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KOREAN JOURNAL OF HOSPITAL MANAGEMENT

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수록정보
수록범위 : 1권1호(1996)~25권3호(2020) |수록논문 수 : 612
한국병원경영학회지
25권3호(2020년 09월) 수록논문
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KCI등재

1신규간호사 '태움(Taeoom)'에 대한 개념 분석

저자 : 김지원 ( Jiwon Kim ) , 배성윤 ( Sung-yoon Bae )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 25권 3호 발행 연도 : 2020 페이지 : pp. 1-13 (13 pages)

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Purpose: This study was conducted to identify the conceptual definition and attributes of 'Taeoom' (or workplace bullying) inflicted to newly employed nurses in Korea.
Method: Walker & Avant(2011)`s eight-stage process was used to perform a conceptual analysis of 'Taeoom'. Literature review of 40 studies published between Jan. 2009 and March 2018 published in Korea was followed by the in-depth interview with nine newly employed hospital nurses and the ex-post review of results by nursing experts.
Findings: 'Taeoom' was associated with five attributes: (1) bullying for no reason, (2) peer rejection for no reason, (3) decreased physical function and psychological withdrawal, and (4) verbal abuse, defamation and nagging, (5) impotent feeling due to power imbalance. Four antecedents found in this study include offensive action, distrust, power imbalance, and undue workload exceeding capacity. As consequences of Taeoom, negative physical and psychological symptoms and turnover intention were increased while nursing performance was decreased.
Conclusion: This study suggests the need for more qualitative researches with more comprehensive approach on Taeoom and the development of effective program to improve the organizational culture in nursing field. This study is significant in that it provides a qualitative but comparative review on the attributes, antecedents and consequences of Taeoom through literature review accompanied by focus group interview and expert review.

KCI등재

2중환자 간호단위의 간호강도에 근거한 적정 간호사 수 산출

저자 : 고유경 ( Yukyung Ko ) , 박보현 ( Bohyun Park )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 25권 3호 발행 연도 : 2020 페이지 : pp. 14-28 (15 pages)

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Purpose: The purpose of this study was to calculate the total daily nursing workload and the optimum number of nurses per intensive care unit (ICU) based on the nursing intensity and the direct nursing time per inpatient using the patient classification.
Methods: Two ICUs at one general hospital were investigated. To calculate the nursing intensity, patient classification according to the nursing needs was conducted for 10 days in each unit during September 2018. We performed patient classifications for a total of 167 patient-days in the Medical Intensive Care Unit (MICU) and 86 patient-days in the Surgical Intensive Care Unit (SICU). The total number of person-days for nurses who responded to the Nursing Time survey was 151 for MICU and 85 for SICU. In each unit, direct and non-direct nursing hours, nursing intensity score, and direct nursing hours were analyzed using descriptive statistics such as frequency, percentage, and average calculated using Microsoft Excel. The amount of nursing workload and the optimum number of nurses were calculated according to the formula developed by the authors.
Findings: For the MICU, the average direct nursing time per patient was 5.59 hours for Group 1, 6.98 hours for Group 2, and 9.28 hours for Group 3. For the SICU, the average direct nursing time per patient was 5.43 hours for Group 1, 7.21 hours for Group 2, 9.75 hours for Group 3, and 12.82 hours for Group 4.
Practical Implications: This study confirmed that the appropriate number of nurses was not secured in the nursing unit of this study, and that leisure time such as meal time during nursing work hours was not properly guaranteed. The findings suggest that to create working environments where nurses can serve for extended periods of time without compromising their professional standards, hospitals should secure an appropriate number of nurses.

KCI등재

3요양병원 치매노인의 장기입원 관련 요인

저자 : 이윤진 ( Yun Jin Lee ) , 이상규 ( Sang Gyu Lee ) , 유창훈 ( Chang Hoon You ) , 김봄결 ( Bomgyeol Kim ) , 김태현 ( Tae Hyun Kim )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 25권 3호 발행 연도 : 2020 페이지 : pp. 29-37 (9 pages)

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Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features.
Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis.
Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups.
Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

KCI등재

4서울시립병원의 코로나19 대응을 통해 본 공공병원의 시사점 고찰

저자 : 손창우 ( Changwoo Shon )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 25권 3호 발행 연도 : 2020 페이지 : pp. 38-52 (15 pages)

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Purpose: The purpose of the study is to suggest the main functions and implications of public hospitals to effectively respond to the future epidemic crisis based on analyzing the accessibility to designated Coronavirus Disease 2019 (COVID-19) medical institutions of Seoul and examining the main features of the quarantine of Seoul municipal hospitals.
Method: To analyze the response and function of Seoul municipal hospitals, we reviewed the Infectious Disease Control and Prevention ACT, 258 articles of Seoul Metropolitan Government press releases from January to the end of April, 48 articles of Seoul Metropolitan Government's daily newsletters, 2019 Health Bureau Budget report. We also referred to internal data of Seoul Children's Hospital, Seoul Seobuk Hospital, and Seoul Eunpyeong Hospital during the same period. Besides, the accessibility to medical institutions was analyzed by using the COVID-19 data which was announced daily basis.
Results: The accessibility of COVID-19 patients living in the Southeastern part of Seoul to a medical institutions was 16.2km on a distance basis, and it was the lowest accessibility among four regions of Seoul since it took about 40 minutes by car. On the other hand, patients living in the Northeast part had the highest accessibility, as the access to medical institutions was 10.7km and 27 minutes by car. Also, the main functions of the municipal hospital of Seoul against COVID-19 were to shift the public hospital function to COVID-19 patients only hospitals, to perform the epidemiological investigation by medical doctors, and to support the operation of self-isolation facilities, community treatment centers and triage rooms of community health centers.
Conclusion: Through the experience of COVID-19, we suggested that the functions of public hospitals will be reorganized as the reinforcement of infectious disease treatment and mental health for quarantined patients, cooperation with private hospitals, supporting for strengthening community health capacity and preparation for another epidemic.

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5병원의 전문화 전략과 운영성과 간의 관계: 근골격계 및 결합조직 질환을 중심으로

저자 : 서슬기 ( Seul-ki Seo ) , 김양균 ( Yang-kyun Kim )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 25권 3호 발행 연도 : 2020 페이지 : pp. 53-66 (14 pages)

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This study is aimed at investigated and compared the differences in the affect of hospital specialization according to hospital size using claims data of the Health Insurance and Review Assessment National Inpatient Sample in 2018 for diseases of the musculoskeletal system and connective tissue.
To this end, we used multivariate hierarchical linear models(a.k.a., multi-level models) using two-tier data from 106,599 patients discharged after diseases of the musculoskeletal system and connective tissue from 734 hospitals.
Multivariate results indicate that patients who were discharged with diseases of the musculoskeletal system and connective tissue from specialized hospitals with 200 beds or less stayed shorter and paid less inpatient charge than those who were discharged from less specialized hospitals. But for hospitals with 201-300 beds, no positive impact relationship was found between hospital specialization and operational performance.
This finding may be limited evidence that the affect of a hospital's specialization strategy may vary depending on the size of the hospital. We discussed several managerial and health policy implications below.

KCI등재

6국내 경제활동 인구의 직업유형별 적정수면과의 연관성

저자 : 김선정 ( Sun Jung Kim ) , 김동준 ( Dong Jun Kim ) , 김은나 ( Eun Na Gim ) , 유태규 ( Tae Gyu Yu )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 25권 3호 발행 연도 : 2020 페이지 : pp. 67-77 (11 pages)

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Background: As of 2016, average Koreans sleep 7 hours and 42 minutes, the lowest figure among Organization for Economic Cooperation and Development(OECD) countries, and the number of people with sleep disorders reached 561,000. Accordingly, the government has promoted the provision of 'Multiple Sleep Test' to strengthen the diagnosis service for patients with 'sleep disorder' in july 2018. As a result, healthcare costs for patients with sleep disorder is on the rise every year. In this study, we utilized 'Appropriate Sleep' criteria of United States`s National Sleep Foundation(NSF) then investigated Korean`s sleep pertinence using 「7th National Health and Nutrition Survey for 2016-2018」by different occupational type, demographic characteristics, socio-economic characteristics, and health behaviors.
Methods: We performed descriptive analysis to examine differences of sleep appropriateness by various sample characteristics. Multivariate logistic regression models were used to examine sleep appropriateness by occupational type and other variables. We also analyzed subgroup models to investigate.
Results: As a result, a total of 1,948 (18.37%) study subjects experienced in-appropriate sleep. Results of the Multivariate logistic regression analysis revealed that blue color group had a higher odds ratio (OR) for experiencing in-appropriate sleep (OR=1.179). In addition, the odds ratio of experienced in-appropriate sleep among the elderly aged 70 and over was 2.698, and the odds ratio of the overstressed group was 1.299. Furthermore, sub-group analysis showed that blue color job of female(Or=1.334), high school or below(OR=1.404), divorce/death/separation(OR=2.039), 25%ile-50%lie income group(OR=1.411) more likely experienced in-appropriate sleep.
Conclusion: Growing sleep disorder patients and related health care costs are expected. Government should apply detailed ʻtotal periodic sleep disorder management policyʼ including pre-consultation, examination, diagnosis, treatment, post-consultation, self-management especially to vulnerable population that this study found.

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7요양병원의 입원급여 적정성 평가 결과에 미치는 영향 요인 분석

저자 : 이상갑 ( Sang-kab Lee ) , 설진주 ( Jin-ju Seol ) , 이광수 ( Kwang-soo Lee )

발행기관 : 한국병원경영학회 간행물 : 한국병원경영학회지 25권 3호 발행 연도 : 2020 페이지 : pp. 78-86 (9 pages)

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Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals 
Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data.
Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients.
Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.

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