• Title/Summary/Keyword: outpatient system

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A Comprehensive Study on Patient Flow Improvement Solutions and Their Implementation Strategies in an Outpatient System (대형 병원 외래 시스템의 환자 흐름 개선방안의 적용 전략에 관한 연구)

  • Lee, Young-Woo;Lee, Tae-Sik
    • IE interfaces
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    • v.23 no.1
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    • pp.1-11
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    • 2010
  • There are various ways to manage the patient flow of the hospital outpatient system. However, it is difficult to apply many implementation solutions to the real outpatient system at once. Because first, the expected effects of each different solution are very much depend on the real situation of the system and applied other solutions, and second, owing to the limited resources, each solution should be implemented according to the priority. In order to overcome these difficulties, this paper focuses on proposing the comprehensive subset of implementation solutions, which is one of the most effective among various kinds of subsets, and verifying the effects of it. The comprehensive subset of solutions is derived from conducting design of experiments and simulation which determine the optimum set of different solutions and analyze the particular interactions and priority order among them. This implementation strategy can solve the difficulties of applying different kinds of various solutions to the hospital outpatient system.

Evaluation of Efficiency of Outpatient Clinic in a General Hospital using Data Envelopment Analysis (DEA) (일 종합병원 외래간호단위의 효율성 평가 -자료포락분석법(Data Envelopment Analysis)의 적용)

  • Im, Hye-Bin;Lim, Ji-Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.19 no.1
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    • pp.11-18
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    • 2012
  • Purpose: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.

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The Change in the Outpatient Visit to Tertiary care Hospital after the Implementation of the Separation of Prescription and Drug Dispensing Policy (의약분업 전.후 3차 진료기관 외래이용 변화)

  • Cho, Dong-Yeong;Yu, Seung-Hum;Sohn, Tae-Yang
    • Korea Journal of Hospital Management
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    • v.7 no.1
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    • pp.19-40
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    • 2002
  • The purpose of this study is to find out if there has been any change in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare program that divides the roles of doctors and pharmacists and the reason for the change if there is any. Two tertiary care hospitals with the largest capacity of 1200 beds and two tertiary care hospitals with the lowest capacity of 600-700 beds were randomly selected. Data of the outpatient visits from March-May 2(xx), before the new healthcare system was adopted, were compared with the data from March-May 2001, after the new policy was adopted. Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. Decrease in re-visits is much higher than the first visits. Female patients decreased more than the male patients. Outpatient visits by economically active patients group aged 25-44 declined much. Tertiary hospitals in Seoul and Kyonggi Province, as well. Outpatient income of tertiary hospitals has dropped up to 14.7% due to the decline in outpatient visits and pharmaceutical income, and resell price system which in turn has caused the hospital financial deficits. While the new program has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs. A full-fledged review of the system should be conducted for the establishment of the new system and I believe this study may be a useful references. Furthermore, more profound and overall studies on the chance in the patients use of hospitals are needed.

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Utilization of Computer System for Outpatient's Dispensing Affairs in Hospital Pharmacy (병원약국의 외래조제업무에 대한 컴퓨터의 이용)

  • Ro, Hwan-Seong
    • Journal of Pharmaceutical Investigation
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    • v.23 no.2
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    • pp.97-102
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    • 1993
  • Hospital pharmacy services are divided into dispensing affairs for inpatients and outpatients, pharmaceutical service, stock control, intravenous admixture service, drug information service, pharmacokinetic consultation service, education and research work, etc. But among those affairs, dispensing affair for outpatient is perceived as the most important work in Korea, because it is linked directly with hospital service for patients. Therefore, total computer system for dispensing area was adopted from opening point of hospital in 1989 in Asan Medical Center. Utilization of computer system for outpatient dispensing area is as follows; 1) Order communication system of prescription by Total Hospital Information System, 2) Automatic print-out system of direction for use by sticker connected with on-line net work, 3) Use of automatic tablet counting and packaging machines connected with on-line net work. Those computer system resulted in curtailment of pharmacy manpower and shortening of waiting-time for outpatient.

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Analysis of Appropriate Outpatient Consultation Time for Clinical Departments (진료과별 적정 외래 진료시간에 관한 연구)

  • Lee, Chan Hee;Lim, Hyunsun;Kim, Youngnam;Park, Ai Hee;Park, Eun-Cheol;Kang, Jung-Gu
    • Health Policy and Management
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    • v.24 no.3
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    • pp.254-260
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    • 2014
  • Background: The purpose of this study is to assume appropriate outpatient consultation time for each clinical department on the basis of measured outpatient consultation time and satisfaction of outpatient. Methods: We surveyed the feeling and satisfactory outpatient consultation time, satisfaction, revisiting intention and recommendation to others to 1,105 patients of single general hospital in Gyeonggi-do and measured their real outpatient consultation time from October 28 to November 27 in 2013. On the basis of satisfaction, we estimated appropriate outpatient consultation time through area under the receiver operating characteristic curve in logistic regression model. Results: Feeling outpatient consultation time was 5.1 minutess, satisfactory outpatient consultation time which was suggested by patient was 6.3 minutes, and real outpatient consultation time was 4.2 minutes. Department which had longest real outpatient consultation time was infection (7 minutes) and department which had longest satisfactory outpatient consultation time was neurology (9.4 minutes). From the univariate and the multiple linear regression analysis, real outpatient consultation time was longer in pulmonology patient, new patient and afternoon patient, satisfactory outpatient consultation time was longer in infection, neurology, neuropsychiatry, neurosurgery, and rehabilitation patient. Appropriate real outpatient consultation time was suggested as 5.6 minutes which differentiated high and low satisfied patient group. However, we could not assume appropriate outpatient consultation time for each clinical department because the number of patient who had bad satisfaction was too low. Conclusion: To improve patient's satisfaction, we hope outpatient reservation system is operated as each patient's outpatient consultation time is at least 5.6 minutes.

Revision and Evaluation of Korean Outpatient Groups-Korean Medicine (한의 외래환자분류체계 개선 및 평가)

  • Ryu, Jiseon;Lim, Byungmook;Lee, Byungwook;Kim, Changhoon;Han, Chang-Ho
    • The Journal of Korean Medicine
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    • v.35 no.3
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    • pp.93-102
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    • 2014
  • Objectives: This study aimed at revising the Korean Out-patient Groups for Korean Medicine (KOPG-OM, version 1.0) based on clinical similarity and resource use, by using the accumulated claims data, and evaluating the validity of the revised classification system. Methods: A clinical specialist panel involving 19 specialists from 8 Korean medicine (KM) specialty areas reviewed the classification tree, diagnosis groups and procedure groups in terms of clinical similarity. Several models of outpatient grouping were formulated, with the validity of each tested based on the $R^2$ coefficient of determination for the treatment costs of all visits. To add age splits, the variances of treatment costs by age groups were also analyzed. These statistical analyses were performed using KM claims data of National Health Insurance from 2010 to 2012. Results: The classification tree designed via panel discussions was used to allocate outpatient cases to 26 diagnosis groups, with cases involving procedures such as acupuncture, moxibustion and cupping, then allocated to 9 procedure groups in each diagnosis group. The cases without procedures were categorized into the visit index - medication group. This process resulted in 298 outpatient groups. The $R^2$ values for treatment costs of all visits ranged from 0.38 to 0.69 depending on the providers' types. Conclusions: The revised model of KOPG-KM has a higher validity for outpatient classification than the current system and can provide better management of the costs of outpatient care in KM.

A Study on the Spatial Organization of Outpatient Department in General Hospital - Focused on the Latest Planned General Hospital of Scale more than 500 Beds - (종합병원 외래진료부의 공간구성과 규모계획에 관한 조사연구 - 최근 계획된 500병상 이상 규모의 종합병원을 중심으로 -)

  • Son, Jae-Won;Lee, Teuk-Koo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.13 no.2
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    • pp.53-60
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    • 2007
  • Various changes in medical environments including growing elderly population, chronic diseases, deepening competition among hospitals since opening to foreign medical service, economic strategy for improvement of profit system have caused hospitals to be specialized. In this backgrounds, the purpose of this study is to receive basic data for architectural planning on the spatial organization of outpatient department in general hospital. The results of this study were as follows; First, major changes of outpatient department in general hospital are composed of 'co-work in medical examination and treatment', 'decentralization of diagnosis and treatment(D/T)' and 'patient-oriented medical service'. Changes by co-work system include appearance of medical offices for co-work, activation of specialized clinics, grouping of E/T section for outpatient and various types of specialized centers. Second, the grouping of E/T sections means the modification of E/T system and organization in general hospitals, and a new spatial organization will be needed. Third, the types of specialized centers are getting varied. they are classified into several types including disease-resource, social stratum-resource, human organ-resource, health-resource, rehabilitation-resource, alternative medical center and so on.

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A SURVEY OF DENTAL TREATMENT UNDER OUTPATIENT GENERAL ANESTHESIA AT CHONBUK NATIONAL UNIVERSITY DENTAL HOSPITAL BETWEEN 2014~2017 (2014년부터 2017년까지 전북대학교 치과병원에서 외래 전신마취 하에 치과치료를 받은 증례에 관한 연구)

  • Ahn, Na Hyun;Lee, Daewoo;Kim, Jaegon;Yang, Yeon Mi
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.1-6
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    • 2019
  • There are increasing number of patients having dental treatment under outpatient general anesthesia. There were researches that studied patients treated under outpatient general anesthesia in Chonbuk National University Dental hospital between 2005~2013. However, there has been an absence of research since 2013. Therefore, the aim of this research is to study cases regarding outpatient general anesthesia visiting Chonbuk National University hospital between 2014~2017 and analyze the trends of these patients. The medical records of 409 cases from January, 2014 to December, 2017 were reviewed. From the patients' charts, data on sex, residence, visiting dates, disability status, and types and number of treatments was collected and investigated. The number of cases has increased from 86 in 2014 to 140 in 2017. Among 409 cases, 275 cases(67.2%) had disabilities, with mental disabilities consisting most of the disabilities. 192 cases were aged under 20 years old mostly with no disabilities, 142 cases were 20~39 years old mostly with mental disabilities, and 75 cases were 40 years old or more mostly with physical disabilities. The conservative treatment was performed most frequently in both disabled and non-disabled patient groups. There was an increasing trend in the number of patients treated under outpatient general anesthesia, and more than half were disabled patients. In order to meet this demand, Chonbuk National University Dental Hospital increased the number of general anesthesia pracrice. To follow this trends, the implementation of safe outpatient general anesthesia system and cooperation among teams is needed to improve the quality of treatments.

A Study on the Spatial Characteristics of the Outpatient Department in the Women′s Hospital - Focused on the Outpatient - (여성 전문병원 외래부의 공간특성에 관한 연구 - 환자관점을 중심으로 -)

  • 주진형
    • Korean Institute of Interior Design Journal
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    • v.13 no.5
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    • pp.133-142
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    • 2004
  • Recently, the Korean medical system changed with diversification & specialization and the field of medical service is also specialized in these days. And healing environment is proposed as a general concept in the hospital architecture. There is a trend that a establishment of women's hospital is increasing as specialized type. In difference from general hospital, they are providing specialized and integrated services in response to the women's disease and demand. Particularly, Outpatient department space in women's hospital has been changed in terms of area, shape and program. However, there used to be not enough research efforts of responding these changes. This study includes the Outpatient department of s women's hospital in the form of small and medium sized building over a certain level in Korea. And the methods of the study adopted the theoric examination based concept and features of women's hospital, the abstraction of distinctions in the Outpatient department through the analysis of the drawing, and the analysis of distinctions in the Outpatient department of women's hospital with the structural space classified and the analysis of space relation. Therefore, the purpose of this is to study investigates and analyzes the spatial characteristics of the Outpatient department space in women's hospital through a analysis of case study. To conclude, the space composition can be classified into the entry space, the clinic space for patients, the support space of patients' check-up, the reception and waiting space, the rest and convenience space, and the link space in the Outpatient department of women's hospital. The level space can account for the waiting space type, the clinic office type, the type based on the relation between the waiting room and the clinic office with its features. As a result, the results will be applied for the planning & design for the future women's hospital.

Individual Variations in the Code of the International Classification of Disease for Similar Outpatient Conditions among General Practitioners (동일 질환에 대한 상병분류기호의 의료기관별 변이에 관한 연구)

  • 문옥륜;김창엽;김명기
    • Health Policy and Management
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    • v.2 no.1
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    • pp.66-79
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    • 1992
  • The code of the International Classification of Disease(ICD) is seriously questioned on its effectiveness in identifing an independent disease entity from similar conditions at general practitioner's offices. This study has attempted to show individual coding variations in ICD for similar ambulatory care conditions. It has been assumed that a following outpatient visit is regarded as the sane kind of visit owing to the same disease if a visit to the different source of care would be mad within an interval of less than two days. The 'D' health insurance association was selected for this analysis. The 'D' association had 153,298 members and made claims of 642,605 outpatient care in 1990. Out of the total outpatient claims, 8.6%(55,102 claims) were counted as the same disease which could meet the above assumption. Percent of conditions classified as the 10 leading causes of frequent visits which were matched accurately to the subsequent ICD diagnostic code found to be 15.8% on the average. The URI was noted for the highest concurrence rate of 20.4%. This proportion was even decreased to 11.6% on the case of chronic disease. Despite the fact that the assumption underlying the definition of the above same disease is rather rough and inappropriate, this study reveals that the code of ICD currently in use has weaknesses in seperating a certain independent disease from similar conditions at the outpatient setting. Thus, efforts need to be elaborated to meet the need of a new system of classification for conditions and diseases encountering at ambulatory care.

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