• 제목/요약/키워드: Quality of Hospital Services

검색결과 601건 처리시간 0.026초

상급종합병원 간호사의 간호서비스 질에 영향을 미치는 요인: 회복탄력성과 간호조직문화를 중심으로 (Factors Influencing Quality of Nursing Service among Clinical Nurses: Focused on Resilience and Nursing Organizational Culture)

  • 신은숙;안민정;최명이;이애경;전은아;정영미;서미화;김혜경;황진화;최옥자;김선희;박수민;황윤영
    • 임상간호연구
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    • 제23권3호
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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.

중국 병원산업에서 서비스품질이 서비스가치, 고객만족 및 재이용의도에 미치는 영향 (The Effect of Service Quality on Service Value, Customer Satisfaction and Reuse Intention in the China Hospital Industry)

  • 조나;장석주
    • 벤처창업연구
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    • 제7권3호
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    • pp.89-97
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    • 2012
  • 최근 중국 경제성장과 더불어 소득수준과 생활수준이 향상됨에 따라 소비자들의 건강, 고도의 의료서비스와 휴양시설 개발 및 이용에 대한 관심이 점점 증대되고 있다. 따라서 중국 병원 산업에서 경쟁력을 향상시키기 위해서 서비스품질의 가치를 다시 인식하는 것을 필요하다. 본 연구는 중국병원의 서비스 품질 구성요인에 대한 분석하고 각 구성요인은 서비스가치, 고객만족 및 재이용의도간의 인과관계를 확인하고자 한다. 이러한 연구목적을 달성하기위해 본 연구에서는 문헌적인 고찰과 실증적인 분석을 병행 실시하였다. 본 연구의 결과는 중국 병원산업에서 서비스품질의 구성요인을 "상호작용품질", "결과품질", "물리적 환경품질"의 세 차원으로 구분하여 각 차원은 고객만족에 대한 직접적이고 유의적인 영향을 미치는 것으로 나타났다. 그리고 서비스가치는 고객만족 및 재이용의도에 직접적이고 유의적인 영향을 미치는 것으로 나타났고, 고객만족은 서비스품질과 재이용의도간의 관계에서, 서비스가치와 재이용의도간의 관계에서 중요한 매개역할을 하고 있음을 실증적으로 보여주고 있다.

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DRG 지불제도에 대한 미국의 경험과 우리 나라에의 시사점 (The U.S. Experience of the DRG Payment System and Suggestions to Korea)

  • 박은철;이선희;이상규
    • 한국병원경영학회지
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    • 제7권1호
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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.

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군 격오지 원격의료서비스 질이 고객충성도에 미치는 영향: 이용만족도의 매개효과 (Effect of Quality of Telemedicine Services in Remote Areas of the Military on Customer Loyalty: Mediation Effect of User Satisfaction)

  • 김동환;남진영
    • 한국병원경영학회지
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    • 제27권2호
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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.

일개 대학병원의 환자군별 진료서비스 변이와 포괄수가제 적용에 따른 진료수익 변화 (Studies on the variations of hospital use and the changes in hospital revenues of 10 KDRGs under the PPS)

  • 전기홍;송미숙
    • 보건행정학회지
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    • 제7권1호
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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.

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의료서비스의 과정적 질과 잠재적으로 예방 가능한 재입원율과의 관계 (Does Process Quality of Inpatient Care Serve as a Guide to Reduce Potentially Preventable Readmission (PPR)?)

  • 최재영
    • 한국병원경영학회지
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    • 제23권1호
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    • pp.87-106
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    • 2018
  • Purpose: 본 연구는 미국 캘리포니아와 플로리다에 위치한 의료기관을 대상으로 급성심근경색증, 심부전, 폐렴을 주진단으로 받은 메디케어 입원환자들에게 제공된 의료서비스의 과정적 질과 잠재적으로 예방이 가능한 30일 이내 위험 보정 재입원율과의 관계를 살펴보았다. Methods: 본 연구의 종속변수는 잠재적으로 예방이 가능한 30일 이내 위험 보정 질환별 재입원율이며 3M PPR 소프트웨어를 이용하여 재입원의 예방 가능 여부를 결정하였다. 미연방 의료 비용 및 이용 프로젝트 데이터베이스, 미국병원협회의 병원조사 자료, 미연방 보건복지부소속 메디케어 및 메디케이드 서비스 센터의 병원비교 자료를 이용하였다. 자료의 위계적 구조를 고려하여 다수준 로지스틱 회귀분석을 이용하여 분석하였다. Findings: 의료서비스의 과정적 품질과 퇴원 후 30일 이내 잠재적 예방 가능 위험도 보정 재입원율과의 관계는 질환별로 차이를 보였다. 폐렴의 경우 의료서비스의 과정적 질은 30일 이내 잠재적 예방 가능 보정 재입원율과 유의한 부(-)의 관계를 보였으나, 급성심근경색증과 심부전의 경우 대체로 유의한 관계를 관찰할 수 없었다. Practical Implications: 잠재적으로 예방 가능한 급성심근경색증, 심부전 재입원율을 줄이기 위해서는 의료기관에서 가이드라인으로 따를 수 있는 더욱 다양한 근거 중심의 과정적 질 지표의 개발에 대한 정부와 보건의료계의 노력이 필요하다.

Uncertainty Assessment: Relative versus Absolute Point Dose Measurement for Patient Specific Quality Assurance in EBRT

  • Mahmood, Talat;Ibrahim, Mounir;Aqeel, Muhammad
    • 한국의학물리학회지:의학물리
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    • 제28권3호
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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.

요양병원 간호사의 간호 서비스 질 영향요인 (Factors Influencing Nursing Service Quality of Nurses in Long Term Care Hospitals)

  • 박주희;박은희
    • 한국융합학회논문지
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    • 제13권1호
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    • pp.409-415
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    • 2022
  • 본 연구는 요양병원 간호사를 대상으로 간호 서비스 질에 영향을 주는 요인을 파악하여 간호서비스 질 향상에 도움이 되고자 시도되었다. 또한 간호 근무 환경, 인간중심 돌봄, 직무스트레스와 간호서비스 질의 상관관계를 파악하고자 한다. 본 연구는 G지역에 근무하는 요양병원 간호사 129명이 대상이었으며, 자가 설문지를 사용하였다. 연구도구는 간호 근무환경, 인간중심 돌봄, 직무스트레스, 서비스 질을 사용하였고, 수집된 자료는 SPSS 24.0으로 분석하였다. 연구 결과 요양병원 간호사들의 서비스 질의 영향요인은 기혼, 간호 근무환경, 인간중심 돌봄으로 확인되었으며, 간호 서비스 질을 49.9% 설명하였다. 이중 간호 근무환경은 간호 서비스 질에 가장 큰 영향요인으로 확인되었고, 간호사의 근무환경 개선이 필수적으로 선행되어야 간호 서비스 질이 향상될 수 있음을 시사한다. 더불어 위의 결과를 토대로 병원 경영진은 바람직한 간호 근무환경을 조성하기 위한 조직 구조 개선을 통한 제도 개선에 나서야 하며, 인간중심 돌봄에 대한 병원 구성원의 인지 정착과 인간중심 돌봄 확대를 위한 다양한 프로그램 개발에 노력해야 할 것이다.

핵의학 영상장비 PET/CT의 정도관리와 성능평가 (Quality Assurance and Performance Evaluation of PET/CT)

  • 이병일
    • Nuclear Medicine and Molecular Imaging
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    • 제42권2호
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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.

전문병원과 일반병원의 서비스의 질과 환자만족도에 관한 실증적 분석 (An Empirical Study on Service Quality and Patient Satisfaction in Specialty and General Hospitals)

  • 김미선;박하영
    • 한국병원경영학회지
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    • 제11권1호
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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.

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