• Safety and Health at Work
• /
• 제11권1호
• /
• pp.10-18
• /
• 2020

Background: The elevated risk of occupational infection such as tuberculosis among health workers in many countries raises the question of whether the quality of occupational health and safety (OHS) and infection prevention and control (IPC) can be improved by auditing. The objectives of this study were to measure (1) audited compliance of primary health-care facilities in South Africa with national standards for OHS and IPC, (2) change in compliance at reaudit three years after baseline, and (3) the inter-rater reliability of the audit. Methods: The study analyzed audits of 60 primary health-care facilities in the Western Cape Province of South Africa. Baseline external audits in the time period 2011-2012 were compared with follow-up internal audits in 2014-2015. Audits at 25 facilities that had both internal and external audits conducted in 2014/2015 were used to measure reliability. Results: At baseline, 25% of 60 facilities were "noncompliant" (audit score<50%), 48% "conditionally compliant" (score >50 < 80%), and only 27% "compliant" (score >80%). Overall, there was no significant improvement in compliance three years after baseline. Percentage agreement on specific items between internal and external audits ranged from 28% to 92% and kappa from -0.8 to 0.41 (poor to moderate). Conclusion: Low baseline compliance with OHS-IPC measures and lack of improvement over three years reflect the difficulties of quality improvement in these domains. Low inter-rater reliability of the audit instrument undermines the audit process. Evidence-based investment of effort is required if repeat auditing is to contribute to occupational risk reduction for health workers.

• 한국보육지원학회지
• /
• 제9권3호
• /
• pp.147-169
• /
• 2013

본 연구의 목적은 어린이집 원장의 의사결정에 영향을 주는 것은 무엇인지 알아보고자 하는 것이다. 연구 참여자는 서울시와 경기도에 위치한 어린이집 원장 7명을 대상으로 하였으며, 개별적인 심층면접을 사용하여 어린이집 원장의 의사결정 기준에 관해 알아보았다. 연구결과는 어린이집 원장들의 의사결정에 영향을 주는 것은 원장 외부와 내부에서 찾아볼 수 있었다. 외부에서 찾아보면, 법적기준 준수, 부모요구 수용, 교사와 협력, 외부의 조언 수용, 현실적 여건 수용으로 나타났다. 내부에서 찾아보면, 원장의 운영철학, 원장 개인의 신앙, 원장의 개인적 경험으로 나타났다. 본 연구는 어린이집 원장이 우수한 보육환경을 제공할 수 있도록 도와주기 위한 정책의 수립과 교육자료 개발을 위한 기초자료를 제공하는데 그 의미가 있다.

• Journal of Preventive Medicine and Public Health
• /
• 제35권3호
• /
• pp.236-244
• /
• 2002

Objective : To empirically investigate the relationship of internal and external customer satisfactions, service quality, and customer loyalty in medical services. Methods : This essay proposes an integrated model to explain the causality of internal and external customer satisfactions, service quality, and customer loyalty. To this end, a structural model was developed, consisting of the following factors: internal and external customer satisfactions, service quality, and customer loyalty. The study included 214 sets of data, with 107 sets being collected for both out-patients and in-patients. The data were analyzed using AMOS 4.0. Results : We found the greater the internal customer satisfaction, the greater the out-patient quality of service quality. Secondly, the greater the service quality, the greater the external customer satisfaction of both in- and out-patients. The service quality of doctors, compared to that of the nurses, had a greater effect on external customer satisfaction. Thirdly, the service quality of doctors and nurses affected both internal and external customer satisfactions, which ultimately affected the customer loyalty. Finally the greater the external customer satisfaction, the greater the customer loyalty. Conclusion : This Study confirms the positive relationship among the internal and external customer satisfactions, service quality, and customer loyalty, which proves the doctors quality of service is the primary factor for external satisfaction, and customer loyalty relating to medical services.

• 가정과삶의질연구
• /
• 제24권1호
• /
• pp.103-116
• /
• 2006

The purpose of the study was to explore what kind of intervention might help foster parents decide to continue engaging in foster care. As foster care services are still in the early stages of development, lacking systematic support systems as well as full understanding of the roles of foster parents and foster care agencies, it is important to recruit, select, and train as many foster parents as possible. Utilizing the Foster Parent Role Perception scale developed by Le Prohn, the author first conceptualized foster parent roles or foster care agency roles; then explored what kind of effects the resource level or the role perception of the foster parents have on the decisions to continue doing foster care. The results showed that the foster parents perceived 'supporting the internal system of the foster child' and 'supporting the external system of the foster child' as the roles of foster parents, whereas 'fortifying the foster care system' and 'maintaining liaison with birth parents' were the roles of foster care agencies. It was also found that foster parents' strong role perception, higher levels of satisfaction towards education on the part of foster parents, and the number of children from the previous marriage had statistically significant positive effects on the decisions to continue foster care. The author argues that clear definitions of roles are needed for both foster parents and foster care agencies. Finally, the role of foster care agencies needs to be strengthened and supported.

• 한국산학기술학회논문지
• /
• 제17권12호
• /
• pp.128-137
• /
• 2016

본 연구는 신생아 중환자실에 입원한 미숙아를 대상으로 캥거루식 접촉이 미숙아의 신체발달, 외부환경 적응, 어머니의 역할수행 자신감에 미치는 효과를 파악하기 위해 시도되었다. 연구대상은 B광역시에 소재한 1개 종합병원에서 제왕절개분만을 한 미숙아와 미숙아 어머니로서 캥거루식 접촉을 시행 한 실험군 19명과 캥거루식 접촉을 하지 않은 대조군 19명이다. 자료수집기간은 2013년 6월 1일부터 2015년 6월 30일까지이며, 실험군에게 캥거루식 접촉을 하루 3회(1회 60분), 총 10회를 실시하였다. 미숙아의 신체발달(체중, 신장, 머리둘레)과 외부환경 적응(체온, 심박동수, 산소포화도)을 캥거루식 접촉 전에 측정하였고, 중재를 제공한 후 다시 측정하였다. 어머니 역할수행 자신감은 자가보고식 설문지로 측정하였다. 연구결과 캥거루식 접촉을 시행한 실험군과 접촉을 시행하지 않은 대조군 간의 차이에서 미숙아의 신체발달은 통계적으로 유의한 차이가 없었으며(체중 t=-0.83, p=.21 신장 t=-0.34, p=.37, 머리둘레 t=1.29, p=.10), 외부환경 적응에서 산소포화도가 유의한 차이가 있었다(t=2.27, p=.02). 미숙아 어머니의 역할수행 자신감은 유의한 차이가 없었다(t=-0.41, p=.34). 결론적으로 캥거루식 접촉은 미숙아의 외부환경 적응에 효과가 있는 것으로 나타났다.

• 한국의류산업학회지
• /
• 제11권5호
• /
• pp.808-817
• /
• 2009

The purpose of this study was to verify potential differences in group- specific external feature concerns and beauty care behaviors of Korean women in their 20's~40's depending on their narcissistic propensity. This study is to take psychological approaches to narcissistic propensity of our contemporary society, so that it can get better understanding about consumers and provide marketing data on beauty-related industry. To meet the above goals, total 400 sheets of questionnaire were distributed to subjects from March 30 to April 8, 2009. Out of 376 sheets of questionnaire collected, total 355 valid questionnaires except incomplete 21 ones were used for final data analysis. For data analysis, this study used SPSS 12.0 as statistic program to perform factor analysis, reliability test (Cronbac's ${\alpha}$ coefficient), cluster analysis, t-test, analysis of variance (ANOVA), Duncan's multiple range test and multiple regression analysis. As a result, this study could come to the following findings: First, according to cluster analysis depending upon different factors such as self-directed narcissism, others-conscious narcissism and others-sensitive narcissism, it was found that our women in 20's to 40's could fall into 4 groups, i.e. complex narcissism group, mixed narcissism group, others-sensitive narcissism group and dispirited narcissism group. Second, according to analysis on potential differences in external feature concerns among four groups depending on their narcissistic propensity, it was found that there were significant differences in all relevant factors among groups. Third, according to analysis on differences in beauty care behaviors among four groups depending upon their narcissistic propensity, it was found that there were significant differences in all relevant factors among groups. Fourth, according to analysis on potential factors of external feature concerns that may influence beauty care behaviors of complex narcissism group, it was found that those factors had significant effects on fashion-orientedness, cosmetic surgery and personality pursuit of this group. And it was also found that there were significant differences in fashion-orientedness, cosmetic surgery, makeup and hair styling of mixed narcissism group, others-sensitive narcissism group and dispirited narcissism group respectively.

• 보건행정학회지
• /
• 제26권2호
• /
• pp.148-152
• /
• 2016

The hospital readmission rate has been widely used as an indicator of the quality of hospital care in many countries. However, the transferrability of this indicator that has been developed in a different health care system can be questioned. We reviewed what should be considered when using the risk-standardized readmission rate (RSRR) as a generic quality indicator in the Korean setting. We addressed the relationship between RSRR and the quality of hospital care, methodological aspects of RSRR, and use of RSRR for external purposes. These issues can influence the validity of the readmission rate as a generic quality indicator. Therefore RSRR should be used with care and further studies are needed to enhance the validity of the readmission rate indicator.

• 보건행정학회지
• /
• 제34권1호
• /
• pp.48-58
• /
• 2024

연구배경: 이 연구는 충청남도 지역 및 환자의 특성과 관외 의료기관 이용과의 연관성을 분석한 연구이다. 충청남도 지역에 거주하는 입원 및 외래 환자들을 통해 도내 진료권을 분석하고, 수도권 및 대전권 의료기관에 대한 관외 의료이용 양상을 파악하여 도내 의료전달체계 개선 및 건강보험 재정 안정 도모를 위한 충청남도 의료정책 사업의 근거적 자료 제공을 목적으로 한다. 방법: 이 연구는 건강보험 코호트 DB 2.0 2016-2019년 자료를 활용하였다. 수집된 원시 자료 중 환자의 거주지가 충청남도 지역이면서, 이용한 요양기관이 상급종합, 종합병원, 병원, 의원인 환자로 한정하였고, 최종적으로 2,570,439건(입원=43,309, 외래=2,527,130)의 자료를 추출하였다. 먼저, 분석대상자의 일반적 특성을 파악하기 위해 각 변수별로 기술통계를 실시하였고, 충청남도 지역 및 환자의 특성과 관외 의료기관 이용과의 연관성을 파악하기 위해 다변량 로지스틱 회귀분석 및 다항 로지스틱 회귀분석을 실시하였다. 또한 관외 의료기관 이용에 따른 입원 및 외래 환자의 진료 1건당 의료비 차이를 파악하기 위해 심사결정 후 건강보험 총요양급여비용을 자연로그값으로 변환하여 분석하였다. 결과: 분석결과, 충청남도 지역 거주 환자들은 충남권, 대전권, 수도권 순으로 의료기관을 많이 이용하였고, 입원 및 외래 환자 모두 천안, 아산 거주 환자들에 비해 모든 권역에서 관외 의료기관을 더 많이 이용하였다. 특히 공주, 부여, 천안(odds ratio [OR], 72.931) 및 계룡, 논산, 금산(OR, 116.817) 거주 입원 환자는 대전권 의료기관 이용과 매우 높은 연관성을 나타냈다. 또한 충청남도 지역 거주 환자들은 충남권 의료기관에 비해 수도권(외래=17.01%, 입원=22.11%)과 대전권(외래=16.63%, 입원=15.41%) 의료기관에서 더 많은 의료비를 지불하였다. 결론: 이 연구는 충청남도 지역 거주 환자들의 관외 의료이용 양상을 분석하고 관련 시사점을 제공하였다. 향후 지역 의료기관과 서비스에 대한 신뢰도 및 만족도와 환자의 주진단과 같은 요인들을 고려한 연구가 추가적으로 진행되어야 하며, 연구결과를 바탕으로 합리적인 의료의 지역화와 의료공급 효율성 및 건강보험 재정 건정성 확보를 위한 정책사업의 기초 자료로 활용되기를 고대한다.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권6호
• /
• pp.2543-2546
• /
• 2015

Purpose: Percutaneous transhepatic biliary drainage (PTBD) is a form of palliative care for patients with malignant obstructive jaundice. We here compared the infection incidence between internal-external and external drainage for patients with malignant obstructive jaundice. Methods: Patients with malignant obstructive jaundice without infection before surgery receiving internal-external or external drainage from January 2008 to July 2014 were recruited. According to percutaneous transhepatic cholangiography (PTC), if the guide wire could pass through the occlusion and enter the duodenum, we recommended internal-external drainage, and external drainage biliary drainage was set up if the occlusion was not crossed. All patients with infection after procedure received a cultivation of blood and a bile bacteriological test. Results: Among 110 patients with malignant obstructive jaundice, 22 (52.4%) were diagnosed with infection after the procedure in the internal-external drainage group, whereas 19 (27.9%) patients were so affected in the external drainage group, the difference being significant (p<0.05). In 8 patients (36.3%) in the internal-external group infection was controlled, as compared to 12 (63.1%) in the external group (p< 0.05). The mortality rate for patients with infection not controlled in internal-external group in one month was 42.8%, while this rate in external group was 28.6% (p< 0.05). Conclusion: External drainage is a good choice, which could significantly reduce the chance of biliary infection caused by bacteria, and decrease the mortality rate at one month and improve the long-term prognosis.

• 한국항행학회논문지
• /
• 제19권6호
• /
• pp.643-647
• /
• 2015

최근 센서와 네트워크 기술을 접목한 유비쿼터스 기술이 부각되고 있으며 이를 USN (ubiquitous sensor network)라 한다. 본 논문에서는 이러한 USN 기술을 기반으로 영유아의 건강과 안전을 관리하기 위해 스마트 센서를 이용한 Baby care 모바일 어플리케이션을 제안하고 개발하였다. 개발한 모바일 어플리케이션은 영유아의 낙상 감지, 울음 감지, 발열 감지 등의 정보를 개발한 모바일 어플리케이션의 화면에 나타내었다. 개발된 모바일 어플리케이션은 모의 실험을 통하여 확인하였다.