The medical fee reimbursement denied by HIRA(Health Insurance Review Agency) amounted to about 1.2% of the total medical fee claim to HIRA for reimbursement. Most of the denials stem from the inappropriate prescriptions of medical staff violating the medical fee review standards issued by HIRA. Considering the significant impacts of the standards observance behavior on the hospitals' financial viability, we attempted to analyze the predisposition factors of medical staffs' review standards observance behavior. The TPB(Theory of Planned Behavior) was adopted as the theoretical framework of the analysis. Data were collected by administrating a survey on the concepts included in TPB model to the 187 medical staff of a tertiary care hospital. Of the 187 questionaries distributed, 150 were responded resulting 80.2% of response rate. The mean differences among the groups classified by age group, years of experience, medical specialty and gender were analysis using ANOVA. The relationships among the TPB concepts were analysed by applying the Structural Equations Modeling method. The TPB model consists of three exogenous concepts (attitude toward the behavior, subjective norm, and perceived behavioral control) and two endogenous concepts (intention and the behavior). The results of ANOVA indicated significant mean differences among the groups classified by the medical staff's age, years of experience, and medical specialty. The older and the more experienced had the higher mean of observance behavior score. The results of Structural Equations analysis showed that the subjective norm and perceived behavioral control had statistically significant influences on intention, but the influence of attitude to intention was not statistically significant. The influences of perceived behavioral control and intention on behavior were significant. Based on these results the theoretical and practical implications were discussed.
Jung, Ji Hyuk;Jeon, Yeo Reum;Song, Joon Ho;Chung, Seum
대한두개안면성형외과학회지
/
제22권6호
/
pp.319-323
/
2021
Background: Prophylactic antibiotics are used to prevent surgical wound infection; however, proper indications must be followed with careful consideration of the risks and benefits, especially in clean or clean-contaminated wounds. Nasal bone fractures are the most common type of facial bone fracture. The most common method for treating nasal bone fracture is closed reduction, which is performed inside the nasal cavity without an incision. The purpose of this study was to determine the need for antibiotic use in the closed reduction of nasal bone fractures. Methods: A retrospective study was conducted using data from the National Insurance Service Ilsan Hospital of the Republic of Korea between 2016 and 2018. The records of patients who underwent closed reduction of nasal bone fracture were reviewed and classified according to sex, age, comorbidities, perioperative antibiotic usage, postoperative complications, nasal packing, anesthesia type, surgeon's specialty, and operation time. Results: Among the 373 patients studied, the antibiotic prescription rate was 67.3%. Just 0.8% of patients were prescribed preoperative antibiotics only, 44.0% were prescribed postoperative antibiotics only, and 22.5% were prescribed both preoperative and postoperative antibiotics. There were no cases that satisfied the definition of "surgical site infection." Furthermore, 2.1% of infection-related complications (e.g., mucosal swelling, synechia, and anosmia) occurred only in the antibiotic usage group. The use of nasal packing, anesthesia type, and surgeon's specialty did not show any difference in infection-related complication rates. Conclusion: According to the study findings, the routine use of perioperative antibiotics is not recommended in uncomplicated nasal bone fracture surgery.
Purpose: This study was designed to explore the perceptions of quality nursing care among nurses. Method: The data were analyzed using content analysis. The data were collected from 19 nurses who worked at diverse clinical areas in 8 general and university hospitals with over 400 beds. Result: 1. The attributes of quality nursing care were categorized into 7 hierarchies in the order of 'caring' (40.65%), 'specialty' (29.03%), 'nurse attainments' (15.48%), 'patient- centered nursing management' (6.45%), 'sincerity' (5.16%), 'kindness' (2.58%), 'satisfaction' (0.65%). 2. The concept of quality nursing care were defined as 'giving a satisfaction both to patients and nurses through patient-centered nursing management with specialty and caring in the ground of the kindness and sincerity'. Conclusion: Based on there findings, we suggest that the study results should be used for development of a quality assurance tool in nursing practice, patient care in hospital setting, education of nurses and nursing students. In addition, further repeated studies need to be conducted.
Background: Head or scalp injury is a life-threatening and typically accidental human injury. Most medical departments require immediate medical treatment and proper treatment with specialized medical personnel and facilities. However, in low-resource environments, such as the rural region of West Africa, the authors have treated emergency trauma patients and provided immediate treatment despite lack of resources. Case presentation: We reviewed three cases of scalp injury patients, with representative clinical information, and used these cases to outline feedback on scalp trauma treatment based on the specialty knowledge of general and emergency surgeon. Conclusions: Oral and maxillofacial surgeons are medical specialists that can immediately diagnose and treat these scalp injuries based on their medical knowledge and experience with the maxillofacial region.
This study reviews the literature of influencing factor on hospital-employed physician's income, and it describes general distribution of hospital-employed physician's income, and analyzes influencing factor of hospital-employed physician's income. A total of 1.795 persons responded to the mail survey. through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study. and the unit of analysis is a physician. To examine the change of average income per month. multiple regression was used to test the change according to physician's characteristics. demographic characteristics. scale of hospital. average intensity of ordinary work. and specialty. The major findings of this study are as follows; 1. As for physicians working in first referral hospital. the average income of neurosurgeon per month was the largest. being 1.34 times larger than that of the family physician, and that of the emergency physician was the smallest, being 0.78 times smaller than that of the family physician, but that of the ophthalmic and Orthopaedic physician was significantly larger than that of the family physician under the control of control variables. And average income per month was significantly larger for physicians who worked in Seoul metropolitan area than physicians who worked in rural area. 2. The year of physician's career, number of average out-patients per month significantly positively associated, but the number of hospital beds and average intensity of therapy significantly negatively associated with average income per month. 3. As for physicians working in second referral hospital. the average income of the psychiatric physician per month was the largest, being 1.33 times larger than that of the family physician, and that of the emergency physician was smallest, being 0.74 times smaller than that of the family physician., but no significant difference was seen under the control of control variables, and average income per month was significantly larger for physicians who worked in Seoul metropolitan area than physicians who worked in large municipal area. 4. The year of physician's career and number of hospital beds significantly positively associated, but average working hours per month significantly negatively associated with average income per month. In conclusion, the year of hospital-employed physician's career is the largest influencing factor on hospital-employed physicians. But the difference of average income per month according to working regions and to number of hospital beds existed in employed physicians under the control of control variables. So this study has implementation that we must consider the influence of working regions and the number of hospital beds on the income of hospital-employed physicians in making policy for hospital. Being a cross-sectional study, this study can not suggest causal explanations. In the future, experiment or cohort study is needed for causal explanations.
Background : The prevalence of the chronic metabolic disease is increasing due to the aging society. Therefore, Korean Society of Health-system Pharmacists (KSHP) has a specialty pharmacist system to improve the professionalism of pharmacists. The purpose of this study is to suggest the difference between specialty pharmacist and non-specialty pharmacist with regards to their knowledge, delivery of information on medication, service provision, and job satisfaction. Methods : An online survey research was conducted for hospital pharmacists. The reliability of the questionnaire items was presented using Cronbach's ${\alpha}$ test. The t-test or ANOVA analysis was used for evaluating differences in continuous variables. Results : A total of 171 pharmacists responded to the questionnaire, and 87.7% of the respondents were aged less than 30 years (76.6%) and four-year graduates (86.0%). Typically, 108 (63.2%) were candidates for the pharmacist's specialty certificate, and the remaining 63 (36.8%) were not enrolled. Considering the field of specialty with overlapping, the total number of certificated patients was 140 (26.3% of the total of 532 in 2016). The results of the reliability analysis of the specific questionnaire showed that the Cronbach's ${\alpha}$ value was over 0.78. There was no significant difference in customer directionality between the two groups. However, there was a significant difference (p<0.05) with respect to overall knowledge about the treatment process, drug efficacy, and side effects, information about medicines and adverse drug reactions, and in providing appropriate information to medical staff including patients and physicians. Conclusions : The pharmacist with specialization showed a positive result of self-evaluation of items such as knowledge about drugs, communication of information on medications, and service provision, compared to other pharmacists, and the result was in correlation with the numbers of specialization. There was no difference in job satisfaction related to working environment. Henceforth, it is hypothesized that there is a necessity for continuous improvement in the working environment to suit the purpose of the pharmacy specialist system.
From 1990 to 1997 Home Care Education Programs have been offered at 11 Home Care Education Institutes. But there have been no revisions in the program. Especially in the clinical practicum, the Ministry of Health and Welfare proposed 248 hours as 'Family Nursing and Practice'. But each of institutes has developed their own program, and the clinical practicum is very different. Institutions for home care practice have been very limited and even now only 40 hospitals started home care in the second demonstration project. A few community-based institutions have also been offering home care services. This study was conducted to analyze home care clinical practicum offered at Y university, and plan for a revised home care clinical practicum. Y university clinical practicum was revised to include 'visits to community institutions', 'laboratory practice', 'hospital practice', 'discharge planning and home care practice', and 'home care specialty practice'. The results of the evaluation and plan for a revision are as follows: 'Visits to community institutions' is a practice that helps the students understand community resources which are available to home care nurses, and as an orientation to institutions for practice. 'Laboratory practice' is to used to improve nursing skills that are applicable to home care. Problems that the students identified in the laboratory practice were 'lack of opportunity for individual practice', and 'inadequate theoretical preparation for practice'. To address these problems the basic nursing skills laboratory was open and could be used freely by the home care students, and practice could be done after the theoretical lectures. 'Hospital practice' is a practicum in which the students apply nursing skills to patients and to obtain assessment skills for discharge planning. Using a preceptorship, five days for hospital practice should be offered. 'Discharge planning and home care practice' was done at Wonju Christian Hospital. This institute is too far away that this practice should be provided at different institutions as soon as it is possible to contract with home care institutions. Patients groups in different home care institutions are very different, so the 'Home care specialty practice' should be done after analyzing patient groups and choosing specialty areas. These areas are' care of patients with respiratory dysfunction', 'care of patients with neurologic dysfunction', 'care of cancer patients', 'care of patients on dialysis', and 'wound care'. This practice should be offered with a preceptorship, so preceptors, clinical directors, and students should meet for home visit orientation.
Objectives : The purpose of this study was to investigate regional commitment index(RGI) of hospital in Korea, and the relationship RGI and hospital characteristics, such as foundation, region, size. Therefore, we are to suggest fundamental information to make and evaluate healthcare resource policy in hospital- and government-level. Methods : The 'Patient Survey 2002(administered by Ministry of Health and Social Welfare(MOHW)' was analyzed. We selected the patient data of the hospitals above 100 beds. Then, we calculated the RGI, number of same cases divided by all cases in each hospital. By using SPSS/win ver 14.0, statistical analysis such as t-test, ANOVA, correlational and regression analysis was carried out. Results : The results are as follows. 1. Overall mean and standard deviation of RGI were revealed as 0.805${\pm}$0.225 in inpatients, and 0.871${\pm}$0.184 in outpatient. The median of inpatients' and outpatients' RGI were 0.890 and 0.933. The RGI of inpatients of private hospitals were revealed significantly higher than that of the public(public: 0.727, private: 0.822). However, outpatients' RGI was not revealed as significantly different. 2. The RGI of general specialty hospitals were significantly lower than others, therefore we could think that more inpatients and outpatients of general specialty hospitals flowed in from others province or metropolitan cities than other hospital types. 3. The RGI of hospitals holding above 400 beds were significantly lower than others in inpatients and outpatients. 5. The RGI of hospitals were significantly different among sixteen province and metropolitan cities. The RGI inpatients of Gwangju and Daejon metropolitan city were lowest sub-group(0.659, 0.664), and the RGI inpatients of Jeju was revealed as highest, 0.979. 6. Available beds, total doctors, and total employees were negatively correlated with RGI of inpatients and outpatients. 7. The significant influencing factors to RGI of inpatients and outpatients were appeared samely such as available beds, wide healthcare region, hospital size, and foundation type. Conclusions : It is considered that RGI of hospital represent competitive power in healthcare market. Also, the competitive advantage and quality of hospital clustered by characteristics could made out by RGI. Therefore, the results of this study would be useful to develop and evaluate hospital policy of individual hospital or local government.
Objectives: This study was performed to investigate selection factors for specialized hospital and to find out the impact of hospital selection factors on satisfaction, revisiting invention and recommendations. Methods: A survey was performed with 398 inpatients of 4 specialized joint hospital in Busan. Data were collected from August to October 2016 with questionnaires and analyzed using SPSS 24.0. Results: First, inpatients know that it was a specialized hospital were highly satisfied and willing to revisit and recommend. Second, in hospital satisfaction, influence size was shown in order of specialty factors, service quality factors, physical factors, and accessibility factors. Third, the intention to revisit hospitals was higher in the awareness of a specialized hospital and high satisfied inpatients, and recommendation intend were affected by the higher revisitation intention, the high satisfaction level, and the high professionality level. Conclusions: All the hospital selection 4 factors for joint specialized hospitals affects satisfaction level which is linked to revisit and recommend. Specialized Hospitals will have to strengthen qualitative management of hospital selection factors to enhance patient satisfaction.
The purpose of this study is to assess individual decisive factors for distribution of medical specialists in Korea. A data set was constructed using several published data sources. including the Korean Medical Association's physician master file as a principal source for physician information. Linear logistic regression analysis was performed to assess the relationship between the location of private specialist clinic for practice with six variables related with individual characteristics: age. sex. location of postgraduate training hospital. location of medical school graduated, size of hospital for training, and specialty. Analysis showed that location of practice. classified into urban and rural areas, was significantly associated with the variables of sex. location of postgraduate training hospital. location of medical school. In addition, significant association was found between the location of practice which was categorized into "near-Seoul area" and others, and sex, location of postgraduate training hospital. and location of medical school. We could conclude that to improve area maldistribution of physicians locations of hospitals for training and medical schools have to have the highest priority in the policymaking.icymaking.
본 웹사이트에 게시된 이메일 주소가 전자우편 수집 프로그램이나
그 밖의 기술적 장치를 이용하여 무단으로 수집되는 것을 거부하며,
이를 위반시 정보통신망법에 의해 형사 처벌됨을 유념하시기 바랍니다.
[게시일 2004년 10월 1일]
이용약관
제 1 장 총칙
제 1 조 (목적)
이 이용약관은 KoreaScience 홈페이지(이하 “당 사이트”)에서 제공하는 인터넷 서비스(이하 '서비스')의 가입조건 및 이용에 관한 제반 사항과 기타 필요한 사항을 구체적으로 규정함을 목적으로 합니다.
제 2 조 (용어의 정의)
① "이용자"라 함은 당 사이트에 접속하여 이 약관에 따라 당 사이트가 제공하는 서비스를 받는 회원 및 비회원을
말합니다.
② "회원"이라 함은 서비스를 이용하기 위하여 당 사이트에 개인정보를 제공하여 아이디(ID)와 비밀번호를 부여
받은 자를 말합니다.
③ "회원 아이디(ID)"라 함은 회원의 식별 및 서비스 이용을 위하여 자신이 선정한 문자 및 숫자의 조합을
말합니다.
④ "비밀번호(패스워드)"라 함은 회원이 자신의 비밀보호를 위하여 선정한 문자 및 숫자의 조합을 말합니다.
제 3 조 (이용약관의 효력 및 변경)
① 이 약관은 당 사이트에 게시하거나 기타의 방법으로 회원에게 공지함으로써 효력이 발생합니다.
② 당 사이트는 이 약관을 개정할 경우에 적용일자 및 개정사유를 명시하여 현행 약관과 함께 당 사이트의
초기화면에 그 적용일자 7일 이전부터 적용일자 전일까지 공지합니다. 다만, 회원에게 불리하게 약관내용을
변경하는 경우에는 최소한 30일 이상의 사전 유예기간을 두고 공지합니다. 이 경우 당 사이트는 개정 전
내용과 개정 후 내용을 명확하게 비교하여 이용자가 알기 쉽도록 표시합니다.
제 4 조(약관 외 준칙)
① 이 약관은 당 사이트가 제공하는 서비스에 관한 이용안내와 함께 적용됩니다.
② 이 약관에 명시되지 아니한 사항은 관계법령의 규정이 적용됩니다.
제 2 장 이용계약의 체결
제 5 조 (이용계약의 성립 등)
① 이용계약은 이용고객이 당 사이트가 정한 약관에 「동의합니다」를 선택하고, 당 사이트가 정한
온라인신청양식을 작성하여 서비스 이용을 신청한 후, 당 사이트가 이를 승낙함으로써 성립합니다.
② 제1항의 승낙은 당 사이트가 제공하는 과학기술정보검색, 맞춤정보, 서지정보 등 다른 서비스의 이용승낙을
포함합니다.
제 6 조 (회원가입)
서비스를 이용하고자 하는 고객은 당 사이트에서 정한 회원가입양식에 개인정보를 기재하여 가입을 하여야 합니다.
제 7 조 (개인정보의 보호 및 사용)
당 사이트는 관계법령이 정하는 바에 따라 회원 등록정보를 포함한 회원의 개인정보를 보호하기 위해 노력합니다. 회원 개인정보의 보호 및 사용에 대해서는 관련법령 및 당 사이트의 개인정보 보호정책이 적용됩니다.
제 8 조 (이용 신청의 승낙과 제한)
① 당 사이트는 제6조의 규정에 의한 이용신청고객에 대하여 서비스 이용을 승낙합니다.
② 당 사이트는 아래사항에 해당하는 경우에 대해서 승낙하지 아니 합니다.
- 이용계약 신청서의 내용을 허위로 기재한 경우
- 기타 규정한 제반사항을 위반하며 신청하는 경우
제 9 조 (회원 ID 부여 및 변경 등)
① 당 사이트는 이용고객에 대하여 약관에 정하는 바에 따라 자신이 선정한 회원 ID를 부여합니다.
② 회원 ID는 원칙적으로 변경이 불가하며 부득이한 사유로 인하여 변경 하고자 하는 경우에는 해당 ID를
해지하고 재가입해야 합니다.
③ 기타 회원 개인정보 관리 및 변경 등에 관한 사항은 서비스별 안내에 정하는 바에 의합니다.
제 3 장 계약 당사자의 의무
제 10 조 (KISTI의 의무)
① 당 사이트는 이용고객이 희망한 서비스 제공 개시일에 특별한 사정이 없는 한 서비스를 이용할 수 있도록
하여야 합니다.
② 당 사이트는 개인정보 보호를 위해 보안시스템을 구축하며 개인정보 보호정책을 공시하고 준수합니다.
③ 당 사이트는 회원으로부터 제기되는 의견이나 불만이 정당하다고 객관적으로 인정될 경우에는 적절한 절차를
거쳐 즉시 처리하여야 합니다. 다만, 즉시 처리가 곤란한 경우는 회원에게 그 사유와 처리일정을 통보하여야
합니다.
제 11 조 (회원의 의무)
① 이용자는 회원가입 신청 또는 회원정보 변경 시 실명으로 모든 사항을 사실에 근거하여 작성하여야 하며,
허위 또는 타인의 정보를 등록할 경우 일체의 권리를 주장할 수 없습니다.
② 당 사이트가 관계법령 및 개인정보 보호정책에 의거하여 그 책임을 지는 경우를 제외하고 회원에게 부여된
ID의 비밀번호 관리소홀, 부정사용에 의하여 발생하는 모든 결과에 대한 책임은 회원에게 있습니다.
③ 회원은 당 사이트 및 제 3자의 지적 재산권을 침해해서는 안 됩니다.
제 4 장 서비스의 이용
제 12 조 (서비스 이용 시간)
① 서비스 이용은 당 사이트의 업무상 또는 기술상 특별한 지장이 없는 한 연중무휴, 1일 24시간 운영을
원칙으로 합니다. 단, 당 사이트는 시스템 정기점검, 증설 및 교체를 위해 당 사이트가 정한 날이나 시간에
서비스를 일시 중단할 수 있으며, 예정되어 있는 작업으로 인한 서비스 일시중단은 당 사이트 홈페이지를
통해 사전에 공지합니다.
② 당 사이트는 서비스를 특정범위로 분할하여 각 범위별로 이용가능시간을 별도로 지정할 수 있습니다. 다만
이 경우 그 내용을 공지합니다.
제 13 조 (홈페이지 저작권)
① NDSL에서 제공하는 모든 저작물의 저작권은 원저작자에게 있으며, KISTI는 복제/배포/전송권을 확보하고
있습니다.
② NDSL에서 제공하는 콘텐츠를 상업적 및 기타 영리목적으로 복제/배포/전송할 경우 사전에 KISTI의 허락을
받아야 합니다.
③ NDSL에서 제공하는 콘텐츠를 보도, 비평, 교육, 연구 등을 위하여 정당한 범위 안에서 공정한 관행에
합치되게 인용할 수 있습니다.
④ NDSL에서 제공하는 콘텐츠를 무단 복제, 전송, 배포 기타 저작권법에 위반되는 방법으로 이용할 경우
저작권법 제136조에 따라 5년 이하의 징역 또는 5천만 원 이하의 벌금에 처해질 수 있습니다.
제 14 조 (유료서비스)
① 당 사이트 및 협력기관이 정한 유료서비스(원문복사 등)는 별도로 정해진 바에 따르며, 변경사항은 시행 전에
당 사이트 홈페이지를 통하여 회원에게 공지합니다.
② 유료서비스를 이용하려는 회원은 정해진 요금체계에 따라 요금을 납부해야 합니다.
제 5 장 계약 해지 및 이용 제한
제 15 조 (계약 해지)
회원이 이용계약을 해지하고자 하는 때에는 [가입해지] 메뉴를 이용해 직접 해지해야 합니다.
제 16 조 (서비스 이용제한)
① 당 사이트는 회원이 서비스 이용내용에 있어서 본 약관 제 11조 내용을 위반하거나, 다음 각 호에 해당하는
경우 서비스 이용을 제한할 수 있습니다.
- 2년 이상 서비스를 이용한 적이 없는 경우
- 기타 정상적인 서비스 운영에 방해가 될 경우
② 상기 이용제한 규정에 따라 서비스를 이용하는 회원에게 서비스 이용에 대하여 별도 공지 없이 서비스 이용의
일시정지, 이용계약 해지 할 수 있습니다.
제 17 조 (전자우편주소 수집 금지)
회원은 전자우편주소 추출기 등을 이용하여 전자우편주소를 수집 또는 제3자에게 제공할 수 없습니다.
제 6 장 손해배상 및 기타사항
제 18 조 (손해배상)
당 사이트는 무료로 제공되는 서비스와 관련하여 회원에게 어떠한 손해가 발생하더라도 당 사이트가 고의 또는 과실로 인한 손해발생을 제외하고는 이에 대하여 책임을 부담하지 아니합니다.
제 19 조 (관할 법원)
서비스 이용으로 발생한 분쟁에 대해 소송이 제기되는 경우 민사 소송법상의 관할 법원에 제기합니다.
[부 칙]
1. (시행일) 이 약관은 2016년 9월 5일부터 적용되며, 종전 약관은 본 약관으로 대체되며, 개정된 약관의 적용일 이전 가입자도 개정된 약관의 적용을 받습니다.