Despite of the vibrant nature of the fitness industry, there has not been a sustained effort to understand the dynamics of the industry, particularly with reference to the quality of services offered in that industry. The purpose of this paper is to present a system based process model of quality in health/fitness services. The characteristics of the organization, the service employees and the client are the inputs into the service encounter where the service is produced (i.e., the throughput). The output is the quality of the service. The extent of quality perceived by both the service provider and the client is said to influence the satisfaction of the respective parties, and subsequent motivation to participate in the production of quality in the service. The model also suggests that physical environment as well as other customers and their behaviors influence customer perception of service quality. The quality of service is enhanced through the quality assurance practices of the organization and the feedback from client. Further, the input, throughput, and output in our model reflect (a) quality of the design of the service delivery system, (b) objective quality of the product, and (c) quality as perceived by client. The specific attributes of the design element (i.e., organization, service employee, and the client) are elaborated upon. It is suggested that the organization can assure quality by seeking feedback from clients and service employees, monitoring the service production phases, and managing inter-customer interactions.
Today the u-government services are becoming more personalized and intelligent. For the successful implementation of personalization, individual user's privacy concerns must be respected and taken care of. Based on the empirical survey results, this research summarizes the reluctance to the government's use of private information using six categories. We measure user's psychological distance toward e-government using the four levels, adopting the suggestions by the Proxemics. Since a positive correlation is Identified between people's psychological Intimacy toward e-government and their tolerance to the use of private Information, the amount and/or types of private information should be sequentially used in personalization systems. Initially allowing the least intolerable private information such as occupation information, the personalization system should additionally use the next tolerable Information such as health information or service request/interest information, as user's psychological distance toward government services becomes shorter.
The emergence of the Internet has provided a new outlet for consumers who experience service failure from products and services, augmenting the traditional options of entry, voice and action. Consumers' negative word of mouth through online (word-of-mouse or eWOM) far exceeds traditional word of mouth (WOM) in respect of its potential effectiveness, speed and spread. This paper tries to figure out the service failure themes in the health care industry by analyzing online word-of-mouse using the critical incidents technique (CIT). Complaint themes in the area of healthcare are identified and analyzed. The results identify that major complaint theme differed according to the site type. Also, the findings indicate that delivery and customer services are critical issues when consumer makes negative WOM.
The purpose of this study was to find out the general characteristics of school health teachers, the status of school health resources and the degrees of self-confident performance for the 124 school health teachers in Pusan City. Data was collected by means of questionaires from Aug. 1986 to Mar. 1987. The data were analyzed by use of percentage, mean, standard deviation, t-test, ANOVA and Pearson-correlation coefficient. The results of this study were as follows: 1 . General Characteristics of School Health Teachers (SHT) 1) The average of age of the SHT was 32.8 years old and 39.5% of them were from 30 to 34 years old. 2) The average for school nursing experience of the SHT was 7.9 years and 37.9% of them were from 5 to 9 years. 3) The 45.2% of them have not the clinical experience. 4) The 74.2% of them were graduated from the 3 years college of nursing. 2. Status of school health resources and nursing activities. 1) The average of student number was 2497.3 and class number was 45.2. 2) The average of school health budget was 1039000 won and 27.7% of school health budget expended on examination cost. 3) Only 29.0% of all schools have organization for school health. 4) The 84.7% of all schools have health clinic separately and 69.1% of schools have less than $33m^2$ sized. 5) The average of clinic visitor number was 2111.8 for 1 year. 6) Major problem was on digestive system. And other problems were skin, respiratory, musculo-skeletal system and dental problem. 7) The number of literal message was 14.4 times for 1 year. 3. The degree of the school health teachers' self-confidence. The school health teachers' self-confidence was deviced into 6 and the maximum degree was 4. 1) Program planning & evaluation; 2.8 2) Clinic management; 2.9 3) Health education, 3.0 4) Management of school environment; 2.7 5) Health care services; 2.7 6) Operating of school health organization; 2.4 4. Significances to the degree of self-confidence on school health nursing activities. 1) There was significant difference between clinical management and Religion (t=2.15 p<.05) 2) There was significant difference between Operating of school health organization and level of school (F=3.588 p<.05) 3) Program planning & evaluation: expending time for clinical management (r=-0.184 p<.05) expending time for health care services (r=0.273 p<.01) 4) Clinical management: use of separate health clinic (r=0.151 p<.05) 5) Health education: use of separate health clinic (r=0.170 p<0.5) 6) Health care services: No. of student (r=-0.144 p<0.5) No. of class (r=-0.160 p<.05) 5. The degree of the school health teachers' self-discipline. The school health teachers' self-discipline was devided into 2 and the maximum degree was 2. 1) Program planning & evaluation:1.8 2) Clinic management: 1.9 3) Health education: 1.9 4) Management of school environment: 1.7 5) Health care services: 1.8 6) Operating of school health organization.: 1.3 6. Significances to the degree of self-discipline on school health nursing activities 1) Program planning & evaluation; Level of nursing education (F=4.309 p<.01) 2) Clinical management: Level of nursing education (F=3.587 p<.05) 3) Operating of school health organization: School health organization (t=-2.68 p<.01) 4) Health care services: School health organization (t=2,58 p<.05) 5) School health performance: School health organization (t=2.32 p<.05) 6) Program planning & evaluation: School health experience (r=0.239 p<.01) Expending time for program planning & evaluation (r=-0.172 p<.05) 7) Clinic management: School health experience (r=0.249 p<.01) Expending time for dinic management (r=0.181 p<.05) No. of student (r=-0.158 p<.05) Expending time of program planning & evaluation (r=-0.199 p<0.5) 8) Health education: School health experience (r=0.234 p<0.1) Expending time of program planning & evaluation (r=-0.193 p<.05) 9) Management of school environment: Age of school health teacher (r=0.142 p<.05) School health experience (r=0.255 p<.01) 10) Operating of school health organization: Medicine Purchase (r=-0.163 p<.05) 11) Health care services: School health experience (r=0.148 p<.05) Medicine purchase (r=-0.229 p<.01) 12) Total school health performance: School health experience (r=0.200 p<.05) Medicine purchase(r=-0.168 p<.05) Based on the above results, the suggestions are as follows: 1) As the SHT take charge of the reasonable number of student, the students will have benefit of the good health service in quality. 2) It is recommended to use the health clinic separately and to arrange adequate place for good school health service. 3) It is necessary that the SHT participate budget for school health. 4) It is required to enhance self-confidence on school health nursing activities through continuous educational programs.
Purpose: This study evaluated the effects of a cultural competence training program for public health nurses (PHNs) using intervention mapping. Methods: An embedded mixed method design was used. Forty-one PHNs (experimental: 21, control: 20) and forty marriage migrant women (MMW) (20, in each group) who were provided nursing care by PHN participated in the study. The experimental group was provided with a four-week cultural competence program consisting of an eight hour offline and online course, e-mail newsletters and social networking services (BAND). Transcultural Self-efficacy (TSE) of the PHNs, client-nurse trust, and satisfaction with nursing care of MMW were measured. Ten PHNs in the experimental group were interviewed after the experimental study. Results: The experimental group showed a significantly greater improvement in TSE, client-nurse trust, and satisfaction with nursing care than did the control group. Six themes emerged from qualitative data: (a) Recognizing cultural differences, (b) Being interested in the multicultural policy, (c) Trying to communicate in MMW's own language, (d) Providing medical information using internet and smart phone, (e) Embracing culturally diverse people into society, and (f) Requiring ongoing cultural competence training. Conclusion: Cultural competence training enabled PHNs to provide culturally competent care and contribute to MMW's health outcomes.
This study attempts to examine the performances of Myun Health Workers-the frontline workers in the Korean rural health care delivery system. The time-activity approach was mainly utilized as a measuring tool. This study was undertaken in September 1976 with 35 Myun Health Workers at the Kang Wha County. The pretested time-activity approach sheets were filled out daily for one month by those Myun Health Workers themselves. Statistical means and variances of analysis were utilized for statistical method in comparing some activities and functions converged into time distribution Findings: 1. The workers's average working hours derived in this study is 8 hours and 48 minutes per day, which takes half an hour longer than normal schedule. 2. They spend 56% working hour for direct services, in other words, the main function, 22% for supportive function, and 22% for other activities, the unrelated health services. 3. Considering the total working hours of main function, out-center activity is far more than in-center services with the ratio of 70% to 30% respectively, which proves, therefore, that the main activity of the workers is home visiting. 4. It takes 20 minutes purely for home visiting and takes 14 minutes for transportation. 5. This research also indicates that such factors as characteristics of the health workers and myun influence in shaping the structures of the worker's function and activity: a. The workers whose working site is located in myun office spend 15% among total working hours in carring out official myun activities, which is incidentally unrelated to health services, while the health subcenter have no rooms for administrative jobs for myun office. b. The workers whose office is in health subcenter contribute much time in doing main function and those working in special project distribute more time in performing supportive function. c. The types of workers are another dominant factor to influence the components of worker's functions and activities. MCH workers and MPW I spend much time for manipulating main function. d. MPW II, whose function is reorganized by special project in 2 myuns shows different pattern of time distribution compared to the TB worker orFP worker in the ordinary area. MPW II distributes their time evenly in performing MCH program, T.B. Program, F.P. program and education activity, while the unipurpose workers engage in carring out only their dominant role. e. Another variables which involve the variation of the worker's activity can be illustrated with the variables like target population, size of myun and convenience for transportation, among which the latter two are remarkable factors in determining the time for out-center service.
Purpose: This study aimed to comprehensively analyze the recent revision of the Outcome and Assessment Information Set (OASIS)-D to version E in the United States to identify the most recent trends in home health care and provide suggestions for implementing home health care in Korea. Methods: This study is a comprehensive literature review. We compared all items in OASIS-D and OASIS-E and identified the most significant changes. Additionally, we have discussed the context in depth. Results: The addition of items related to health literacy and medication reconciliation, strengthening assessment in the cognitive and mood domains, and improving items related to pain assessment were identified. These major revisions resulted from a greater emphasis in the healthcare field on social determinants of health. Additionally, the COVID-19 outbreak highlighted the importance of monitoring and managing the symptoms of home care patients in the community. Conclusion: The key items of the OASIS amendment and their background analysis proposed in this study could serve as a cornerstone for the revision of home health care assessment tools or the development of systematic common assessment tools in Korea.
The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.
The purpose of this empirical study is to test hypotheses in order to identify the cost drivers that drive indirect costs in general hospitals in Korea. In various cases' studies, it has been suggested that overhead costs are driven by volume and complexity variables, how they are structurally related and how the cost impacts of these variables can be A unique feature of the research is the treatment of complexity as an endogenous variable. It is hypothesized that level of hospital complexity in terms of the number of services provided(i.e., “breath" complexity) and the intensity of individual estimated in practice. overhead services(ie., “depth" complexity) are simultaneous determined with the level of costs needed to support the complexity. Data used in this study were obtained from the Database of Korean Health Industry Development Institute, Health Insurance Review Agency and analyzed using simultaneous equation model, path model. The results found those volume and complexity variables are all statistically signi-ficance drivers of general hospital overhead costs. This study has documented that the level of service complexity is a significant determinant of hospital overhead costs, caution should be exercised in interpreting this as supportive of the cost accounting procedures associated with ABC. with ABC.
Health care organizations have been faced with financial difficulties under turbulent health care environment. This situation led hospitals to concentrate their efforts to improve their managerial efficiency in various ways. This study aims to evaluate technical efficiency of 31 tertiary hospitals in Korea and find determinants which are closely related with hospital efficiency. Data envelopment analysis(DEA) and Tobit Model were adopted for study. For the analysis, human resource factors such as number of physicians, nurses, and administrative staffs are used as input variables and the number of inpatients and outpatients) are used as output variables. Among 31 hospitals, in CCR model, 8 hositals showed efficiency score 1 which means they have been operated in very efficient ways and BCC model showed 13 of 31 hospitals as efficient organizations. Next, we analyzed determinants which are closely related with hospital efficiency. By using Tobit model, the study showed hospital size, Quality of care, value added per capita, and revenue per patient were closely related with hospital efficiency, However, it appeared that financial status of hospitals(i.e : making profit or not) was not related with hospital efficiency.
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