• 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.

• 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.

• 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.

• 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.

• Journal of Korean Society of Industrial and Systems Engineering
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• v.39 no.2
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• pp.82-87
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• 2016

As contemporary society has become more complicated, specialized, and segmented, people are experiencing more diverse types of stress. In particular, while several factors associated with job stress have been examined among nurses, who belong to a professional group, the existing research has made no quantitative assessments of stress that reflect temporal differences in individuals. Therefore, the aim of this study is to understand the effects of job stress on alpha-amylase with regard to the working hours of nurses, to assess the variations in jobs stress over time, and provide basic data to improve the quality of nursing services. Ninety nurses working in three shifts in general, emergency, and intensive care wards of a university hospital in D City participated in this study. Salivary alpha-amylase (SAA) was extracted and analyzed at two-hour intervals from 07:00 to 15:00 from nurses on the day shift and from 23:00 to 07:00 from those working the night shift. The SAA level was highest between 23:00 and 01:00 for nurses in general wards ($mean{\pm}S.D.\;39.00{\pm}14.88$) and between 11:00 and 13:00 for those in both intensive care units and emergency wards ($mean{\pm}S.D.\;67.50{\pm}62.93$ and $mean{\pm}S.D.\;39.67{\pm}35.96$, respectively). The characteristic variation in SAA was significant between 23:00 and 01:00 (p < 0.01) and for those in their fifties or older (p < 0.01). The activation ratio of alpha-amylase, a stress reactant, showed an increase when the sympathetic nervous system was activated by mental stress; in addition, job stress was manifested with the effect of awakening at different time segments and at different ages among the nurses. With the aim of raising the level of service based on the nurses maintaining their mental health, it is necessary to focus sharply on the time segment for critical control and to conduct repetitive studies to determine the divisions of eustress critical values as well as to expand the population.

• Korea Journal of Hospital Management
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• v.27 no.4
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• pp.22-35
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• 2022

Purpose: Physician's occupational burnout has been a very important issue that can cause negative consequences not only for individual's physical and mental health, but also for patient's health and the overall national healthcare system. For the reason, this study confirmed how consultation length and the number of outpatients affect physician's occupational burnout in the medical environment. Methodology: In the study, the data of '2020 Korean Physician Survey' conducted by Korean Medical Association(KMA) was used for the analysis, and a total of 4,215 physicians were selected as study samples. The differences in the degree of occupational burnout according to the physicians' general characteristics were confirmed through uni-variate analysis, and also a regression analysis was conducted to confirm the effects of consultation length and the number of outpatients on physician's occupational burnout. Findings: As a result. the overall degree of physician's occupational burnout decreased(𝛽=-0.051, p<0.01) as the consultation length increased. Specifically, the physician's emotional exhaustion increased(𝛽=0.051, p<0.01), while the reduction of accomplishment decreased(𝛽=-0.131, p<0.001). Furthermore, the overall occupational burnout decreased(𝛽=-0.047, p<0.01) as a proportion of advice and education during the consultation increased, and it had an effect on the decrease in depersonalization(𝛽=-0.045, p<0.01) and the reduction of accomplishment(𝛽=-0.065, p<0.001). At last, as the number of outpatients increased, the overall occupational burnout increased(𝛽=0.041, p<0.05) with more emotional exhaustion(𝛽=0.095, p<0.001), depersonalization(𝛽=0.065, p<0.001), and less reduction of personal achievement(𝛽=-0.081, p<0.001). Practical implication: Consequently, it is necessary to prevent physician's occupational burnout by ensuring sufficient consultation length and providing a medical environment to treat an appropriate number of patients. Therefore, national policies should expand health insurance coverage and compensate medical fees for sufficient consultation length that both patients and physicians can satisfy. It will ultimately contribute to ensuring the patients' health and improving the quality of national healthcare services.

• Journal of the Korean Society of Radiology
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• v.11 no.7
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• pp.605-610
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• 2017

Unlike adults, cognitive ability and communication are not accurate in pediatric patients. Therefore movement due to psychological anxiety in X-ray photography is one of the factors that increase repeated irradiation. In order to minimize the rejection of X-ray and to improve the satisfaction of medical service, it is necessary to improve the environment of the radiological room to help psychological stability and to find a positive measure for reduction of radiation dose, including unnecessary. The subjects of this study were 186 pediatric patients from May to July, 2017, who were from 6 months to 36 months, The study group was set up a radiological room without auditory and visual environment changes is A group, except for changes in visual environment, the room where only auditory environmental changes were applied was group B, the auditory environment changes were excluded, and the room where only the visual environment change was applied was divided into group C, the auditory and visual environment changes were applied to the D. In group A, 10 retrospectives were obtained, 7 in group B, 5 in group C, and 2 in group D. Especially in group A and group D, statistically significant at p <0.053 In conclusion, hearing and visual environment changes affected the psychological stability of pediatric patient, and the repeated irradiation was reduced, thus improving the quality of medical services.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.10 no.6
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• pp.1124-1131
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• 2006

The recent medical treatment guidelines and the development of information technology make hospitals reduce the expense in surrounding environment and it requires improving the quality of medical treatment of the hospital. Moreover, MIS, PACS(Picture Archiving and Communication System), OCS, EMR are also developing. Medical Information System is evolved toward integration of medical IT and situation is changing with increasing high speed in the ICT convergence. Mobile component refers to construct wireless system of hospital which has constructed in existing environment. Through RFID development in existing system, anyone can log on easily to internet whenever and wherever. It is the core technology to implement automatic medical processing system. This paper provides a basic review of RFID model, PACS application component services. In addition, designed and implemented database server's component program and client program of mobile application that recognized RFID tag and patient data in the ubiquitous environments. This system implemented mobile PACS that performed patient data based db environments, and so reduced delay time of requisition, medical treatment, lab.

• Journal of agricultural medicine and community health
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• v.32 no.2
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• pp.75-86
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• 2007

Objectives: The research was aimed at analyzing the contents of university intranet for systematically execution of the healthy information provision and healthy consultation services from 2000 January to 2004 December. Methods: We have analyzed 300(28.3%) the instances of accomplished health consultation cases from the whole 1,059 instances which were the replied in a university intranet. Results: According to the contents of health consultation in ICPC code, a general symptom 91 cases(30.3%) was most, muscle-skeletal system 44 cases(14.7%), and digestive system 43 cases(14.3%) in order of cases of health counselling. The symptoms and complaint with 155 cases(51.7%) were most in the distribution of the health counselling contents by 17 charter of ICPC. The most common reason of counselling by 17 charter of ICPC were as follows; questions about the symptom and diagnosis(118 cases, 39.3%), the preventive and treatment methods(91 cases, 30.0%), and medical fee(20cases, 6.7%) in order. We mainly answer on the content of health counselling were as follows; make an offer of medical information and knowledge(48.3%), recommend visit clinic or hospital(23.7%), guide to treatment(12.7%), and so on. Conclusions: This research showed that the program of health counselling may not meet completely the high quality and adequate distribution of health counselling by the intranet in a university by content analysis. The finding suggests that health counselling by intranet in a university may be used to supplement of systemic improvement on the intranet Q/A format from current lack of essential health information and security for the quality of the health counselling.

• Journal of Korean society of Dental Hygiene
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• v.8 no.4
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• pp.153-163
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• 2008

The purpose of this study was to investigate the quality of life of clients who treated and equipped prosthesis in Eulji University Hospital in Dae-Jun City. The results of this study were as follows. The oral status of Female had more carious tooth than male had. Carious tooth(p<0.05) and losed tooth(p<0.001) was more popular in older female. The frequency of treated tooth was higher under 59 years old female than over 60 years old(p<0.01). In education category, carious tooth(p<0.05) and losed tooth(p<0.000) was more popular in low education than high education In the score of relation of OHIP-14 category and general characteristic, female was significantly higher than male in dysfunction( p<0.05), physical disorder(p<0.001) and activity disorder(p<0.05). The score was significantly higher in older than younger in dysfunction(p<0.05), physical disorder(p<0.001) and activity disorder(p<0.001). The score of education was significantly higher in low education group than high education group in physical pain (p<0.001), mental discomfort (p<0.001). The score of marriage status was significantly higher in marriaged group than other group in dysfunction (p<0.05) and mental discomfort (p<0.05). In the score of relation of OHIP-14 category and oral status, the score of carious tooth group was significantly higher in dysfunction(p<0.05), physical disorder(p<0.05) and activity disorder(p<0.05). The score of losed tooth group was significantly higher in dysfunction(p<0.05), physical pain (p<0.05), mental discomfort(p<0.05), physical disorder(p<0.05) and activity disorder(p<0.01). The score of non treated tooth group was significantly higher in dysfunction(p<0.05), mental discomfort(p<0.05), social disorder(p<0.05) and activity disorder(p<0.05). In the score of relation of OHIP-14 category and the sort of prosthesis, the score of being bridge group was significantly higher than being crown group in activity disorder(p<0.05). The OHIP-14 category and the number of prosthesis was not significant relationship. These results suggest that the information and services of the process of dental prosthesis based on subjective evaluation should be provided to clients rather than based on clinical evaluation. The continued system of oral management should be developed and provided.