• Quality Improvement in Health Care
• /
• v.24 no.2
• /
• pp.62-75
• /
• 2018

Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

• Quality Improvement in Health Care
• /
• v.26 no.2
• /
• pp.104-112
• /
• 2020

This study was done to investigate the independent organizations established for patient safety, related policies, and the duties of experts in other countries. Australia established an organization called the Commission in 2006, the United Kingdom established the National Patients Safety Agency in 2001, and the United States assigned its work to the Agency for Healthcare Research and Quality in 2005. This was done by law in all three countries. The experts for patient safety were mainly called the "patent safety and quality coordinator", and although there was no qualification system for carrying out patient safety work, all three countries had licenses in the health care field or required more than 4-5 years of practical experience. The main duties were planning on patient safety and quality of healthcare service, data collection and analysis, and education, etc. and for this, competencies such as communication, leadership, and teamwork were required.

• Korean Journal of Child Care and Education Policy
• /
• v.12 no.3
• /
• pp.31-53
• /
• 2018

The aim of this study was to examine trajectories in and predictors of marital satisfaction among parents with one year old baby. Latent growth modeling was used with a sample of 984 households. Data from Panel Study on Korean Children conducted by Korea Institute of Child Care and Education were used. The study results revealed that for both fathers and mothers, marital satisfaction decreased over time after the birth of the first child. However, fathers' marital satisfaction decreased more steeply than mothers'. Furthermore, mothers' employment was associated with the changes of fathers' marital satisfaction. Father involvement and marital conflict predicted changes of mothers' marital satisfaction. These findings show that factors such as father involvement and marital conflict are more highly associated with changes in mothers' marital satisfaction than fathers'. Also, the study suggests that parent education should be systematically organized to promote father involvement and to resolve marital conflict.

• Journal of Korean Public Health Nursing
• /
• v.35 no.2
• /
• pp.254-267
• /
• 2021

Purpose: This study aimed at identifying the factors affecting the service satisfaction of urban elderly, focusing on the outreach community health service in Seoul, and suggesting policy directions for the successful implementation of community care. Method: Individuals aged 65 and 70 who used the outreach community health service from July 2017 to June 2019 were eligible for the survey. A total of 2,028 people were sampled using a proportional allocation method for each autonomous district in the survey which covered 25 districts. A multi-level logistic regression analysis was conducted, taking into account the individual's socioeconomic level, health status, type of service provided, and the healthcare-related environment and service provision period of the autonomous district. Result: The results revealed that the health status of the urban elderly, the type of services provided (health screening, linkage to community health center and clinic/hospital, medical checkup results counseling, frailty evaluation), and personal experience of the service were the major factors associated with the satisfaction with the outreach health services. Conclusion: The development of customized health services based on the close relationship between visiting nurses and the elderly may be considered to promote a sustainable community health care model.

• Quality Improvement in Health Care
• /
• v.27 no.2
• /
• pp.30-44
• /
• 2021

Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.

• Journal of Digital Convergence
• /
• v.20 no.4
• /
• pp.127-132
• /
• 2022

This study is a descriptive research to understand the leadership, communication ability, peer care behavior and relationship of nursing students. Data were collected from 192 nursing students in November 2021. The data were analyzed by t-test, ANOVA, Pearson's correlation ciefficients, using SPSS 28.0. As a result of the study, revealed positive correlations between leaderships and communication competence(r=.634, p<.001), communication competence and peer group caring interaction(r=.390, p<.001), leaderships and peer group caring interaction(r=.285, p<.001). Therefore, it is necessary to develop educational environment and programs to improve leadership, communication ability, and peer care behavior of nursing college students in the future.

• Korea Journal of Hospital Management
• /
• v.27 no.1
• /
• pp.1-10
• /
• 2022

Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

• Journal of Korean society of Dental Hygiene
• /
• v.21 no.2
• /
• pp.183-191
• /
• 2021

Objectives: The purpose of this study was to identify the factors of satisfaction with regional oral health centers for people with disabilities in Korea. Methods: A survey was conducted with 784 patients who visited regional oral health care centers in Korea. A self-developed questionnaire (29 items) was adapted with a consent form and IRB (Institutional Review Board). All collected data were analyzed for statistics using SPSS version 25.0. Results: The study participants were 452 (57.7%) male patients, 207 (26.4%) aged 20-29 years old, and mostly had physical, developmental, and mental disabilities. The patients were introduced by their acquaintances, and the major reason for visit was specific dental care for the disabled. Most patients used their cars and took half to one hour to commute. The common factor affecting the comprehensive satisfaction was the facility satisfaction. Conclusions: A more comprehensive and standardized questionnaire should be developed for the annual evaluation of all centers. This study presents the basic data that can aid to activate the operation of the four oral health care centers for the disabled, which are scheduled to be implemented in the future, as well as 10 currently operated centers.

• Journal of Digital Convergence
• /
• v.20 no.2
• /
• pp.455-462
• /
• 2022

This study was conducted to find ways to utilize human-centered IT in caring for elderly people who live alone. Through focus group interviews with experts, this study investigated the problems with delivery system, and ethical issues. Problems such as lack of trust, supplier-centered care, and uniform service provision were derived as major problems in the delivery system. These findings indicate that IT should be used as an auxiliary means of face-to-face services and to be controllable and convenient. Issues such as "guaranteeing the right to self-determination," "protecting privacy," "sufficiently guaranteeing the right to know," and "encompassing blind spots" were raised as important ethical issues related to human-centered IT utilization. Based on the research results, this study presented the necessity of designing user-centered information technology and the necessity of developing ethical indicators for the use of human-centered technology.

• International Journal of Computer Science & Network Security
• /
• v.22 no.3
• /
• pp.364-374
• /
• 2022

Health information systems (HIS) are facing security challenges on data privacy and confidentiality. These challenges are based on centralized system architecture creating a target for malicious attacks. Blockchain technology has emerged as a trending technology with the potential to improve data security. Despite the effectiveness of this technology, still HIS are suffering from a lack of data privacy and confidentiality. This paper presents a blockchain-based data storage security architecture integrated with an e-Health care system to improve its security. The study employed a qualitative research method where data were collected using interviews and document analysis. Execute-order-validate Fabric's storage security architecture was implemented through private data collection, which is the combination of the actual private data stored in a private state, and a hash of that private data to guarantee data privacy. The key findings of this research show that data privacy and confidentiality are attained through a private data policy. Network peers are decentralized with blockchain only for hash storage to avoid storage challenges. Cost-effectiveness is achieved through data storage within a database of a Hyperledger Fabric. The overall performance of Fabric is higher than Ethereum. Ethereum's low performance is due to its execute-validate architecture which has high computation power with transaction inconsistencies. E-Health care system administrators should be trained and engaged with blockchain architectural designs for health data storage security. Health policymakers should be aware of blockchain technology and make use of the findings. The scientific contribution of this study is based on; cost-effectiveness of secured data storage, the use of hashes of network data stored in each node, and low energy consumption of Fabric leading to high performance.