• Title/Summary/Keyword: University hospitals

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The Effect of Organisational Structure on Quality Management in Public Hospitals in a Developing Nation: A Comparative Study Between District, State and National Level Hospitals in Malaysia

  • Manaf Noor Hazilah Abd.
    • International Journal of Quality Innovation
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    • v.7 no.1
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    • pp.161-176
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    • 2006
  • The objective of the study was to empirically assess the practice of quality management among employees of Malaysian public hospitals at the district, state and national level hospitals. Comparative analysis on the practice of quality management was made among the three groups of hospitals. Self-administered questionnaire was the main method of data collection. Twenty-three public hospitals throughout Peninsular Malaysia participated in the survey. Practice of quality management was found to be significantly higher in district hospitals than in the national referral centre, which is based in the capital city of Kuala Lumpur. However, there was no significant difference in perception of implementation outcome between the three levels of hospitals. Among the factors of quality management, teamwork was found to be significantly higher in district hospitals than in state hospitals and the national referral centre. Leadership and management commitment was found to be significantly higher in district and state hospitals than in the national referral centre. The effect of organizational structure could have an effect on practice of quality management.

Patient Satisfaction as an Indicator of Service Quality in Malaysian Public Hospitals

  • Manaf, Noor Hazilah Abd;Nooi, Phang Siew
    • International Journal of Quality Innovation
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    • v.10 no.1
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    • pp.77-87
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    • 2009
  • The main aim of the paper is to provide an empirical analysis on patient satisfaction as an indicator of service quality in Malaysian public hospitals. Self-administered questionnaires were administered to patients by convenience sampling. Two sets of questionnaires were used, one for inpatient and another one set for outpatient. Selection of hospitals was made according to states in Peninsular Malaysia. 23 hospitals covering all state level hospitals, the National Referral Centre and selected district hospitals were chosen as respondent hospitals. Two dimensions of service quality emerged, namely clinical and physical dimension of service. Both outpatient and inpatient were found to be more satisfied with clinical dimension of service than physical dimension. For outpatient satisfaction, there was positive correlation between waiting time and patient satisfaction. Patient satisfaction was also found to be higher in the smaller district hospitals than in the larger state hospitals. For clinical dimension of service, patients were satisfied with the services of doctors and nurses, while for physical dimension of service, patients were satisfied with the cleanliness of the facilities. The ability of the research to be conducted by random sampling was inhibited by the reluctance of patients to cooperate, which led to the use of convenience sampling. Studies have also shown that patients are reluctant to express their feelings on services provided by their caregivers. The study provides primary data for a nationwide study on patient satisfaction in Malaysian public hospitals, for both inpatient and outpatient.

Evaluation of Patient-Centered Healthcare Provision in Hospitals and General Hospitals- Based on Patient Experience Assessment (병원과 종합병원의 환자중심 의료서비스 제공 수준 평가- 환자경험평가를 중심으로)

  • Hwang, Byung-Deog;Kim, Yun-Jeong
    • The Korean Journal of Health Service Management
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    • v.12 no.3
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    • pp.1-11
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    • 2018
  • Objectives: The purpose of this study is to evaluate patient experience assessment of inpatients, and to prepare measures to improve the quality level of medical services and guarante patient rights. Methods: The study was conducted among 199 patients admitted to hospitals and general hospitals in the metropolitan area. The analysis method used was crossover analysis, including a comparison of means, and logistic regression analysis. Results: The overall average score of satisfaction with healthcare service was 3.39 for nurses, 3.35 for hospitals and 3.42 for general hospitals. Age at the time of hospitalization affected satisfaction. The overall average score of healthcare service satisfaction was 3.09 for doctors, 3.14 for hospitals, and 3.04 for general hospitals. The factors affecting hospital satisfaction were gender and subjective health status. The factors affecting satisfaction in general hospitals were education, medical department, and hospitalization route. Conclusions: Hospitals should also introduce a systematic management system of general hospitals and strengthen the guarantee of the rights of patients who can improve the quality of medical care through positive communication between medical personnel and patients.

Current status of nutritional support for hospitalized children: a nationwide hospital-based survey in South Korea

  • Kim, Seung;Lee, Eun Hye;Yang, Hye Ran
    • Nutrition Research and Practice
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    • v.12 no.3
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    • pp.215-221
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    • 2018
  • BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

A Study on Nonpatient Revenues in University Hospitals (대학병원의 의료외수익에 관한 연구)

  • Yang, Jong-Hyun;Lee, Jung-Woo
    • The Korean Journal of Health Service Management
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    • v.8 no.2
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    • pp.1-10
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    • 2014
  • This study examined nonpatient revenues of university hospitals in korea. The data source for this study was 22 university hospitals over the period 2010-2012. In this study, patient revenues, patient expenses, operating profit, nonpatient revenues, total revenues, operating margin, normal profit to gross revenues, ratio of the nonpatient revenues in the total revenues were analysed by the annual and three-year average. The analysis of nonpatient revenue differences by hospital type, bed size, location, management performance was performed by T-test and oneway ANOVA. The results were as follows. First, nonpatient revenues of university hospitals were increased during the period 2010-2012. Second, nonpatient revenues according to hospital type, bed size, location in the university hospitals had significant difference. Third, hospital type was significantly associated with normal profit to gross revenues which was profitability index about nonpatient revenues. Based on these results, this study suggests implications to diversify for management performance in hospitals.

A comparison study on the online media relations reported in homepages of hospitals in Korea and hospitals in USA (국내 병원과 미국 병원의 홈페이지를 통한 언론관계 비교 분석에 관한 연구)

  • Lee, Hyun-Seon
    • Korea Journal of Hospital Management
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    • v.15 no.1
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    • pp.70-92
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    • 2010
  • Now more than ever, many journalists are using hospitals' homepages for articles about hospitals, their mission, research, and events. Therefore hospitals' homepages have to be planned and constructed for journalists. The purpose of this study is to investigate hospitals' online media relations through analysing homepages. For investigating specifically, this study compares hompages of hospitals in Korea and hospitals in USA. This study uses four categories; basic media relations tools, useful information, interactive communication tools, and ease of use for journalists. The result of this study shows that hospitals' homepages in Korea are needed to improve for building with journalists. The hospitals' hompages have to be constructed by a variety of materials; press room, image and graphic archives, multimedia resources, and interactivity or responsiveness. This study suggests that the hospitals' homepages have the potential to achieve the desired public relations objective but are not commonly being used to their full potential in media relations.

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Management Efficiency Evaluation of Korean Medicine Hospitals by Data Envelop Analysis(DEA) Model (DEA모형을 활용한 한방병원의 경영효율성 분석)

  • Park, Joon;Choi, Byunghee;Lim, Byungmook
    • Journal of Society of Preventive Korean Medicine
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    • v.17 no.3
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    • pp.103-114
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    • 2013
  • Objectives : This study aimed to analyze the management efficiency of Korean Medicine hospitals for recent 10 years(2001~2010) using the Data Envelop Analysis(DEA) model. Methods : We collected the management data of 23 Korean Medicine hospitals for DEA model from the Korean Oriental Medicine Hospitals' Association (KOMHA). Input variables of DEA model are numbers of beds, numbers of doctors, numbers of nurses and numbers of other staffs of each Korean Medicine hospitals. Output variables are numbers of inpatients and numbers of outpatients of each Korean Medicine hospitals. Based on the DEA model, we calculated the efficiency score of each Korean Medicine hospital and compared it by hospital's ownership, location, and size. Results : Average DEA efficiency scores of Korean Medicine hospitals by year ranged from 0.86 to 0.92. Private owned hospitals showed higher efficiency scores than the university affiliated hospitals with statistical significance (p=0.001). And Korean Medicine hospitals located in capital region of Korea(Seoul City, Incheon City, Gyeonggi-do) and the rest Korean Medicine hospitals did not show statistical difference (p=0.516). Lastly, Korean Medicine hospitals with different size did not show statistical difference in management efficiency (p=0.499). Conclusion : We have found that Korean Medicine hospitals management efficiency have not changed throughout 10 years, and that different ownership forms of Korean Medicine hospital show statistical difference in management efficiency while location, and size do not.

Survey of Institutional Review Board Risk Level Classification of Clinical Trials Among Korean University Hospitals (임상시험심사위원회(Institutional Review Board)의 임상시험에 대한 위험평가 분류조사연구)

  • Lee, Sun Ju;Kang, Su Jin;Maeng, Chi Hoon;Shin, Yoo Jin;Yoo, Soyoung
    • The Journal of KAIRB
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    • v.4 no.2
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    • pp.36-41
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    • 2022
  • Purpose: The purpose of this study is to evaluate how university hospital Institutional Review Boards (IRBs) in Korea classify risk when reviewing clinical trial protocols. Methods: IRB experts (IRB chairman, vice chairman, IRB administrator) in the university hospitals obtaining a Human research protection program (HRPP) or IRB accreditation in Korea were asked to fill out the Google Survey from September 1, 2020 to October 10, 2020. Result: Among the 23 responder hospitals, 8 were accredited by the American Association for Human Research Protection Program (AAHRPP) and 8 were accredited by the HRPP of Ministry of Food and Drug Safety (MFDS). Seven were accredited by Forum for Ethical Review Committees in Asia and the Western Pacific or Korea National Institution for Bioethics Policy. Thirteen of 23 hospitals (56.5%) had 4 levels (less than minimal, low, moderate, high risk), 4 hospitals had 3 levels (less than, slightly over, over than minimal risk), 1 hospital had 5 levels (4 levels plus required data safety monitoring board), and 1 hospital had 2 levels (less than, over than minimal risk) risk classification system. Thirteen of 23 hospitals (56.5%) had difficulty classifying the risk levels of research protocols. Fourteen hospitals (60.9%) responded that different standards among hospitals for risk level determination associated with clinical trials will affect the subject protection. Six hospitals (26.1%) responded that it will not. Three hospitals (13.0%) responded that it will affect the beginning of the clinical trial. To resolve differences in standards between hospitals, 14 hospitals (60.9%) responded that either the Korean Association of IRB or MFDS needs to provide a guideline for risk level determination in clinical trials: 5 hospitals (21.7%) responded education for IRB members and researchers is needed; 3 hospitals (13.0%) responded that difference among institutions needs to be acknowledged; and 1 hospital (4.3%) responded that there needs to be communication among IRB, investigator, and sponsor. Conclusion: After conducting a nationwide survey on how IRB in university hospital determines risk during review of clinical trials, it is reasonable to use 4-level risk classification (less than minimal, low, moderate, high risk); the most utilized method among hospitals. Moreover, personal information and conflict of interest associated with clinical trials have to be considered when reviewing clinical trial protocols.

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Nurse Staffing Levels and Proportion of Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing for 1996~2013 (의료법에 의거한 의료기관 종별 간호사 정원기준 충족률 추이 분석)

  • Cho, Sung-Hyun;Lee, Ji-Yun;June, Kyung-Ja;Hong, Kyung Jin;Kim, Yunmi
    • Journal of Korean Academy of Nursing Administration
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    • v.22 no.3
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    • pp.209-219
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    • 2016
  • Purpose: To analyze the proportion of medical institutions meeting the legal standard for nurse staffing. Methods: Data collected from 29,282 institutions between 1996 and 2013 were analyzed. Nurse staffing was measured as daily patient census per registered nurse (RN). The standard for general hospitals, hospitals, and clinics is 2.5 or less, and that for long-term care hospitals is 6.0 or less of the daily patient census per RN. Clinics may substitute nursing assistants for RNs by 50% or 100% depending on their daily inpatient census; long-term care hospitals may substitute nursing assistants for RNs by two thirds of the required number of RNs. Results: The proportion of general hospitals, hospitals, clinics, and long-term care hospitals meeting the standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in hospitals and clinics. In 2013, nurses were estimated to care for 16 (interquartile range: 12~24) patients per shift in general hospitals. Three quarters of clinics had no RNs in 2013. Conclusion: Many medical institutions did not meet the legally mandated minimum staffing level. The government must implement policy actions for all medical institutions to meet the legal standards.

Variation in resource utilization for inpatients among university teaching hospitals in a city (한 도시 대학병원 자료를 이용한 입원환자의 의료서비스 이용량 변이에 관한 연구)

  • Park, Ha-Young;Shin, Eui-Chul;Meng, Kwang-Ho
    • Journal of Preventive Medicine and Public Health
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    • v.23 no.4 s.32
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    • pp.451-464
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    • 1990
  • The variation in resource utilization for hospitalized patients who had a group of similar diseases -- a Korean Diagnosis Related Group (KDRG) -- among the same type of hospitals was studied to assess the utillization variation due to the practice pattern of hospitals. Information about inpatients who were beneficiaries of the medical insurance for teachers and government officials discharged from 20 large university teaching hospitals in Seoul during 1986 and information about the hospitals were analyzed to achieve the study objective. A total of 20,223 non-outlier patients in 100 most frequent KDRGs were included in the analysis. Case charges after the review and length of stay (LOS) were used as measures of resource utilization during a hospitalization. A substantial variation among hospitals was found in most KDRGs : o the ratio of the maximum and the minimum among the mean case charges of hospitals was greater than 2 in 83 KDRGs ; o the difference between the maximum and the minimum among the mean case charges of hospitals was greater than 100,000 Won in 94 KDRGs : o the ratio of the maximum and the minimum among the mom LOS of hospitals was greater than 2 in 82 KDRGs ; o the difference between the maximum and the minimum among the mean LOS of hospitals was greater than 3 days in 94 KDRGs. The practice pattern of hospitals explained more than 20% of charge variation in 49 KDRGs and more than 20% of LOS variation in 43 KDRGs. The study results indicated need for a new health policy initiative for cost containment and quality assurance.

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