• Health Policy and Management
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• v.11 no.4
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• pp.38-53
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• 2001

The price of the hospitals' services is regulated by the governmental health insurance reimbursement schedule in Korea. On the other hand, the emphasis on the quality of care of hospitals service is ever increasing. Under the environment, hospitals have to understand the effects of the activities to improve quality of care on efficiency and on financial performance so that they develop a management strategy that allows quality of care, operational efficiency, and financial achievement simultaneously. This study investigates the relationship among the concepts. The sample for the study includes 23 hospitals that have more than 300 beds. The concept of quality of care is measured by the score reported by the Hospital Standardization Survey (HSS) instituted by Korean Hospital Association. Efficiency is measured by the ratio of number of employee to the number of patients served. Financial performance is measured by the financial ratios indicating the profitability of a hospital. An analysis is performed using the multiple regression. The results show significant positive relationships between the HSS score and efficiency indicators, md between the HSS score and profit measures. However, the significant positive relationship between the HSS score and profit measures disappeared when efficiency indicators were introduced to the model. This study concludes that the structural quality of a hospital has a positive effect on efficiency of the hospital and that the structural qualify indirectly affects the financial performance of a hospital through the improvement of efficiency. Based on the findings, the implications on hospital management and health policy are discussed.

• Journal of Physiology & Pathology in Korean Medicine
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• v.20 no.2
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• pp.328-332
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• 2006

This study aims to provide definitions and standardization for necessities that elderly people can use conveniently and properly in their daily lives and classify necessities for different purposes. First, standard terminologies were defined by reviewing the literature and the relevant laws related to daily necessities for the elders. Secondly, a concept for necessities for the elders was also defined through consultation with experts. Lastly, the elderly's necessities were selected and classified. The elderly's necessities are defined as aids that ordinary elderly people in normal aging process need for the purpose of the convenience of life and aids they wear or use to maintain or improve their health. In this study, the elderly's necessities are divided into three categories: necessities of health, necessities of Oriental medical aids and necessities of daily living. Each category is further classified as follows: Necessities of health include aids for personal medical treatment, aids for personal care and protection and aids for recreation. Necessities of Oriental medical aids include aids for personal medical treatment, aids for personal care and protection and others. Necessities of daily living include aids for personal care and protection, aids for personal mobility, aids for housekeeping, furnishings, aids for communication, information and signalling, aids for handling products and goods and aids for recreation. The classification of the elderly's necessities in this study can be used as basic information for further studies of demand for necessities for the elderly. The results will lay the foundation for a standardization system for the elderly's necessities and the development of silver industry.

• Research in Community and Public Health Nursing
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• v.14 no.1
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• pp.75-82
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• 2003

The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.73-83
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• 2008

Purpose: Purpose of this study was to analyze the nursing focuses for standardization of ICU nursing records. Methods: The data were collected from 1,000days'nursing records of 197 ICU patients at a tertiary hospital in Seoul. Nursing focuses were unified at the consulting group meeting and they were cross-mapped with the NANDA nursing diagnoses. Results: The 62 nursing focuses in 7 NANDA categories were extracted from nursing record. Among total nursing focuses 41 correspond to the NANDA nursing diagnoses and 21 were added to ICU nursing focuses. The 10 most frequently used nursing focuses are 'Ineffective airway clearance', 'Impaired gas exchange', 'Ineffective tissue perfusion: cardiopulmonary', 'Ineffective breathing pattern', 'Ineffective tissue perfusion: renal', 'Ineffective infant feeding pattern', 'Risk for impaired skin integrity', 'Hyperthermia', 'Impaired skin integrity', 'Decreased cardiac output', Conclusion: Nursing focuses list of ICU was extracted from the result of this study. These nursing focuses might form a framework for development of research-based assessment guideline and care plans for ICU patients through standardization of nursing records.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.4
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• pp.65-75
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• 1997

The needs for the home care of postpartum mothers and their infants are increasing, but the quality control of home care nurses is not developed yet. The objective of this study is to develop assessment - intervention algorithms for the home care of postpartum mothers and their infants. We can use these algorithms when we assess the client's condition, and find appropriate nursing interventions. Also, these algorithms can offer guidelines for home care nurses, so that standardization of home care can be attained. Common problems for postpartum mothers are postpartum hemorrhage, abnormal vaginal discharge(endometritis), episiotomy pain, breast problems, breastfeeding difficulty, edema, urinary dysfunction and defecation difficulties. Also, commom problems for infants are abnormal body temperature, tarchycardia, respiratory problem, neonatal jaundice, cord problem, abnormal stool, breast feeding, and bathing. These algorithms can be used as a basis for the development of computerized infomation system for the home health care.

• Korean Journal of Hospice Care
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• v.3 no.1
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• pp.12-30
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• 2003

We all human beings, should be reached the terminal of life in the world. There is the only difference between that comes suddenly or slowly. Persons who should be come the terminal stage suddenly due to disease, especially, malignancy, are Hospice patients. Hospice work is the work of all of us because anyone, anywhere, whenever can be suffered in terminal stage. The characters of Hospice-care are total care of wholistic human beings, comprehensive total assessment of the life and the team work composed of diverse team-members, for example, doctors, nurses, social workers, physical therapists, psychologists, ministers & volunteers. The care manager of the total care(the coordinator of Hospice care), should be worked systemically and, rationally. The comprehensive assessment concept should be entered to the infra-consultant of terminal care-program. The care manager should be have the ability of comprehensive assessment for terminal patients. It will also help standardization of Hospice, and application of medical insurance and social security.

• Quality Improvement in Health Care
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• v.29 no.2
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• pp.85-93
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• 2023

Purpose: The predominant approach for mitigating inadequate sampling rates has primarily involved bolstering the volume of education. This study aimed to curtail inadequate sampling rates through the implementation of continuous quality improvement (CQI) activities, tailoring effective methods to the unique needs of each institution. Methods: We developed a sample handling guidebook and implemented QI activities to address this issue. Results: These measures resulted in a 4.7% decrease in inadequate sampling rates, concurrently improving knowledge of sample handling and overall nurse satisfaction. We addressed the root causes of inadequate sampling before laboratory pre-processing by: 1) focusing on systematic rather than erratic errors through CQI activities, 2) revising the sample handling guide, and 3) delivering face-to-face education based on the specific needs of the nursing department. These changes resulted in an additional 0.6% decrease in the inadequate sampling rate. Conclusion: This study demonstrates that the implementation of CQI activities based on evidence derived from a multifaceted causal analysis significantly reduced the inadequate sampling rate compared to previous studies.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.2
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• pp.180-188
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• 2011

Purpose: This study was done to evaluate the operating status of community-based home health center for revitalization of the centers. Method: In this study performance data including organization plan and service utilization plan were evaluated according process theory. Target of evaluation was the community-based home health care center. Results: The vulnerable part of the organization was the information system and financial resources. The home health center introduced PDA (Personal Digital Assistants) in 2005, however home health care nurses did not make full use of it. This service received full support from Seoul city and local government and there were no other sources of income. The vulnerable part of service utilization was service expansion and standardization due to vulnerability of organizational aspects. Conclusions: The home health care center provides high quality services to underprivileged people. In the future, these services should be provided with equity for continuous health care for this population.

• Health Policy and Management
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• v.5 no.2
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• pp.155-172
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• 1995

This study is an empirical analysis on the equity in the delivery of heatlh care under the Korean Medical Insurance Corporation System. The purposes of this study are to find out effects of income on the health care utiliztion and measure the income-related inequity in the distribution of health care. This study was carried out based on the fact that the health insurance program has been organized to achieve the equity objective, "equal treatment for equal needs". Of 41, 828 insured persons who had been diagnosed in the 1993 Health Screening Test and utilifzation data from 1, January 1993 through 31, December 1993 were derived from the Benefit Managment File. Inequity was measured by means of I) share approach, ii) standardization concentration curve approach, iii) inequity index, iv) test for inequity. The major findings were as follows : 1. The expenditure shares of the top two quintile groups exceeded their morbidity shares, whereas the opposite was true of the bottom three quintile groups, Which showed a positive HI$_{LG}$ inequity index, suggesting the presence of some inequity favoring the rich group. 2. Compared with other residential areas, the rural area showed the highest positive HI$_{LG}$ irrespective of need indicatior applied. 3. Standardized expenditure concentration indices adjusted by age, gender and need structure were also found to be positive, and therefore still indicated that there has been inequity favoring the rich after the standardization. 4. The Loglikelihood Ratio (LR) test for the statistical significance of income-related inequity of medical care utilization was carried out using the logistic regression model. The resulting loglikelihood ratio test statistic value was 176, which did exceed the 0.5 percent critical value of the chi-square distribution with 28 degrees of freedom, which is 50.993. Therefore, the null hypothesis of no income-related inequity of medical care utilization was rejected at the 99.5 percent confidence level. 5. The Regression based F-test has been carried out for analyzing the income-related inequity of medical expenditure in terms of age, gender, morbidity indicators as explanary variables. The hypothesis of the absence of income-relate inequity was rejected for all need indicators at the 95% confidence level.nce level.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.353-366
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• 2003

Purpose: This study was to define the care time of elderly in long-term care facilities and to compare and analysis the care time by staff and facility types. Method: The data were collected from 530 elderly over sixty, residing in two long-term care hospitals for dementia, three long-term care hospitals for the elderly and two skilled nursing facilities. Care time for individual residents was measured the total time spent by nurses, aides. Result: The average care time measured by nursing staff was 158.6 minutes a day. The average care time for one resident by nurse was 40.4 minutes, and by aides, 118.2 minutes. The difference of the care time showed statistical significance between long-term care facility types(p<0.001) : average care time for dementia hospital(199.1min) was twice as long as that of skilled nursing facility(94.1min). Conclusion: The results of the study showed that the care time differentiates care time provided to elderly in long-term care facilities in Korea. The study suggests the need to emphasize the importance of standardization of level of staff and service programs by the long-term facilities.