The purpose of this study was a quantitative analysis for the influence of physician's assistants on national health insurance revenue and number of patients in clinic. The data was derived from the Korean national health insurance. That was complete enumeration. Dependent variables were measured by national health insurance revenue and number of patients. Independent variables were reported physician's assistants that the number of nurse, nurse-aid, technologist of clinical laboratory, physical therapist and radiologist in clinic. Confounding variables were classified by demand(region, number of inhabitants, number of clinics, number of bed per a hundred thousand persons) and supply(sex and age of representative, number of bed, subjective of medical treatment). On the multiple regression analyses, the physician's assistants that nurse, nurse-aid, technologist of clinical laboratory and physical therapist were statistically significant for outputs. But radiologist was statistically significant only for number of patient.
Objectives : This study aims to analyze the tasks, recognition and obstacles in operation of school dental clinics and to examine opinions on installation, operation and prerequisites for toothbrushing facilities. Methods : It conducted a survey t o the persons in charge at 378 school dental clinics in Korea and total 127 sheets, excluding incompletely answered data, were used for analysis by using SPSS 18.0. Results : Two regular dental hygienists visit school dental clinics 2-3 times per week and work 4-6 hours per week on average. Their tasks include oral health education, toothbrushing instruction, oral examination, sending school newsletters, and dental sealants. The obstacles of operation include excessive workload other than the work for the school dental clinic, lack of dentists, and lack of cooperation of principals and teachers in school. The persons in charge think that the chief task of the school dental clinic is the continuous oral health management, and it effectively affects students' oral health improvement. Most of them were for the installation of toothbrushing facilities. They said that it will be effective in students having an adequate toothbrushing habit and their toothbrushing rate increasing higher. They thought that if the school dental clinic is changed to toothbrushing facilities, it will improve students' oral health management. The prerequisites for toothbrushing facilities are the support of manpower in charge, principal's support, and development of operational programs. Conclusions : The most effective function of school dental clinics is constant oral health management. However, when public health doctors are reduced and dental sealants get included in health insurance, the budget of local government will decrease and then it will eventually reduce the work of school dental clinics. Therefore, it is needed to enhance support for school dental clinics or install a toothbrushing facilities rather than a school dental clinic.
As of 1 July 2000 a big reform was introduced into the Korean health care system: the separation between prescribing and dispensing of drugs (SPD reform). There was, however, a big financial stake associated with pharmaceuticals, particularly before the reform, because physicians as well as pharmacists were allowed to purchase drugs at much lower costs than the insurance reimbursement. In this respect, this study focuses on the change in income and profit of both doctor's clinics and pharmacies after the reform. Data from National Health and Nutritional Survey by the ministry of health and welfare were used to estimate the income or expenditure that are financed by out-of-pocket payment of the patients, while national health insurance data etc. were used for the estimation of the income or expenditure that is financed by insurers. Average annual income per doctor's clinic increased from 299 million won to 338 million won for the three years between 1998 and 2001, whereas average annual income per pharmacy increased enormously from 60 million won to 305 million won for the same period. Average annual 'profit' increase per each doctor's clinic caused by the reform itself was estimated to range from 50 to 83 million won, while that per each pharmacy, from 23 to 87 million won. In sum, while both doctor's clinics and pharmacies are beneficiaries of the SPD reform, its positive impact is particularly prominent on the latter.
Purpose: The purpose of this study was to examine current status of somatic symptoms of late school-aged children using the school health clinic and to investigate the influence of perceived attachment security and social support on their somatic symptoms. Methods: For this descriptive study, self-report questionnaires were completed by fifth and sixth graders attending 'A' elementary school in Gyeonggi-do. Data from 216 students were included. Data analysis included descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and multiple regression analysis. Results: Most frequent somatic symptoms were headache, fainting, backache, numbness in a body part, and muscle ache in that order. More frequent somatic symptoms were reported by girls, students who recognized their family SES as low, students who used school health clinic often and students who were dissatisfied with school life. Somatic symptom showed negative correlations with attachment stability and perceived social support from family and teachers. In the regression analysis, the variables; low attachment stability, female gender, and low satisfaction with school affected more frequent somatic symptoms. Conclusion: Careful monitoring of late school-aged children expressing frequent somatic symptoms is required. Intervention programs to improve attachment security and satisfaction with school should be developed for school children, especially girls, presenting with somatic symptoms.
The purpose of this study was to explain the performance pattern of health education and related factors in elementary school. The data were collected from school nurses who have been working elementary school. Sample of 77 were analyzed by percent distribution, ${\chi}^2$-test, discriminant analysis. The performance rates of health education was 74%, Only 19% of total carried out health education of 6 hours per week. Important variables that was showed significant association with health education level were as follows: Perception of importance about health education among personal characteristics of school nurses and size of school c1ass, cooperation level of school administrator, operation method of school health clinic, the difficulty of school health clinic among school organization characteristics. The canonical correlation between the health education (yes or no) and important independent variables was 0.52. Among them, operation method of school health clinic. perceiveness of health education, size of school class represented the significant contribution (canonical coefficient: 0.66, 0.54, 0.52) to school health education. These findings suggest that structure and management variables of school organization are more important than personal variables of school nurses related to activation of school health education. Therefore, it is expected that the quantity and quality improvement of school health education be able to accomplish through the systematic support of school organization and government demension.
Purpose: The purpose of this study was to explore the experiences of nursing college students who attended delivery practices at midwifery clinic. Methods: This was a qualitative study using focus groups. Data were collected by group interviews with a total of 12 students who observed natural childbirth at midwifery clinic. Data were analyzed through Colaizzi's method in which meaningful statements were extracted. Results: The meanings of experiences were identified five theme clusters from thirteen themes and thirty-one sub-themes. The five theme clusters were 'ultimate process of natural childbirth', 'allowed birth', 'role recognition of the midwife', 'positively changed perception', and 'barriers'. Conclusion: This study showed that observation of delivery at midwifery clinic was helpful for nursing students in terms of positive impression about natural childbirth with maternal and baby being centered. Nursing students expressed value and concern about delivery at midwifery clinic. Further in-depth study of natural childbirth in terms of husband and family perspective is required. For quality improvement of maternity nursing care, natural childbirth process needs to be included in nursing care at hospitals as well as students' clinical practicum.
The purpose of this study is to identify the status of school health and analyze affecting factors of school nurses' self confidence and nursing activities of the secondary school in Seoul. The data was collected from 13th of August to 30th of October. The self reported questionairs were distributed during one of the school nurses seminars held in Seoul and 93 secondary school nurses answered. Analysis of the data was done utilizing SPSS for percentage, mean, T-test ANOVA and Pearson Correlation Coefficients. The results of study are summerized as follows; 1. General Characteristics The mean age of the subjects was 33.4 and mean length of experience as a school nurse was 7.3 years. 79.5 percent of them had clinical experiences and the mean clinic experience was 2.1 years. The majority of them were graduate of the baccalaureate nursing programs and 82.8 percent of them were married. 72.0 percent of the sample had religion, and 60.2 percent of them were in the national or public schools. 90.3 percent of them had independent duty. 2. The status of school health resources In average, there were 2,445 students, 37 classes and 63 teachers per school nurse. 48.4 percent of them were aware of the school budget. The budget for school health was 585,000 won per school in average. 30.0 percent of the schools had school health organization. The schools whose health clinics were on the first floor consisted of 79.3 percent, among them 42.9 percent were on the center of the building office. 3. Activities of school health nursing The average number of students using health clinic were 430 per month. The majority of the problem was digestive problem. There were 7.5 times of mean correspondences with parents per year. The activities of the school nurses were clinic management (29.0%), health care services (23.5%) and health education (14.1%). 4. The degrees of self confidence of the school nurse and nursing activities Self confidence measured by 6 items of self-reported questionaires scored by 4 point Likert Scale revealed. The nurses' self-confidence was 2.922 in clinic management, 2.909 in health education, 2.759 in program planning and evaluation, 2.757 in health care services, 2.692 in management of school environment, and 2.250 in operation of school health organization. The nursing activities scored by 2 point. The nursing activities was 1,870 in program planning and evaluation, 1.853 in health education, 1.843 in clinic management, 1.739 in health care services, 1.696 in management of school environment and 1.265 in operating of school health organization. 5. Factors affecting self confidence and nursing activities of school nurses The general characteristics of the school nurses and the school health resources were related to self confidence and nursing activities. The most significant variable to nurses' self confidence was type of the school ownership and the presence of school health organization was the most significant factor to nursing activities.
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: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.
Objectives : This study purposed to identify factors related to dental service quality perceived by dental clinic patients, and for this purpose. Methods : The data conducted a questionnaire survey of 362 patients who had visited a dental clinic in Daejeon twice or more in August 2010 and aged over 20 during the period from the 1st to 31st of August 2010 and obtained results as follows. Results : The patients' general characteristics, perceived dental service quality was higher in older ones, married ones, high school or lower school graduates, civil servants, self-employed ones, and housewives, and the differences were statistically significant. according to the patients' dental clinic use characteristics, perceived dental service quality was higher when the stay in dental clinic was short, and the difference was statistically significant. Conclusions : Perceived dental service quality was related to the patients' general characteristics and dental clinic use characteristics. therefore, dentists and dental hygienists should make efforts to be more patient-oriented and to create pleasant dental care environment.
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