• 보건행정학회지
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• 제22권1호
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• 한국산업정보학회논문지
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• 제15권3호
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• pp.23-32
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• 2010

U-헬스케어는 인간에게 많은 편의를 제공하고 건강을 지켜준다. 하지만 시설중심의 의료 환경이 환자 중심의 의료 환경으로 변함에 따라 다양한 문제점들이 발생되고 있다. 이 문제점들은 제도적인 문제부터 기술적인 문제, 생산자의 문제, 사용자의 문제에 이르기까지 다양한 원인에 의해 발생된다. 연구자는 이 문제들 가운데 사용자로부터 기인한 문제, 그 중에서도 특히 노인환자 또는 노인이 환자의 보호자인 경우에 관심을 가졌다. 주요 연구내용은 U-헬스케어 관련 기기들의 HMI 숙달훈련과 응급상황대처능력 훈련을 위한 학습용 기능성콘텐츠의 설계방향이다. 이는 노인의 인지심리학과 노인운동반응에 관한 연구로부터 출발하여 다양한 디지털 콘텐츠 형식들의 특성을 연관 짓는 과정을 거쳤다. 연구 결과는 가파른 성장세를 보일 노령인구와 그에 따른 U-헬스케어 산업분야에서 쓰임새를 가질 것으로 기대한다.

• 보건의료산업학회지
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• 제11권1호
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• pp.143-158
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• 2017

Objectives : This study aims to analyze differences in the use of postpartum care services and identify the factors affecting their use. Methods : Data were collected from the 2008-2014 Korean Health Panel. Chi-square tests were conducted to analyze differences in the characteristics of women after birth by the use of postpartum care services. Logistic regression analysis was used to identify factors affecting the use of each type of postpartum care service. Results : Participants with higher education and household income levels were more likely to use a postpartum care facility. Individuals with a lower number of household members, who gave birth in 2011-2013, and who used hospitals specializing in obstetrics and gynecology had a greater likelihood of using a postpartum care facility. The probability of using a postpartum caretaker was higher when participants did not perform any economic activities. Conclusions : It is meaningful to confirm that use patterns and determinants of postpartum care facilities and postpartum caretakers are completely different and that the socioeconomic status of women affects the utilization of postpartum care facilities.

• 임상간호연구
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• 제23권3호
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• pp.267-280
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• 2017

Purpose: The purpose of this study was to describe the status of infection control nurses (ICNs) and their activities, and to identify the factors affecting the level of infection control activities. Methods: Data were collected from 199 hospitals from June 24 to July 26, 2016. The structured questionnaires included status of infection control nurses, type and level of infection control activities. Results: Most participating hospital were advanced general hospital (20.1%) and general hospital (67.8%). Among the hospitals, 86.4% had an infection control department (ICD). The average hospital work experience of ICNs was 14.62 years, and their average infection control career was for 4.94 years. Among the ICNs, 85.6% worked in full time and the average number of beds per ICN was 311.21. There were significant differences in the existence of ICD, infection control activities including surveillance, outbreak investigation, negative pressure room, hand hygiene monitoring, disinfection, and sterilization according to hospital size. The level of infection control activities was higher with more number of ICNs, ICN employment as full time, and healthcare institution accreditation status. The explanatory power was 37.5%. Conclusion: These results of this study which reflect infection control status of healthcare facilities with more than 150 beds in 2016 will provide baseline data to establish infection control system in small to medium sized hospitals after the Middle East Respiratory Syndrome outbreak in 2015.

• 한국정보과학회논문지:컴퓨팅의 실제 및 레터
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• 제15권12호
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• pp.891-898
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• 2009

본 논문은 서로 다른 벤더의 응용 프로그램과 생체 신호 측정 장치가 동적으로 데이터 전달을 할 수 있는 생산자(Producer)/소비자(Consumer) 패턴 기반의 데이터 결합기 구조를 제안한 것으로 휴대용 정보 단말에서 컴포넌트 기반의 프로그래밍이 가능하고 서비스 지향적인 동작 메커니즘을 제공하는 OSGi 플랫폼의 번들로서 구현된다. 데이터 결합기는 정적으로 데이터 생산자와 소비자를 연결하는 OSGi WireAdmin 서비스의 단점을 보완한 것으로, 데이터를 사용하는 주체인 응용 프로그램의 요구 사항을 응용 프로그램 설명자(Application Descriptor)로 형식화하고 데이터를 생산하는 주체인 생체 신호 측정 장치의 기능을 장치 설명자(Device Descriptor)로 형식화하여 런타임에 데이터 생산자-소비자 쌍을 만들어 동적으로 데이터가 연결되는 기능을 제공한다. 따라서 센서 기반 응용을 개발할 때 데이터 생산자와 데이터 소비자를 사이에서 빈번하게 일어나는 연결 관리를 동적으로 해주는 기능 구현에 활용 가능하다. 본 논문의 목적은 생체 신호 측정 장치와 같은 데이터 생산자와 헬스케어 응용 프로그램과 같은 데이터 소비자를 분리시켜 헬스케어 서비스 개발의 편이성을 제공하기 위한 것이다.

• 디지털융복합연구
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• 제19권2호
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• pp.299-305
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• 2021

본 연구는 입원환자의 만족도과 병원추천의향에 미치는 영향 요인을 연구하기 위해 '2018년 의료서비스경험조사' 원시자료중 입원의 경험이 있는 593명의 자료를 분석에 활용하였다. 분석결과, 환자의 입원 경험은 의사 요인, 간호사 요인, 시설 및 행정, 보건의료제도의 4개 요인으로 분류되었다. 의사 요인, 간호사 요인, 시설 및 행정 요인, 보건의료제도 요인은 성별, 연령, 교육수준 등의 인구사회학적 요인과 건강관련 요인을 통제한 다중회귀분석에서, 입원환자의 만족도와 병원추천의향에 각각 영향을 미치는 것으로 나타났다. 따라서 입원환자의 만족도를 제고하기 위해 의사, 간호사 등 의료진과 병원의 시설 및 행정지원 서비스가 총체적으로 환자중심적인 태도와 방향으로 개선하는 노력 외에도 보건의료제도에 대한 신뢰와 만족을 제고하기 위한 다각적인 방안이 강구되어야 할 것이다.

• Journal of Preventive Medicine and Public Health
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• 제55권1호
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• pp.49-59
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• 2022

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권2호
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• pp.73-82
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• 2017

Purpose: Since the facility guidelines for National Designated Isolation Unit wards(NDIUs) had been edited since 2016, all hospital who want to expand or install NDIU should adapt the new guidelines. Instead of providing area requirement, by the way, only essential or optional facility requirements are suggested except patient bedroom in the guidelines. So, as analyze area and area composition of the NDIUs, it could be expected that this study has a role as an area planing reference for not only NDIU but also another airborne infection isolation room. Methods: For the area analysis, 18 sample hospitals are selected among 2016 year applicants. All rooms in NDIUs are grouped as zones whether those are negative air pressurized or not and programed room or not. At the end, area of the zones are summarized and analysed a relationship between area increase and bed number by both correlation analysis and regression analysis. In addition, department usable and gross area per bed, N/G ratio, G/N ratio, and average area ratio of each zone is calculated. Results: First of all, rooms in none negative air pressurized zone of the NDIUs haven't shown a regular installation so that only those in negative air pressurized zone are targeted for the area analysis. Second of all, patient room unit(0.92) and support area(0.79), by correlation analysis, are correlated with total net area. Patient room unit(0.94) and total net area(0.79) are also shown a correlation with bed number. Department usable area($R^2=0.63$, y=36.278x + 102) and patient room unit area($R^2=0.89$, y= 27.993x - 0.8924) has a relationship with bed number by regression analysis. Average N/G is shown as 0.85 and G/N 1.36. Average area ratio of circulation, doffing area, patient room unit, and support area are 25.4%, 9.1%, 50.9%, and 14.6% in order. Implications: This study is a basic research for exploring the NDIUs guidelines to find resonable evidence to develop it for its practical use. Still, it is possibly expected that the guideline is to be developed by post occupancy evaluation in the area of where minimum requirement or facility grade needs to be defined, and by further studies with various perspectives.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제20권3호
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• pp.49-55
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• 2014

Purpose: AIn recent years, the rapid progress of aging and the increase in the elderly people with dementia is becoming a big social issue. Therefore, this paper studies the development of therapeutic environmental rating scales for the elderly people with dementia in korean nursing homes. Methods: We identify the development process and structure of TESS-NH and understand the details of its nature and features. Then, based on the detailed items, we provide major scale factors which do influence on therapeutic environmental rating scales using PCA. Results: In the results, TESS, in the case of the initial stage of TESS-NH, has an advantage to evaluate on physical environments for a short period of time. TESS-2 + sets a large rage of activities of the elderly people with dementia, and tries to evaluate ongoing cares. TESS-NH has a complete set of well-thought-out assessment features for improving quality of care (Quality of Care) On the other hand, the main factors affecting the therapeutic environmental rating scales in nursing homes are "a consideration for facility management (Care for facilities' maintenance)", "a consideration for spatial cognition (Care for spatial cognition) ", and "a consideration for the safety (Care for safety)". Implications: In the future, to develop the therapeutic environmental rating scales on Korea's dementia nursing home, we should actively consider cares of spaces and facility utilization which the residents (the elderly people with dementia) are more secure and comfortable.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제25권4호
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• pp.47-60
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• 2019

Purpose: Regional public hospitals have implemented functional reinforcement projects, and the facilities to accommodate them have increased in size. Nevertheless users in hospital are concerned about space shortage and area imbalances. Therefore I will trace the factors and trends that influence the size, and derive the relationship between these and the uses' critical opinion. Methods: Among the indicators for determining the size of medical facilities, the number of beds and total floor area are the essential indicators that directly affect the composition of space and allocation of area inside the medical facility. The purpose of this study is to investigate the change and the factors of change on the these two indicators in regional public hospitals and analyze the trend of changes. Results: In accordance with support undertaking, regional public hospitals have been increased the number of chronic-based beds and expanded additional facilities such as O.P.D specialized centers, emergency centers and funeral homes for reflecting the needs of the regions and times. However, as a result of analyzing the area, regional public hospitals are growing in size mainly on the ward and O.P.D is only expanded the scope of functional reinforcement division but total area level of O.P.D is lower than the recent level. In addition, the levels of D&T, Supply, mechanical/electrical equipment area related to medical support and control environment quality are very low. This is because the functional reinforcement projects have been done without concerning diagnose the whole facility. Implications: If functional reinforcement projects are conducted, to cope with problems of space shortage and imbalance of area, it is judged that an architectural planning that comprehensively analyzes existing facilities and related departments should be included.