Influencing Factors Affecting Caregivers’ Service Quality for the Elderly with Dementia: Focusing on Dementia Knowledge, Work Value, and Job Performance Confidence

Purpose@#The purpose of this study was to verify influencing factors affecting service quality provided by caregivers working for the elderly with dementia. @*Methods@#Data were collected using a self-reported questionnaire from 214 caregivers in a long-term care facility in D city. The data were analyzed with service quality, dementia knowledge, work value, and job performance confidence. For data analysis, the descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression were performed using SPSS/WIN 21.0 program. @*Results@#There were significant differences in service quality depending on the health status. Factors influencing service quality were work value, and job performance confidence with R2 value of 38%. The highly influencing factors were work value, and job performance confidence. @*Conclusion@#The results of this study indicate that the effort to improve the service quality of caregivers should focus on work value and job performance confidence.

Evaluation on the Accuracy of Vaccination Card for National Immunization Program in a 2005 Population-Based Survey in Nonsan, Korea / 農村醫學 地域保健

No abstract available.

Correlation of Progesterone Challenge Test and Endometrial Thickness in Postmenopausal Women / 대한산부인과학회지

OBJECTIVE: The aim of this study is to assess the correlation of progesterone challenge test (PCT) and endometrial thickness as a primary screening test for endometrial pathology in postmenopausal women prior to hormonal replacement therapy (HRT). METHODS: 92 postmenopausal women were measured serum estradiol (E2) level, endometrial thickness by transvaginal ultrasonography, and followed by PCT before HRT. And we compared the results of PCT with endometrial thickness and E2 levels. RESULTS: Women with a positive result of PCT in 32% of case and 75.9% of positive test showed endometrial thickness 4 mm or more. However 60.3% of negative test showed endometrial thickness 4 mm or more. This resulted in a PPV=76%, NPV=40%, sensitivity=37%, and specificity=78%. Mean serum E2 was significantly higher in patient with positive PCT but serum E2 showed no positive correlation with endometrial thichness (CI 95%, P

Improvement of Underlying Cause of Death Determination Using Health Related Data Bases from Death Certificates in Which Causes of Death Recorded as Cardiopulmonary Arrest, Nonspecific Symptom, Senility / 대한의료정보학회지

We performed this study to show that it is possible to identify underlying causes of de ath not identif ied by issued death certificates by mapping and adding information from National Database(DB) such as health insurance DB or KUHDDS(Korea Uniform Hospital Discharge Data Sets) with death certificates. We collected 2,986 death certificates issued at Cheonan, Asan provinces and 458 death certificates issued at 3 general hospitals at Chenoan city. Mapping of death certificate data with health insurance DB was possible in 77.4%(Cheonan, Asan provinces) and 87.3%(3 general hospitals at Cheonan city) of cases. Rate of underlying causes of death identified from records on death certificates before mapping was 64.4% and 68.3% each. After mapping and adding information from health insurance DB, the rate increased to 79.8% and 79.2% each. This work was done by skilled medical record officers. We also selected death certificates which recorded the causes of deaths as old age, cardiopulmonary arrest, or nonspecific symptoms. The possibility was shown that old age, ca rdiopulmonary a rrest, and nonspecific symptoms can be corrected by information from mapped health insurance DB and KUHDDS. With these results, we discussed some cause of incorrect recording practices. And we suggested simple but practical method to improve the correctness of death certificates; there is a possibility that comparing death certificates with KUHDDS before it is issued, where available, can improve the quality of death certificate.

Study on Establishment of Disease Database and Query System Through Internet Using Uniform Hospital Discharge Data Sets / 대한의료정보학회지

It is necessary to have accurate statistical data of disease for planning and evaluating public health policy as well as assessing population health index. The national health insurance data is the only data to assess incidence of diseases nation-wide. However, inaccuracy of the data pose serious limitations of use of the data. The Medical Record Departments of individual health facilities have used discharge summary information for hospital management and clinical research, but a nation-wide integrated database of diseases has not been setup and utilized. We applied previously developed Korean Uniform Hospital Discharge Data Sets to collect discha rge summary data from health care facilities and establish integrated database. We also made the question and answer column about disease of the database in the internet. We collected patient discharge data from a tertiary-care hospital for one year using the electronic discharge summary data collection system, except for health care costs. The internet querying system provided optional selection of columns or rows, individual and/or disease groups and surgical procedures. To make query easy, the system provided various functions like querying codes of diseases and/or surgical operations, reviewing questions, downloading results via excel files, help functions of query. The establishment of disease database and the interactive system through internet is in its inception, further studies may be necessary to make it a user friendly and accurate system. There is a need of an accurate assessment of current population-based health status and future trends in Korea. It is hoped that this study may trigger to establish national accurate database for enhancing studies of health policy making, clinical research and vital health statistics by expanding data collections to the se condary- care and primary- care institutions.

The Fact-finding Survey for medical Information Security Management / 대한의료정보학회지

The possibility of a large quantity of information outflow has been growing since patients' private and medical information is being transmitted to inside and outside of the hospital because of the country's medical record computerization system. Accordingly, it has been threatening patient's privacy and the duty of confidentiality of medical people, and the introduction of security policy is needed which is required for patient information protection. We evaluated medical treatment facilities of diagnostic information security management by conducting questionnaire survey of medical documentation office about their standard of medical information security management, range of medical information access sanction to inside users, outside users' request for information and it's purpose. In the data of medical information user identification and authentication, about the grant of the ID and Password to official in charge, "All have it" has the most high percentaged as 60.0%, "Officer who's most needful have it" is the second as 15.7%, "one's post share it" is the third as 12.9%, but treatment facilities all show similar distribution. About the request for information by patients, All medical institution opened the information on occasion that patients themselves visited the institute and asked information, but in case of telephone inquiry, the only score 0.08 of the institutes accepted. This research, I hope, could be utilized for basic materials for medical recorder who control medical information to manage medical information security and to evaluate operation, and for individual hospital to manage the bound of opening to public and authority to access considering specificity of medical information, and supervisor. Also, the Goverment should set up a definite legal support about the political and technological plan to protect private information in the medical record.

Statistical Analysis of Diseases with Discharge Data Set / 대한의료정보학회지

This study was performed to investigate the factors concerning the structures of diseases in Korea. The data were collected from the 11 tertiary referral hospitals and the number of investigated patients were 242.038 and the diagnoses were based on 21 chapters of Korean Standard Classification of Diseases(KCD-3). The results were as fellows: 1. The number of investigated patients were 242,038 Among them male(51.1%) was a little more than female 48.9%). In age distribution, the group of 45-64 was the highest(25.5%) and 30-49year age group was 20.9%. under l4year age group was 20.3%. and above 65years age group was the lowest( 15.3%). 2. In single diagnosis group division by 21 chapters of KCD-3. diseases of the respiratory system were the highest(11.3%) , injury. poisoning and the next were certain other consequences of external causes( l0.39% ) and neoplasms(10.0%) . The low est were diseases of the blood and blood-forming organs and certain disorders involving the immune mechanism(0.7%). in single diagnosis group, sex, age. season, region and operation and procedures were statistically significant in the x2-test analysis. 3. In multiple diagnoses group. neoplasms were the highest (17.0%). and the next were pregnancy, chirdbirth and the puerperium(l0.6%) and the diseases of the circulatory systems(9.2%). The lowest was diseases of the blood and blood forming organs and certain disorders involving the immune mechanism(0.6%). In multiple diagnoses group, sex. ace. season, region and operation and procedures were statistically significant iii the x2-test analysis.

A Survey Study of Organizational Situation of Medical Record Department for Producation of Disease Statistics on National Basis / 대한의료정보학회지

The purpose of this study was to survey the organizational situation of medical record department(MRD) in hospitals to identify the factors influencing the production ol disease statistics in Korea. 134 hospitals answered for the structured questionnaires mailed to the 218 hospitals. This studs results are as follows. 1 ) There were three types in organizational situation of MRD: independent department (70.1%) a unit in other department (26.1 %) .and in the rest 3.7%. there were no MRD or unit. 2) The differences of work performed in MR ~) or on it in the second referral level hospitals and the third referral level hospitals were statistically significant in incomplete medical record management(p<0.05) DRG coding supplying research data, quality improvement activity. cancer registration(p<0.01) and transeription of medical record( p<0.0l). 3) 66.4% of the target hospitals were performing the recheeking of disease classification data after reponsible physicians completed the incomplete record 4) statistically significant variables which affect works performed in MRD are organizational situation of MRD(<0.001) and the number of medical record professionals. 41.3% of variation of works performed in MRD was explained by variation of organizational situation and the number of medical record professionals.

Feasibility Study of Application of UHDDS Items for Hospital Discharge Abstract and Analysis in Tertiary Care Hospitals / 대한의료정보학회지

The purpose of this study is to identify standardized items from Hospital Discharge Abstract and Analysis data by using UHDDS(Uniform Hospital Discharge Data Sets in USA) and to ascertain the computerization in tertiary hospitals. The data were collected by questionnaire survey, responded 38 hospitals(86.4%) out of 44 tertiary hospitals, and the conclusions are as follows. 1. As for the general characteristics of patient; hospital registration number, patient name, sex and social identification number were reported to 0.92%. 2. As for admission and discharge aspects; admission date was showed 0.92, type of admission and insurance were 0.87%, discharge date 0.92%, the code of primary condition, other diagnoses and primary procedure were 0.89%, disposition of discharge was 0.61%. 3. As for the other characteristics; attending physician license number and name of operating physician were showed 0.87%, birth weight of newborn 0.74%, nationality 0.44%. 4. As for the order communicating system, computerization for the medical record management was showed 57.9%, administration of outpatient 53.6%, administration of inpatient 44.7%, administration of emergency care 28.9%. Judging from the study, the development of Korean Uniform Hospital Discharge Data Sets using Discharge Abstract and Analysis System is applicable to the national wide collection of statistics on the diseases for the discharged patients.

A Survey on the Status of Health Statistics Generation by the Medical Record Offices of Hospitals and its Automation Rate / 대한의료정보학회지

We surveyed the generation rate of health statistics by medical records offices of the 78 hospitals and its automation rate using computerized hospital information system. Structured questionnaire was given to one medical record officer of each hospital. Items in the questionnaire was selected from statistics required for hospital service evaluation or OECD health statistics. More than 50% of the medical record office generated questioned health statistics, and most of them was automated. Because many of the medical record offices of the hospitals are producing essential health statistics and automated, there is a possibility that we can collect and use these datas to build up national health database if adequate standardization procedure can be implemented.

The Study on the Chief Complaints and Completion of Referral Sheets of Patients Transferred to ER

We studied the contents of referral sheets of the patients transferred to DMC Emergency Center from Jan 1, 1999 to Jan 31, 1999. The study far the completion and chief complaints in the referral sheets shows the followings. 1. Examining the referral sheets status of disease, name and age record of 5 major items grade 0.92, the highest point, examining item and laboratorial record grade 0.72, dignosis record grades 0.38, and patients condition and diagnosis opinion record grade 0.10. 2, Name and age item had high completion score in referral sheets from local clinic and hospital for secondary referral level. For address item, however, local clinic scored 0.63 and hospital for secondary referral level scored 0.28, which showed statistically significant difference(P<0.001). 3. In the aspect of severity, name and age record leveled 0.94 to the non emergency patient, 0.92 to the emergency patient, 0.91 urgent patient, showed and no statistic significant difference. 4. The major 10 symptoms of the complaints were these the pain of abdomen and pelvis(25.2%), somnolence and stupor, coma(13.6%), headache(10.9%), and open wound of head(4.0%), ranked 10th common symptom level.

A Study on the Medical Record Technicians Manpower Relation by Before and after Computerization of Medical Record / 대한의료정보학회지

This research investigated on the medical recorder manpower relation by before / after medical record computerization for the object of 51 hospitals in 1998 year. Judging from the situation before / after computerization shown on this investigation, the number of personnels was more increased since computer work than manual work, and the medical recorder present conditions by years show that they have been gradually increasing. This is considered why affairs diversely change according to computerization, the auxiliary recorder present conditions shows the reduction of 98 year in comparison with 94 year. This is regarded that personnels were reduced by facilities like existing transporting pipes. Accordingly, vast data are produced and utilized in the medical record department(room) too, therefore information will be quickly / correctly dealt for this. The times invested for simple affairs will be easily diminished by making existing simple affairs be computerized, and so personnels will have to be invested to earnestly / diversely utilize vast information not to reduce personnels in proportion to diminished times.