choi, Sung-Eun;Kang, Sung-Nyun;Park, Jung-Suk;Sohn, Sue-Kyung;Kang, Eun-Sil;Lee, Young-Eun
    • Journal of Hospice and Palliative Care
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    • v.10 no.3
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    • pp.145-153
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    • 2007
  • Purpose: This study was to analyze the research trend centering on the theses to hospice released in Korea. Methods: The researcher collected the academic degrees and theses published on the book of the academic society from 1991 to 2004, and examined 110 domestic papers of hospice. Results: 1) The number of articles increased 3 years after 1997, 52 (47%) theses were published in $2000{\sim}2002$. 97 (88%) articles were quantitative studies, and 13 (12%) were qualitative studies. 2) As for the subject, the results were: patients with end stage 44 (40%), nurse 18 (16%), hospice care system, facilities, and literature review 12 (10%). 3) As for main concepts of correlational studies 15 (13%), the results were: quality of life, activities of volunteers, suffering experience of nurse, and so on. 4) The subjects and contents of survey, the results were: pain control and need for nursing care in patients, need for spiritual and physical care in family, and so on. 5) The treatment of experimental research, the results were: hospice nursing, educational program, informational support, spiritual nursing, supportive nursing intervention, home hospice care, information services for control of cancer pain, and so on. 6) In the theme of the qualitative studies, the results were: experience of dying patients, perceive of hospice care and death, experience of family of terminal ill patients, meaning of dying in Korean. 7) In the instrument in studies, the results were: MQOL, EQOL, QOL, NIC, Need Scale, Spiritual Well-being Scale, Spiritual Perspective Scale, Coping for Grief Scale, K-CPAT, VAS, BPI, Depression Scale, Strait-anxiety Scale, Care-giver Burden Inventory, Burnout Inventory, Mental quality. Conclusion: More research needs to be encouraged in experimental and qualitative research fields. Researches should be conducted for the establishment of the basis of practical and theoretical framework and hospice polices.

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Management and Supporting System on the Occupational Health Nursing Services Provided in Group Occupational Health Agencies of Korea (소규모 사업장 보건관리대행기관의 간호업무 운영관리 지원체계)

  • Yoo, Kyung-Hae
    • Korean Journal of Occupational Health Nursing
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    • v.8 no.2
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    • pp.193-211
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    • 1999
  • This study was carried out to investigate the management and support system affecting to the occupational health nursing services(OHNS) provided in group occupational health agencies(GOHA). Questionnaire was developed and distributed to 82 nurses who were working in GOHA and who agreed to participate in the survey. The results were as follow: 1. OH nurses responded were mostly in the age of twenty to thirties(89%), married(73.7%), technical college graduates(88.9%), worked in hospital(85.4%) and participated more than 1 year in group occupational health services (96.3%). 2. Fifty eight point four percent of the OH nurses worked in number of workplace more than 30 to less than 60 in the OHNS form. The figure of workplaces undertaken by nurses was ranged greatly from 9 to more than 100. Number of employees who cared by nurses were mostly under 5,000 peoples in 93.3%. The types of industry was mostly manufacturing and located in the order of factory complex area, suburban, urban and others. 3. Most OH nurses(87.8%) were fully involved in the OHNS for the SSE. Their working days to visit SSE was 5 days per week(77.8%) and one day in the GOHA at 41.3%. 4. The OH documents using by nurses were found in more than 23 different types. However, they were largely summarized in the types of 'Workplace Health Management Card', 'Personal Health Counselling Card', 'Daily Health Management Report', 'Visiting List of Workplace' and 'Sick Employee List'. 5. The items of laboratory test provided by GOHA were mostly achieved in the purpose of basic health examination. They were used to be the blood pressure check(98.8%), blood sugar test (98.8%), urine sugar and protein(91.4%), SGOT and SGPT(85.3% each), cholesterol (82.9%), hepa vaccine immunization(82.9%), r-GPT(81.7%), hemoglobin(79.3%) and triglyceride(75.5%). 6. The OH nurses(92.7%) followed the work pattern to visit the GOHA before and after small-scale enterprises(SSE) visit by car driven by nurses in 74.3%. They were payed by GOHA for transportation fees in certain amounts. However, nurse is the main person(75.0%) who covers up in case of traffic accident. If the GOHA has no transportation regulation for the formal workplace visit, data showed that nurses had been responsible to take charge(31.7%). 7. The personnel manager who takes in charge for nursing services was 'nurse' in 61.7% and 41.2% worked as the final decision maker related to nursing work. The OH nurses' opinions about factors affecting to the management were classified in the four areas such as 'Nature(Quality) of health professional'. 'Content of OHNS', 'Delivery system of the GOHS', and 'Others'. The factors were indicated highly in 'Authority as health professional', 'Level of perception of director on the OH' and 'Physical work condition for OHNS'. The things that this study suggests in the recommendation would be summarized in such as the management and supporting system working for SSE in the OHNS is necessary to reform thoroughly. The reconsidered aspects might be in the matters of number of workplaces undertaken by nurses, development of effectively practical health documents, preparation for guideline of the laboratory test in the workpleces, establishment of convenient and encouraging support system and cooperation between other health professionals with respect and skill.

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A study on the actual condition of dental clinic use of the out patient (일부 외래환자의 치과의원 이용실태에 관한 연구)

  • Han, Se-Young;Han, Soo-Youn
    • Journal of Korean society of Dental Hygiene
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    • v.10 no.4
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    • pp.635-644
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    • 2010
  • Objectives : The purpose of this study was to analyze and investigate the effecting factors on the actual condition of dental clinic use of the out patient. Methods : In oder to achieve this purpose, A survey for 302 patients in 6 participating dental clinics located in Daejeon metropolitan city from May 01 to May 30, 2010. The result of this study was as follows. Results : 1. The duration of dental clinic use was reflected in 36.1% of the under 1 year, 34.1% of over 2 years, and 29.8% of over 1 ~ under 2 years in order. Especially, the higher the duration of over 2 years the higher the age was, on married group had a significance. 2. The type of medical examination for samples was 27.6% of periodontal, 26.5% of conservative, 17.2% of prosthodontics, 10.9% of implant, and 7.9% of preventive in order. Especially, the male group the more the prosthodontics, implant had a significance. the higher the monthly income, on married group, the more the periodontal, prosthodontics and implant had a significance. 3. The motive of dental clinic selection was 38.4% of acquaintances' inducement, 33.4% of the superb treatment, 15.6% of easy convenience, and 7.0% of friendliness staff in order. Especially, male group the more the easy convenience, superb treatment, friendliness staff had a significance. 4. The mean of transportation in order to visit a dental clinic was 38.7% of public transportation, 37.5% of the own car, 23.8% of others in order. Especially, there was a highly significant difference on the public transportation in female, the lower education level, lower monthly income, and medical protection group. 5. The duration of time required of dental clinic reflected in 80.1% of the under 30 minute, 16.3% of over 30 minute~under 1 hour, and 3.6% of over 1 hour in order. Especially, the higher the treatment satisfaction, the dissatisfaction the higher the duration of time required under 30 minute had a significance. Conclusions : These results indicate that as medical services upgrade and get more varied, the expectation of medical quality also increases. It is thus considered that the revitalization of this hospital's management strategy can be achieved by providing highly developed medical services, and, more importantly, by better understanding the actual conditions of dental clinic use by the patients themselves.

A study of the impact of using a nursing care standards on the quality of nursing care in gastrectomy patients (위절제술환자의 간호실무표준 사용이 간호의 질에 미치는 영향)

  • Woo, Young-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.2
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    • pp.97-107
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    • 1996
  • Nursing standards determine the type and extent of services that are delivered to the patients and define quality care and communicate the institution's expectations of care. Thus, taking the standard of care and incorporating it into a welldefined indicator of excellent patient care becomes one of the first activities in setting up the nursing service's quality assurance process. The purpose of this study was to determine the impact of using a nursing care standards for the quality of nursing care in gastrectomy patients. The subjects were composed of fourty-two under going gastrectomy patients with stomach cancer in general surgery nursing care unit of K University Hospital in Pusan. The data was collected from January 3 to April 13,1996. The subjects were divided into a control group - those admitted from Jan.3 to Feb.12 and an experimental group those admitted from Feb.18 to April 13. The instruments used for this study were a nursing care standards in gastrectomy patients developed by the investigator and an evaluation tool for the quality of nursing care in abdominal surgery patients developed by Byoung-Sook Lee in 1995. The data was analized by means of chi-square test, t-test and Cronbach-alpha test with the SAS System. The result was as follows : The hypothesis, that scores of the quality of nursing care in the experimental group would be higher than that of the control group. was supported(t=-6.12, p=0.00). The detailed results of each standards of evaluation tool were as follows : The mean score of the experimental group was significantly higher than that of the control group in audit standard 1:'Collection of basic data of the patients', (t=-3.76, p=0.00). The mean score of the experimental group was significantly higher than that of the control group in audit standard 2 : 'Defining nursing diagnoses(or nursing problems)', (t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit standard 3:'Estabilishment of nursing care plan according to nursing diagnoses(or nursing problems)',(t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit stndard 4:'Implimentation of nursing care plan', (t=-2.38, p=0.01). The mean score of the experimental group was significantly higher than that of the control group in audit standard 8 : 'Increase of the knowledge of health related to surgery',(t=-2.40, p=0.01). No significant differences between the mean scores of the experimental group and that of the control group in audit standard 5 : 'Recover and maintain of the physical function', audit standard 6:'Prevention of the post-operative complication', audit standard 7 : 'Decrease of discomfort caused by operation', and audit standard 9 : 'Patient satisfaction in nursing care' were found. The standards of evaluation tool were devided into two dimension. One was process dimension which contains four standards(audit standard 1 to 4), the other was outcome dimension which contains five standards(audit standard 5 to 9). The mean score of the experimental group was significantly higher than that of the control group in process dimension (t=-12.30, p=0.00), but no significant difference between the mean scores of the experimental group and that of the control group in outcome dimension was found. From these results, it is concluded that using a nursing care standards in gastrectomy patients promotes quality of nursing care and nursing care standards of various fields are necessary for effective nursing care.

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The Developmental Device for 119 fire fighting helicopter use activations (119 소방헬기 이용 활성화를 위한 발전방안)

  • Koh, Jae-Moon;Kim, Tae-Min;Kim, Hyo-Sik;Lee, Young-Ah
    • The Korean Journal of Emergency Medical Services
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    • v.11 no.3
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    • pp.93-109
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    • 2007
  • The pre-hospital care in site transportation care and site care will be divided, it will follow in site or evacuation it will enforce it will can evacuate in condition of the emergency patient of like this at the initial stage and emergency care from inside fire fighting helicopter back transfer means and the manpower security of the specialty emergency necessary personnel(nursing and 1st EMT's) as the medical treatment agency and modernization of first aid equipment necessity inside American securing and fire fighting helicopter and specialty first aid packet won about lower the emergency care which is appropriate cannot become accomplished are the actual condition in total lack of emergency care equipment. Consequently craving augmentation, in order to be adapted with the handling kind transfer whose specialty and is appropriate and present time of rapid increase and the citizen of emergency demand by fire fighting helicopter simplicity transfer compared to it is a condition where the countermeasure preparation is earnest. Must expand emergency care equipment first even in fire fighting helicopter and 1st EMT's which it follows in him become arrangement and quickly the execution and specialty temporary disposal(ALS) must be enforced a temporary disposal and must buy the life which is. Also it gets by experience a helicopter induction outline, a radio communication method and the patient helicopter on-board hour attention point back various attention fact back with the body and when where it stands but accurately there must be it will be able to induce the helicopter. Also every manuals anger it does a helicopter transfer method and the emergency care method back and that all processes must do fixed form anger, it becomes feed. Also it related with a helicopter transfer even from the relationship agency many research to lead, difference of the advanced foreign nation and the maximum it is the actual condition where the medical emergency system construction which it reduces is earnestly demanded. Also with emergency structure(crane) it confronts to an aviation transfer even from the establishment college and education it leads intensively and 1st EMT's of the good quality which relates with an aviation structure expects is cultivate at all.

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A study on the gratification of the patient in the Dental Hospital (치과병원 내원환자의 만족도 조사분석)

  • Kim, Min-Young;Lee, Keun-Woo;Moon, Hong-Suk;Chung, Moon-Kyu
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.1
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    • pp.65-82
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    • 2008
  • Statement of problem : Today's market economy has been changed more and more to consumer concerned. It is owing to not only consumers ' rising standard of living and education, but also purchasers' easy accessibilities to products through various mass media. The consumer centered market system, where customer can choose items with diverse alternatives to satisfy their self esteem, is also applied to the field of medical business, and accelerated by an increasing income level of shoppers and introducing the whole nations' medical insurance system. Today, the medical industry has become competitive due to increasing number of medical institutions and medical personnel, and this offers wide choices to consumers in the medical market place. At this point of time, it is essential to survey on the primary factor of gratification for the patient in the Dental clinic, as well as on the problems and suggestions in medical service. Purpose : The analysis in this study shows essential factors and expected influential elements in satisfaction of the patient in the Dental Hopsital, and strategic suggestions for the provider of dental service, which can be of benefit to the prospective customer as well as can make improvement in the quality of dental treatment service. Material and method : This study had been researched by collecting and analyzing the organized questionnaires, which were filled in directly from 784 patients, who visit Dental Hospital, Yonsei University in Seoul, from January 23rd to April 15th. Result : It can be summarized like the followings. 1. The social and demographical peculiarities of respondents are as follows. Samples of gender and marital status are adequately extracted, but data on occupation and treatment are are under a bias toward students, undergraduates and graduate students, and orthodontics. 2. 74% of patients who answer the questionnaire were highly satisfied with the service of dental clinic in the section of overall satisfaction. 3. The survey result about specific service of dental treatment, within sections of independent variables, is like the followings; Patients are highly gratified with service system, kindness, explanation, explanation on expected waiting hours, reservation system, emergency measures, expert treatment, existence of knowledge of dentistry, size of hospital, disinfection, equipment and parking, but lowly satisfied with expense of treatment, preparatory hours for treatment, waiting hours, treatment hours and the period of subscription. 4. The correlation analysis showed that there is no significant linear relationship between the independent variables. 5. The probit regression analysis showed that 8 out of 34 independent variables explained the dependent variables at the level of 0.01. 6. It shows that 8 independent variables, which can affect customers 'satisfaction, are clearing up of inconvenience, service system, kindness, explanation, treatment hours per attendance, reservation system, existence of knowledge of dentistry, and contentment of equipment in the hospital. Conclusion : The consumer's satisfaction totally relies on subjective evaluations of customers. Providing appropriate service, which can meet the criteria for the customer who demands various wares, pursues luxury goods, and expects high quality of medical service, is essential to fulfill patients' satisfaction. Many medical institutions do their best to satisfy their customer, touch their consumer, and offer patience centered services, and it is also applied to the field of dentistry. Establishing brand new strategic managements and elevating the quality of dental service based on this survey are required to improve the satisfaction of patience in the Dental Hospital.

호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.1 no.1
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    • pp.46-69
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    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

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Comparison of Treatment Outcome Assessment for Class I Malocclusion Patients: Peer Assessment Rating versus American Board of Orthodontics-Objective Grading System

  • Hong, Mihee;Kook, Yoon-Ah;Baek, Seung-Hak;Kim, Myeng-Ki
    • Journal of Korean Dental Science
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    • v.7 no.1
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    • pp.6-15
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    • 2014
  • Purpose: The purpose of this retrospective study is to investigate the degree of coincidence between the peer assessment rating (PAR) index and American Board of Orthodontics objective grading system (ABO-OGS) in the assessment of orthodontic treatment outcomes of Class I malocclusion cases. Materials and Methods: The sample consisted of 26 Class I patients. The PAR index was used for evaluation of pre-(T0) and posttreatment (T1) casts, and the ABO-OGS for assessment of T1 casts. If there was a reduction in PAR scores from T0 to T1 of more than 30%, the label 'PAR+' was given to the case, and if not, it was labeled 'PAR-'. If the ABO-OGS was less than 27, the label 'OGS+' was given to the case and if not, it was labeled 'OGS-'. 'A PAR-only qualified group' (PAR+), 'ABO-OGS-only qualified group' (OGS+), 'both indices qualified group' (PAR+/OGS+), and 'both indices disqualified group' (PAR-/OGS-) were compared with a Wilcoxon rank-sum test, sensitivity/specifi city test and Spearman's correlation test. Result: PAR scores for T0, T1, and percentage reduction were 21.1, 6.4, and 65.9%, respectively, and 35.4 for ABOOGS. The distribution of the 'PAR+/OGS+', 'PAR+', and 'PAR-/OGS-' group was 19.3%, 76.9%, and 3.8%, respectively. The T0-PAR, T1-PAR and PAR point reductions for the 'PAR+' group were significantly higher than those of 'PAR+/OGS+' groups (23.1 vs. 15.6; 6.7 vs. 4.6; and 16.5 vs. 11.0; all P<0.05). However, the PAR-percentage reduction and treatment duration between the two groups were not statistically different (70.0% vs. 67.0%, P=0.4325; 24.1 months vs. 25.0 months, P=0.4057). The T1-ABO-OGS score for 'PAR+' group was significantly higher than that of the 'PAR+/OGS+' groups (38.2 vs. 24.0, P<0.001). Conclusion: Since the fraction of the 'PAR+/OGS+' group was less than 20% and there was no significant correlation between PAR-percentage reduction and T1-ABO-OGS, development of a new index system for the accurate evaluation of treatment outcome is needed.

THE STUDY ON THE DEVELOPMENT OF RELATIVE VALUE IN MEDICAL TREATMENT OF THE ORAL AND MAXILLOFACIAL SURGERY (구강악안면외과 의료행위 상대가치 개발에 대한 조사연구)

  • Song, Gin-Ah;Baek, Kyung-Won;Hwang, Jong-Min;Yu, Soon-Yong;Choi, Jin-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.4
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    • pp.334-347
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    • 2006
  • The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.