• 보건의료산업학회지
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• 제10권4호
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• pp.61-73
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• 2016

Objectives : The aim of this study was to investigate the satisfaction determinants of rehabilitation care group inpatients in rehabilitation long-term care hospitals. Methods : A survey was conducted with 262 patients from 6 rehabilitation long-term care hospitals located in Busan Kyungnam. Data were collected from June 2016 to July 2016 with a structured questionnaire and analyzed with SPSS 23.0. Results : The significant factors affecting the overall satisfaction score were disease group and 5 quality indices of medical services(Medical service quality, Rehabilitation services quality, Hospital reputation, External physical environment, and Internal physical environment). Additionally, the significant factors affecting intention to revisit were age, disease group, length of hospital stay and the 5 quality indices of medical services. Conclusions : The results of this study indicate that rehabilitation long-term care hospitals should try to improve the overall satisfaction of inpatients, especially focusing on the internal physical environment and the quality of the rehabilitation services and medical services, which will lead to a high level of intention for patients to revisit.

• Neonatal Medicine
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• 제25권2호
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• pp.53-57
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• 2018

Even with the increasing number of high risk infants, neonatal care in Korea has undergone development with improved survival rate. This rapid improvement in the outcomes brought care quality in neonatal intensive care unit (NICU) to the surface. Quality improvement (QI) involves safe, timely, effective, efficient, equitable, and patient-centered care. In this review, methods of QI are described with examples of NICU QI topics. Each NICU can voluntarily develop a QI project, but systematic supports are essential. As human and systemic resources in NICUs in Korea are insufficient, institutional and national supports are necessary to attain QI. Furthermore, collaborative neonatal network can provide a QI standard and evidence based-medicine, as well as QI research.

• Journal of Yeungnam Medical Science
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• 제36권1호
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• pp.1-7
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• 2019

The number of people with chronic diseases has been increasing steadily but the indicators for the management of chronic diseases have not improved significantly. To improve the existing chronic disease management system, a new policy will be introduced, which includes the establishment of care plans for hypertension and diabetes patients by primary care physicians and the provision of care coordination services based on these plans. Care coordination refers to a series of activities to assist patients and their families and it has been known to be effective in reducing medical costs and avoiding the unnecessary use of the hospital system by individuals. To offer well-coordinated and high-quality care services, it is necessary to develop a service quality assurance plan, track and manage patients, provide patient support, agree on patient referral and transition, and develop an effective information system. Local governance should be established for chronic disease management, and long-term plans and continuous quality improvement are necessary.

• 한국의료질향상학회지
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• 제3권1호
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• pp.104-124
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• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• 대한간호학회지
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• 제49권2호
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• pp.161-170
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• 2019

Background: Quality ratings could provide vital information to help people in choosing a nursing home. Purpose: This study investigated factors aligned with quality ratings of nursing homes. Methods: We employed a cross-sectional descriptive design to assess publicly available data on 1,354 nursing homes with 30 or more beds in the Republic of Korea. After excluding 289 nursing homes with no reported quality-evaluation ratings, we analyzed the 2015 data of 1,065 nursing homes. To prevent multicollinearity among independent variables, we carefully selected the final set of variables based on clinical and theoretical meaningfulness to direct nursing care. Quality, the ordinal outcome, was scored from 1 to 5 with a higher score indicating higher quality of the organization. We constructed a multivariate ordered logistic regression model. Results: Higher quality ratings of nursing homes was significantly related to the number of unoccupied beds (OR=0.99, p=.024), registered nurses (RNs) (OR=1.30, p=.003), qualified care workers (OR=1.03, p=.011), cognitive-improvement programs (OR=1.05, p=.024), and other programs for residents' activities (OR=1.09, p<.001). Conclusion: The number of RNs had the strongest influence on the publicly reported quality rating, while the rating of qualified care workers demonstrated little effect and that of nursing assistants had no effect. The number of RNs could be used as a crucial indicator for high-quality homes; more resident-engaging programs also demonstrated better quality of nursing home care.

• 한국의료질향상학회지
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• 제2권2호
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• pp.112-129
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• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• 대한가정학회지
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• 제36권6호
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• pp.95-108
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• 1998

This study is the second study which was aimed to validate the Infant/ Toddler Environment Rating Scale(ITERS). The test-retest reliability included 10 infant/toddler classes among 30 national/public and private child care centers in Inchon city which had been observed in the first validation study. The Spearman's correlation coefficient for test-retest reliability was ranged from .52 to .84. In addition, two raters observed 10 family day care centers in Inchon city, where two observers independently rated each centers on the ITERS during a single visit. The Spearman's correlation coefficient for interrater reliability was ranged from.72 to .99 For the second measure of content validity, experts who were working in day care centers and who were graduate students, lecturers, or professors majoring child studies rated the appropriateness of each ITERS items for the provision of high-quality programs for infants and toddlers, using a 1(low) to 5(high) scale. The mean rating was ranged from 2.52 to 4.52. In sum, when the rating scores were analyzed by the type of child care centers, national/public child care centers have better quality than private or family child care centers.

• 가정과삶의질연구
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• 제22권2호
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• pp.23-35
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• 2004

The purpose of this study is to evaluate child - care effects on young child's aggression in ecological context. For this, main effects, interaction effects and cumulative effects between child care experiences(quantity, quality, age of entry and stability) and maternal behavior as well as characteristics of child(sex, age and temperament) were examined. A total of 62 young children(34 boys and 28 girls) enrolled in child - care center were observed, and mothers and caregivers completed questionnaires. Data was analysed by three - way ANOVA, logistic regression and crosstabs. As result, first, main effects of quantity, rejective and regulative mothering on children's aggression were found. Second, there were significant interaction effects between both quality and quantity of day-care and rejective mothering. In particular, the interaction effects provided evidence that high - quality child - care served a compensatory function for extensive care and rejective mothering. Third, logistic regression analysis revealed risk factors for child's aggression and the effects of these risk factors were cumulative. Interaction effects of day-care quality and cumulative effects of day-care, characteristics of child and maternal behavior on child aggression were discussed.

• 대한가정학회지
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• 제39권3호
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• pp.67-81
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• 2001

The purpose of this investigation was to examine whether early child-care experience, alone or in combination with mother/child factors, was associated with emotion regulation. Participants were forty 12-18 month-old infants, their mothers and their caregivers. Infants were observed in the Strange Situation to assess the pattern of emotion regulation. Mothers were interviewed, given Questionnaires, and observed in play. Caregivers were observed in child care to assess the caregiving environment. There were significant main effects of good quality child care on open emotion expression and heightening emotion expression. Significant interaction effects revealed that infants were more likely to be open emotion expression when high maternal sensitivity /responsiveness was combined with good quality child care, or nonmaterial care initiated prior to six month of age. Infants were more likely to be minimizing emotion expression when low maternal sensitivity/responsiveness was combined with nonmaternal care initiated after six month of age, or more than one care arrangement. Difficult temperament infants received nonrelative care were somewhat more likely to be minimizing emotion expression. Infants were more Likely to be heightening emotion expression when high maternal sensitivity/responsiveness was combined with relative care. Boys experiencing nonrelative care were more Likely to be heightening emotion expression.

• 한국사회정책
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• 제19권3호
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• pp.49-83
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• 2012

현재 독일은 '케어비상사태(Pflegenotstand)'라는 말이 등장했을 정도로 '요양서비스 질과 인력부족(Qualit't der Pflegeversicherung und Mangel an Pflegekr?fte)'의 위기에 직면해 있다. 독일 정부는 이 문제를 해결하고자 체계적이고 수준 높은 교육을 통해 전문지식을 갖춘 노인요양사를 양성하는 것을 목표로 정하였으며, 노인요양사라는 직업의 사회적 이미지와 위상을 높임으로써 직업에 대한 선호도를 높이는 것과 특히 젊은 세대를 노인요양인력 유치 주요대상자로 선정하고, 이들을 대상으로 노인요양직업에 대한 긍정적인 이미지를 심어 주고, 관심을 가질 수 있도록 하는 데 필요한 대책을 마련하는 것에 중점을 두고 있다. 본 논문의 주요관점은 독일 고령화 사회에서 노인요양사의 전문성을 고려한 교육체계에 초점이 맞춰있으며, 독일의 노인요양인력 양성 교육내용과 시스템과 더불어 교육내용에 내포되어 있는 노인요양인력의 역할 및 업무와 사회적 위치가 어떠한지를 알아보며, 독일의 노인요양사 인프라 구축 대안으로는 어떤 것들이 있는지를 소개한다.