The purpose of this study is to identify medical consumers' hospital selection factors in response to the rapidly changing environment of medical industry. For that purpose this study classified consumers' hospital selection factors into three categories such that human factors including expertise, reliability, empathy; system factor including, convenience, differentiation, efficiency; and facility factor including tangibility, accessibility, and location, based on the previous studies and the results of a preliminary survey of the patients of a small private hospital. The nine factors were further divided into 23 more specific attributes. Then, an online survey was conducted to measure the perceptions of the 23 attributes by the medical consumers over the age of 20. The analysis of the survey data using Kano model and Timko model indicated that 14 of the 23 attributes were classified as attractive factors, eight attributes were or classified as, one-dimensional factors, and one attribute, doctors' educational background, was classified as indifference factor. Of the 14 attractive factors, "unique and differentiated services related to medical treatment" and "distance from home to hospital" had the highest customer satisfaction coefficients. Of the eight one-dimensional factors, "kind treatment," "providing adequate explanations," "accuracy of diagnosis," and "cleanness of facilities" had the highest customer satisfaction coefficients as well as the highest dissatisfaction coefficients. The findings indicate that these six attributes are the most basic and most impactful attributes that hospitals must manage strategically to improve their service quality and attract more medical consumers to their hospitals.
Though the attending system was first implemented in 2003 to facilitate the efficient utilization of medical resources and specialties, only a few hospitals and physicians are participated in that system. The purpose of this study was to investigate the actual facts which related to operation of attending system and propose a basic information to revitalized of the attending system in Korea. The data were collected between August 1 and October 30, 2005 from 25 hospitals and 42 attending physicians who were in part of the attending system. Medical institutions were unwilling to participate despite the advantages of the attending system with respect to the utilization of medical resources and improvement in the quality of medical services. The primary reason for this was the lack of understanding among physicians about the attending system and the difficulty(lack of time) encountered by the attending physicians in administering care to patients hospitalized in the attending hospitals. Moreover insufficient reimbursement for rendered medical services constituted another important reason. In conclusion, we can state that the establishment of a committee is required to discuss the issues surrounding the attending system and to control the growing disparity between the viewpoints of hospitals and physicians. Regardless, there is a need to develop economical incentives for medical institutes. The attending system served as a useful policy in promoting the medical service system and bringing about an improvement in the management of medical institutes.
The purpose of this study is to verify the relationship between medical service quality, relationship quality and patient loyalty in domestic nursing hospitals and the mediating effect between medical service quality and patient loyalty. A survey was conducted on 324 inpatients in nursing hospitals, and statistical analysis was conducted on the collected data through questionnaire survey. The following main results were derived. First, among the quality of medical services, the reputation of nursing facility equipment, nursing medical staff, nursing service system, and nursing facility was found to have a significant positive effect on the quality of the relationship, but medical expenses had no significant effect. Second, among the quality of the relationship, both trust and commitment were found to have a significant positive effect on patient loyalty. Third, among the quality of medical services, the reputation of nursing facility equipment, nursing medical staff, nursing service system, and nursing facility was found to have a significant positive effect on patient loyalty, but medical expenses had no significant effect. Fourth, it was found that nursing facility equipment, nursing medical staff, nursing service system, and reputation of nursing facilities, excluding nursing care expenses, all had a positive effect on patient loyalty through the quality of relationships between patients and hospitals.
Journal of The Korea Institute of Healthcare Architecture
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제22권4호
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pp.105-115
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2016
Purpose: This study is a case study of a small-mid sized hospital to promote a full-scale remodeling to ensure the quality and competitiveness of the medical services and trying to arrange the remodeling characteristics of small-mid sized hospital which is suffering from aging facilities as well as chronic congestion and lack of spaces. Methods: Research was conducted by consultation with hospital executives and each department operators, and on-site investigation, Results: The result of this study can be summarized into two points. The first one is that existing statistical value like area per bed, in the remodeling of the small-mid hospitals may not mean much. planners have to verify the necessary room space areas in close consultation with the department operators. And after confirming layout possibilities, they have to create the program. The second one is that remodeling planning can be a realistic plan with structural and installation diagnosis at the same time. If so, it is advisable to proceed architectural design from the beginning for cost and time savings. Implications: This results can be applied to small-mid hospitals to apply to the medical law revision and others.
Purpose: The purpose of this study was to determine how the use of level D personal protective equipment (PPE) and cardiopulmonary resuscitation (CPR) feedback equipment affects chest compression (CC). Furthermore, this study provides basic data for developing Korean CPR guidelines that can be applied to patients with suspected or confirmed COVID-19. Methods: This randomized, single-blinded, crossover simulation trial included 26 student paramedics who performed 2-minute chest compressions using three different methods: Method A involved performing traditional CC for two minutes without donning level D PPE, Method B involved performing CC while donning level D PPE, and Method C involved performing CC with a CPR feedback device while donning level D PPE. Results: The use of a CPR feedback device during the 2-minute CC increased the exercise intensity of the subjects, but donning level D PPE didn't affect the quality of CC and the exercise intensity. The results of methods A and B showed changes in the quality of compression 80 seconds after the start of CC. No significant changes occurred in 2-minute CC when using the CPR feedback device. Conclusion: Using a CPR feedback device could prevent deterioration in the quality of CC while donning level D PPE.
Objective: Given the considerable disagreement between the Peer Assessment Rating (PAR) index and the American Board of Orthodontics Cast-Radiograph Evaluation, we aimed to develop a novel assessment system-the Improvement and Completion of Outcome (ICO) index-to evaluate the outcome of orthodontic treatment. Methods: Sixteen criteria from 4 major categories were established to represent the pretreatment malocclusion status, as well as the degree of improvement and level of completion of outcome during/after treatment: dental relationship (arch length discrepancy, irregularity, U1-SN, and IMPA); anteroposterior relationship (overjet, right and left molar position, ANB); vertical relationship (anterior overbite, anterior open-bite, lateral open-bite, SN-MP); and transverse relationship (dental midline discrepancy, chin point deviation, posterior cross-bite, occlusal plane cant). The score for each criterion was defined from 0 or -1 (worst) to 5 (ideal value or normal occlusion) in gradations of 1. The sum of the scores in each category indicates the area and extent of the problems. Improvement and completion percentages were estimated based on the pre- and post-treatment total scores and the maximum total score. If the completion percentage exceeded 80%, treatment outcome was considered successful. Results: Two cases, Class I malocclusion and skeletal Class III malocclusion, are presented to represent the assessment procedure using the ICO index. The difference in the level of improvement and completion of treatment outcome can be clearly explained by using 2 percentage values. Conclusions: Thus, the ICO index enables the evaluation of the quality of orthodontic treatment objectively and consecutively throughout the entire treatment process.
Background : The purpose of this research was to evaluate the appropriateness of preoperative hospital days in a tertiary care hospital and to examine the reasons of the inappropriateness, so as to provide basic information and policy for enhancing appropriateness of preoperative hospitalization and benefit of patients and hospital. Methods : The subjects of the research were the 344 patients who received operation among discharged patients during January, 1996 in surgical departments including general surgery, neurosurgery, orthopedic surgery, plastic surgery and ophthalmology. Their medical records were reviewed and appropriateness of hospital days was evaluated by the Appropriateness Evaluation Protocol. Result : The results of evaluating the appropriateness of preoperative hospitalization showed that inappropriate hospital days were 80.8%. The reasons of inappropriate hospital stays were the tests or preparation which could be done in outpatient basis' followed by 'possible tests or preparation on the operation day' and 'cancelation of operation'. Conclusion : In order to shorten the inappropriate preoperative length of stay, it is recommended that lengthening of laboratory running time and doing most of tests necessary for operations on the outpatient basis prior to admission should be considered. In addition, the operation at the same day of hospitalization and usage of day surgery should be encouraged. Finally there should be changes in the inpatient management system and attitudes and behaviors of surgeons to shorten unnecessary preoperative and maximize the benefit for patients and hospital.
Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.
International Journal of Knowledge Content Development & Technology
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제10권2호
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pp.39-49
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2020
Accurate and reliable Information improves decision making, reduces costs, and saves time. The ophthalmic Libraries supply quality ophthalmic information to the ophthalmologists to serve the patients in a better way and stimulate the growth of ophthalmic field. This paper aims to study the usage of library collection, services and assistance among the Ophthalmologists - Eye Doctors in India. A survey method is used to obtain the ophthalmologists' usage of library collection, services and assistance. Through convenient sampling method, a structured questionnaire is circulated to the ophthalmologists in India and 633 ophthalmologists are responded. Among the 633 ophthalmologist, 82.15% of the ophthalmologists use the library collection - book. 73.46% of the ophthalmologists use the online data / journals. 89.73% of the ophthalmologists seek assistance to locate books/articles/documents. There exists a significant difference between the ophthalmologists use of Library Service and gender (p value 0.001**). There exists a significant difference between the ophthalmologists use of Library Assistance / help and designation category (p value 0.000**). There exists a significant difference between the ophthalmologists use of Library Assistance / help and working experience (p value 0.017**). There exists a significant difference between Library Services (p value 0.009**), Library Assistance / help (p value 0.000**) and institution type. The study results will help the ophthalmic libraries to serve the user better.
Lee, Young Mi;Lee, Hyun Hee;Jung, Jin Hee;Yang, Jin Kee;Lee, Ji Eun;Kim, Sun Kyung
Journal of Korean Clinical Nursing Research
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제24권2호
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pp.188-196
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2018
Purpose: The purpose of this study was to compare the differences in compassion fatigue, compassion satisfaction and burnout between nurses working at comprehensive nursing care unit and general ward. Methods: The subjects were 35 nurses in general ward and 42 nurses in the Comprehensive Nursing Care unit in one hospital. Measurement instrument included the Stamm's professional quality of life (ProQOL) version 5-Korean. Descriptive statistics, t-test, paired t-test, ANCOVA, and Pearson correlation were used to analyze the data. Results: Nurses working at the Comprehensive nursing care unit demonstrated significantly lower compassion fatigue (F=17.00, p<.001), higher compassion satisfaction (F=14.39, p<.001), and lower levels of burnout (F=40.07, p<.001) than control group. Conclusion: Compassion fatigue and burnout were lower and compassion satisfaction was higher among nurses working at comprehensive nursing unit than general ward. In order to improve quality of the comprehensive nursing care services, there is a need to be concerned with the nurse's compassion fatigue, compassion satisfaction, and burnout.
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