• 대한간호학회지
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• 제40권3호
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• pp.349-358
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• 2010

Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

• 보건행정학회지
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• 제25권3호
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• pp.197-206
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• 2015

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.

• 임상간호연구
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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.

• 보건행정학회지
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• 제18권3호
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• pp.1-17
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• 2008

The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.

• 대한지역사회작업치료학회지
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• 제8권1호
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• pp.23-31
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• 2018

목적 : 요양병원 입원노인의 우울과 자아효능감이 삶의 질에 미치는 영향을 알아보고자 하였다. 연구방법 : 대상자는 경상북도 K시에 소재하고 있는 요양병원 입원노인 212명을 대상으로 하였다. 대상자의 일반적 특성, 한국판 노인 우울척도(GDS-K), 자아효능감척도, 세계보건기구 삶의 질 간편형 척도(WHOQOL-BREF)가 첨가된 구조화된 설문지를 통해 자료를 수집하였다. 수집된 자료는 부호화하여 SPSS ver.18을 사용하여 일반적 특성에 따른 우울, 자아효능감, 삶의 질의 차이와 자아효능감, 우울, 삶의 질 간 상관계수 그리고 우울, 자아효능감이 삶의 질에 미치는 영향을 알아보았다. 연구결과 : 일반적 특성에 따른 우울과 자아효능감은 입원기간과 종교가 통계적으로 유의한 차이가 나타났고, 삶의 질은 종교에서 유의미한 차이가 나타났다. 입원노인의 우울은 삶의 질과 통계적으로 유의한 부적 상관관계(p<.001)가 나타났고, 자아효능감 하위변인과 삶의 질은 통계적으로 유의한 정적 상관관계(p<.001)가 나타났다. 입원노인의 우울과 자아효능감이 삶의 질에 영향을 미치는 변인은 우울정도(${\beta}=-.328$)이고, 사회적 효능감(${\beta}=.248$), 신체적 효능감(${\beta}=.193$)으로 나타났다. 결론 : 입원노인의 삶의 질을 높이기 위해 우울을 감소시키고 자아효능감을 높일 수 있는 요양의료서비스의 제공 및 개발이 필요할 것이다.

• 대한세포병리학회지
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• 제19권2호
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• pp.65-71
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• 2008

In Korea, the quality control(QC) program forcytopathology was introduced in 1995. The program consists of a checklist for the cytolopathology departments, analysis data on all the participating institutions' QC data, including the annual data on cytologic examinations, the distribution of the gynecological cytologic diagnoses, as based on The Bethesda System 2001, and the data on cytologic-histolgical correlation of the gynecological field, and an evaluation for diagnostic accuracy. The diagnostic accuracy program has been performed 3 times per year with using gynecological, body fluid and fine needle aspiration cytologic slides. We report here on the institutional QC data and the evaluation for diagnostic accuracy since 2004, and also on the new strategy for quality control and assurance in the cytologic field. The diagnostic accuracy results of both the participating institutions and the QC committee were as follows; Category 0 and A: about 94%, Category B: 4-5%, Category C: less than 2%. As a whole, the cytologic daignostic accuracy is relatively satisfactory. In 2008, on site evaluation for pathology and cytology laboratories, as based on the "Quality Assurance Program for Pathology Services" is now going on, and a new method using virtual slides or image files for determining the diagnostic accuracy will be performed in November 2008.

• 가정∙방문간호학회지
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• 제18권1호
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• pp.48-57
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• 2011

Purpose: The aim of this study was to develop and to analyze the task of hospital based home care nurse practitioners in Korea. Method: The definition of home care nurse practitioners and job description was developed based on developing a curriculum(DACUM) by 7 panels who have experienced in home care nursing. One hundred fifty four nurses who were working at hospital based on home care were participated. Result: Fourteen kinds of duties were identified : the selection of home care patients; basic home care nursing; advanced home care nursing; patient/family education and counseling; medical decision making and coordination of patient service; management of home care supplies and drugs for patients; management of medical records; management of home care the agency; management of home care personnel; management of the home care supplies for agency; home care public relations; improvement of home care quality; management of long-term care service; and self-improvement. Ninety-six tasks were classified. Conclusion: The abilities for quality improvement and the advanced nursing practice of home care nurses should be empowered.

• 대한영양사협회학술지
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• 제10권2호
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• pp.184-189
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• 2004

The purposes of this study were to evaluate the quality of hospital food services in view of patients in orthopedic wards and accomplish the quality improvement in hospital foodservice operations. Quantitative questionnaires for patients containing foodservice satisfaction and demographic information were developed. A survey of 8 general hospitals was undertaken and detailed information was collected from 290 patients in orthopedic wards. The collected data were processed using the SAS PC 6.12 for descriptive analysis, t-test. In demographic information of patients, 32.6% was over 50 years old and 31% was hospitalized over 30 days. 80% of patients was taking normal diet. 47.7% and 47.9% of patients showed moderate appetite and moderate pain respectively. The overall satisfaction score for patients was 3.24 out of 5, showing slightly higher level than the average score(3.00). According to foodservice involvement scores of patients, they were divided into two groups which were high involved group and low involved group. Two groups showed significant differences in taste of meals, variety of menu, punctuality of meal times, temperature of meals and portion size. The foodservice involvement factor which affected significantly patient foodservice satisfaction was 'kindness of foodservice staff'.

• 보건의료산업학회지
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• 제4권1호
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• pp.23-41
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• 2010

The purpose of this study was to provide basic materials needed to enhance quality of organizational life by identifying the improvements of labor union management in the perspective of hospital organization management. Materials were collected from administrators, nurses and medical technicians in target hospitals from March 3 to March 3 to March 30, 2010 through survey questionnaires. The main results of this study were as follows: 1. The commitment level of the subjects according to their satisfaction was higher when the administrators both in Private hospitals and Public hospitals were not satisfied in their works. 2. The commitment level of the subjects according to the subjects' job dedication level was higher those who had higher emotional attachment to their job in all vocations in both Private hospitals and Public hospitals. 3. The commitment level of the subjects according to the subjects' labor union involvement was higher in those who had higher satisfaction in labor union and perceived their colleagues' attitudes more positively in all vocations in both Private Hospitals and Public Hospitals. 4. From the results of multiple regression analysis to identify major influencing factors of labor union commitment level, In Private hospital employees, those who had senior officer posts in labor union and higher normative commitment showed higher commitment union. Therefore hospital managers should have democratic and flexible attitudes toward labor union. Additionally, as colleagues attitudes is important determinant in union commitment, hospital managers should have countermeasures to enhance the work atmosphere of hospital employees.

• 한국식생활문화학회지
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• 제12권1호
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• pp.71-78
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• 1997

The productivity of a hospital foodservice system has a significant implication in hospital management as costs for labor and material increase, competitions among hospitals increase, and patients' expectations as to the quality of hospital services increase. The foodservice is characterized by its labor intensiveness. The objective of this study was to examine associations between operational and managerial factors and the productivity of dishwashing work in hospital foodservice systems. The labor productivity in 20 conventional food service systems was assessed and related to a number of influencing variables within the system. The productivity measurement was based upon the total dish equivalents as a ratio of the total direct and non-direct labor hours required to wash these dishes. 20 hospitals with more than 500 beds located in Seoul were surveyed to obtain data for study variables. Questionnaire and a survey form were mailed. Statistical methods used in this study were descriptive analysis and Pearson product moment correlation analysis. Hospital system characteristic which was found to correlate significantly with productivity was the ratio of dish loss. As this increased, the productivity level increased.