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Study on Types and Counterplans of Medical Accident Experienced by Dentists in Seoul(2004) (서울특별시 개원 치과의사의 의료사고 및 분쟁의 유형과 대책에 관한 연구(2004년))

  • Yoon, Jeong-Ah;Kang, Jin-Kyu;Ahn, Hyoung-Joon;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.163-199
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    • 2005
  • Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.

The Jurisdictional Precedent Analysis of Medical Dispute in Dental Field (치과임상영역에서 발생된 의료분쟁의 판례분석)

  • Kwon, Byung-Ki;Ahn, Hyoung-Joon;Kang, Jin-Kyu;Kim, Chong-Youl;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.283-296
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    • 2006
  • Along with the development of scientific technologies, health care has been growing remarkably, and as the social life quality improves with increasing interest in health, the demand for medical service is rapidly increasing. However, medical accident and medical dispute also are rapidly increasing due to various factors such as, increasing sense of people's right, lack of understanding in the nature of medical practice, over expectation on medical technique, commercialize medical supply system, moral degeneracy and unawareness of medical jurisprudence by doctors, widespread trend of mutual distrust, and lack of systematized device for solution of medical dispute. This study analysed 30 cases of civil suit in the year between 1994 to 2004, which were selected among the medical dispute cases in dental field with the judgement collected from organizations related to dentistry and department of oral medicine, Yonsei university dental hospital. The following results were drawn from the analyses: 1. The distribution of year showed rapid increase of medical dispute after the year 2000. 2. In the types of medical dispute, suit associated with tooth extraction took 36.7% of all. 3. As for the cause of medical dispute, uncomfortable feeling and dissatisfaction with the treatment showed 36.7%, death and permanent damage showed 16.7% each. 4. Winning the suit, compulsory mediation and recommendation for settlement took 60.0% of judgement result for the plaintiff. 5. For the type of medical organization in relation to medical dispute, 60.0% was found to be the private dental clinics, and 30.0% was university dental hospitals. 6. For the level of trial, dispute that progressed above 2 or 3 trials was of 30.0%. 7. For the amount of claim for damage, the claim amounting between 50 million to 100 million won was of 36.7%, and that of more than 100 million won was 13.3%, and in case of the judgement amount, the amount ranging from 10 million to 30 million won was of 40.0%, and that of more than 100 million won was of 6.7%. 8. For the number of dentist involved in the suit, 26.7% was of 2 or more dentists. 9. For the amount of time spent until the judgement, 46.7% took 11 to 20 months, and 36.7% took 21 to 30 months. 10. For medical malpractice, 46.7% was judged to be guilty, and 70% of the cases had undergone medical judgement or verification of the case by specialists during the process of the suit. 11. In the lost cases of doctors(18 cases), 72.2% was due to violence of carefulness in practice and 16.7% was due to missing of explanation to patient. Medical disputes occurring in the field of dentistry are usually of relatively less risky cases. Hence, the importance of explanation to patient is emphasized, and since the levels of patient satisfaction are subjective, improvement of the relationship between the patient and the dentist and recovery of autonomy within the group dentist are essential in addition to the reduction of technical malpractice. Moreover, management measure against the medical dispute should be set up through complement of the current doctors and hospitals medical malpractice insurance which is being conducted irrationally, and establishment of system in which education as well as consultation for medical disputes lead by the group of dental clinicians and academic scholars are accessible.

Clinical Study of Pulmonary Tuberculosis for Admitted Patients at National Masan Tuberculosis Hospital (국립마산결핵병원에 입원한 환자에 대한 폐결핵의 임상적 동태에 관한 연구)

  • Park, Seung-Kyu;Choi, In-Hwan;Kim, Chul-Min;Kim, Cheon-Tae;Song, Sun-Dae
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.241-250
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    • 1997
  • Objective : Although the prevalence of pulmonary tuberculosis has decreased progressively after the national control program for tuberculosis began, nowadays the number of MDRTB is increasing seriously. MDRTB tends to be poor responsive to current antituberculosis regimens. It is mainly due to poor compliance, high rate of side reaction of secondary drugs, and limitation in number of available drugs. The purpose of present study is to evaluate the clinical features of pulmonary tuberculosis patients admitted in one national tuberculosis hospital and to expose the problems pertaining to current remedies, to increase the treatment efficacy for pulmonary tuberculosis including MDRTB in the end. Method : Retrospective analysis of 336 pulmonary tuberculosis patients admitted in National Masan Tuberculosis Hospital was done. Contents of analysis were patients profile, the first diagnosed time and medical institutes, family history, residence, previous treatment history, chief complaints at the time of admission, lesion site on chest X -ray film, combined deseases, side reaction to antibuberculosis drugs, used drugs before admission and the results of drug sensitivity test. Results : The ratio between male and female was 4 : 1. Age showed relatively even distribution from 3rd to 6 th decades. 64.6% of the patients was diagnosed at public health center. Weight loss was the most common complaint at admission. Bilateral lesions on chest X-ray films were 59.8%. 130patients had combined desease, of which DM was the most common(37.7%). 95patients had family history, of which parents were the most common(41.7%). According to the time of first diagnosis, 31 patients were diagnosed before 1980, and after then the number of patients was increased by degrees. Residence overwhelmed in pusan and gyung-nam province. 258 patients got previous treatment history, of which 112 patients(43.4%) had more than 3 times and only 133 patients(51.6%)got regular medication. 97 patients used more than other 3 drugs in addition to INH, EMB, RFP and PZA before admission. 154 patients were informed with the results of drug sensitivity test. of which 77 patients had resistance to more than 5 drugs. Gastrointestinal problem was the most common in side reaction to drugs. Conclusion : In the case of weight loss of unknown cause, tuberculosis should be suspected. In first treatment, sufficient and satisfactory explanation for tuberculosis is necessary and treatment period should not be stict to 6 month-short term therapy. In retreatment, new drugs should not be added to used drugs even though drug sensitivity results show sensitivity to some of them. Proper time for surgical intervention should not be delayed.

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Survey of Current Status of the Patients with Home Ventilator in Seoul and Kyunggi Province (가정용 인공호흡기를 사용하는 서울 및 경기 지역 환자의 실태)

  • Ahn, Jong-Joon;Lee, Ki-Man;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.624-632
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    • 2000
  • Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

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The Bronchial Biopsies and Steroid Response in Unexplained Chronic Non-Productive Cough (원인을 알 수 없는 만성 기침의 기관지 생검소견과 경구 스테로이드의 효과)

  • Lee, Sang-Yeub;Jeong, Hye-Cheol;Kim, Kyung-Kyu;Kim, Je-Hyeong;Kwan, Young-Hwan;Lee, Sung-Yong;Lee, So-Ra;Cho, Hyun-Deuk;Lee, Sin-Hyung;Shim, Jae-Jeong;Cho, Jae-Yun;Kim, Han-Gyum;Kang, Kyung-Ho;Yoo, Se-Hwa;In, Kwang-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.3
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    • pp.372-385
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    • 1999
  • Background: The purpose of this study was to examine the causes and pathologic process of chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph by investigating clinicopathologic findings. Method: We studied 25 adults with chronic non-productive cough over a 3-week period with a normal chest radiograph and pulmonary function tests without any other symptoms. Clinical assessment, cough score, chest and sinus radiograph, pulmonary function tests, methacholine challenge, allergic skin prick test, and bronchoscopy for bronchial biopsies were performed. Subjects were then treated with prednesolone 20 to 30 mg/day for 1 to 2 weeks. Results: The experimental group was divided into two subgroups-those infiltrated with eosinophils, and those infiltrated with lymphocytes depending on eosinophil and lymphocyte counts, both of which were respectively higher than those of the control group. Eosinophils infiltrated group had mean numbers of eosinophil of 89.8 $cells/mm^3$ while control group's mean was 0.4 $cells/mm^2$(p=0.005). Lymphocyte infiltrated group was 4 patients whose mean was 84.3 $cells/mm^2$ with 28.4 $cells/mm^2$ of control group(P=0.026). In addition, the mean thickness of the basement membrane of experimental group was $14.20{\pm}5.20{\mu}m$ in contrast of control group whose mean was $3.50{\pm}1.37{\mu}m$(P=0.001). With the methacholine challenge test, 7 of the 21 eosinophil infiltrated subjects were diagnosed with cough variant asthma ; the other 14 with eosinophilic bronchitis. Three subjects with eosinophilic bronchitis were atopic positive (21.4%) with the skin prick test In the lymphocyte dominant group, all four subjects were diagnosed with lymphocytic bronchitis. Cough score was improved after steroid treatment in 22 of 25 subjects in the experimental group (88.0%). Conclusion: These results suggest chronic non-productive cough as an isolated symptom with a normal spirometry and chest radiograph was associated with airway inflammation by eosinophil and lymphocyte infiltration. The causes for chronic non-productive cough were eosinophilic bronchitis, cough variant asthma, and lymphocytic bronchitis(written in frequency). They further suggest that therapeutic treatment with steroids can provide effective symptomatic relief.

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The Effect of Glucocorticoid on the Change of Nitric Oxide and Cytokine Levels in Induced Sputum from Patients with Bronchial Asthma (기관지 천식 환자에서 부신피질 스테로이드 투여 전후 유도객담내 Nitric Oxide 및 Cytokine의 변화)

  • Kim, Tae-Yon;Yoon, Hyeong-Kyu;Choi, Young-Mee;Lee, Sook-Young;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Park, Sung-Hak;Song, Jeong-Sup
    • Tuberculosis and Respiratory Diseases
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    • v.48 no.6
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    • pp.922-931
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    • 2000
  • Background : It has been well known that bronchia1 asthma is a chronic airway inflammatory disorder. Recently, sputum induced with hypertonic saline was introduced as a simple and useful nonivasive medium to investigate airway inflammation and symptom severity in patients with asthma. We examined the eosinophil, eosinophil cationic protein (ECP), interleukin(IL)-3, IL-5, granulocyte-macrophage colony-stimulating facta (GM-CSF), and nitric oxide (NO) derivatives in induced sputum from patients with bronchia1 asthma in order to determine the role of NO and various inflammatory cytokines as a useful markers of airway inflammation or changes in pulmonary function tests and symptoms. Methods : A total 30 patients with bronchia1 asthma received oral prednisolone 30 mg daily for 2 weeks. Forced expiratory volume in one second ($FEV_1$), total blood eosinophil count and induced sputum eosinophil count, ECP, IL-3, IL-5, GM-CSF, and NO derivatives were determined before and after the administration of prednisolone. Results : Of the 30 patients, 13 (43.3%) were male and 17 (56.7%) were female. The mean age of patients was 41.8 years (range 19-64 years). Two patients could not produce sputum at the second study and 3 could not be followed up after their first visit. Two weeks after the prednisolone administration, there was a significant increase in $FEV_1$ (% of predicted value) from 78.1$\pm$20.6 % to 90.3$\pm$ 18.3 % (P<0.001). The eosinophil percentages in induced sputum were significantly decreased after treatment with prednisolone, with values of 56.1$\pm$27.2 % versus 29.6$\pm$21.3 % (P<0.001), and ECP were $134.5\pm68.1\;{\mu}g/L$ versus $41.5\pm42.4\;{\mu}g/L$ (P<0.001) respectively. After the prednisolone treatments, the eotaxin concentration also showed a decreasing tendency from 26.7$\pm$12.8 pg/ml to 21.7$\pm$8.7 pg/ml. There was a decreasing tendency but no significant differences in total blood eosinophil count (425.7$\pm$265.9 vs 287.7$\pm$294.7) and in the concentration of NO derivatives ($70.4\pm44.6{\mu}mol/L$ vs $91.5\pm48.3\;{\mu}mol/L$) after the prednisolone treatments. IL-3, IL-5, GM-CSF were undetectable in the sputum of most subjects either before the prednisolone treatments or after the treatments. Before the prednisolone treatments, a significant inverse correlation was observed between FEV1 and sputum ECP (r=-D.364, P<0.05) and there was a significant correlation between sputum eosinophils and eotaxin (r=0.369, P<0.05) Conclusion : The eotaxin and ECP concentration in induced sputum may be used as markers of airway inflammation after treatments in bronchia1 asthma. In addition, the measurement of sputum eosinophil percent ages is believed to be a simple method displaying the degree of airway inflammation and airway obstruction before and after the prednisolone treatment in bronchia1 asthma. However, unlike exhaled NO, the examination of NO derivatives with Griess reaction in induced sputum is considered an ineffective marker of changing airway inflammation and obstructing symptoms.

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Effect of Additional 1 hour T-piece Trial on Weaning Outcome to the Patients at Minimum Pressure Support (최소압력보조 수준에서 추가적 1시간 T-piece 시도가 이탈에 미치는 영향)

  • Hong, Sang-Bum;Koh, Youn-Suck;Lim, Chae-Man;Ann, Jong-Jun;Park, Wann;Shim, Tae-Son;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.4
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    • pp.813-822
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    • 1998
  • Background: Extubation is recommended to be performed at minimum pressure support (PSmin) during the pressure support ventilation (PSV). In field, physicians sometimes perform additional 1 hr T-piece trial to the patient at PSmin to reduce re-intubation risk. Although it provides confirmation of patient's breathing reserve, weaning could be delayed due to increased airway resistance by endotracheal tube. Methods: To investigate the effect of additional 1 hr T-piece trial on weaning outcome, a prospective study was done in consecutive 44 patients who had received mechanical ventilation more than 3 days. Respiratory mechanics, hemodymic, and gas exchange measurements were done and the level of PSmin was calculated using the equation (PSmin=peak inspiratory flow rate $\times$ total ventilatory system resistance) at the 15cm $H_2O$ of pressure support. At PSmin, the patients were randomized into intervention (additional 1 hr T-piece trial) and control (extubation at PSmin). The measurements were repeated at PSmm, during weaning process (in cases of intervention), and after extubation. The weaning success was defined as spontaneous breathing more than 48hr after extubation. In intervention group, failure to continue weaning process was also considered as weaning failure. Results: Thirty-six patients with 42 times weaning trial were satisfied to the protocol. Mean PSmin level was 7.6 (${\pm}1.9$)cm $H_2O$. There were no differences in total ventilation times (TVT), APACHE III score, nutritional indices, and respiratory mechanics at PSmin between 2 groups. The weaning success rate and re-intubation rate were not different between intervention group (55% and 18% in each) and control group (70% and 20% in each) at first weaning trial. Work of breathing, pressure time product, and tidal volume were aggravated during 1 hr T-piece trial compared to those of PSmin in intervention group ($10.4{\pm}1.25$ and $1.66{\pm}1.08$ J/L in work of breathing) ($191{\pm}232$ and $287{\pm}217$cm $H_2O$ s/m in pressure time product) ($0.33{\pm}0.09$ and $0.29{\pm}0.09$ L in tidal volume) (P<0.05 in each). As in whole, TVT, and tidal volume at PSmin were significantly different between the patients with weaning success ($246{\pm}195$ hr, $0.43{\pm}0.11$ L) and the those with weaning failure ($407{\pm}248$ hr, $0.35{\pm}0.10$L) (P<0.05 in each). Conclusion : There were no advantage to weaning outcome by addition of 1 hr T-piece trial compared to prompt extubation to the patient at PS min.

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Retail Product Development and Brand Management Collaboration between Industry and University Student Teams (산업여대학학생단대지간적령수산품개발화품패관리협작(产业与大学学生团队之间的零售产品开发和品牌管理协作))

  • Carroll, Katherine Emma
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.239-248
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    • 2010
  • This paper describes a collaborative project between academia and industry which focused on improving the marketing and product development strategies for two private label apparel brands of a large regional department store chain in the southeastern United States. The goal of the project was to revitalize product lines of the two brands by incorporating student ideas for new solutions, thereby giving the students practical experience with a real-life industry situation. There were a number of key players involved in the project. A privately-owned department store chain based in the southeastern United States which was seeking an academic partner had recognized a need to update two existing private label brands. They targeted middle-aged consumers looking for casual, moderately priced merchandise. The company was seeking to change direction with both packaging and presentation, and possibly product design. The branding and product development divisions of the company contacted professors in an academic department of a large southeastern state university. Two of the professors agreed that the task would be a good fit for their classes - one was a junior-level Intermediate Brand Management class; the other was a senior-level Fashion Product Development class. The professors felt that by working collaboratively on the project, students would be exposed to a real world scenario, within the security of an academic learning environment. Collaboration within an interdisciplinary team has the advantage of providing experiences and resources beyond the capabilities of a single student and adds "brainpower" to problem-solving processes (Lowman 2000). This goal of improving the capabilities of students directed the instructors in each class to form interdisciplinary teams between the Branding and Product Development classes. In addition, many universities are employing industry partnerships in research and teaching, where collaboration within temporal (semester) and physical (classroom/lab) constraints help to increase students' knowledge and experience of a real-world situation. At the University of Tennessee, the Center of Industrial Services and UT-Knoxville's College of Engineering worked with a company to develop design improvements in its U.S. operations. In this study, Because should be lower case b with a private label retail brand, Wickett, Gaskill and Damhorst's (1999) revised Retail Apparel Product Development Model was used by the product development and brand management teams. This framework was chosen because it addresses apparel product development from the concept to the retail stage. Two classes were involved in this project: a junior level Brand Management class and a senior level Fashion Product Development class. Seven teams were formed which included four students from Brand Management and two students from Product Development. The classes were taught the same semester, but not at the same time. At the beginning of the semester, each class was introduced to the industry partner and given the problem. Half the teams were assigned to the men's brand and half to the women's brand. The teams were responsible for devising approaches to the problem, formulating a timeline for their work, staying in touch with industry representatives and making sure that each member of the team contributed in a positive way. The objective for the teams was to plan, develop, and present a product line using merchandising processes (following the Wickett, Gaskill and Damhorst model) and develop new branding strategies for the proposed lines. The teams performed trend, color, fabrication and target market research; developed sketches for a line; edited the sketches and presented their line plans; wrote specifications; fitted prototypes on fit models, and developed final production samples for presentation to industry. The branding students developed a SWOT analysis, a Brand Measurement report, a mind-map for the brands and a fully integrated Marketing Report which was presented alongside the ideas for the new lines. In future if the opportunity arises to work in this collaborative way with an existing company who wishes to look both at branding and product development strategies, classes will be scheduled at the same time so that students have more time to meet and discuss timelines and assigned tasks. As it was, student groups had to meet outside of each class time and this proved to be a challenging though not uncommon part of teamwork (Pfaff and Huddleston, 2003). Although the logistics of this exercise were time-consuming to set up and administer, professors felt that the benefits to students were multiple. The most important benefit, according to student feedback from both classes, was the opportunity to work with industry professionals, follow their process, and see the results of their work evaluated by the people who made the decisions at the company level. Faculty members were grateful to have a "real-world" case to work with in the classroom to provide focus. Creative ideas and strategies were traded as plans were made, extending and strengthening the departmental links be tween the branding and product development areas. By working not only with students coming from a different knowledge base, but also having to keep in contact with the industry partner and follow the framework and timeline of industry practice, student teams were challenged to produce excellent and innovative work under new circumstances. Working on the product development and branding for "real-life" brands that are struggling gave students an opportunity to see how closely their coursework ties in with the real-world and how creativity, collaboration and flexibility are necessary components of both the design and business aspects of company operations. Industry personnel were impressed by (a) the level and depth of knowledge and execution in the student projects, and (b) the creativity of new ideas for the brands.

Service Quality, Customer Satisfaction and Customer Loyalty of Mobile Communication Industry in China (중국이동통신산업중적복무질량(中国移动通信产业中的服务质量), 고객만의도화고객충성도(顾客满意度和顾客忠诚度))

  • Zhang, Ruijin;Li, Xiangyang;Zhang, Yunchang
    • Journal of Global Scholars of Marketing Science
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    • v.20 no.3
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    • pp.269-277
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    • 2010
  • Previous studies have shown that the most important factor affecting customer loyalty in the service industry is service quality. However, on the subject of whether service quality has a direct or indirect effect on customer loyalty, scholars' views apparently vary. Some studies suggest that service quality has a direct and fundamental influence on customer loyalty (Bai and Liu, 2002). However, others have shown that service quality not only directly affects customer loyalty, it also has an indirect impact on customer loyalty by influencing customer satisfaction and perceived value (Cronin, Brady, and Hult, 2000). Currently, there are few domestic articles that specifically address the relationship between service quality and customer loyalty in the mobile communication industry. Moreover, research has studied customer loyalty as a whole variable, rather than breaking it down further into multiple dimensions. Based on this analysis, this paper summarizes previous study results, establishes an effect mechanism model among service quality, customer satisfaction, and customer loyalty in the mobile communication industry, and presents a statistical test on model assumptions by using customer investigation data from Heilongjiang Mobile Company. It provides theoretical guidance for mobile service management based on the discussion of the hypothesis test results. For data collection, the sample comprised mobile users in Harbin city, and the survey was taken by random sampling. Out of a total of 300 questionnaires, 276 (92.9%) were recovered. After excluding invalid questionnaires, 249 remained, for an effective rate of 82.6 percent for the study. Cronbach's ${\alpha}$ coefficient was adapted to assess the scale reliability, and validity testing was conducted on the questionnaire from three aspects: content validity, construct validity. and convergent validity. The study tested for goodness of fit mainly from the absolute and relative fit indexes. From the hypothesis testing results, overall, four assumptions have not been supported. The ultimate affective relationship of service quality, customer satisfaction, and customer loyalty is demonstrated in Figure 2. On the whole, the service quality of the communication industry not only has a direct positive significant effect on customer loyalty, it also has an indirect positive significant effect on customer loyalty through service quality; the affective mechanism and extent of customer loyalty are different, and are influenced by each dimension of service quality. This study used the questionnaires of existing literature from home and abroad and tested them in empirical research, with all questions adapted to seven-point Likert scales. With the SERVQUAL scale of Parasuraman, Zeithaml, and Berry (1988), or PZB, as a reference point, service quality was divided into five dimensions-tangibility, reliability, responsiveness, assurance, and empathy-and the questions were simplified down to nineteen. The measurement of customer satisfaction was based mainly on Fornell (1992) and Wang and Han (2003), ending up with four questions. Based on the study’s three indicators of price tolerance, first choice, and complaint reaction were used to measure attitudinal loyalty, while repurchase intention, recommendation, and reputation measured behavioral loyalty. The collection and collation of literature data produced a model of the relationship among service quality, customer satisfaction, and customer loyalty in mobile communications, and China Mobile in the city of Harbin in Heilongjiang province was used for conducting an empirical test of the model and obtaining some useful conclusions. First, service quality in mobile communication is formed by the five factors mentioned earlier: tangibility, reliability, responsiveness, assurance, and empathy. On the basis of PZB SERVQUAL, the study designed a measurement scale of service quality for the mobile communications industry, and obtained these five factors through exploratory factor analysis. The factors fit basically with the five elements, indicating the concept of five elements of service quality for the mobile communications industry. Second, service quality in mobile communications has both direct and indirect positive effects on attitudinal loyalty, with the indirect effect being produced through the intermediary variable, customer satisfaction. There are also both direct and indirect positive effects on behavioral loyalty, with the indirect effect produced through two intermediary variables: customer satisfaction and attitudinal loyalty. This shows that better service quality and higher customer satisfaction will activate the attitudinal to service providers more active and show loyalty to service providers much easier. In addition, the effect mechanism of all dimensions of service quality on all dimensions of customer loyalty is different. Third, customer satisfaction plays a significant intermediary role among service quality and attitudinal and behavioral loyalty, indicating that improving service quality can boost customer satisfaction and make it easier for satisfied customers to become loyal customers. Moreover, attitudinal loyalty plays a significant intermediary role between service quality and behavioral loyalty, indicating that only attitudinally and behaviorally loyal customers are truly loyal customers. The research conclusions have some indications for Chinese telecom operators and others to upgrade their service quality. Two limitations to the study are also mentioned. First, all data were collected in the Heilongjiang area, so there might be a common method bias that skews the results. Second, the discussion addresses the relationship between service quality and customer loyalty, setting customer satisfaction as mediator, but does not consider other factors, like customer value and consumer features, This research will be continued in the future.

A Study on Differences of Contents and Tones of Arguments among Newspapers Using Text Mining Analysis (텍스트 마이닝을 활용한 신문사에 따른 내용 및 논조 차이점 분석)

  • Kam, Miah;Song, Min
    • Journal of Intelligence and Information Systems
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    • v.18 no.3
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    • pp.53-77
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    • 2012
  • This study analyses the difference of contents and tones of arguments among three Korean major newspapers, the Kyunghyang Shinmoon, the HanKyoreh, and the Dong-A Ilbo. It is commonly accepted that newspapers in Korea explicitly deliver their own tone of arguments when they talk about some sensitive issues and topics. It could be controversial if readers of newspapers read the news without being aware of the type of tones of arguments because the contents and the tones of arguments can affect readers easily. Thus it is very desirable to have a new tool that can inform the readers of what tone of argument a newspaper has. This study presents the results of clustering and classification techniques as part of text mining analysis. We focus on six main subjects such as Culture, Politics, International, Editorial-opinion, Eco-business and National issues in newspapers, and attempt to identify differences and similarities among the newspapers. The basic unit of text mining analysis is a paragraph of news articles. This study uses a keyword-network analysis tool and visualizes relationships among keywords to make it easier to see the differences. Newspaper articles were gathered from KINDS, the Korean integrated news database system. KINDS preserves news articles of the Kyunghyang Shinmun, the HanKyoreh and the Dong-A Ilbo and these are open to the public. This study used these three Korean major newspapers from KINDS. About 3,030 articles from 2008 to 2012 were used. International, national issues and politics sections were gathered with some specific issues. The International section was collected with the keyword of 'Nuclear weapon of North Korea.' The National issues section was collected with the keyword of '4-major-river.' The Politics section was collected with the keyword of 'Tonghap-Jinbo Dang.' All of the articles from April 2012 to May 2012 of Eco-business, Culture and Editorial-opinion sections were also collected. All of the collected data were handled and edited into paragraphs. We got rid of stop-words using the Lucene Korean Module. We calculated keyword co-occurrence counts from the paired co-occurrence list of keywords in a paragraph. We made a co-occurrence matrix from the list. Once the co-occurrence matrix was built, we used the Cosine coefficient matrix as input for PFNet(Pathfinder Network). In order to analyze these three newspapers and find out the significant keywords in each paper, we analyzed the list of 10 highest frequency keywords and keyword-networks of 20 highest ranking frequency keywords to closely examine the relationships and show the detailed network map among keywords. We used NodeXL software to visualize the PFNet. After drawing all the networks, we compared the results with the classification results. Classification was firstly handled to identify how the tone of argument of a newspaper is different from others. Then, to analyze tones of arguments, all the paragraphs were divided into two types of tones, Positive tone and Negative tone. To identify and classify all of the tones of paragraphs and articles we had collected, supervised learning technique was used. The Na$\ddot{i}$ve Bayesian classifier algorithm provided in the MALLET package was used to classify all the paragraphs in articles. After classification, Precision, Recall and F-value were used to evaluate the results of classification. Based on the results of this study, three subjects such as Culture, Eco-business and Politics showed some differences in contents and tones of arguments among these three newspapers. In addition, for the National issues, tones of arguments on 4-major-rivers project were different from each other. It seems three newspapers have their own specific tone of argument in those sections. And keyword-networks showed different shapes with each other in the same period in the same section. It means that frequently appeared keywords in articles are different and their contents are comprised with different keywords. And the Positive-Negative classification showed the possibility of classifying newspapers' tones of arguments compared to others. These results indicate that the approach in this study is promising to be extended as a new tool to identify the different tones of arguments of newspapers.