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A Study on Medical Service Quality affecting percieved value, Satisfaction and Intention of Revisit in Middle Hospitals (중소병원 환자가 인지하는 의료서비스 품질이 서비스 가치, 고객만족, 재이용 의도에 미치는 영향)

  • Ji, Kyung-Ja
    • Korea Journal of Hospital Management
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    • v.18 no.4
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    • pp.18-38
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    • 2013
  • This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, indoor environment, admission procedure, hospital image, service quality of physicians nurses medical technicians medical staff that patients perceived. Inpatients and outpatients were selected from three hospital in D city Questionnaire survey was employed to collect data from the subjects. For inpatients, indoor environment, admission procedure, hospital image and service quality of physicians have an effect on perceived value. Admission procedure, hospital image and service quality of physicians nurses medical technicians has an effect on the patient satisfaction. Hospital image and service quality of physicians nurses medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. For outpatients, Admission procedure, hospital image and service quality of physicians medical technicians have an effect on perceived value. Indoor environment, hospital image and service quality of physicians medical technicians medical staff has an effect on the patient satisfaction. Indoor environment, hospital image and service quality of physicians medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve middle hospitals.

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The Difference in Attitude toward Medical Care between Patients and Physicians (환자와 의사의 의료에 대한 태도 차이 -한 중소도시의 대학병원과 한의과대학 부속 한방병원을 중심으로-)

  • Kang, Myung-Guen;Park, Jong-Ku;Kim, Han-Joong;Sohn, Myong-Sei;Kim, Dal-Rae
    • Journal of Preventive Medicine and Public Health
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    • v.31 no.3 s.62
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    • pp.516-539
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    • 1998
  • The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

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Analysis of influencing factors on hospital-employed physician's income (병원근무 전문의 소득에 영향을 미치는 요인분석)

  • 박웅섭;김한중;손명세;박은철
    • Health Policy and Management
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    • v.9 no.3
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    • pp.1-20
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    • 1999
  • This study reviews the literature of influencing factor on hospital-employed physician's income, and it describes general distribution of hospital-employed physician's income, and analyzes influencing factor of hospital-employed physician's income. A total of 1.795 persons responded to the mail survey. through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study. and the unit of analysis is a physician. To examine the change of average income per month. multiple regression was used to test the change according to physician's characteristics. demographic characteristics. scale of hospital. average intensity of ordinary work. and specialty. The major findings of this study are as follows; 1. As for physicians working in first referral hospital. the average income of neurosurgeon per month was the largest. being 1.34 times larger than that of the family physician, and that of the emergency physician was the smallest, being 0.78 times smaller than that of the family physician, but that of the ophthalmic and Orthopaedic physician was significantly larger than that of the family physician under the control of control variables. And average income per month was significantly larger for physicians who worked in Seoul metropolitan area than physicians who worked in rural area. 2. The year of physician's career, number of average out-patients per month significantly positively associated, but the number of hospital beds and average intensity of therapy significantly negatively associated with average income per month. 3. As for physicians working in second referral hospital. the average income of the psychiatric physician per month was the largest, being 1.33 times larger than that of the family physician, and that of the emergency physician was smallest, being 0.74 times smaller than that of the family physician., but no significant difference was seen under the control of control variables, and average income per month was significantly larger for physicians who worked in Seoul metropolitan area than physicians who worked in large municipal area. 4. The year of physician's career and number of hospital beds significantly positively associated, but average working hours per month significantly negatively associated with average income per month. In conclusion, the year of hospital-employed physician's career is the largest influencing factor on hospital-employed physicians. But the difference of average income per month according to working regions and to number of hospital beds existed in employed physicians under the control of control variables. So this study has implementation that we must consider the influence of working regions and the number of hospital beds on the income of hospital-employed physicians in making policy for hospital. Being a cross-sectional study, this study can not suggest causal explanations. In the future, experiment or cohort study is needed for causal explanations.

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A study on the productivity of physicians operating clinic in Kyeongsangnamdo (경상남도(慶尙南道) 개원의(開院醫)의 진료생산성(診療生産性)에 관한 조사연구(調査硏究))

  • Kim, J.H.;Jeong, K.W.;Chun, J.H.;Lee, C.U.;Pae, K.T.;Kim, K.H.;Shin, H.R.;Park, H.J.
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.171-180
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    • 1991
  • Productivity analysis of physician is one of essential factors for the optimal health manpower planning. Among 690 physicians operating clinic and registered on the Kyeongsangnamdo Medical Association, 623 physicians were studied with a structural questionaire from April 1 to May 31, 1990. This study covers the general characteristics and productivity of physicians and attempts to find relevant determinants of their productivity through stepwise multiple regression analysis based on collected data. The mar results were as follows. First, physicians were more prevalent $35{\sim}44$ group (30.2%) in age, male (95.8%) in sex, specialist (76.5%) in specialization,'city (78.0%) in geographical location. Age group of 35-54 and specialist were mere prevalent in cities than in counties, while age group of 25-44 and 55 over and general practitioner in counties (p<0.001). Second, daily outpatients load of all physician were 77.1 persons on average. Age group of $35{\sim}44$ had the most outpatient load (90.3 persons) among all age group, $6{\sim}10$ years group (94.2 persons) in years of duration of practice, 11 hours per day group (83.4 persons) in working hours per day. Specialists had more outpatient load (82.6 persons) than general practitioners (61.1 persons) and physicians in cities had more (80.2 persons) than physicians in counties (66.3 persons). Daily average outpatient load of physicians were significantly different by their age, speciality, number of assistants and years of practice (p<0.001) and working location (p<0.05), but not significantly different by working hours per day of physician (p>0.1). Third, the productivity of physicians operating clinic were significantly affected by the three factors-number of assistants of physician, age of physician and duration of practice at the current clinic. Age of physician had negative regression coefficient.

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Nonpsychiatric Physicians' Attitudes toward Psychiatry (타과 의사들의 정신과에 대한 태도)

  • Koh, Kyung-Bong;Lee, Hee-Sang
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.13-21
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    • 1998
  • The purpose of the study was to examine nonpsychiatric physicians' attitudes toward psychiatry. 129 physicians responded to the questionnaire regarding attitudes toward psychiatry. A majority were favorable about psychiatric education, psychiatric consultation, psychoanalysis, students' choice of psychiatry as a career, and psychiatrists. Staff were more positive toward psychiatry than residents, and senior staff were more positive about psychiatry than junior staff. Overall, however, no significant differences were found in attitudes toward psychiatry between nonsurgical physicians and surgeons, although staff or residents in nonsurgical departments were more favorable about some aspects of psychiatry than staff or residents in surgical departments. The physicians with more interest in psychiatry as a career in the past were more likely to to be positive about psychiatry as a comprehensive science and a rapidly expanding field of medicine. Physicians with older age were more likely to be positive about status and efficacy of psychiatry, role and functioning of psychiatrists than those with. younger age. The results suggest that previous interest in psychiatry, age and clinical experience favorably influenced physicians' attitude toward psychiatry. In addition, development of models for psychiatric education will be needed to enhance physicians' attitude toward psychiatry.

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Radiation Exposure of the Hand and Chest during C-arm Fluoroscopy-Guided Procedures

  • Jung, Cheol Hee;Ryu, Jae Sung;Baek, Seung Woo;Oh, Ji Hye;Woo, Nam Sik;Kim, Hae Kyoung;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.26 no.1
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    • pp.51-56
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    • 2013
  • Background: The C-arm fluoroscope is an essential tool for the intervention of pain. The aim of this study was to investigate the radiation exposure experienced by the hand and chest of pain physicians during C-arm fluoroscopy-guided procedures. Methods: This is a prospective study about radiation exposure to physicians during transforaminal epidural steroid injection (TFESI) and medial branch block (MBB). Four pain physicians were involved in this study. Data about effective dose (ED) at each physician's right hand and left side of the chest, exposure time, radiation absorbed dose (RAD), and the distance from the center of the X-ray field to the physician during X-ray scanning were collected. Results: Three hundred and fifteen cases were included for this study. Demographic data showed no significant differences among the physicians in the TFESIs and MBBs. In the TFESI group, there was a significant difference between the ED at the hand and chest in all the physicians. In physician A, B and C, the ED at the chest was more than the ED at the hand. The distance from the center of the X-ray field to physician A was more than that of the other physicians, and for the exposure time, the ED and RAD in physician A was less than that of the other physicians. In the MBB group, there was no difference in the ED at the hand and chest, except for physician D. The distance from the center of the X-ray field to physician A was more than that of the other physicians and the exposure time in physician A was less than that of the other physicians. Conclusions: In conclusion, the distance from the radiation source, position of the hand, experience and technique can correlate with the radiation dose.

Discordance between Physician and the General Public Perceptions of Prognostic Disclosure to Children with Serious Illness: a Korean Nationwide Study

  • Kim, Min Sun;Lee, Jihye;Sim, Jin-Ah;Kwon, Jung Hye;Kang, Eun Joo;Kim, Yu Jung;Lee, Junglim;Song, Eun-Kee;Kang, Jung Hun;Nam, Eun Mi;Kim, Si-Young;Yun, Hwan-Jung;Jung, Kyung Hae;Park, June Dong;Yun, Young Ho
    • Journal of Korean Medical Science
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    • v.33 no.49
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    • pp.327.1-327.10
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    • 2018
  • Background: It is difficult to decide whether to inform the child of the incurable illness. We investigated attitudes of the general population and physicians toward prognosis disclosure to children and associated factors in Korea. Methods: Physicians working in one of 13 university hospitals or the National Cancer Center and members of the general public responded to the questionnaire. The questionnaire consisted of the age appropriate for informing children about the prognosis and the reason why children should not be informed. This survey was conducted as part of research to identify perceptions of physicians and general public on the end-of-life care in Korea. Results: A total of 928 physicians and 1,241 members of the general public in Korea completed the questionnaire. Whereas 92.7% of physicians said that children should be informed of their incurable illness, only 50.7% of the general population agreed. Physicians were also more likely to think that younger children should know about their poor prognosis compared with the general population. Physicians who opposed incurable illness disclosure suggested that children might not understand the situation, whereas the general public was primarily concerned that disclosure would exacerbate the disease. Physicians who were women or religious were more likely to want to inform children of their poor prognosis. In the general population, gender, education, comorbidity, and caregiver experience were related to attitude toward poor prognosis disclosure to children. Conclusion: Our findings indicate that physicians and the general public in Korea differ in their perceptions about informing children of poor prognosis.

Korean physicians' attitudes toward the prenatal screening for fetal aneuploidy and implementation of non-invasive prenatal testing with cell-free fetal DNA

  • Kim, Soo Hyun;Kim, Kun Woo;Han, You Jung;Lee, Seung Mi;Lee, Mi-Young;Shim, Jae-Yoon;Cho, Geum Joon;Lee, Joon Ho;Oh, Soo-young;Kwon, Han-Sung;Cha, Dong Hyun;Ryu, Hyun Mee
    • Journal of Genetic Medicine
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    • v.15 no.2
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    • pp.72-78
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    • 2018
  • Purpose: Physicians' attitudes may have a strong influence on women's decision regarding prenatal screening options. The aim of this study is to assess the physicians' attitudes toward prenatal screening for fetal aneuploidy including non-invasive prenatal testing (NIPT) in South Korea. Materials and Methods: Questionnaires were distributed and collected at several obstetrics-gynecological conferences and meetings. The questionnaire included 31 multiple choice and 5 fill-in-the-blank questions. Seven questions requested physicians' demographic information, 17 questions requested information about the NIPT with cell-free fetal DNA, and 12 questions requested information about general prenatal screening practices. Results: Of the 203 obstetricians that completed the survey. In contrast with professional guidelines recommending the universal offering of aneuploidy screening, only 53.7% answered that prenatal aneuploidy testing (screening and/or invasive diagnostic testing) should be offered to all pregnant women. Physicians tended to have positive attitudes toward the clinical application of NIPT as both primary and secondary screening methods for patients at high-risk for fetal trisomy. However, for patients at average-risk for fetal trisomy, physicians tended to have positive attitudes only as a secondary screening method. Physicians with more knowledge about NIPT were found to tend to inform their patients that the detection rate of NIPT is higher. Conclusion: This is the first study to investigate expert opinion on prenatal screening in South Korea. Education of physicians is essential to ensure responsible patient counseling, informed consent, and appropriate management after NIPT.

Primary Care Physicians' Cancer Screening Recommendation Practices and Perceptions of Cancer Risk of Asian Americans

  • Kwon, Harry T.;Ma, Grace X.;Gold, Robert S.;Atkinson, Nancy L.;Wang, Min Qi
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.3
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    • pp.1999-2004
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    • 2013
  • Asian Americans experience disproportionate incidence and mortality rates of certain cancers, compared to other racial/ethnic groups. Primary care physicians are a critical source for cancer screening recommendations and play a significant role in increasing cancer screening of their patients. This study assessed primary care physicians' perceptions of cancer risk in Asians and screening recommendation practices. Primary care physicians practicing in New Jersey and New York City (n=100) completed a 30-question survey on medical practice characteristics, Asian patient communication, cancer screening guidelines, and Asian cancer risk. Liver cancer and stomach cancer were perceived as higher cancer risks among Asian Americans than among the general population, and breast and prostate cancer were perceived as lower risks. Physicians are integral public health liaisons who can be both influential and resourceful toward educating Asian Americans about specific cancer awareness and screening information.

Analysis of Prejudice Toward Foreigners by Nurses and Physicians in Korea (국내 의료인의 외국인에 대한 편견)

  • Nam, Kyoung A;Jeong, Geum Hee
    • Journal of Korean Public Health Nursing
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    • v.27 no.3
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    • pp.437-449
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    • 2013
  • Purpose: To improve the cultural competency of nurses and physicians in Korea by disclosing their degree of prejudice toward foreigners who were major target of international medical tourists. Method: A descriptive research design was employed. Data were collected from a total of 458 nurses and physicians at general hospitals in Korea. Subjects completed questionnaires on their demographic information and prejudice toward foreigners from a cognitive, emotional, and behavioral perspective. Results: While there was a positive attitude toward Caucasian Americans and Japanese, there was a negative prejudice toward Chinese and African Americans. There was an especially high and negative prejudice from a cognitive and behavioral perspective toward Chinese. There was a significant difference in the level of prejudice according to the education level, workplace, and multi-cultural education of Korean health professionals. Conclusion: It is necessary to investigate the negative prejudice toward foreigners of specific races or countries with cautious consideration. We also recommend the development and application of strategies to improve the multi-cultural competency of Korean nurses and physicians.