OBJECTIVE: This study aimed to achieve expert consensus for the evaluation of Emergency medical system operation fund (EMSOF) support projects using the Delphi method in Korea. METHODS: The Delphi study was performed in June 2018. Experts who are members of the policy committee of the Korean Society of Emergency Medicine (KSEM) participated in the study. Respondents were asked to express their level of agreement of appropriateness for the following 6 categories for 21 projects: project contents, amount of support, indicators, performance, overall evaluation, and need to maintain. With a possible score of 9 points, the project categories were classified into 3 groups, inappropriate, moderate and appropriate, based on the median score of the respondents' ratings in each question. RESULTS: Sixteen of the 18 policy committee members participated in the survey. Their average professional work years were 8.2 years. All 21 projects were evaluated as appropriate for content. Amount of support and indicators were evaluated as moderate. Only 5 out of the 21 projects were evaluated as having appropriate indicators. No projects were evaluated as ineffective. Comprehensive evaluation of the projects was evaluated as moderate, and no project was evaluated as inappropriate in fund support. CONCLUSION: Overall, the contents of the EMSOF assistance project were rated high; however, there was a disagreement on the amount of support and evaluation indicators for each project. The results of this study are expected to be used as basic data to improve the use of EMSOF.
Committee Membership ; Consensus ; Delphi Technique ; Emergencies ; Emergency Medicine ; Financial Management ; Korea ; Methods ; Resource Allocation ; Surveys and Questionnaires

The aim of this study was to identify bibliographic characteristics and research trends of articles published on the elderly people in dental hygiene. An analysis was done of 191 articles published from 1999 to 2017. Bibliographic characteristics were nine items such as publication journal, research design, research participants, number of researchers, data analysis method, keywords, research topic, and validity and reliability report. The collected data were analyzed using descriptive statistics of statistical program. First, the research on the elderly, which was published in dental hygiene, started to be published in 1999 and on going. Though major publications have been published in Journal of Korean Society of Dental Hygiene and Journal of Dental Hygiene Science, the kinds of journals are becoming diverse. Second, cross-sectional research was the most. Third, the elderly were the most studied subjects, but the criteria varied. Fourth, the number of authors was largest in order of two and three person. Fifth, data analysis method was in order of descriptive statistics, t-test, and ANOVA. Sixth, there were many duplication of keywords about oral, elderly, and health. Seventh, oral health behavior science was the most studied subject. Eighth, validity and reliability were reported at 27.4% and 51.6%, respectively. Ninth, only 15.7% of study was founded research funding. Based on the results of this study, we consider increase experimental research further. Therefore, it is recommeded that validity and reliability should be reported in research paper, and the keywords used in the field of dental hygiene should be agreed upon.
Aged* ; Financial Management ; Humans ; Methods ; Oral Health ; Oral Hygiene* ; Publications ; Reproducibility of Results ; Research Design ; Statistics as Topic

Being aimed at the management of investment equipments, the flow of data has been put forward and the two main modes of data calculating have been established by our relying on No.1 Network of Military Healthy. The real-time management has been realized by the system in regard to eguipments' contact, charges, payouts, interest, payment, forecast and decision-makiing. It has been steadily test-running for more than 10 months in our hospital, and data have been processed exactly and creditably.
Computer Communication Networks ; Computer Simulation ; Computer Systems ; Cost-Benefit Analysis ; methods ; Equipment and Supplies, Hospital ; economics ; Financial Management, Hospital ; methods ; Software

PURPOSE: The purpose of this study is to identify trends in research on cultural competency of nursing students and nurses in Korea and to provide suggestions for future studies. METHODS: A literature search was conducted with 432 papers published between 1985 and 2016 from five electronic databases and other sources using such key words as ‘cultural competency’, ‘cultural nursing’, ‘multi-cultural competency’, ‘nursing students’, ‘nurses’, etc. RESULTS: The research design of 86 nursing researches on the cultural competence of nurses and nursing students analyzed in this study was 90.7% in quantitative research, 9.3% in qualitative research, and 2.3% in mixed research. Cultural competence was the most measured concept. A total of 41 papers (47.7%) out of 86 papers were used to measure cultural competence. Ten different tools were used various instruments of cultural competency were used in 41 papers. In 11 experimental studies, new methods such as role playing, case study, four stage 3D puzzle model, newspaper reading, and writing reflection note were used other than traditional method of lecture. CONCLUSION: The overall findings of this study suggest that future research should include more well-designed experimental studies, qualitative studies and repeated studies to confirm the effects of findings from previous studies. Development of effective and highly diverse teaching methods is recommended to increase cultural competency. Supporting systems and funding are required to help activate research of nurses.
Cultural Competency ; Financial Management ; Humans ; Korea ; Methods ; Nursing Research ; Nursing ; Qualitative Research ; Research Design ; Role Playing ; Students, Nursing ; Teaching ; Writing

PURPOSE: The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. METHODS: Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. RESULTS: After analyzing the results, nine key components were selected: corporate management and accounting, introduction to financial management in hospitals, basic structure of accounting, basics of hospital accounting, basics of financial statements, understanding the accounts of financial statements, advanced analysis of financial statements, application of financial management, and capital financing of hospitals. CONCLUSIONS: The present findings can be used to develop a financial management education program to strengthen the financial management competencies of nurse.
Adult ; Education, Nursing, Continuing/*methods ; Financial Management/*methods ; Focus Groups ; Humans ; Middle Aged ; *Needs Assessment ; *Nurses ; Nursing Staff, Hospital/*education ; Republic of Korea

PURPOSE: This study was performed to suggest a realistic measure of charging for 119 emergency medical services (EMS) in Korea using Delphi study targeting emergency medical specialists. METHODS: The Delphi study was conducted four times targeting 24 emergency medical specialists. The first Delphi survey contained five categories as follows: Subjects of charging for 119 EMS, method of charging, strategy of implementation, utilization of fund, measure of quality improvement. In the second and third Delphi surveys, respondents were asked to indicate the level of importance with the questionnaire statements on a Likert scale, ranging from 0 to 5. The final consultation survey collected opinions on the system of charging for 119 EMS. RESULTS: The results from the first three Delphi surveys showed subjects of charging, method of charging, strategy of implementation, utilization of fund, and measure of quality improvement for 119 EMS. The fourth Delphi survey resulted in step 1 (classification of severity), step 2 (scene of accident), and step 3 (classification of severity at hospital). The classification of severity in steps 1 and 2 should be evaluated by first grade emergency medical technicians, and the classification of severity in step 3 should be evaluated by a person notified by the Ministry of Health and Welfare. Non-emergent patients should pay for the charge of 119 EMS to the hospital. CONCLUSION: Delphi study proposed charging for 119 EMS based on three levels of severity. This study suggests that charging for EMS can reduce unnecessary emergency calls and offer proper medical services to emergency patients.
Classification ; Delphi Technique* ; Emergencies* ; Emergency Medical Services* ; Emergency Medical Technicians ; Fees and Charges ; Financial Management ; Humans ; Korea ; Methods ; Quality Improvement ; Specialization ; Surveys and Questionnaires

PURPOSE: This study was done to propose an improvement in the Nursing Fee Differentiation Policy to alleviate polarization of nursing staffing level among hospitals and to rectify the confusion of legally mandated standards between the Korean Medical Law and National Health Insurance Act. METHODS: The policy regulation was reconstructed related to nurse staffing standards and nurse-to-patients ratios. Data on nurse staffing grades were obtained from database of the Health Insurance Review & Assessment Service (HIRA) for the third quarter of 2010 for 44 tertiary hospitals, 274 general hospitals, and 1,262 hospitals. A break-even analysis was used to estimate financial burden of the revised policy improvement proposal. An industrial engineering method was used to calculate Nurse-to-Patients ratios per shift. RESULTS: Twelve tertiary hospitals were downgraded. 74 general hospitals and 102 hospitals were upgraded after application of the regulation. Finances for total hospitalization expenditures changed from -3.55% to +3.14%. CONCLUSION: The results indicate that the proposed policy would decrease polarization between tertiary hospitals and small hospitals, and would not put a major strain on the finances of the Korean National Health Insurance. Therefore, it is suggested that government stake-holders and many interest groups consider this policy proposal and build a consensus.
Consensus ; Fees and Charges* ; Financial Management ; Health Expenditures ; Hospital Charges ; Hospitalization ; Hospitals, General ; Humans ; Insurance, Health ; Jurisprudence ; Methods ; National Health Programs* ; Nurse-Patient Relations ; Nursing Administration Research ; Nursing Staff ; Nursing* ; Public Opinion ; Tertiary Care Centers

OBJECTIVES: The aims of this study were to compare the performance of machine learning methods for the prediction of the medical costs associated with spinal fusion in terms of profit or loss in Taiwan Diagnosis-Related Groups (Tw-DRGs) and to apply these methods to explore the important factors associated with the medical costs of spinal fusion. METHODS: A data set was obtained from a regional hospital in Taoyuan city in Taiwan, which contained data from 2010 to 2013 on patients of Tw-DRG49702 (posterior and other spinal fusion without complications or comorbidities). Naïve-Bayesian, support vector machines, logistic regression, C4.5 decision tree, and random forest methods were employed for prediction using WEKA 3.8.1. RESULTS: Five hundred thirty-two cases were categorized as belonging to the Tw-DRG49702 group. The mean medical cost was US $4,549.7, and the mean age of the patients was 62.4 years. The mean length of stay was 9.3 days. The length of stay was an important variable in terms of determining medical costs for patients undergoing spinal fusion. The random forest method had the best predictive performance in comparison to the other methods, achieving an accuracy of 84.30%, a sensitivity of 71.4%, a specificity of 92.2%, and an AUC of 0.904. CONCLUSIONS: Our study demonstrated that the random forest model can be employed to predict the medical costs of Tw-DRG49702, and could inform hospital strategy in terms of increasing the financial management efficiency of this operation.
Area Under Curve ; Costs and Cost Analysis ; Dataset ; Decision Trees ; Diagnosis-Related Groups ; Financial Management ; Forests ; Humans ; Length of Stay ; Logistic Models ; Machine Learning ; Methods ; Sensitivity and Specificity ; Spinal Fusion ; Support Vector Machine ; Taiwan

PURPOSE: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. METHODS: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. RESULTS: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. CONCLUSION: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.
Adolescent ; Child ; Delivery of Health Care ; Disabled Children ; Financial Management ; Great Britain ; Health Services Needs and Demand ; Home Care Services ; Hospice Care ; Hospices ; Humans ; Japan ; Korea ; Methods ; Palliative Care ; Pediatrics ; Primary Health Care ; Quality of Life ; Referral and Consultation ; Singapore ; Specialization ; Tertiary Care Centers ; United States