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An Empirical Study on The Relationships of Service Quality, Customer Satisfaction and Its Influencing Variables in Medical Service area (의료서비스의 품질 및 고객만족 관련 변수들의 관계에 관한 실증적 연구)

  • Cho, Hyun-Joo
    • Korea Journal of Hospital Management
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    • v.4 no.1
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    • pp.171-189
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    • 1999
  • This study aims to investigate the determinants of service quality and the relationships of service quality, customer satisfaction, word of mouth and subsequent purchase intention of medical service. SERVQUAL, an instrument developed by the marketing area, is offered as a possible measure of medical service quality. SERVQUAL measures service dimension of tangibles, reliability, responsiveness, assurance and empathy. The questionnaire method is used in this study. A survey is conducted on patients who are randomly selected. The questionnaire are sent to 300 patients and 208 are available. The objectives of this study were: 1) to find out the influence of determinants of service quality on medical service. 2) to investigate the relationship of medical service quality and customer satisfaction. 3) to analyze the relationship of customer satisfaction and favorable word of mouth, ubsequent purchase intention 4) to find out the gap perceived service quality between secondary and tertiary hospital. The results of this study are summarized as follows: 1) Reliability, responsiveness and assurance have a positive impact on the medical service quality. 2) Medical service quality has a positive impact on the customer satisfaction. 3) Customer satisfaction has a positive impact on the favorable word of mouth and subsequent purchase intention. 4) There is no gap between secondary and tertiary hospital of perceived service quality.

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Understanding and Use of Emergency Medical Service System by Health Educator (보건교사의 응급의료체계 인식과 활용 실태)

  • Choi, Uk-Jin
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.2
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    • pp.59-69
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    • 2008
  • Purpose : This study aims to provide basic data to establish an effective emergency medical service system by analyzing health educator' understanding and use of emergency medical service system at schools. Method : 93 questionnaires from 200 elementary, middle and high school nurses in the city D were collected from May 26 to July 7, 2008 and ${\chi}^2$ analysis and frequency analysis were carried out with SPSS win PC 14.0. Results : 1. As for emergency contact points, 3(3.30%) answers 'they do not have any knowledge', 40(43.96%) said 'they have some idea' and 48(52.75%) said 'they do know about it'. Among 24 respondents who have less than five years of working experience, 2(8.33%), 16(66.67%) and 6(25.00%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. As for 9 who have 6-10 years of career, 1(12.50%), 4(50.00%) and 3(37.50%) answered 'have no knowledge', 'a little knowledge' and 'clear knowledge on it' respectively. Among 32 respondents who have 11~20 years, there were no respondents with no knowledge on the given question, and 9(29.03%) said they have some understanding and 22(70.97%) answered they have clear understanding on the topic. From this result, it can be said that there is statistically meaningful differences among different working year groups with ${\chi}^2=16.583$ and p= .010. 2. As for 119 emergency contact in the given district, 24(29.63%), 30(37.04%) and 27 (33.33%) answered 'do not know', 'know' and 'know very well' respectively. As for the question to ask whether they know Emergency Medical Information Center 1339, 66(70.97%) answered 'Yes' and 27(29.03%) answered 'No'. When it comes to emergency contact numbers and list of hospitals, 59(63.44%) said 'they have some list', 20(21.51%) answered 'they have well established contact network' and 14(15.05%) said 'they have none'. 3. As for the use of 119 service at the time of emergency at schools, 59(63.44%), said 'Yes' and 12(12.90%) answered 'No'. Among those who said 'yes', 29(31.18%), 24(25.81%) and 5(5.38%) answered they have used the service 1-2, 3-5 and 6-10 times respectively. Conclusion : In order to ensure health educator to effectively deal with emergency situations at schools, there should be special activities to enhance health educator' understanding on 119 and Emergency Medical Information Center 1339 and at the same time, a system should be established to connect schools, 119 in a given district, hospitals and Emergency Medical Information Center 1339.

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An Analysis of the Determinants of Consumers' Perceived Medical Service Quality and Complaining Behavior (소비자들이 지각한 의료서비스 품질결정요인과 불만호소행동 특성 분석 -인천, 부천 지역을 중심으로-)

  • 강이주
    • Journal of the Korean Home Economics Association
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    • v.35 no.2
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    • pp.217-234
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    • 1997
  • This study attempts to analyze some determinants of consumers' medical service quality and their complaining behavior. The results can be summerized as follows: 1. The determinants of consumers' perceived medical service quality could be categorized as five factors; i.e. nursery, hospital environment, medical doctors, other staffs service fee. Among them nursery sector consists of 32% variance. 2. According to the discriminant analysis, those determinants are of great value to distinguish between satisfied/unsatisfied group. The hit ratio was 85.4% which is relatively high score. 3. The type of complaining behavior could be grouped into no action, private and public complaining behavior. Most of respondents belonged to no action group and a few showed private complaining behavior. Any respondents who were willing to show public complaining behavior could not be found out. 4. These variables which influence complaining behavior were preconception toward hospital, barrier to complaining process and expected complaining behavior. Among them the first one was most influential variable. 5. In order to distinguish between complaining/non complaining behavior group, discriminant analysis was done. The result showed the above three variables had a significantly discriminatory power, the hit ratio reaching above 70%. In summary, we can see that consumers' evaluation on the whole medical service depends on the external factor such as staffs' attitude or hospital facilities due to the lack of their ability to evaluate highly specialized service like doctor's treatment.

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The Effects of Changed Selective Treatment System on Medical Service Usage and Payments for Lung Cancer Patients (선택진료제도 개선이 폐암환자 의료이용 및 본인부담액에 미치는 영향)

  • Jeon, Insook;Lee, Haejong
    • Korea Journal of Hospital Management
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    • v.22 no.4
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    • pp.61-73
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    • 2017
  • In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.

Immobilization Effect and Abdominal Pressure of Newly-Developed Lumbosacral Spinal Orthosis during Task Performance (새롭게 개발한 요천추 보조기의 과제 수행 중 척추의 고정효과와 복부압력)

  • Jeon, Kyung Soo;Yang, Hee Seung;Jang, Soo Woong;Shin, Hee Dong;Lee, Yun kyung;Lee, Young;Lee, Seul Bin Na;Ahn, Dong Young;Sim, Woo Sob;Cho, Min;Cho, Kyu Jik;Park, Dong Beom;Park, Kwan Soo
    • Clinical Pain
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    • v.19 no.2
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    • pp.70-79
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    • 2020
  • Objective: We evaluated the efficacy of a newly-developed spinal orthoses (V-LSO) by comparing the stabilizing effect, abdominal pressure, and comfort of 3 different semirigid LSOs (classic LSO, V-LSO, and Cybertech®) during various body movements. Method: Thirty healthy volunteers (23~47 years, 24 males, 6 females) were selected. A dual inclinometer measured the range of motion (ROM) while the participants performed flexion/extension and lateral flexion of the lumbar spine with 3 LSOs. The LSO's pressure on the abdominal surface was measured using 9 pressure sensors while lying, sitting, standing, flexion/extension, lateral flexion, axial rotation, and lifting a box. Comfort and subjective immobilization were analyzed by a questionnaire. Results: V-LSO had a statistically significant effect on flexion over Cybertech®. No significant differences were noted during extension and lateral flexion between the 3 LSOs. The abdominal pressure showed no significant differences while supine. While sitting, standing, and lifting a box, the mean abdominal pressure for V-LSO were significantly higher than those for Cybertech®. During lumbar flexion, the mean abdominal pressures for classic LSO and V-LSO were significantly higher than that of Cybertech®. For extension, lateral flexion and axial rotation, the abdominal pressure for V-LSO was significantly higher than those of classic LSO and Cybertech®. In the subjective analysis, V-LSO and Cybertech® scored best for comfort. Conclusion: The V-LSO and Cybertech® were more comfortable than the classic LSO, and hence, may have improved compliance with decreased discomfort. V-LSO may be superior to the other LSOs in restricting lumbar movement and increasing intraabdominal pressure.

The Effects of Physical Environment, Perceived Justice and Perceived Waiting-Time on Repurchase Intension (의료서비스에서 물리적 환경, 공정성, 지각된 대기시간이 재이용의도에 미치는 영향)

  • Yoon, Sung-Wook;Kim, Su-Bae
    • Journal of Global Scholars of Marketing Science
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    • v.12
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    • pp.135-154
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    • 2003
  • This study having purpose of promoting the convenience of medical service customer at medical service encounter have tried to know the influence of physical environment, perceived justice, and perceived waiting time to the intention of re-use of medical service through mediating variable such as service Quality evaluation and negative emotion. Particularly, this exploratory study have first tried to know what influence the physical environment and perceived justice have on negative emotion. Findings are; First, the physical environment affect positive influence to service Quality evaluation, and lower the negative emotion. Second, perceived justice have no influence to the service Quality evaluation and negative emotion. Third, the perceived waiting time lower the service Quality and increase the negative emotion. Fourth, the service Quality have positive influence to intention of re-use of medical service. However, the negative emotion have no influence to the intention of re-use of medical service. Therefore physical environment of medical service becomes more important and it is necessary to shorten the waiting time. In addition, even though negative emotion have no influence to the intention of re-use of medical service it is necessary to make the smallest of negative emotion. Because it is possible to separate once switching barner due to the medical service specificity is solved.

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The Effect of Aprepitant Regimen on the Prevention of High-Dose Cisplatin-Induced Nausea and Vomiting (Aprepitant Regimen의 고용량 Cisplatin 유발 오심 및 구토 예방 효과)

  • Park, Su-Jin;Choi, Ji-Seon;Ahn, Jin-Seok;Shin, Ka-Young;Min, Kyoung-A;Chung, Seon-Young;In, Yong-Won;Sohn, Kie-Ho
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.1
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    • pp.17-23
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    • 2010
  • Aprepitant is a substance P/neurokinin-1 (NK1)-receptor antagonist that was approved in 2003 for prevention of CINV. In addition, updated anti-emetic guidelines that include the aprepitant regimen have been published by NCCN and ASCO. However there is scarce clinical data in Korea. The prospective study was performed to evaluate the prevention of high dose cisplatin induced nausea and vomiting in all patients who started high-dose cisplatin-based chemotherapy at our hospital. We checked the nausea severity and vomiting episodes by calling patients within 4 to 5 days after chemotherapy. The retrospective study was performed to compare the prevention of CINV in solid tumor patients who switched their anti-emesis regimen from the standard regimen to the aprepitant regimen. In aprepitant regimen, aprepitant was added to the same anti-emetic regimen used during previous cycles. We checked the nausea, vomiting grades and adverse events in electronic medical records (EMR). In prospective study, 195 patients were included in the analysis. 88.2% of patients achieved a complete response (no emesis and no rescue therapy). In retrospective study, 54 patients were reviewed. With aprepitant regimen, nausea and vomiting grades were improved in 22 patients (40.7%) and in 9 patients (16.7%), respectively. Compared with standard regimen, addition of aprepitant provided superior prevention against CINV in Korean patients receiving highly emetogenic cisplatin-based chemotherapy. Moreover, aprepitant significantly prevented CINV in patients who received the standard regimen to prevent CINV in previous chemotherapy cycles.

Association between defoliant exposure and survival to discharge after out-of-hospital cardiac arrest (고엽제 노출과 병원 밖 심정지 후 생존 퇴원과의 연관성)

  • Kim, Dong Wook;Kye, Yu Chan;Lee, Jung Youp;Jung, Eui Gi;Kim, Dong Sung;Choi, Hyun Jung;Lee, Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.1
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    • pp.38-43
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    • 2021
  • Purpose: We investigated the association between defoliant exposure and survival to discharge after out-of-hospital cardiac arrest. Methods: This is a retrospective case-control study based on the cardiopulmonary resuscitation (CPR) registry. The electronic medical records of out-of-hospital cardiac arrest victims from 6/9/2008 to 12/31/2016 were analyzed statistically. The case patients group had a history of defoliant exposure while the control group did not. Among the 401 victims studied, a total of 110 patients were male out-of-hospital cardiac arrest patients. Baseline characteristics and the parameters involved in cardiac arrest were analyzed and compared between the two groups after propensity score matching. The primary outcome was survival to discharge, and secondary outcomes were sustained return of spontaneous circulation (ROSC) and survival to admission. Results: After propensity score matching a total of 50 patients (case=25, control=25) were analyzed. Primary outcome (survival to discharge) was not significantly different between case and control groups [(OR, 1.759; 95% C.I., 0.491-6.309) and (OR, 1.842; 95% C.I., 0.515-6.593), respectively]. In the subgroup analysis, there were also no significant differences between the control group and subgroups in primary and secondary outcomes according to defoliant exposure severity. Conclusion: There is no statistically significant association between defoliant exposure and survival of out-of-hospital cardiac arrest.

The Association between Weather Conditions and the Number of No-Show Patients at an Academic Medical Center (기상변화와 일개 대학병원 외래환자 예약부도와의 관련성)

  • Park, Il-Soon;Jung, Sang-Jin;Shin, Hwan-Ho
    • The Korean Journal of Health Service Management
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    • v.11 no.4
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    • pp.41-51
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    • 2017
  • Objectives : This study investigates the association between weather conditions and the rate of no-shows at an academic medical center. Methods : Electronic data regarding medical appointments atover the course ofone academic year (2016.03~2017.02) were used for analysis. Characteristics of weather conditions and the daily number of no-shows were compared by Chi-square test. A logistic regression was run to determine if certain aspects of weather affected the rate of no-shows. Results : The results reveal an overall no-show rate of 6.8% that appears to vary in accordance with specific weather conditions. Lower average temperatures, in particular, corresponded with a higher rate of no-show patients. This may indicate that o-show rates in autumn and winter can be expected to exceed those during spring. Conclusions : This study investigates the association between no-show patients and weather conditions, and offers suggestions for augmenting this loss. One recommendation is to begin conducting investigations nationwide in order to provide more useful information.

Recognition and attitude of paramedic students regarding patient privacy protection (응급구조(학)과 학생들의 환자 개인정보보호에 대한 인식 및 태도)

  • Shin, Yo-Han;Kim, Jung-Sun;Kim, Bo-Kyun
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.2
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    • pp.113-128
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    • 2021
  • Purpose: This study sought to analyze perceptions and attitudes regarding patient personal information protection according to the general characteristics of paramedic students and their clinical practice experience. Methods: A total of 215 paramedic students from G university in I metropolitan city and D university in G do were surveyed. Frequency analysis, percentage analysis, and one-way distribution analysis were conducted using the software SPSS version 23.0. Results: First, recognition regarding the operation of laws and systems related to medical law and personal information protection was high among students who had no clinical practice experience, and there were no differences with regard to students' general characteristics. Second, the level of recognition regarding patient personal information protection and exposure did not differ depending on students' general characteristics and clinical practice experience. Conclusion: Based on the results of this study, students' recognition and attitude should be improved by carrying out continuous education on patient personal information protection. Furthermore, more specialized and systematic training related to patient personal information protection should be conducted to nurture appropriately trained paramedic students.