• 한국의료질향상학회지
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• 제25권2호
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• pp.16-25
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• 2019

Purpose:The healthcare system of South Korea is at the extreme of the dispersed system. Few regulations limit patients from directly visiting higher-level medical institutions for primary care sensitive conditions. As a result, similar to local clinics, general and tertiary teaching hospitals also provide diverse primary care services. Our study aimed to examine the general public's perceptions of their primary care performance. Methods: Face-to-face surveys were conducted with 1000 adults who were living in South Korea with the aid of a questionnaire that included the Korean Primary Care Assessment Tool (KPCAT). The KPCAT consists of five domains, which are the main indicators of primary care performance: first contact, comprehensiveness, coordination, personalized care, and family/community orientation. One-way analysis of variance and post hoc tests were used to compare the KPCAT scores across the three types of medical institutions. Results: Domain-wise analyses revealed two different patterns. With regard to first contact and its subdomains, the highest and lowest scores emerged for local clinics and tertiary teaching hospitals, respectively. However, the other four domain scores were significantly lower for local clinics than for the other two types of medical institutions. Conclusions: Local clinics were perceived to be medical institutions that are responsible for providing primary care. However, the general public perceived only one domain of their primary care to be superior to that of the other two types of medical institutions: first contact. National efforts should be taken to strengthen their other four domains of primary care by training their workforce and providing appropriate incentives.

• 한국응급구조학회지
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• 제22권3호
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• pp.131-148
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• 2018

Purpose: This study examined the associations of job stress and burnout with the quality of life (QOL) among 119 emergency medical technicians (EMTs). Methods: Using a descriptive correlational design, 260 EMTs working in D City or S City completed the questionnaires. Hierarchical multiple regression analysis was conducted to determine the predictors of QOL among 119 EMTs. Results: Overall, there was relatively low job stress among 119 EMTs. There were significant differences in job stress and burnout by general characteristics, especially regarding those of gender, service career, job rank, and self-reported health. In a hierarchical multiple regression, general characteristics explained 29% of QOL (Model I, F=16.369, p<.001). The explanatory power for QOL increased to 49% upon adding job stress (Model II, F=18.737, p<.001), and 59% upon adding burnout (Model III, F=22.621, p<.001). In the last model, self-reported health (${\beta}=.316$, p<.001), job demand (${\beta}=-.130$, p=.009), job insecurity (${\beta}=-.136$, p=.010), lack of reward (${\beta}=-.189$, p=.001), emotional exhaustion (${\beta}=-.196$, p=.004) and lack of personal accomplishment (${\beta}=-.334$, p<.001) were significant predictors of QOL among 119 EMTs. Conclusion: Based on the results, it is necessary to assess and manage job stress and burnout systematically among EMTs, and to develop health improvement programs for better QOL.

• 의학교육논단
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• 제25권2호
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• pp.174-183
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• 2023

Educational evaluation involves data collection and the analysis of various education-related factors to make decisions that improve educational quality. Systematic educational evaluation is essential for enhancing the quality of education. This study reports a case of student-conducted process evaluation of a medical school's student support system and the procedure for devising improvement plans. Sixteen Inje University College of Medicine students participated in the Education Evaluation Committee (IUCM-EEC) to understand the educational improvement process as learners and actively achieve improvement. The Quality Improvement Committee of the Inje University College of Medicine (IUCM-QIC) decided to reform its student support system based on a previous educational evaluation in 2019. The evaluation of the student support system was conducted for 10 months in 2021 by the student subcommittee, under the guidance of the IUCM-EEC. The CIPP (context-input-process-product) evaluation model was used for a systematic evaluation. Accordingly, the subcommittee developed evaluation criteria and indicators, and analyzed relevant data collected from surveys and the previous literature. For further recommendations and revision ideas, the student subcommittee members interviewed faculty members from six other medical schools and also conducted a focus group interview with the dean and vice deans of IUCM. Finally, the student subcommittee submitted a report to the IUCM-QIC. Communication with various stakeholders is essential for a successful evaluation process. In this case, students, as key stakeholders in education, evaluated the student support system. Their active participation helped improve their understanding of the evaluation process.

• Asian-Australasian Journal of Animal Sciences
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• 제32권3호
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• pp.437-441
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• 2019

Objective: Paraoxonase 1 (PON1), a calcium-dependent serum enzyme, has been shown to be involved in lipid metabolism. In this study, we examined the putative correlation of the serum PON1 level of Hanwoo, Korean native cattle, with gender and meat quality grade. Methods: PON1 levels were estimated by determining the arylesterase and paraoxonase activities (AE and PO, respectively) in serum samples from Hanwoo individuals (n = 56). Serum PON1 levels were analyzed in different gender groups (female [n = 21], castrated male [n = 17], and male [n = 18]), and meat quality grades (${\geq}1$ [n = 23], 2 [n = 21], and 3 [n = 12]). Results: Serum PON1 levels were similar in female ($AE=120{\pm}55U/mL$, $PO=84{\pm}43mU/mL$) and castrated male ($123{\pm}44U/mL$, $PO=89{\pm}30mU/mL$), while male showed a significantly lower level ($AE=65{\pm}43U/mL$, $PO=44{\pm}34mU/mL$). Furthermore, analysis of serum PON1 levels in three different grades of meat quality showed similar levels in the grades ${\geq}1$ ($AE=118{\pm}49U/mL$, $PO=84{\pm}37mU/mL$) and 2 ($AE=116{\pm}54U/mL$, $PO=82{\pm}43mU/mL$), while the level was significantly lower in the grade 3 ($AE=58{\pm}35U/mL$, $PO=39{\pm}27mU/mL$) of lower meat quality. Conclusion: We discovered the gender-dependent differences in serum PON1 levels of Hanwoo and a positive association of the serum PON1 level with meat quality. Results in this study suggest that PON1 would be a useful serum marker for preliminary screening of Hanwoo individuals with high-quality meat and applicable for genetic improvement.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제11권1호
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• pp.23-31
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• 2005

Rehabilitation medicine patients in Korea have increased due to the development of medical technology and the structural change of diseases resulted from life quality improvement. Following this trend, many hospitals are making efforts, such as renovating rehabilitation medicine, but architectural criteria are not sufficiently suggested for specialized rehabilitation medicine. The purpose of this study is to present the research data to improve the quality of rehabilitation medicine in general hospital. Data collecting skills such as drawing documents analysis, interviews, observation were used to examine the condition of rehabilitation medicine. And, case study method was used to generate the design data which can be used for the appropriate spatial composition and the area calculation

• 한국의료질향상학회지
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• 제4권2호
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• pp.242-259
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• 1997

This study describes associated factors of readmission of 213 inpatients from an university hospital in Seoul. This retrospective study reviewed medical records of patients who discharged from a hospital stay for general diseases between 1 August 1995 and 31 October 1995, Cases were 68 discharge patients with an unplanned readmission within 30 days of discharge from an index stay. And the other cases are 145 patients who had more than two discharges and didn't have an unplanned readmission within 30 days. Logistic regression model was analyzed and the results were as follows; 1. duration of readmission, rate of unpayed, room, path, and risk of disease were more likely to be readmitted unexpectedly than the expected readmission patients. 2. early readmission, low risk condition group, and inadquateness of discharge plann for patients had unplanned radmissions rather than planned readmissions. Therefore, discharge planning education to health care provider is required and assessement of discharge planning should be evaluated. Readmissions are usually for related problems that arose during the original hopitaliztion and caused cost problems. Especially the unplanned readmissions are frequently preventable. Ultimately, models for readmissions can serve as a valuable clinical tool for target high-risk patients and older patients and with this kind of tools we can reduce hospital readmissions and maintain high-quality of inpatient care.

• 한국의료질향상학회지
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• 제19권1호
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• pp.16-26
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• 2013

Health information technology (HIT) is one of the most familiar tools to healthcare providers. It is used in routine practice to reduce cost, to improve clinical performance, and to improve patient safety. Patient safety is the driving force of recent expansion of HIT industry. But there are many evidences that it can be harmful to patient safety. Role of HIT and HIT-related error became big issues because more and more healthcare providers and healthcare organizations are willing to adopt it. Adoption rate of HIT in Korea is higher than that of United States. But researches of HIT regarding patient safety are rare. In this article, types of HIT, their mechanisms of improving patient safety and HIT-related errors were reviewed. Status of HIT in terms of patient safety in Korea was also reviewed. Knowledge of how HIT can improve patient safety, its' limitation, and how to make it safer is crucial to whom have to use it to improve patient safety. Impact of HIT on patient safety must be evaluated actively in Korea. HIT which was proven to improve patient safety must be widely adopted. Government must prepare a strategic plan to improve HIT quality, support hospitals financially and institutionally to introduce qualified HIT, and develop HIT infrastructures and standard designed for patient safety.

• 한국병원경영학회지
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• 제21권4호
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• pp.1-12
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• 2016

The purpose of this study are suggest to performance measurement model of Electronic Medical Record(EMR) and Key Performance Index(KPI). For data collection, 665 questionnaires were distributed to medical record administrators and insurance reviewers at 31 hospitals, and 580 questionnaires were collected(collection rate: 87.2%). Regarding methodology, Critical Success Factor(CSF) and index of the information system were derived based on previous studies, and these were set as performance measurement factors of EMR system. The performance measurement factors were constructed by perspective using BSC, and analysis on causal relationship between factors was conducted. A model of causal relationship was established, and performance measurement model of EMR system was proposed through model validation. Analysis on causal relationship between performance management factors revealed that utility cognition of the learning & growth perspective factor had causal relationship with job efficiency(${\beta}=0.20$) and decision support(${\beta}=0.66$) of the internal process perspective factors, and security had causal relationship with system satisfaction(${\beta}=0.31$) of the customer perspective factor. System quality had causal relationship with job efficiency(${\beta}=0.66$) and decision support(${\beta}=0.76$) of the internal process perspective factors, all of which were statistically significant(P<0.01). Job efficiency of the internal process perspective had causal relationship with system satisfaction(${\beta}=0.43$), and decision support had causal relationship with decision support satisfaction(${\beta}=0.91$) and job satisfaction (${\beta}=0.74$), all of which were statistically significant(P<0.01). System satisfaction of the customer perspective had causal relationship with job satisfaction(${\beta}=0.12$), job satisfaction had causal relationship with cost reduction(${\beta}=0.53$) of the financial perspective, and decision support satisfaction had causal relationship with productivity improvement(${\beta}=0.40$)of the financial perspective(P<0.01). Also, cost reduction of the financial perspective had causal relationship with productivity improvement(${\beta}=0.37$), all which were statistically significant(P<0.05). Suitability index verification of the performance measurement model whose causal relationship was found to be statistically significant revealed that $X^2/df=2.875$, RMR=0.036, GFI=0.831, AGFI=0.810, CFI=0.887, NFI=0.838, IFI=0.888, RMSEA=0.057, PNFI=0.781, and PCFI=0.827, all of which were in suitable levels. In conclusion, the performance measurement indices of EMR system include utility cognition, security, and system quality of the learning & growth perspective, decision support and job efficiency of the internal process perspective, system satisfaction, decision support satisfaction, and job satisfaction of the customer perspective, and productivity improvement and cost reduction of the financial perspective. In this study, it is expected that the performance measurement indices and model of EMR system which are suggested by the author, will be a measurement tool available for system performance measurement of EMR system in medical institutions.

• 한국건강관리협회지
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• 제4권1호
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• pp.125-131
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• 2006

Background: Inadequate samples make laboratory tests delay cause errors, which will deteriorate the quality of the tests. Therefore, adequate samples are essential for reliable test result. To reduce the inadequate samples, they should to analyze problems and seek a way of improvement through CQI (Continuous Quality Improvement) activity. This will minimize errors during the test and produce a fast and accurate result. Eventrally, the qualily of entire test may be improved, and as a result, a good quality of medical care service may be provided. Methods: At first, inappropriate testing items were collected. Then, generating fctors and problems were investigated and analyzed in each case, In addition, the category with higher frequency wes primarily supervised. In consegalnce, a reduction of are dustion of improper testing sample was oxpected through continuous education and CQI activity. Conclusion : At the beginning of CQI activitv, the number of inadequate testing sample was of 8,591 total samples, which gives the frequency of 0.72%. As CQI activity was carried out the number of improper testing sample reduced to 58 out of 11,415 cases, which yields the frequency of 0,51%. One may notice the difference 0.2%. Among the inadequate sample(blood), there was a high frequency of hemolysis; thus, more of CQI activity is required for this specific matter. Because the occurrence of inadequate testing affects the clinical outcomes, it is extremely important that one manages each step of the procedure in collecting samples and mamtaines the quality of entire tests.

• 한국의료질향상학회지
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• 제8권1호
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• pp.74-83
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• 2001

Background : Since a Gamma Knife had been installed on December 1997, 405 patients have been treated until December 1999 at department of neurosurgery of Seoul National University hospital. The authors analyzed results of a work to improve satisfaction of Gamma Knife surgery patients and to reduce hospital length of stay. Methods : To understand main discontent of patients, a pre-survey was performed from October 1998 to December 1999 using a questionnaire. By Analyzing 93 questionnaire received from 234 patients, pain on frame application, explanation before surgery, waiting time before surgery, waiting time before medical procedure were main discontent factor and overall satisfaction ratio was 71.0%. To improve satisfaction ratio, several quality improvement activity works were designed and applied to 123 patients during the period between January 2000 and September 2000. The same questionnaire were analyzed. Works to reduce the patient hospital LOS were devised and applied during the same period. Results : The overall satisfaction ratio of Gamma Knife radiosurgery patients was increased to 83.7%(P=0.10). The main factor to improve satisfaction ratio was to reduce waiting time(P=0.05) and improvement of discomfort during the surgery(P=0.06). The average LOS was reduced from 3.1 to 2.7 days(P=0.003). Conclusion : As a result of quality assurance activities, the overall satisfaction ratio of patients was improved and LOS was reduced. The pain during frame application was remained as a main discontent factor and a further study is required to reduce this pain.