• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.6
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• pp.2819-2827
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• 2013

The purpose of his study was to analyze the environmental and the medical factors of prematurely discharged patients in a rehabilitation hospital. The subjects were 107 inpatients. The data were collected using self-report questionnaire and analyzed using the SPSS Win 19.0 program. In result, Firstly, general selection of hospitals was the 'Recommendation' 35.5%, Environmental dissatisfaction factors are Hospital facilities 37.4%. Hospital choice is the highest 'Acquaintances' 23.4%. Second, the lowest group about professionalism, kindness, and description of explanation on satisfaction in survey is group of care workers for the sick. The highest group is physical and occupational therapist. Third, the satisfaction regarding medical procedures of administrative work, waiting time and medical expenses is the highest normal. Hospital facilities in one of the highest factors in environmental dissatisfaction is can be considered as an element of patient departure because of not much number of nervous special hospitals. Medical dissatisfaction factors is the lowest satisfaction of care worker even if those spend much time. this is the focus leaving hospital. Therefore, factors care workers on service satisfaction and dissatisfaction in analysis and problem solving is considered that the need to find ways to improve the quality of service care workers.

• Health Policy and Management
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• v.28 no.4
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• pp.339-351
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• 2018

Background: The purpose of this study is to estimate empirically whether there is a difference in medical use among income groups, and if so, how much. This study applies econometric model to the most recent year of Korean Medical Panel, 2015. The model consists of outpatient service and inpatient service models. Methods: The probit model is applied to the model which indicate whether or not the medical care has been used. Two step estimation method using maximum likelihood estimation is applied to the models of outpatient visits, hospital days, and outpatient and inpatient out-of-pocket cost models, with disconnected selection problems. Results: The results show that there was the inequality favorable to the low income group in medical care use. However, after controlling basic medical needs, there were no inequities among income groups in the outpatient visit model and the model of probability of inpatient service use. However, there were inequities favorable to the upper income groups in the models of probability of outpatient service use and outpatient out-of-pocket cost and the models of the number of length of stay and inpatient out-of-pocket cost. In particular, it shows clearly how the difference in outpatient service and inpatient service utilizations by income groups when basic medical needs are controlled. Conclusion: This means that the income contributes significantly to the degree of inequality in outpatient and inpatient care services. Therefore, the existence of medical care use difference under the same medical needs among income groups is a problem in terms of equity of medical care use, so great efforts should be made to establish policies to improve equity among income groups.

• The Journal of Korean Obstetrics and Gynecology
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• v.18 no.3
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• pp.139-151
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• 2005

Purpose : 1. To analyze the cognition and realities of postpartum care and to aid the spread of oriental medicine in postpartum care. 2. Get a basic guideline of postpartum care home and O.M.D.'s role model of postpartum care. Methods : We studied the cognition and realities of postpartum care with questionnaire from May 2005 to July 2005, in postpartum care home at Gangdong-gu and Seocho-gu. 147 puerperants answered us. Results : Puerperants pay postpartum care for without regard to economic state. 59.2% of 147 puerperants replied that the reason of postpartum care at postpartum care home is for systematic care. Important selection guidelines of postpartum care home are expertness at infant and puerperant management. We can find that 78.2% of 147 puerperants will visit oriental medical clinic for postpartum care and 61.2% of 147 puerperants will take herb-medicine. Conclusion : Puerperants has well-expectation in postpartum care by oriental medicine. There is much room for extension of oriental medical province in postpartum care. So continuous publicity activities about oriental medical postpartum care are required.

• Clinical and Experimental Pediatrics
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• v.45 no.2
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• pp.166-173
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• 2002

Purpose : The aim of this study is to find out the distribution of illness, patterns of medical care utilization and factors determining medical care utilization in elementary school children. Methods : We performed the questionnaires in Gwangju city on 2,036 children of two elementary schools from June 1 to June 30, 1998. Results : The prevalence rate of illness was 32.3%. The distribution of illness was respiratory disease(64.7%), gastrointestinal disease(12.8%), injury & poisoning. The rate of persons having received medical treatment when they were sick, was 89.8%. The selection distribution among various medical facilities was pediatric hospital(46.7%), otolaryngologic hospital(19.8%), pharmacy (13.2%) and internal medicine in the decreasing frequency sequence. The major factors influencing the selection of medical facility were geographic accessibility and good results. The most common reason for the first visit to the pediatric hospital was geographic accessibility. The most common reason for a visit and to otolaryngologic hospital was a good result. The most frequently utilized medical facility for respiratory symptoms and gastrointestinal symptoms was pediatric hospital. The persons influencing the selection of medical facility in the children were mother(73.3%), father( 10.8%), doctor and others in decreasing sequence. The persons answering the questionaire thought that the optimal age of pediatric care was from 0 to 12 years(47.8%), to 10 years(22.4%) and to 15 years(18.5%) in decreasing rate. Conclusion : Other departments instead of pediatrics have treated children. Children have particular growth and development process, which is different to those of adults. So, it is necessary to choose special medical care and adequate medical facilities for children.

• The Korean Journal of Emergency Medical Services
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• v.1 no.1
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• pp.42-53
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• 1997

To offer basic data about the influential factors on patient's Satisfaction level for emergency medical services the authors were performed this study in 60 patients visited to emergency room of third stage general hospital in Taejeon city. Data were collected through interview with patients by using a 15 items' questionaire according to care subscale, teaching subscale of Likert's five stage quantitative scale and the tools developed by Barbara Davis. The data were analyzed by using the SPSS/PC computerized program for mean, standard deviation, percentage, ANOVA, t-test, and pearson correlation. The results are as followings ; 1. Satisfaction of emergency medical service were showed in care area, but not showed in teaching and total area 2. Satisfaction of sociodemographic characteristics were a statistically significant difference only marriage, that were the higher in marriaged than single(P<.0.05). 3. In the emergency situation characteristics the satisfaction accordings to the visit cause were lower in accident than disease group, the reason of hospital selection were in order trust, introduction group, distance, traffic, kinds, and score of satisfaction were showed each of 43.47, 51.27(P<.001), the transportation vehicle was the 119, hospital ambulance group. but were not a satistically significant difference. 4. The negative correlation was observed between satisfaction and the length of stay at ER and the longer length of stay at ER was showed the lower satisfaction. But the positive correlation was observed between satisfacton and the arrival time, patients who arrived ER from 6:00P.M. to midnight were more satisfied than patients who arrived other time. 5. The length of stay at ER was significantly different according to the reason of hospital selection, the reason of ER selection, the visitant cause and hopital decisioner. Especially the length of stay was much longer in accident group and unconscious group.

• 모자간호학회지
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• v.4 no.1
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• pp.3-11
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• 1994

Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

• Health Policy and Management
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• v.8 no.2
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• pp.1-24
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• 1998

There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.

• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.27-38
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• 2009

Purpose: The purpose of this study was to develop a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The blood glucose control protocol was developed through the following process: selection of preliminary protocols, clinical application, and evaluation. The clinical validity of the protocol was measured by application, along with examination of the effects of the Yale and the Mayo blood glucose protocols. Seventeen medical ICU adults patients whose blood glucose levels exceeded 200 mg/dL consecutively participated in the study. The development protocol was evaluated by an expert group. Results: Incidence of normal blood glucose levels (p=.041) increased significantly in the Yale protocol application group. Also, incidence of severe hyperglycemia (p=.029) decreased significantly and time to target range of glucose (p=.023) decreased significantly after application of the Yale protocol. However, there was no significant difference in incidence of hypoglycemia (p=.666) between three groups. Conclusion: Using the developed protocol as a basis for the modified Yale protocol was found to be effective in improving the state of blood glucose control for medical ICU patients and is expected to be used for nursing intervention in critical care.

• Tuberculosis and Respiratory Diseases
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• v.60 no.2
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• pp.142-150
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• 2006

Pulmonary arterial hypertension (PAH) is often difficult to diagnose and challenging to treat. Untreated, it is characterized by a progressive increase in pulmonary vascular resistance leading to right ventricular failure and death. The past decade has seen remarkable improvements in therapy, driven largely by the conduct of randomized controlled trials. Still, the selection of most appropriate therapy is complex, and requires familiarity with the disease process, evidence from treatment trials, complicated drug delivery systems, dosing regimens, side effects, and complications. We tried to provide evidence-based treatment recommendations for physicians involved in the care of these complex patients. Due to the complexity of the diagnostic evaluation required, and the treatment options available, it is strongly recommended that consideration be given to referral of patients with PAH to a specialized center.

• The Korean Journal of Emergency Medical Services
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• v.9 no.2
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• pp.183-206
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• 2005

Nowadays, the whole world is putting in the knowledge information society by the internet which is connecting the global network. The internet enable us to see the life of the other people in real time. Most of health care professional obtain and update their new knowledge and skills through continuing education. EMTs who works five or ten shifts per day are not easy to attend continuing education session usually offered during their off-times. One of solutions to this problem would be to develop a education program which does not limit time and place. There has been increasing interest in the use of computers in medical education, but all designated facilities and teachers have no sufficient preparations for the education and training of EMT. There has been less attention to the rationale for the use and selection of applications. This article discusses an approach to the selection of medical informatics applications for the undergraduate medical curriculum. The aim of this study is to develop and evaluate a web-based continuing education program, to help EMT improve their knowledge of transfusion therapy and medical law, and to enhance their ability to contribute to the quality of patient care. The program generally was well received by EMTs. The program is a useful adjunct to the existing continuing education program. It also could be used in EMT student education and other health sciences.