Objective : The purpose of this study is to establish a concept called as 'medical service' newly and to develop an reliable and valid scale that measures medical service. Methods : In order to accomplish these objectives, both conceptual study and empirical study were performed. In a conceptual study, 5 core factors(doctor, medical team, medical facilities, medical process, and hospital) and 24 sub factors were extracted with assistant by 7 experts, based on antecedent studies about components of medical service. In an empirical study, data was taken from 244 adults living in Seoul and Daejeon with the conceptually founded medical service scale. Results : Results of empirical study showed reliability and validity of the medical service scale. Internal consistency coefficient showed high score of .97 and, in accordance with the conceptual study, "medical treatment factor", "appearance factor", "personal factor", "trust factor" and "dissatisfaction factor" were extracted from the data as the five main factors. Conclusions : Finally, limitations of this study and directions for further studies are discussed. Acknowledgement : This work was supported by the Daejeon University Research Grant.
These days, the environment of hospital marketing is changing rapidly. The level of expectation and demand of patients have become greater and more diversified, and patients have more alternatives in selecting hospitals. The standard of hospital selection and the type of using hospital have been changed, and competition among hospitals has been accelerated due to the opening of the medical market through globalization. Accordingly, differentiation strategies are critical in hospital marketing. The quality of medical service oriented toward patient satisfaction becomes a strong strategic weapon to secure a hospital's competitive advantage. Therefore, marketing and communication strategies should be focused on patient-oriented, rather than hospital-oriented. Considering the changes in the hospital environment and the increase in the patients' expectation level, this study categorizes doctors' communication styles into four different ones: trust-type, professional-type, cooperation-type, and control-type. The effects of these communication styles on patient satisfaction were empirically examined. The moderating roles of the patient's characteristics and clinical characteristics between the doctors' communication styles and patient satisfaction were also investigated to find out managerial implications for hospital management. To achieve such goals, data were collected from patients of 12 general hospitals in Busan. The data were analyzed to test research hypotheses that examine 1) the relationships between doctors' communication styles and patient satisfaction, 2) the moderating roles of the patient characteristics and clinical characteristics in the research model, and 3) the impact of patient satisfaction on positive word-of-mouth and repurchase. The following summarizes the major results of this research. First, the data showed that patient satisfaction varied across doctors' communication styles. Trust-type style had the strongest impact on patient satisfaction while control-type style had the weakest influence on patient satisfaction. Professional-type style and cooperation-type style also had positive effects on patient satisfaction but the impact of the two are not statistically different. Second, significant differences in terms of patient satisfaction were found depending upon demographic variables such as gender, marital status, age, occupation, and education. Patient satisfaction, however, was consistent across varying income groups. Third, patients' medical insurance types were also related to patient satisfaction. It implies that a doctor may need to use different communication styles depending on a patient's medical insurance type. Fourth, out-patient and in-patient showed a different level of satisfaction with varying communication styles. Fifth, highly professional knowledge and strong control can influence patient satisfaction depending on the characteristics of the patient treatment field. Sixth, patient satisfaction were proved to have significantly positive effects on word-of-mouth and repurchase. The implications drawn from this study must be tempered by its limitations. First of all, the subjects used in this study were patients in Busan and small- and medium-size hospitals were excluded from the research. Therefore, future research should examine the research model by using a variety of hospitals and clinics throughout Korea. Another research agenda has to do with finding more determinant and moderating variables which will increase an explanatory power of the model. In short, this study may be the first empirical research that investigates the effects of doctors' communication styles on patient satisfaction. Interestingly enough, the results showed that each communication style had a unique impact on patient satisfaction. The findings from this research can be very useful in developing hospital marketing strategies.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.46
no.6
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pp.403-408
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2020
Objectives: Appropriate and accurate local anesthetic (LA) techniques are indispensable in the field of oral and maxillofacial surgery to obtain a satisfactory outcome for both the operating surgeon and the patient. When used alone, the inferior alveolar nerve block (IANB) technique requires supplemental injections like long buccal nerve block for extraction of mandibular molars leading to multiple traumatic experiences for the patient. The aim of this study was to anesthetize the inferior alveolar, lingual, and long buccal nerves with single-needle penetration requiring a minimal skillset such as administering a conventional IANB through introduction of the Benny Joseph technique for extraction of mandibular molars. Materials and Methods: This was a prospective study conducted in the Department of Oral and Maxillofacial Surgery, Kunhitharuvai Memorial Charitable Trust (KMCT) Dental College, Calicut, India. The duration of the study was 6 months, from June to November 2017, with a maximum sample size of 616 cases. The LA solution was 2% lignocaine with 1:100,000 adrenaline. The patients were selected from a population in the range of 20 to 40 years of age who reported to the outpatient department for routine dental extraction of normally positioned mandibular right or left first or second molars. Results: Of the 616 patients, 42 patients (6.8%) required re-anesthetization, a success rate of 93.2%. There were no complications such as hematoma formation, trismus, positive aspiration, and nerve injuries. None of the cases required re-anesthetization in the perioperative period. Conclusion: The Benny Joseph technique can be employed and is effective compared with conventional IANB techniques by reducing trauma to the patient and also requires less technique sensitivity.
Yasser Al Omran;Ellie Evans;Chloe Jordan;Tiffanie-Marie Borg;Samar AlOmran;Sarvnaz Sepehripour;Mohammed Ali Akhavani
Archives of Plastic Surgery
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v.50
no.3
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pp.264-273
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2023
The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.
Background/Aims: Cholangiogram interpretation is not used as a key performance indicator (KPI) of endoscopic retrograde cholangiopancreatography (ERCP) training, and national societies recommend different minimum numbers per annum to maintain competence. This study aimed to determine the relationship between correct ERCP cholangiogram interpretation and experience. Methods: One hundred fifty ERCPists were surveyed to appropriately interpret ERCP cholangiographic findings. There were three groups of 50 participants each: "Trainees," "Consultants group 1" (performed >75 ERCPs per year), and "Consultants group 2" (performed >100 ERCPs per year). Results: Trainees was inferior to Consultants groups 1 and 2 in identifying all findings except choledocholithiasis outside the intrahepatic duct on the initial or completion/occlusion cholangiogram. Consultants group 1 was inferior to Consultants group 2 in identifying Strasberg type A bile leaks (odds ratio [OR], 0.86; 95% confidence interval [CI], 0.77-0.96), Strasberg type B (OR, 0.84; 95% CI, 0.74-0.95), and Bismuth type 2 hilar strictures (OR, 0.81; 95% CI, 0.69-0.95). Conclusions: This investigation supports the notion that cholangiogram interpretation improves with increased annual ERCP case volumes. Thus, a higher annual volume of procedures performed may improve the ability to correctly interpret particularly difficult findings. Cholangiogram interpretation, in addition to bile duct cannulation, could be considered as another KPI of ERCP training.
This paper explored that medial consumers' trusts in both hospitals and doctors are developed by and during investigating hospital websites and that these trusts directly build the consumers' purchase intentions of the hospitals' offline medical services. 208 questionnaires based on the websites of two virtual hospitals, captured on survey brochures, were collected and analyzed. This research indicated information quality of hospital websites affected more on developing consumers' trusts than service quality.
Mohammad K.H.B. Abdulaziz;Mohammad Al-Jamali;Sundus Al-Mazidi;Sarah Albuloushi;Ahmad B. Al-Ali
Archives of Plastic Surgery
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v.51
no.2
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pp.251-257
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2024
Background Plastic surgery has developed to benefit in a variety of challenging areas formerly handled by other disciplines. Medical students do not have a clear picture of plastic surgery as a career due to lacking scope, clinical practice, and understanding of plastic surgery as a clinical area of expertise, including general practitioners, nursing staff, medical trainees, and the general public, and misconceptions about the extent of reconstructive and plastic surgery. Methods A cross-sectional observational study was conducted on Kuwait University Medical students (2nd-7th Years) over a period of 1 month. A questionnaire and a consent form were provided to eligible students. The inclusion criteria were Kuwait University Medical students from 2nd to 7th Years with signed consent form. The response was collected via email sent in coordination with the Vice Dean of Student Affairs in the Faculty of Medicine. Using statistical package for the social sciences, responses were statistically analyzed. Pearson's chi-square test was used to calculate p-values, where p < 0.05 was considered statistically significant. Results A total of 244 eligible medical students, 121 males and 123 females, were included in the study, with a mean age of 21 (±2) years. Similarly, 126 (51.6%) were preclinical students (2nd-4th-year students), while 118 (48.4%) were clinical students (5th-7th-year students). About 79.8% of medical students believed that plastic surgery plays an essential role in trauma management, whereas 9.2% did not consider plastic surgery significant for trauma management. This study found that only 15.5% of medical students were interested in enrolling in plastic surgery residency after graduation, while 47.1% of students did not consider plastic surgery residency after graduation. However, 37.4% were uncertain. The two most driving factors in deciding on plastic surgery residency were expected income (61.8%) and lifestyle (14.3%). Conclusion Improving medical students' education quality can enhance their perception and awareness of plastic surgery. Students should be taught the broader scope of plastic surgery. The inclusion of formal training during undergraduation is the essence of time and should be added to or improved during plastic surgery rotations with more emphasis on reconstructive and hand/peripheral nerve surgery. Student-led interest groups can be a useful tool for educating students about their specialty.
Although the use of social media by doctors raises important issues concerning medical professionalism, the relevant professional bodies in South Korea have failed to issue clear guidelines on social media usage. The Korean Medical Association's newly revised ethics guidelines do require members to maintain dignity while using social media, but the idea of "maintaining dignity" is far from clear, and its premodern connotation prevents it from being reliably used in professional codes of conduct. The authors of this article examine the concept of maintaining dignity and conclude that once it is clarified and redefined it can and should be used as a viable ethical standard in a variety of contexts, including the use of social media. Social media's unpredictability and uncontrollability, and the blurred distinction between professional/public and personal/private can be a threat to medical professionalism. In order to deal with this threat, the concept of dignity is important. We present three examples in which the dignity of medical professionals is undermined and explain why these jeopardize public trust. We conclude that in order to maintain public trust the Korean Medical Association should provide more detailed guidelines on the use of social media by its members.
This study proposes new protocol protecting patients' personal record more safely as well as solving medical dispute smoothly by storing the record not into a computer server in hospitals but into the National Health Insurance Corporation computer server. The new protocol for electronic medical record is designed using RSA public key algorithm and DSA digital signature. In addition, electronic medical record systems are built up with more safety and reliability through certificate authority. The proposed medical information systems can strengthen trust between doctors and patients. If medical malpractice occurs, the systems can also provide evidence. Furthermore, the systems can be helpful to reduce medical accidents. The systems could be also utilized efficiently in various applied areas.
In this study, we intended to find out how to improve the relationship performance between a hospital who is a buyer and its suppliers in the medical supply chain. For specific, in control of the transaction period and the number of bed, we investigated the effect of information sharing between a buyer and its suppliers along with the trust for the suppliers' capabilities perceived by the buyer on the buyer's relationship performance. In addition, in control of the transaction period and the number of bed, we also examined the influences of moderating effect of the interactional justice on the relations between information sharing and relationship performance, and between capability-trust and relationship performance. For this, we conducted reliability analysis, exploratory/confirmatory factor analyses, discriminant validity analysis, and moderated multiple regression analysis including control variables. Our results showed that there are positive effects of information sharing between a buyer and suppliers, and the buyer's perceived trust for the suppliers' capability on the relationship performance while controlling the transaction period and the number of bed. Besides, we empirically confirmed that there was the moderating effect of the interactional justice on the relations between capability-trust and relationship performance, whereas we could not find that statistically significant moderating effect of the interactional justice on the relations between information sharing and relationship performance.
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