• 제목/요약/키워드: medical services and medical clients

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외국인 의료서비스 향상을 위한 주요 요소: 델파이 연구 (Key Elements for the Improvement of Healthcare Services for Foreigners in Korea: A Delphi Study)

  • 이현희;이병숙
    • 간호행정학회지
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    • 제18권2호
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    • pp.137-145
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    • 2012
  • Purpose: This study was performed to identify the key elements for the improvement of healthcare services for foreigners in Korea. Method: Delphi technique was used for this study. As the members of an expert panel for this study, 32 healthcare professionals, who were physicians, nurses, administrators, and care coordinators, with at least 6 months of experiences in international clinics and healthcare services in five metropolitan areas in Korea participated. Data collections were conducted three times from August to October, 2009. The priority and the importance were analyzed using descriptive statistics in SPSS Win 15.0. Result: The key element selected most frequently by the experts was the 'Healthcare providers' abilities for foreign languages' followed by 'Guidelines for facing medical accidences and disputes', 'Information and guide for healthcare services written in English', 'Informed consent preventing medical disputes', 'System of healthcare service fees for foreigners'. Conclusions: The key elements for the improvement of healthcare services for foreigners in Korea were mostly the requirements for effective communication with the foreign clients and the systemic support. The key elements identified in this study can be applied usefully for the development of strategies to improve the quality of healthcare services for foreigners.

병원행정 서비스의 품질 향상을 통한 고객만족도 제고 방안 (Enhancing the Client Satisfaction through Improving the Quality of Hospital Administration Services)

  • 김유호;이주호;류상일;이재은
    • 한국콘텐츠학회논문지
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    • 제9권7호
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    • pp.233-240
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    • 2009
  • 본 연구는 병원행정 서비스의 품질 향상을 통해 고객만족도를 높이기 위한 방안을 제시하는데 목적이있다. 연구 목적 달성을 위하여 병원행정 서비스를 행정직원 서비스, 의료직원 서비스, 시설 서비스, 제도적 서비스로 구분하여 실증연구를 실시하였다. 연구 분석 결과, 다음과 같은 병원행정 서비스의 품질 향상을 위한 방안을 제시하였다. 첫째, 행정직원 서비스 부문에서는 고객에 대한 진료비 내역의 자세한 설명, 환자의 대기 시간을 줄이기 위한 신속한 업무처리와 부서간의 원활한 업무협조가 요구된다. 둘째, 의료직원 서 비스 부문에서는 진료 예약 시간의 정확성 확보를 위해 진료 절차의 단순화와 외래 진료 개시 및 퇴원 수속 완료 시각을 조기화 하는 것이 필요하다. 셋째, 시설 서비스 부문에서는 고객을 위한 편의 시설과 휴식공간의 마련, 주차시설의 확충 및 식단 개편 등이 요구된다. 넷째, 제도적 서비스 부문에서는 진료수가의 정확한 공개 및 서비스 효율화 방안이 마련되어야 한다.

의료서비스에 대한 서비스 부문별 중요도와 만족도에 관한연구 (A Study on the Degree of Importance of Medical Service Sector and Consumer Satisfaction of Service Quality)

  • 이상협
    • 가정과삶의질연구
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    • 제15권1호
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    • pp.129-146
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    • 1997
  • The purpose of this paper was to discover the importance and degree of satisfaction toward medical service perceived by clients and analize some characteristics and any siginificant difference by deomographic and social variables. In addition the subjects were divided into groups(i. e. satisfied and dissatisfied groups) and tested significant difference between two groups, The results can be summerized as follows: 1,. While the importance of over attributes of medical services percevied by customs was higher the degree of satisfaction was relatively low. 2. According to our analysis the degree of satisfaction toward hospital facilities and staff appeared to have relatively have relatively heavy weights compared to total satisfaction scores. 3. As far customers' quality evaluation about medical service is concerned the importance and degree of satisfaction could not be discriminated by demographic variables except education and income level. 4. The discrepancy of satisfaction s ore between satisfied and dissatisfied group was the highest in hospital facilities compared to other three sectors.

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가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정∙방문간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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QFD방법을 이용한 의료 서비스 개선전략에 관한 연구 (A Study on Strategy for Improving Health Care Service through Quality Function Deployment)

  • 김순이;최재하
    • 품질경영학회지
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    • 제27권2호
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    • pp.1-19
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    • 1999
  • It is truism to say that today's customers demand high quality products and services; nevertheless, nowhere is this more prevalent than in the medical industry. Korea's globalization has increased it's citizen's awareness of greater life expectancies and medical improvements in other regions of the globe. Therefore, it is universally essential that in order to be successful in the medical industry, vendors must meet the ever increasing demands of better educated customers. The purpose of this study was twofold: 1) The first objective was discover what health care services are in demand and the quality factors related to these services. 2) The second objective was to determine a strategy for improving health care service through quality function deployment(QFD). One hundred and ninety-five respondents were randomly selected and asked to fill out a questionnaire after having undergone treatment at a medical clinic, located in Daejon, South Korea. The questionnaire was designed to obtain information about both he clients' satisfaction with, and their sense of the value of the medical treatment they received. Penalty-reward analysis and QFD were used to interpret the survey results and to deploy the collective voices of the customers. The results of the penalty-reward analysis illustrated that the 'communication' service quality factor was classified into an excitement factor that incurs no penalty if not achieved but adds value if the requirement is exceeded. As a result of the QFD analysis on the 'communication' service quality factor, eleven strategic alternatives were prioritized, and isolated a vital service quality characteristic. This characteristic can be implemented to bring value-added changes for the improvement of health care services.

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Drools 기반 한방전문가 시스템의 Nginx를 이용한 확장성 연구 (A Scalability Study with Nginx for Drools-Based Oriental Medical Expert System)

  • 장원용;김태우;차은채;최은미
    • 정보처리학회논문지:소프트웨어 및 데이터공학
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    • 제7권12호
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    • pp.497-504
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    • 2018
  • 본 논문은 웹 기반의 한방 전문가 시스템(Oriental Medical Expert System)에 대한 룰 기반 진단 프로세스를 제공하는 확장성, 가용성, 변경 가능성을 가진 시스템으로, 오픈 소스 Drools 기반으로 Spring MVC 프레임워크와 Ajax를 이용하여 구현하였다. 본 한방 전문가 시스템의 처리 프로세스는 일반 사용자가 웹으로 접근하여 설문을 작성한 후 기본적인 진단 및 평가를 제공하여 주는 서비스를 제공한다. 한방 전문가 시스템의 효율적인 운영을 위하여 클라이언트와 서버 간에 비동기적 통신으로 JSON 데이터를 주고받아 서버의 부담을 감소하였으며, 데이터베이스 접근은 기존의 복잡한 JDBC 단점을 보완하고자 Mybatis 프레임워크를 적용하여 RDBMS의 성능을 향상시켰다. 또한, 웹 기반의 장점을 최대한 활용하여 사용자 수가 늘어남에 따라 서버 트래픽 문제를 해결하기 위하여 Nginx를 이용한 로드밸런싱 구조를 구축하여 서비스의 가용성을 확대하였다. 연구 결과로 확장성 테스트를 통하여 서비스의 안정화에 대한 검증을 나타내었다.

Barriers to Health Service Utilization Among Iranian Female Sex Workers: A Qualitative Study

  • Asadi-AliAbadi, Mehran;Abolghasemi, Jamileh;Rimaz, Shahnaz;Majdzadeh, Reza;Rostami-Maskopaee, Fereshteh;Merghati-Khoei, Effat
    • Journal of Preventive Medicine and Public Health
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    • 제51권2호
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    • pp.64-70
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    • 2018
  • Objectives: In most countries around the world, sex work is an illegal activity. Female sex workers (FSWs) in Iran hide their identities, and they are known to be a hard-to-reach population. Despite free access to HIV testing, fewer than half of FSWs receive HIV testing. The purpose of this study was to characterize the reasons for which FSWs do not seek testing at drop-in centers (DICs) and voluntary counseling and testing (VCT) centers in Iran. Methods: A qualitative study was conducted in 2016. The participants were 24 FSWs who received services at VCT centers and DICs for vulnerable females in the north of Iran and 9 males who were the clients of FSWs. In this study, we made use of purposive sampling and carried out a thematic analysis. Results: We found 4 major and 6 minor themes. The major themes were: fear of being infected (with HIV), stigma, indifference, and knowledge. Conclusions: Despite the significant efforts made by the government of Iran to establish and expand DICs for vulnerable females, the number of FSWs receiving services at these centers has not been very considerable. Consequently, by introducing and implementing training programs for peer groups, it may be possible to take steps toward establishing strategic programs for the control and prevention of HIV/AIDS.

실시간 의료 정보 공유 프레임워크 기반의 스마트 의료 클라이언트 개발 (Development of Smart Health Client based on Real-Time Health Information Sharing Framework)

  • 임석진;황희정
    • 한국인터넷방송통신학회논문지
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    • 제14권3호
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    • pp.131-137
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    • 2014
  • 스마트폰과 태블릿등 다양한 스마트 기기들의 등장으로 의료기관의 정보 시스템에도 많은 변화가 시작 되었다. 특히 클라이언트 기기의 다양화는 의료기관내에서 효과적인 의료정보 공유의 필요성은 증대시켰고 이를 위해 N 스크린 기반의 서비스의 요구가 커지고 있다. 그러나 N 스크린 기반의 의료 정보 공유 서비스를 위해 iOS, 안드로이드 등 서로 다른 OS를 지원하는 클라이언트를 개별적으로 개발하고 유지하기에는 많은 비용이 소요되고 사용자에게 다중기기를 통해서 끊김없는(seamless) 서비스를 제공하는 것을 어렵게 하는 문제가 있다. 또한 보안상의 문제로 클라이언트와 의료정보 시스템과의 데이터를 중계해주기 위한 방법도 필요 하다. 본 논문에서는 이러한 문제점 해결을 위해 실시간 의료정보 공유 프레임워크 기반의 스마트 의료정보 클라이언트를 개발 하였다. 개발된 클라이언트는 하이브리드앱 기반으로 의료정보공유 프레임워크를 통해 N 디바이스간의 실시간 정보공유가 가능하며 다양한 클라이언트 개발에도 활용될 수 있다.

지역사회중심 가정간호사업 개발 및 평가 (Development & Evaluation of Community-Based Home Care Nursing Service Program)

  • 이원희;김조자;강규숙;오의금;박희옥;조원정
    • 지역사회간호학회지
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    • 제15권2호
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    • pp.209-217
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    • 2004
  • Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

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국내 가정간호 사업의 성과 측정 연구의 고찰 (Literature review on the domestic studies of the Outcomes of Home Care Service for 1981-1996)

  • 윤순녕;조명숙;김홍수
    • 가정∙방문간호학회지
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    • 제4권
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    • pp.41-52
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    • 1997
  • The purpose of this study is to identify the domestic research results related to the outcomes of home care services for 1981-1996. 12 studies were analized by the characteristics of the subjects, home care services provided, and outcome variables and tools during the period of Apirl-June, 1997. The results were as follows: the subjects of 8 studies conducted before 1993 were discharged patients comparing to early discharged patients of 2 studies conducted after 1994. The main home care service delivered to the clients and their families were education before 1993. The outcome variables were used the level of sat. isfaction of home care services, quality of care, cost-effectveness, health status, quality of life, and self -care ability. A variable, health status, were mainly measured by the global outcome measures such as quality of life, health hehelief, health perception, activity of daily living, health management pattern but also foused outcome measures that could be specified by the medical diagnoses.

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