• Journal of Korea Multimedia Society
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• v.12 no.11
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• pp.1680-1691
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• 2009

To improve the quality of healthcare and build up the health delivery system, electronic health record system is important for healthcare institutions providing health services. However, the systems currently operated in domestic healthcare institutions use independent software interface with distributed environment for data search and process. Therefore, it raises an additional expense to buy or develop each interface module when there is a link to new system and the problem of complexity. To solve these problems, this study implemented the service oriented architecture basis for home nursing service and carried out an assessment. The study defined the process modeling and business requirements based on the scenario of service and drew 17 suitable services based on five verification items for service design. To draw the final service, seven services were selected by service litmus test (SLT). The study found that, by the improvement of business process for healthcare service support department, SOA based information system has an effect of time reduction of patient processing time. In conclusion, to enable the hospital information system to cope with various demands of healthcare consumers, it is necessary to consider the application of SOA technology which has excellent interoperability, reusability and maintenance.

• 대한예방의학회:학술대회논문집
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• 1996.10a
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• pp.185-186
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• 1996

• Journal of Korean Clinical Health Science
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• v.2 no.3
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• pp.158-166
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• 2014

Purpose. This study pursued the way for the effective application of the differentiated charge (Nursing grading system) by the nursing manpower which is performed for the nursing service quality improvement to the in-patients in Korea and the minimum employment problem solution of nurses. Methods. For this matter, the status of the nursing grade for 1,452 hospitals (44 high class general hospitals, 259 general hospitals, 265 hospitals, 59 oriental medicine hospitals and 825 recuperation hospitals) was identified which were registered in the Health Insurance Review and Assessment Service in March 2011 status quo. Results. In the most nursing grade by the kind of medical institutions, 70.5% of the nurses were third-graded in upper general hospitals, 38.1% were sixth graded in general hospitals, 62.7% were seventh-graded in oriental medicine hospitals and 40.4% were first-graded in recuperation hospitals. In the nursing grade by the scale of hospitals (in terms of the number of beds), there was a significant difference in general hospitals, but there was no significant difference between oriental medicine hospitals and recuperation hospitals. In the nursing grade by the location of hospitals and the foundation type of hospitals, there was a significant difference between general hospitals and recuperation hospitals. Conclusion. For the effectiveness of applying differentiated nursing fees by the number of nurses, it seems necessary to consider adjusting the present differentiated inpatient-charge system for the better so that small and medium-sized hospitals may induce more nurses.

• The Korean Journal of Health Service Management
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• v.14 no.1
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• pp.93-102
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• 2020

Objectives: This study analyzed the prescription characteristics of medication for acute respiratory diseases before and after pay-for-performance to provide basic data on effective medical quality management policies. Methods: The research data were collected from the 2013-2014 sample cohort of the National Health Insurance Corporation, from Internal Medicine, Pediatrics, Otorhinolaryngology, Family Medicine and General practitioner clinics (classification of disease codes: J00-J06, J20-J22, J40 outpatients). Results: The antibiotics prescription rates decreased from 43.9% in 2013 to 43.5% in 2014 when the major diagnosis was for upper respiratory infections and increased from 62.0% in 2013 to 62.5% in 2014 when the major diagnosis was for lower respiratory infections. Conclusions: There is a need to identify the correct antibiotic prescription method by expanding the current assessment standards. Such standards must include acute lower respiratory infections and minor diagnoses as the current evaluation techniques focus only on the major diagnosis of acute upper respiratory infections.

• Korea Journal of Hospital Management
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• v.14 no.3
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• pp.83-103
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• 2009

The main objective of this study is to investigate the influence of physician's communication styles and quality, and physician-patient relationship on patient satisfaction for improving physician's communication which is one of factors determining service quality in health care services, and providing the suggestion for building the positive physician-patient relationship. Data were collected from 341 inpatients in 13 general hospitals and university hospitals located in Busan Metropolitan City and Kyeongsang-do area using structured self-administered questionnaires. Major results of the empirical analysis are as follows; First, mutual-opened-cooperative physician-patient relationship, patient's communication receptive attitude, patient-oriented physician's communication style, and quality were significantly varied by respondents' characteristics such as age, consensual, job, and income. Second, empathy, patient's communication receptive attitude, physician-patient relationship, and patient satisfaction were significantly varied by respondents' medical-related conditions. Third, there was a significant correlation between active communication receptive attitude of patient and mutual-opened-cooperative physician-patient relationship. Fourth, patient-oriented physician's communication style and physician-patient relationship were found to have positive influence on total communication quality and effectiveness and empathy facet of communication quality both. Finally, patient-oriented physician's communication style, empathy, active communication receptive attitude of patient, and mutual-opened-cooperative physician-patient relationship were found to have positive influence on patient satisfaction. This research findings suggest that putting emphasis on effective physician's communication and enhancing positive physician-patient relationship are crucial for marketing activities and customer satisfaction management in health care settings.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.347-353
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• 2001

Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

• Health Policy and Management
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• v.34 no.2
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• pp.178-184
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• 2024

Background: This study aimed to determine the effectiveness of drug utilization review (DUR) evaluation indicators on safe drug use by comparing the changes in DUR inspection rates and drug duplication prescription prevention rates between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative. Methods: This study used DUR data from the Health Insurance Review and Assessment Service in 2018 (pre-implementation) and the evaluation results of the Healthcare Quality Evaluation Grant Initiative in 2023 (post-implementation). The dependent variables were the DUR evaluation indicators, including DUR inspection rate and drug duplicate prescription prevention rate. The independent variable was the implementation of the DUR evaluation indicators, and the control variables included medical institution characteristics such as type, establishment classification, location, DUR billing software company, and number of beds. Results: The results of the analysis of the difference in the prevention rate of drug duplicate prescriptions between the pre- and post-implementation of the DUR evaluation indicators of the Healthcare Quality Evaluation Grant Initiative showed that the prevention rate of drug duplicate prescriptions increased statistically significantly after the implementation of the DUR evaluation indicators. Conclusion: The policy implications of this study are as follows: First, ongoing evaluation of DUR systems is needed. Second, it is necessary to establish a collaborative partnership between healthcare organizations that utilize DUR system information and the organizations that manage it.

• Journal of Environmental Impact Assessment
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• v.32 no.2
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• pp.112-122
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• 2023

To restore the ecological function of contaminated soil and maximize the ecological services provided by the soil, besides the toxicity orrisk caused by pollutants, the functional aspects of the soil ecosystem should be considered. In this study, a method for evaluating the health of cleaned soil was presented, and the applicability of the proposed evaluation method was examined by applying it to soil treated with washing and landfarming. Productivity, habitat, water retention capacity, nutrient cycling, carbon retention capacity, and buffering capacity were used as soil health evaluation indicators. The results showed that the soil health was not completely recovered after remediation, and even in the case of the washed soil, the health was lower than before remediation. On the other hand, there was no significant change in soil quality due to oil pollution, but soil health deteriorated. Unlike the slightly improved soil quality after landfarming treatment, soil health was not completely restored. Therefore, the results of this study indicate that it is desirable to consider both soil quality and health when evaluating the remediation effect. The soil health evaluation method proposed in this study can be usefully utilized for the sustainable use of cleaned soil and to promote ecosystem services.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.29-37
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• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• Women's Health Nursing
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• v.18 no.3
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• pp.200-208
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• 2012

Purpose: This study was aimed to examine the gap between predicted cesarean section rate and real cesarean section rate and it's determining factors of 44 tertiary hospitals. Method: This study is a cross-sectional analysis using the data of 25,623 deliveries in 2009 drawn from homepage of Health Insurance Review and Assessment Service. Data were analyzed with t-test, F-test, Scheff$\acute{e}$ test, and logistic regression. Result: There were statistically significant differences in the gap of cesarean section rate (more gap indicates higher quality of delivery) by grade of nurse staffing and delivery cases. Hospitals with nurse staffing grade 1 to 2 had more possibility to be classified into higher grade in quality of delivery (OR 5.67, 95% CI 1.07-30.08). Also hospitals with over 500 delivery cases had more possibility be classified into higher grade in quality of delivery (OR 4.92, 95% CI 1.14-21.23, respectively). Conclusion: The finding suggests that grade of nurse staffing may influence the real cesarean section rate because nurses do a vital role to prevent unnecessary cesarean section. Further study is required to provide evidence that nurse staffing influence on patient outcome and cost-effectiveness in order to obtain adequate number of nursing staffs.