Journal of the Korea Academia-Industrial cooperation Society
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v.7
no.2
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pp.231-237
/
2006
A controversy get more deeply intensified about the price of inpatient's meal provided in hospital as the Ministry of Health and Welfare declared the National Health Insurance will cover inpatient's meal from 2006. By using newly designed cost analysis method and stratification method of the population, the optimal price of inpatient's meal are derived based on the 71 sample hospitals. This study analyzed 71 samples based on the activity based costing(ABC) and the method of relative units value(RUV). The factors influencing the level of cost are found by linking the results of cost and statistical analysis. As the key factors influencing the cost are the number of employees in a nutrition department and a the number of meals provided to the patients, These factors should be considered when the optimal price of inpatient meals is set for the coverage of the National Health Insurance.
The purposes of this study were to analyze the gap between foodservice personnel and inpatients, to urge foodservice providers to reconsider by identifying the problems in service delivery for customer satisfaction, and to deduce the priority for foodservice quality improvement. The results of this study can be summarized as follows : the average perception score of personnel (4.32 out of 5) was higher than that of customers (3.90). In particular, the customers' perceptions of 17 attributes, which included 'removal service of tray by foodservice personnel', 'nutrition and health-related information service', 'handling inpatient's complaint ASAP', 'delicious meals' and 'salty enough meals' and so on, was significantly lower than personnel's. Both service providers and customers perceived that 'personnel attitude' was the highest and 'meal quality' was the lowest among the 4 factors, but there was significant difference on 'meal quality'(p < .001), 'customer reception' (p < .001) and 'personnel attitude' (p < .05) between the two groups. As a results of quadrant analysis, 'removal service of tray by foodservice personnel', 'handling inpatient's complaints ASAP' and 'meal service according to doctor's orders were categorized into Quadrant A with meaning of high personnel's perceptions and low customers'. Therefore service providers have to perceive the gap between the two viewpoints and grant priority to these attributes in improving foodservice qualify. (Korean J Community Nutrition 10(6) $943\∼951$, 2005)
This work has performed to find what activities of daily living are required for the intensive interests when inpatient elderly more than 3 months has been supported and convalescent care, where the inpatient elderly were judged by the inpatient assessment report in the time of December, 2013. According to the estimation with logistic function of the relationship between the state of decision making recognition technology and the Activities of Daily Living(ADL), the intensive cares for the elderly are required in the parameters of 'Having meal' and 'transferring sitting' when they are severed and convalescently cared as the degree of functional independence for ADL are severly proceeded. In addition, the senescence and disease the activities except 'Having meal' and 'transferring sitting' seem to be influenced by the decline of body function more than the state of decision making recognition technology for daily living.
Kim, Hyung-Mi;Kim, Eun-Mi;Kim, Hye-Jin;Baek, Hee-Joon;Park, Mi-Sun;Lee, Geum-Ju;Lee, Hae-Young
Journal of the Korean Dietetic Association
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v.22
no.2
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pp.118-130
/
2016
The objectives of this study were to analyze the operational characteristics and to explore the substantiality plan of inpatient diets for foreigners in hospitals. Questionnaires were mail-delivered to 128 hospitals, and a total of 62 questionnaires were usable with a response rate of 48.4 percent. Statistical data analysis was completed using SPSS Win 11.0 for descriptive analysis, independent t-test, and ${\chi}^2$ test. Results can be summarized as follows. The average number of inpatient meals for foreigners in the last 6 months were 405 and 53 for general therapeutic diets and special therapeutic diets, respectively. The rates of hospitals with an exclusive department and exclusive staff for foreign inpatients were 48.4% and 53.2%, respectively. Major nationalities of foreign inpatients were China (37.5%) and Russia (31.3%), and their major medical departments were internal medicine (43.9%) and surgery (39.0%). The number of hospitals that provided inpatient diet only for foreigners was 42 (72.4%) and influencing factors were number of permitted beds (P<0.05), an exclusive department (P<0.001), and exclusive staff (P<0.01). The main type of menu was USA European style (61.1%), and the price of inpatient meals for foreigners was mostly \10,000~\25,000 (62.0%). As 75.9% of hospitals did not possess dietary slip manuals for foreigners, the case of preparing inpatient meals for foreigners in the form of a general therapeutic diet partially-modified according to disease was the majority (55.4%). Dietitians felt the need for nutrition management guidelines and dietary slip manuals (47.3%) as a substantiality plan of inpatient diets for foreigners. There is a need for exclusive foodservice standards for foreign inpatients in the changing medical environment.
Kim, Hye-Jin;Kim, Eun-Mi;Lee, Geum-Ju;Lee, Jung-Joo;Lim, Jung-Hyun;Lee, Jung-Min;Jeon, Hyun-Jung;Lee, Hae-Young
Journal of the Korean Dietetic Association
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v.16
no.4
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pp.378-396
/
2010
The objectives of this study were to explore hospital foodservice management and to investigate conditions related to health insurance coverage of inpatient meals. A questionnaire was distributed to the nutrition departments of 44 hospitals in Seoul on July 2009. The average kitchen area was 0.5 $m^2$, and centralized distribution systems were in place. Partition walls from contamination zones, separate work tables to prevent cross-contamination, exclusive areas for preparing tube feeding, and split carts with refrigerated and convection heat settings were largely used in tertiary hospitals. Most dietitians did meal rounds (93.2%) and surveyed for patient satisfaction (86.4%). The major theme of QI (Quality Improvement) was menu management (31.8%). The health insurance fees for meals were (won)4,938.9 for a general diet, (won)5,199.8 for a therapeutic diet, (won)4,067.0 for tube feeding, (won)9,950.0 for sterilized diet, and (won)18,383.4 for diets not covered by health insurance. The prices for general and therapeutic diets were significantly lower in hospitals compared to tertiary or general hospitals (P<0.001). The cost composed of 48.3% food, 44.0% labor and 7.7% overhead for general diets and 47.9%, 44.5% and 7.6% for therapeutic diets. In the case of health insurance coverage for patient meals, the number of items applied to general diets averaged 2.8 out of 4 and for therapeutic diets it averaged 1.9 out of 3. To reform the health insurance coverage system for patient meals, it is urgent that the qualified level of patient meals is presented from a national viewpoint, and monitoring should be performed consistently by developing the evaluation tools.
Journal of the Korean Society of Food Science and Nutrition
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v.35
no.10
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pp.1491-1497
/
2006
The purpose of this study was to analyze the relationship among inpatients' perceptions of foodservice quality, satisfaction and revisit intention. Questionnaires were hand-delivered to 350 inpatients and a total of 230 questionnaires were usable (response rate 65.7%), Statistical data analysis was completed using the SPSS Win 11.0 for descriptive analysis, independent t-test, $x^2$ test and k-means cluster analysis. The results of this study can be summarized as follows: The average score of overall importance of meal service in medical service was 4.25 out of 5.0, yet the score of overall quality of meal service and value had lower than importance score. A helpfulness to medical treatment (3.48), bringing customer happiness (3.18), overall satisfaction for foodservice (3.66), satisfaction based on expectation before discharge (3.53) and offering foodservice apt to hospital reputation (3.40) were measured as expressions of satisfaction. As a result of clustering analysis, two clusters were classified and named as affirmative opinion group and negative one. Expectation for four factors of foodservice quality between two groups had no significance. But affirmative opinion group had significantly higher score than negative one in perception and satisfaction. Affirmative customers' intention to revisit in the near future was evaluated as high in both considering general medical service (4.04) and reflecting meal service level (3.84).
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.4
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pp.570-577
/
2017
The purpose of this study was to provide a basis for the development of a health insurance payment system by exploring inpatient hospice & palliative care activities in a long-term care hospital by occupational personnel. The contents and frequency of inpatient hospice-palliative care activities were obtained retrospectively from the chart review of 12 terminally ill patients who died during the 6 months before their deaths. According to their occupational personnel, doctors were doing blood transfusion, family counseling, and medication guidance. Nurses' main activities were airway suction, oxygen supply, EKG monitoring, observing patient's status, helping medication and tube feeding. Other workers' activities are as follows: social workers were applying individualized programs, physical therapists were doing electrostimulation, nutritionists were giving nutrition evaluation and meal rounding, and careworkers were assisting with meals and nutrition. Although certain nursing activities, like emotional support, were performed by nurses, the hospice-palliative activities from doctors, social workers and physical therapists were largely unavailable for terminally ill patients in a long-term care hospital. And some terminally ill patients were receiving too intensive and invasive medical cares for end end-of-life care. The results highlight the importance of valid measures of hospice-palliative care quality and the need for establishing an adequate reimbursement system for ensuring and improving end-of-life care.
Kim, Yeong-Hye;Sin, Eun-Su;Gang, Eun-Hui;Kim, Ju-Hyeon;Kim, Mi-Gyeong;Kim, Gye-Jin;Hong, Hui-Seon
Journal of the Korean Dietetic Association
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v.2
no.2
/
pp.199-215
/
1996
In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.
Objectives : This study was designed to evaluate the effects of oriental medical treatments on the facial nerve palsy in Herpes Zoster Oticus. Methods : Subjects were 1 patients with the facial nerve palsy in Herpes Zoster Oticus. She had improved slightly still she had be gotten the medical services on inpatient states for 2 month. We gave Kamiligigepung-san to the patient 90 minutes after each meal and tried acupuncture 2 times every day. And we had evaluated the conditions of the patient using VAS, House-Brackmann Grade and Yanagihara scale. Results : After the comparison between an admission and discharge date at VAS, House-Brackmann Grade and Yanagihara scale, the facial nerve palsy of the patient had improved. Conclusions : It is effective the Kamiligigepung-san and Acupuncture on the facial nerve palsy in Herpes Zoster Oticus.
Purpose: The purpose of this study was to calculate the total daily nursing workload and the optimum number of nurses per intensive care unit (ICU) based on the nursing intensity and the direct nursing time per inpatient using the patient classification. Methods: Two ICUs at one general hospital were investigated. To calculate the nursing intensity, patient classification according to the nursing needs was conducted for 10 days in each unit during September 2018. We performed patient classifications for a total of 167 patient-days in the Medical Intensive Care Unit (MICU) and 86 patient-days in the Surgical Intensive Care Unit (SICU). The total number of person-days for nurses who responded to the Nursing Time survey was 151 for MICU and 85 for SICU. In each unit, direct and non-direct nursing hours, nursing intensity score, and direct nursing hours were analyzed using descriptive statistics such as frequency, percentage, and average calculated using Microsoft Excel. The amount of nursing workload and the optimum number of nurses were calculated according to the formula developed by the authors. Findings: For the MICU, the average direct nursing time per patient was 5.59 hours for Group 1, 6.98 hours for Group 2, and 9.28 hours for Group 3. For the SICU, the average direct nursing time per patient was 5.43 hours for Group 1, 7.21 hours for Group 2, 9.75 hours for Group 3, and 12.82 hours for Group 4. Practical Implications: This study confirmed that the appropriate number of nurses was not secured in the nursing unit of this study, and that leisure time such as meal time during nursing work hours was not properly guaranteed. The findings suggest that to create working environments where nurses can serve for extended periods of time without compromising their professional standards, hospitals should secure an appropriate number of nurses.
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