• 한국병원경영학회지
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• 제17권3호
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• pp.37-56
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• 2012

The purpose of this study is to analyze effects of medical service quality on the customer satisfaction and intention of revisit in long-term care hospitals. To achieve purpose of the research, the data was collected from 321 patients in 8 long-term care hospitals using a standardized questionnaires. Using the structural equation modeling(SEM), this study examines the relationship among medical service quality, customer satisfaction and intention of revisit. The results show that the medical service quality factors such as convenience and accessibility have positive effects on the customer satisfaction which positively relates to intention of revisit. Medical expertise of the service quality factors has positive influence upon intention of revisit in long-term care hospitals. Therefore, the results of this study show that the medical service quality factors which are convenience and accessibility leading to customer satisfaction are important factors to select long-term care hospitals.

• 한국응급구조학회지
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• 제19권3호
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• pp.51-68
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• 2015

Purpose: This study validated the influential relations between the effects of emergency care quality, credibility of 119 emergency medical technicians (119 EMTs), and perceived usefulness and attitude of emergency care, focusing on the moderating effect of protectors' characteristics (education, experience, age, and recognition of patient severity). Methods: This study was based on elaboration likelihood and technology acceptance models. In total, 172 protectors with experience in utilizing prehospital service were surveyed from April 1 to July 31, 2011. Results: The results showed that the emergency care quality and the credibility of 119 EMTs were the main determinants of the perceived usefulness and attitude of emergency care, irrespective of the protector's characteristics (p <.001). In addition, the findings showed that the protector's intention of emergency care had a moderating role. The impact of the quality of emergency care on its perceived usefulness was greater for high-level protectors (p <.001). By contrast, the impact of the credibility of 119 EMTs on the perceived usefulness of emergency care was greater for low-level protectors (p <.001). Conclusion: The protectors' characteristics have different influences on the relations between the effects of emergency care quality, the 119 EMT credibility, and the perceived usefulness and attitude of emergency care.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.2107-2111
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• 2013

Objectives: To investigate data agreement of cancer registries and medical records as well as the quality of care and assess their relationship in a 5-year period from 2006 to 2011. Methods: The present cross-sectional, descriptive-analytical study was conducted on 443 cases summarized through census and using a checklist. Data agreement of Nemazi hospital-based cancer registry and the breast cancer prevention center was analyzed according to their corresponding medical records through adjusted and unadjusted Kappa. The process of care quality was also computed and the relationship with data agreement was investigated through chi-square test. Results: Agreement of surgery, radiotherapy, and chemotherapy data between Nemazi hospital-based cancer registry and medical records was 62.9%, 78.5%, and 81%, respectively, while the figures were 93.2%, 87.9%, and 90.8%, respectively, between breast cancer prevention center and medical records. Moreover, quality of mastectomy, lumpectomy, radiotherapy, and chemotherapy services assessed in Nemazi hospital-based cancer registry was 12.6%, 21.2%, 35.2%, and 15.1% different from the corresponding medical records. On the other hand, 7.4%, 1.4%, 22.5%, and 9.6% differences were observed between the quality of the above-mentioned services assessed in the breast cancer prevention center and the corresponding medical records. A significant relationship was found between data agreement and quality assessment. Conclusion: Although the results showed good data agreement, more agreement regarding the cancer stage data elements and the type of the received treatment is required to better assess cancer care quality. Therefore, more structured medical records and stronger cancer registry systems are recommended.

• 한국의료질향상학회지
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• 제3권2호
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• pp.60-68
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• 1997

Background : Medical records are used to assess clinical performance of physicians and quality of care. The contents which are written in medical records are considered as the objective evidences to know what the doctors think about the patient's problems. But the problem to use medical records as the assessment tools is the incompleteness of medical recording. The purpose of this study is to know if the completeness of medical recording is correlated to quality of care for inpattients and it can predict physicians's quality of care. Method : 32 clinical physicians reviewed 200 patients' medical records who were selected randomly from the inpatients who were admitted to the university hospital during July, 1995 and June, 1996. The reviewers used the structured evaluation questionnaires which were composed of two part. One part evaluated the completeness of the medical recording and the other evaluating appropriateness of diagnosis and treatment processes. We summated the scores of each items and calculated percentile scores. Results : The mean percentile score of completeness of the medical recording was 67.9% in 1995 and 79.8% in 1996. The mean percentile score of appropriateness was 52.2% in 1995 and 69.5% in 1996. This change between 1995 and 1996 was statistically significant. In non-surgical patients, the percentile scores of the completeness and those of the appropriateness were correlated positively and this correlation was statistically significant(p<0.05). In surgical patients, the positve correlation between the completeness and the appropriateness was also statistically significant(p<0.05). Discussion : In conclusion, the completeness of medical recording is considered as the good predictor of the quality of care for inpatients.

• 한국의료질향상학회지
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• 제19권2호
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• pp.68-80
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• 2013

Background: This study investigates improvements in non-value-added nursing activities in clinical work, in order to improve the efficiency and quality of nursing activities. Methods: The study was performed as a quality improvement project at a tertiary general hospital. The nursing activities that needed improvements were categories into admission care, discharge care, supply management, diagnostic work-up related activities, and others. The nursing time and frequency of non-value-added activities were compared across nine nursing units before and after implementation of the quality improvement program. Post-implementation patient and nurse satisfaction were subsequently analyzed. Result: Post-implementation, the time spent on non-value-added nursing activities was reduced and patients and nurses were satisfied with the improvements. Discussion: Reducing non-value-added activities in nursing can increase the work efficiency and ensure time for patient care, thus improving the quality of nursing care. For further study, accurate surveys on nursing activities based on nursing time are required.

• International Journal of Quality Innovation
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• 제2권2호
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• pp.127-135
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• 2001

Personnel engaged in the medical field have implemented continual improvement by team activities in an effort to construct a system that reduces the risks involved in medical care. Knowledge in total quality management (TQM), especially statistical quality control (SQC) developed for industry, seems to be applicable to medical care. This paper describes the application of SQC to continual improvement in medical care.

• 한국의료질향상학회지
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• 제5권2호
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• 한국의료질향상학회지
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• 제6권1_2호
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• pp.38-46
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• 1999

Background : To evaluate the frequency and cause of return to the emergency department within 48 hours and to identify the nature of the problem. Methods : We reviewed the medical records of 76 patients who returned to the emregency department within 48 hours from September 1998 to February 1999. Results : Overall revisit rate within 48hours was 2.6%. Of 76 patients, 5(6.6%) had planned return, 64(84.2%) had unplanned return and 7(9.2%) had incomplete documentation. The causes of unplanned return were inadequate medical management (11.8%), discharge against medical advice (27.6%), return after scheduled ambulatory care (22.4%), and unavoidable revisit due to symptom aggrevation or development of new symptom (22.4%). Conclusion : The study provided a basic information for us to improve the quality of emergency care by reducing unnecessary return to the emergency department. It is necessary to monitor continuously the quality of emergency care and to develop the standard of emergency return rate.

• 한국의료질향상학회지
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• 제24권1호
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• pp.30-39
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• 2018

Objectives: In Korea, there are many kinds of evaluations for medical institutions. However, evaluations are increasingly burdensome for medical institutions because evaluation agencies, evaluation timing, and evaluation methods are different. The purpose of this study is to improve the efficiency of evaluation for medical institutions and ultimately to provide quality medical services to patients. Methods: In this study, 2,310 indicators of 19 kinds of evaluation for medical institutions were analyzed. Results: 1,424 indicators were available for on-site surveys and 886 indicators were not available for on-site surveys. There were 4 kinds of evaluation that can be integrated in total, 12 kinds of evaluation that can be integrated partially, and 3 kinds of evaluation that need to maintain the current evaluation system. Conclusion: In order to provide patient-centered quality medical services through reduction of burden due to the evaluation for medical institutions, it is necessary to deeply discuss the efficiency of evaluation integration and result utilization.

• 보건의료산업학회지
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• 제10권4호
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• pp.61-73
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• 2016

Objectives : The aim of this study was to investigate the satisfaction determinants of rehabilitation care group inpatients in rehabilitation long-term care hospitals. Methods : A survey was conducted with 262 patients from 6 rehabilitation long-term care hospitals located in Busan Kyungnam. Data were collected from June 2016 to July 2016 with a structured questionnaire and analyzed with SPSS 23.0. Results : The significant factors affecting the overall satisfaction score were disease group and 5 quality indices of medical services(Medical service quality, Rehabilitation services quality, Hospital reputation, External physical environment, and Internal physical environment). Additionally, the significant factors affecting intention to revisit were age, disease group, length of hospital stay and the 5 quality indices of medical services. Conclusions : The results of this study indicate that rehabilitation long-term care hospitals should try to improve the overall satisfaction of inpatients, especially focusing on the internal physical environment and the quality of the rehabilitation services and medical services, which will lead to a high level of intention for patients to revisit.