저작자표시 - 비영리 - 변경금지 2.0 대한민국 이용자는아래의조건을따르는경우에한하여자유롭게 이저작물을복제, 배포, 전송, 전시, 공연및방송할수있습니다. 다음과같은조건을따라야합니다 : 저작자표시. 귀하는원저작자를표시하여야합니다. 비영리. 귀하는이저작물을영리목적으로이용할수없습니다. 변경금지. 귀하는이저작물을개작, 변형또는가공할수없습니다. 귀하는, 이저작물의재이용이나배포의경우, 이저작물에적용된이용허락조건을명확하게나타내어야합니다. 저작권자로부터별도의허가를받으면이러한조건들은적용되지않습니다. 저작권법에따른이용자의권리는위의내용에의하여영향을받지않습니다. 이것은이용허락규약 (Legal Code) 을이해하기쉽게요약한것입니다. Disclaimer
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Ⅰ. 1. 1989 7.,,.,,, (, 2010). 1998 (, 2006). (30 ), ( : 30, : 100 ), ( ),,, ( 3 ). 1 2, 1 2, 1, 2 ( 2 )..,. - 1 -
(, 2003).., (, 2004). 3 1, 2,, (, 2003).. (, 1996).,,, 1 2 3 3. - 2 -
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Ⅱ. 1. ( ) 1989 (,, 1994).., 1... 1989., (,, 1991). 8 140,. 1 2, 3 1 2. 1 2 1 3 2-5 -
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(, 1999).,,,,,, (, 2003).. 1, 2, 3 3 3. (, 2009). (1999).,,.,,,.,.. 3-7 -
. (, 2009)., 3..,..,, 3.,,.. - 8 -
3.,,. 32.6% 28.8%, 18.9%. 28.8%, 28.4%, 26.5%, 9.8%, 6.5%. (69.1%), (41.2%), (20.6%), (4.4%) (, 1999).,,,,,,,.,,,,.. 30. (, 2003). - 9 -
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,... < 1>. 1. 연구논문연구자연구연도연구결과 의료협력센터에대한개원의역할기대와환자만족도조사협력병원및환자의뢰병원선택요인연구 한순희 2007 배명자 2008 협약체결은진료의뢰와밀접한관계가있으며신속한진료와검사에대한기대가크다의료진의높은진료수준과환자의뢰절차의간편성이가장주요한요인이다. 병원간협력관계에관한연구안민정 2009 협력관계체결의주된이유는병원 의인지도및브랜드네임때문이 다. 의료협력서비스에대한개원의의역할기대와만족도진료협력병원선택요인과만족도에관한연구 이해옥 2009 조유순 2012 의료진의높은진료수준과이동거리, 환자의뢰절차의간편성이주요선정요인이며회신에대한만족도, 환자만족도상승에대한기대효과가가장높다. 환자의선호도가의뢰병원선택요인에가장중요한요인이며, 직원의친절도에가장만족했다. 한대학병원의진료협력서비스에대 한개원의의만족도조사 정혜경 2016 직원의친절, 신속한예약및진료를위한 의뢰시스템구축, 회신과, 회송율향상을 위한노력이영향을미친다. - 13 -
Ⅲ. 1. N 2016, N 70, 50 120. 2., 6, 3, 3, ( ) 2, 9, 13 30..,,,,,..,, ( ),,,,, ( ), ( ) - 14 -
.. (2012).,,,, 5 9. (Likert) 5 5, 4, 3, 2, 1.. (2006).,,,, 5 13. (Likert) 4 4, 3, 2, 1.,. < 2>. - 15 -
2. 1. 2. 1. 39, 2. 40~49, 3. 50~59, 4. 60 1. 10, 2. 11~20, 3. 21 1., 2. 1., 2., 3., 4. 1. 1, 2. 2~3, 3. 4~5, 4. 6, 5. 1., 2. 1. 2. 3. 4. (, ) 5. 6. 7. 1. 2. 3. 4. 5. 6. 7. 8. 9. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. - 16 -
3.. 2017 3 6 3 30 120 91..,,... 2,,. - 17 -
4.., ANOVA. t-test. t-test.,,,, ( ),. 5 3, 7 3, 13 5.,,. [ ],,, [ ], [ ]. - 18 -
[ ],,,, [ ],, [ ], [ ], ( ) [ ]... SAS 9.4. (Institutional Review Board, IRB) ( ; 2-10400939-AB-N-01-2017-114-02). - 19 -
Ⅳ. 1. < 3>. 74 (81%), 17 (19%), 35 72, 40 ~49 37 (41%) 50~59 32 (35%), 35 ~39 12 (13%), 60 10 (11%). 57 (63%), 34 (37%).,,,,,,,,,,,. 6 39 4, 18 5 11~20 39 (43%), 21 38 (42%), 10 14 (15%). 65 (72%), 19 (21%), - 3 (3%), 4 (4%), 2~3 40 (44%), 4~5 31 (34%), 6 13 (14%), 1 4 (5%), 3. 52 (57%), 39 (43%). - 20 -
3. (%) 39 12 13 40-49 37 41 50-59 32 35 60 10 11 74 81 17 19 57 63 34 37 120 (10 ) 14 15 121 (10 1 )-240 (20 ) 39 43 241 (20 1 ) 38 42 65 71 19 21 3 3 4 4 1 4 4 2-3 40 44 4-5 31 34 6 13 14 3 3 Y 52 57 N 39 43-21 -
2. < 4> 59 (42%), 49 (36%). 70 (38%), 33 (18%),. 45 (50%), 21 (23%). 84 (92%). 59 (48%), 1 38 (31%). ( ) ( ) 40 (44%), 31 (34%). - 22 -
4. 특성 구분 빈도 백분율 (%) 병원선택요인 콜 ( 전화예약 ) 센터또는인터넷진료예약 9 6 진료의뢰시 이용매체 진료의뢰병원 선택요인 진료결과회신 진료결과회신방법 진료결과회신서 활용도 회신서받는시기 되의뢰 ( 회송 ) 의뢰한환자의 되의뢰 ( 회송 ) 정도 회송여부에따른 의뢰병원선택 영향력 직접진료협력센터로예약 49 36 전문의와통화하여예약 3 2 직원통한진료협력센터예약 19 14 환자에게진료의뢰서주고직접예약 59 42 의료진의높은진료수준 31 17 의뢰했던환자의만족도및환자의선호도 70 38 의뢰환자의진료정보공유여부정도 15 8 진료협력센터의협력태도 33 18 적정진료및진료비적정성 11 6 협력병원체결여부 14 8 의료진과의개인적인친분 8 4 우편 45 50 팩스 16 18 전화 3 3 이메일 21 23 진료회신웹사이트 1 1 SMS문자전송 5 5 추후해당환자방문시사용 84 92 확인하는정도 6 7 직접의뢰했던환자만확인 1 1 1차진료완료후 38 31 최종진단확정후 59 48 치료종결후 26 21 거의없다 10 11 있지만적다 31 34 적당하다 40 44 알수없다 10 11 거의없다 9 10 약간있다 29 32 보통있다 24 26 많다 29 32-23 -
3. < 5>. 5 2.70 3.59, 3.13. (3.59 ), (3.29 ), (3.26 ). (2.7 ), ( )(2.9 ), (3.03 ). 5. 1 3.59 0.494 1 2 3.26 0.892 3 3 3.11 0.767 5 4 3.10 0.633 6 5 ( ) 2.90 0.616 8 6 3.03 0.750 7 7 3.16 0.776 4 8 2.70 0.790 9 9 3.29 0.750 2 3.13 0.72-24 -
4. < 6>. 4 2.25 3.21, 2.81. 3.0 3.21, 3.1, 3.03, 3.02, 3.01. 2.0 3 2.25, 2.59, 2.62. - 25 -
6. 1. 2.67 0.585 8 2. 2.96 0.392 6 3. 3.01 0.723 5 4. 2.74 0.728 7 5. 2.67 0.716 8 6. 3.10 0.761 2 7. 3.21 0.409 1 8. 3.02 0.614 4 9. 3.03 0.722 3 10. 2.62 0.663 11 11. 2.67 0.616 8 12 13. ( ). 2.25 0.607 13 2.59 0.760 12 2.81 0.638-26 -
5. < 7>. 1..,. N,. - 27 -
7. ( ) 항목 진료의뢰후만족도 ( 총점 45 점 ) M±SD P-value 연령성별진료과목진료년수 39 29.92 ± 3.60 40-49 28.03 ± 2.65 50-59 28.47 ± 3.61 60 29.70 ± 4.27 남자 28.41 ± 3.03 여자 29.53 ± 4.49 내과계 28.72 ± 3.65 외과계 28.44 ± 2.81 10년 29.93 ± 3.25 10년1개월 ~20년 28.46 ± 2.86 20년 1개월 28.29 ± 3.79 <.0001 <.0001 <.0001 <.0001 의원 28.46 ± 3.54 <.0001 소속의료 기관형태 병원 28.84 ± 3.18 <.0001 국공립병원 28.67 ± 0.58 0.0001 의료법인 30.00 ± 2.16 0.0001 1 개 32.00 ± 4.32 0.0007 2-3 개 28.75 ± 3.82 <.0001 협력체결병원수 4-5 개 28.00 ± 2.84 <.0001 6 개 29.23 ± 1.69 <.0001 없음 26.00 ± 3.46 0.0059 협약체결유무 Y 27.94 ± 3.22 N 29.51 ± 3.35 <.0001-28 -
6. < 8>.,, ( ), (p<0.0001).,. - 29 -
8. ( ) ( 45 ) M±SD P-value ( ) ( ) 29.22 ± 2.95 27.68 ± 3.02 30.42 ± 3.47 29.03 ± 3.70 28.16 ± 3.13 29.22 ± 2.91 28.78 ± 3.70 28.00 ± 2.99 27.67 ± 1.15 29.24 ± 2.98 33.00 ± 0.00 SMS 26.20 ± 2.59 28.62 ± 3.35 28.61 ± 3.42 28.00 ± 2.00 33.00 ± 0.00 27.70 ± 2.95 28.23 ± 3.16 29.10 ± 3.51 28.80 ± 3.77 31.22 ± 3.83 28.93 ± 2.90 27.92 ± 3.34 28.07 ± 3.36 <.0001 <.0001 0.317 0.388 <.0001 <.0001-30 -
7. < 9>. 1 2 8 5.70. 3, 4, 5, 6 16 11.92, 60 12.30, 12.00, 12.32, 10 12.14, 13.75, 6 12.54. 9.67. 7, 8, 9 12 9.42 10.75. 10, 11 8 5.34 6.33. 12, 13 8 4.81, 39 5.33, 5.32, 1 5.75. - 31 -
9. MEAN ± SD P-value MEAN ± SD P-value MEAN ± SD P-value MEAN ± SD P-value MEAN ± SD P-value 39 5.58 ± 0.90 12.08 ± 1.73 9.42 ± 0.90 5.17 ± 1.03 5.33 ± 0.98 40-49 5.81 ± 0.78 <.0006 11.57 ± 2.05 9.27 ± 1.17 5.27 ± 1.07 4.68 ± 0.97 50-59 5.56 ± 0.88 1 11.84 ± 2.44 <.0001 9.41 ± 1.34 <.0001 5.19 ± 1.18 <.0001 4.88 ± 1.29 <.0001 60 5.70 ± 0.67 12.30 ± 2.11 9.40 ± 1.08 5.60 ± 1.08 4.90 ± 1.52 5.65 ± 0.78 11.77 ± 2.09 9.27 ± 1.16 5.26 ± 1.05 5.03 ± 1.05 5.82 ± 0.95 <.0001 12.00 ± 2.42 <.0001 9.71 ± 1.21 <.0001 5.29 ± 1.31 <.0001 4.12 ± 1.36 <.0001 5.65 ± 0.81 12.32 ± 2.09 9.54 ± 1.23 5.39 ± 1.15 4.88 ± 1.18 5.74 ± 0.83 <.0001 10.97 ± 1.99 <.0001 9.03 ± 1.03 5.06 ± 0.98 <.0001 4.82 ± 1.14 <.0001 10 5.71 ± 0.73 12.14 ± 1.41 9.36 ± 1.28 5.21 ± 0.98 5.21 ± 0.80 10 1 ~20 5.77 ± 0.84 <.0001 11.56 ± 2.11 <.0001 9.23 ± 0.99 <.0001 5.21 ± 0.98 <.0001 4.74 ± 1.02 <.0001 20 1 5.58 ± 0.83 11.95 ± 2.40 9.47 ± 1.33 5.34 ± 1.26 4.84 ± 1.39 5.71 ± 0.91 <.0001 11.58 ± 2.08 <.0001 9.25 ± 1.06 <.0001 5.18 ± 1.14 <.0001 4.80 ± 1.11 <.0001 5.58 ± 0.51 <.0001 12.00 ± 2.24 <.0001 9.37 ± 1.26 <.0001 5.16 ± 0.90 <.0001 5.32 ± 1.00 <.0001 5.67 ± 0.58 0.0034 13.00 ± 2.65 0.0135 9.67 ± 2.08 0.0151 6.33 ± 0.58 0.0028 3.67 ± 1.53 0.0533 5.75 ± 0.50 0.0002 13.75 ± 1.71 0.0005 10.75 ± 1.50 0.0007 6.25 ± 0.50 0.0001 4.50 ± 1.91 0.0182 5.67 ± 0.58 0.0034 9.67 ± 2.08 0.0151 9.00 ± 0.00 4.00 ± 2.00 0.0742 4.00 ± 2.00 0.0742 1 6.00 ± 1.63 0.0052 12.00 ± 2.45 0.0023 9.25 ± 0.50 5.75 ± 1.26 0.0028 5.75 ± 1.26 0.0028 2-3 5.73 ± 0.78 <.0001 11.33 ± 2.12 <.0001 9.35 ± 1.23 <.000 5.15 ± 1.12 <.0001 4.75 ± 1.15 <.0001 1 4-5 5.55 ± 0.89 <.0001 12.32 ± 1.94 <.0001 9.26 ± 1.12 5.19 ± 1.01 <.0001 4.87 ± 1.06 <.0001 6 5.77 ± 0.44 <.0001 12.54 ± 2.26 <.0001 9.69 ± 1.44 5.92 ± 0.49 <.0001 5.08 ± 1.19 <.0001 N 5.72 ± 0.72 11.59 ± 2.05 9.13 ± 1.06 5.28 ± 0.94 5.03 ± 0.96 Y 5.65 ± 0.88 <.0001 11.98 ± 2.22 <.0001 9.52 ± 1.24 <.0001 5.25 ± 1.20 <.0001 4.73 ± 1.29 <.0001-32 -
8. < 10>. 8 5.70 6.00. 16 11.78 12.05, 12.02, ( ) 12.40, 12.67. 12 9.26. 8 5.36 6.0. 8 4.93 ( ) 5.30, 5.33. - 33 -
10. ( ) MEA N ± SD P-valu e MEAN ± SD P-value MEAN ± SD P-value MEAN ± SD P-valueMEAN ± SD P-value Y 5.67 ± 0.83 12.05 ± 2.33 9.51 ± 1.32 5.34 ± 1.15 4.84 ± 1.27 <.000 <.000 <.00 <.000 <.000 1 1 01 1 1 N 5.70 ± 0.79 11.33 ± 1.65 9.03 ± 0.72 5.10 ± 0.96 4.90 ± 0.92 5.57 ± 0.90 11.81 ± 2.03 9.30 ± 0.94 5.43 ± 1.17 4.95 ± 1.22 <.000 <.000 <.00 <.000 5.71 ± 0.79 1 12.02 ± 2.34 1 9.53 ± 1.36 01 5.04 ± 1.09 1 4.71 ± 1.16 6.00 ± 0.50 10.78 ± 1.30 8.67 ± 0.87 5.67 ± 0.50 5.22 ± 0.83 5.60 ± 0.52 12.40 ± 1.96 9.50 ± 1.84 5.70 ± 1.34 4.90 ± 1.29 5.45 ± 0.93 12.23 ± 2.33 9.35 ± 1.05 5.29 ± 1.07 4.71 ± 1.24 <.000 <.000 <.00 <.000 5.85 ± 0.83 1 11.50 ± 2.15 1 9.50 ± 1.13 01 5.08 ± 1.00 1 4.85 ± 1.05 5.80 ± 0.42 11.20 ± 1.48 8.60 ± 0.70 5.50 ± 1.27 5.30 ± 1.25 <.000 1 <.000 1 5.78 ± 0.44 12.67 ± 1.66 9.33 ± 1.12 6.00 ± 0.87 5.33 ± 1.41 5.69 ± 0.89 <.000 11.34 ± 1.63 <.000 9.14 ± 1.06 <.00 5.14 ± 0.95 <.000 4.79 ± 0.86 5.54 ± 0.83 1 11.71 ± 2.53 1 9.25 ± 1.26 01 4.96 ± 1.16 1 4.83 ± 1.34 5.76 ± 0.83 12.10 ± 2.35 9.66 ± 1.23 5.41 ± 1.15 4.79 ± 1.21 <.000 1-34 -
9. < 11>. (β=2.040, p=0.030). 1 0 (β=7.612, p=0.004). (β=-3.468, p=0.001). (β=-1.547, p=0.047). 49.5%. - 35 -
11. 39 Ref. β P-value 40-49 -0.886 0.500 50-59 -0.274 0.861 60 1.106 0.547 Ref. 2.040 0.030 Ref. -0.798 0.319 10 Ref.. 10 1 ~20-1.033 0.399 20 1-0.058 0.969 Ref. 0.836 0.407-0.388 0.850 2.982 0.080 Ref. 1 7.612 0.004 2-3 3.670 0.051 4-5 4.017 0.043 6 6.247 0.007 N Ref. Y 0.823 0.287 N Ref. Y -3.468 0.001 Ref. -1.547 0.047-0.270 0.832-1.902 0.135-0.791 0.326 ( ) 적당하다 Ref. -0.639 0.562 R-Square 0.495-36 -
10. < 12>. (β=-1.545, p=0.009). (β=2.418, p=0.048) (β=1.486 p=0.035), (β=1.433, p=0.022). 0 1 (β=2.719, p=0.004), 2~3 (β =1.596 p=0.021), 4~5 (β=1.837 p=0.012), 6 (β=2.482 p=0.004). (β=-0.973 p=0.009), (β=-1.833 p=0.027), 0 1 (β=2.719, p=0.004). ( ) (β=-0.585, p=0.021). ( ) (β=-1.128 p=0.015). 18.9%, 36.8%, 30.8%, 36.9%, 34.1%. - 37 -
12. Est. SE P-value Est. SE P-value Est. SE P-value Est. SE P-value Est. SE P-value 39 Ref. Ref. Ref. Ref. Ref. 40-49 0.223 0.403 0.582-0.361 0.937 0.701-0.353 0.538 0.514 0.033 0.477 0.945-0.643 0.518 0.218 50-59 0.021 0.480 0.965-0.065 1.114 0.954-0.336 0.640 0.602-0.096 0.568 0.867-0.315 0.616 0.611 60 0.056 0.563 0.921-0.129 1.308 0.922-0.639 0.752 0.398-0.195 0.666 0.770-0.697 0.722 0.338 Ref. Ref. Ref. Ref. Ref. 0.131 0.283 0.644-0.334 0.657 0.613 0.153 0.378 0.687 0.038 0.335 0.909-0.973 0.363 0.009 Ref. Ref. Ref. Ref. Ref. 0.212 0.245 0.391-1.545 0.569 0.009-0.379 0.327 0.251-0.489 0.290 0.097-0.376 0.315 0.237 10 Ref. Ref. Ref. Ref. Ref. 10 1 ~20-0.164 0.375 0.663-0.939 0.871 0.285-0.404 0.500 0.422-0.061 0.444 0.890 0.242 0.481 0.616 20 1-0.303 0.454 0.506-0.504 1.054 0.634-0.038 0.606 0.950 0.421 0.537 0.436 0.092 0.582 0.875 Ref. Ref. Ref. Ref. Ref. -0.144 0.309 0.642-0.479 0.717 0.507-0.204 0.412 0.622-0.194 0.365 0.598 0.378 0.396 0.343-0.327 0.630 0.606 0.944 1.464 0.522 0.612 0.842 0.470 0.112 0.746 0.881-1.833 0.809 0.027 0.330 0.517 0.526 2.418 1.201 0.048 1.486 0.690 0.035 1.433 0.612 0.022 0.293 0.664 0.660 Ref. Ref. Ref. Ref. Ref. 1 0.225 0.776 0.772 3.126 1.802 0.088 0.254 1.036 0.807 2.719 0.918 0.004 2.178 0.996 0.032 2-3 -0.048 0.569 0.933 1.065 1.322 0.423-0.259 0.760 0.734 1.596 0.674 0.021 0.779 0.730 0.290 4-5 -0.139 0.601 0.818 2.316 1.395 0.102-0.258 0.802 0.749 1.837 0.711 0.012 0.905 0.771 0.245 6-0.055 0.696 0.937 2.161 1.618 0.186-0.078 0.930 0.934 2.482 0.825 0.004 1.121 0.894 0.214 N Ref. Ref. Ref. Ref. Ref. Y 0.107 0.236 0.653 0.349 0.549 0.528 0.086 0.316 0.787 0.242 0.280 0.390 0.257 0.303 0.400-38 -
12. ( ) ( ) Est. SE P-value Est. SE P-valu e Est. SE P-value Est. SE P-valu e N Ref. Ref. Ref. Ref. Ref. Est. SE P-value Y 0.338 0.291 0.250 0.232 0.675 0.733 0.472 0.388 0.229-0.073 0.344 0.834 0.151 0.373 0687 Ref. Ref. Ref. Ref. Ref. 0.293 0.236 0.218 0.513 0.547 0.352 0.433 0.314 0.174-0.235 0.279 0.402 0.005 0.302 0.987 0.399 0.390 0.309-0.0950.905 0.917-0.345 0.520 0.509 0.662 0.461 0.156 0.787 0.500 0.121-0.499 0.387 0.202 0.461 0.900 0.610-0.215 0.517 0.679 0.272 0.459 0.556-0.133 0.497 0.790-0.585 0.247 0.021 0.597 0.573 0.301-0.492 0.329 0.140 0.197 0.292 0.502 0.065 0.317 0.838 Ref. Ref. Ref. Ref. Ref. -0.128 0.338 0.707-0.7280.784 0.356-1.128 0.451 0.015 0.266 0.400 0.508 0.461 0.433 0.291 Ref. Ref. Ref. Ref. Ref. -0.432 0.424 0.312-1.8050.985 0.071-0.634 0.566 0.267-0.576 0.502 0.255-0.706 0.544 0.199-0.783 0.474 0.104-1.2661.102 0.255-0.831 0.633 0.194-0.875 0.562 0.124-0.914 0.609 0.138-0.242 0.445 0.589-0.8711.033 0.403-0.138 0.594 0.817-0.311 0.527 0.557-0.510 0.571 0.375 R-Square 0.189 0.368 0.308 0.369 0.341-39 -
Ⅴ. N..., (2007), (2009), (2012), (2016).,,. (2007), (2012).., N 6 4. 3-40 -
..,,,. (2008),., (3.59 ), (3.29 ), (3.26 ), (3.03 ), ( )(2.90 ), (2.70 )., (2012) (4.01 ), (3.76), (3.59 ), ( ),,. (2012) N. (2012) ( ),. ( ). - 41 -
, (3.21 ), (3.1 ), (3.03 ), (3.02 ), (3.01 ). 3 (2.25 ), (2.59 ), (2.62 )., (2007) (3.46 ), (3.33 ), (3.33 ), (2.65 ), (2.58 ), (2.52 ), (2.48 ), (2.40 ). (2007),. (2010).., (β=2.040, p=0.030), 0 1 (β=7.612, p=0.004), (β=-3.468, p=0.001), (β =-1.547, p=0.047). (2009) 30-42 -
(p=0.010), (p=0.001). 1. N., (β=5.960, p=0.025), 0 1 (β=8.502, p=0.033). (β=-2.577, p=0.040), ( ) (β=-3.841, p=0.046) (β=-4.260, p=0.041), N. (2012),,,, (F=3.17, p=0.04), (F=3.38, p=0.03), (F=6.60, p=0.00), (F=12.28, p=0.00). (2012).. - 43 -
.,, N., N.,. - 44 -
Ⅵ...... - 45 -
. 1,2 [ ]., 2002.,.,, 1991.,.,, 2010.. - [ ]., 2003.. [ ],, 2008.. [ ]., 2004.. [ ]., 2009.. [ ],, 2006.,. (I)., 1994..., 2012;7:50-67. - [ ]., 2003.,,,.., 1999. - 46 -
. [ ],, 2006..., 1996.. [ ],, 2009.,,. :., 2013;9:1-20.,,,,,. -.,, 2016.,.,., 2012;12(3):570-581.. [ ],, 2016.. [ ],, 2004.. [ ],, 2012..., 2010;11:6-15. [ ],, 2006.. [ ],, 1999. - 47 -
서식 4-1. Ver. 1.0 연구대상자동의서 동의서관리번호 연구제목 : 진료의뢰병원선택요인과진료협력센터역할 기대및만족도에관한연구 1. 본인은이설명문을읽었으며, 본연구의목적, 방법, 기대효과, 가능 한위험성등에대한충분한설명을듣고이해하였습니다. 2. 모든궁금한사항에대해질문하였고, 충분한답변을들었습니다. 3. 충분한시간을갖고생각한결과, 본인은이연구에참여하기를자유 로운의사에따라동의합니다. 4. 본인은설명문및작성된동의서사본 1 부를받았음을확인합니다. - 48 -
서식 4-1. Ver. 1.0 연구참여자의성명서명날짜 ( 년 / 월 / 일 ) 법정대리인의성명 ( 해당되는경우 ) 서명날짜 ( 년 / 월 / 일 ) 설명한연구자의성명서명날짜 ( 년 / 월 / 일 ) - 49 -
서식 4-1. Ver. 1.0 설문지 안녕하십니까? 저는국민건강보험일산병원진료협력센터에서근무하는정은진입니다. 연세대학교보건대학원에서병원경영학을전공하고있으며현재석사학위논문을준비하고있습니다. 본설문지는환자를의뢰할경우선생님께서의뢰할병원을선택할때어떤점을선호하는지에대한의견을조사하는내용입니다. 급변하는의료환경속에서병원간협력체제를구축하는것은새로운경영패러다임에따른중요한과제라고생각합니다. 이에평소에가지고계신의견을적어주시면국민건강보험일산병원이지역의료기관과의진료협력를위한효율적인운영및개선방안을마련하는기초자료로사용될수있을것으로사료됩니다. 본설문지에응답해주시는모든내용은일괄적으로전산처리하여특정개인이나병원의노출이나추측이불가능하도록처리될것이며, 순수한연구목적으로만사용됩니다. 바쁘신중에도시간을내어본설문조사에도움을주셔서진심으로감사드립니다. 끝으로귀원의무궁한번영과발전을기원합니다. 2017 년 2 월 전화 : 010-4255-8749 팩스 : 0303-3448-7142 e-mail : grape@nhimc.or.kr 연구자 : 정은진올림지도교수 : 김태현 - 50 -
서식 4-1. Ver. 1.0 선생님의인구학적, 사회학적현황등 1. 연령은? 만세 2. 성별은? 남 ( ) 여 ( ) 3. 진료년수는? 년월 4. 전문진료과목은? 과 5. 소속의료기관의설립형태 1 의원 2 병원 ( 병상 : 유 무 ) 3 국 공립병원 4 의료법인 6. 협력체결병원수 ( 귀원보다상위의료기관과의협력체결된병원 ) 1 1 개 2 2~3 개 3 4~5 개 4 6 개이상 5 없음 병원선택요인 1. 진료의뢰시주로어떤매체를이용하십니까?( 중복선택가능 ) 1 콜 ( 전화예약 ) 센터또는인터넷진료예약 2 진료협력센터로전화하여예약 3 담당진료과전문의와통화하여예약 4 직원에게진료협력센터로전화하여예약하도록함 5 환자에게진료의뢰서를주고직접예약하도록함 6 기타 2. 진료의뢰가필요한경우의뢰병원을선택하는주된요인은무엇입니까? (2가지중복선택가능 ) 1 의료진의높은진료수준 2 의뢰했던환자의만족도및환자의선호도 3 의뢰환자의진료정보공유여부정도 ( 회신서 & 진료정보시스템사용 ) 4 진료협력센터의협력태도 ( 신속, 정확한진료예약 ) 5 적정진료및진료비적정성 6 협력병원체결여부 7 의료진과의개인적인친분 - 51 -
서식 4-1. Ver. 1.0 3. 진료의뢰가필요한경우국민건강보험일산병원을의뢰병원으로선택하지않은주된이유는무엇입니까? (2가지중복선택가능 ) 1 진료의뢰절차의불편함 ( 전화통화불가, 진료의뢰방법단일화등연락문제 ) 2 진료예약및접수일정불만족 3 의뢰했던환자의불만족 4 진료수준및전문분야의부적합 5 되의뢰 ( 회송 ) 만족도저하 6 응급전원에대한불만족경험 7 진료협력센터에협력태도불만 진료결과회신 1. 진료회신을어떤방법으로받아보시기를원하십니까? 1 우편 2 팩스 3 전화 4 이메일 5 진료회신웹사이트 6 SMS 문자전송 7 원 치않음 2. 진료회신서을받으면이를어떤용도로활용하십니까? 1 챠트에메모해두었다가추후해당환자방문시유용하게사용한다. 2 확인해보는것으로끝난다. 3 직접의뢰했던환자만확인한다. 4 관심없다. 3. 진료회신을받기를원하는시기는언제라고생각하십니까?( 중복선택가능 ) 1 1 차진료완료후 2 최종진단확정후 3 치료종결후 4 기타 되의뢰 ( 회송 ) 1. 국민건강보험일산병원으로의뢰하신환자중회송되는환자는어느정도입니까? ( 회송 : 귀원으로다시내원 ) 1 거의없다 2 있지만적다 3 적당하다 4 알수없다. - 52 -
서식 4-1. Ver. 1.0 2. 회송 ( 되의뢰 ) 여부가진료의뢰시의뢰병원을선택하는데에미치는영향은어느정도 입니까? 1 거의없다 2 약간있다 3 보통이다 4 많다. 만족도 1. 선생님께서진료의뢰를하고난후느끼시는만족도에관한질문입니다. 읽고해당란에표 ( ) 해주십시오. 항목 1. 진료비의적절성 2. 의뢰환자에대한결과회신 3. 신속한예약및진료 4. 원만한입원 5. 되의뢰 6. 의학적지식의자문 7. 의료시설및장비의이용 매우 만족 만족보통불만족매우불만족 8. 의학정보망의자유로운개방 9. 진료협력센터직원의친절도 - 53 -
서식 4-1. Ver. 1.0 2. 선생님의진료협력센터에관한역할기대를묻는내용입니다. 읽고해당란에표 ( ) 하여주십시오. 항 목 매우 기대 된다 기대 된다 기대 되지 않는다 전혀 기대되지 않는다 1. 전문지식을활용하여진료상담을할것이다. 2. 적절한진료과선별에도움을줄것이다. 3. 진료의뢰시신속한예약서비스를제공할것이다. 4. 원스톱서비스를제공해줄것이다. 5. 입원실배정에도움을줄것이다. 6. 응급환자에게신속한도움을줄것이다. 7. 진료결과를회신해줄것이다. 8. 적절하게되의뢰시켜줄것이다. 9. 되의뢰시킬때정보를제공해줄것이다. 10. 의뢰환자의불편사항을병원에건의하여개선 해줄것이다. 11. 진료의뢰의의불편사항을개선하기위해노력 할것이다. 12. 진료협약체결의료기관과의정기적인모임을 주선할것이다. 13. 진료의뢰환자정보시스템 ( 웹사이트 ) 을관리 할것이다. 끝까지설문에성의껏응답해주셔서대단히감사합니다. - 54 -
ABSTRACT A Study on the Factors affecting the Selection of the Hospitals for Referral, Expectation of the Care Cooperation Centers' Roles and Satisfaction with the Care Cooperation CHOUNG EUN JIN Yonsei University (Directed by Professor Tae Hyun Kim, M.D., Ph.D.) The medical service competition among the medical institutions is very fierce, while the medical service delivery system has been nominal. In such circumstances, the purpose of this study was to identify the factors affecting clinic doctors' selection of the hospitals for referral through the care cooperation centers, and survey the clinic doctors for their satisfaction with the care cooperation and their expectation of the care cooperation centers' roles and thereby, provide for some basic data useful to the reinforcement of the medical cooperative system. For this purpose, this study randomly selected 120 clinic doctors who had ever referred their patients to 'N' general hospital, and conducted a questionnaire - 55 -
survey for them; 91 doctors responded to the survey. The data collected were processed for descriptive statistics, analysis of variance and multiple regression analysis. This study reviewed referrals for treatment, replies and returns, and thereupon, analyzed the relationship between subjects' satisfaction after their referral and their expectation of the care cooperation centers' roles depending upon their demographic variables, and further, analyzed their post-referral satisfaction and their expectation of the cooperation centers' roles depending on the factors affecting the selection of the hospitals for referral. The results of this study can be summed up as follows; First, as a result of reviewing referrals for treatment, replies and returns, it was found that clinic doctors wrote a letter of referral for treatment to the patients and urged them to reserve their treatment for themselves in most cases, and in terms of the factors affecting doctors' selection of the hospital for referral, such factors as patients' satisfaction and preferences were overwhelming. The subjects wanted to receive the resultant replies by post mail, and wrote the memos about the replies on a chart, and referred to them later when the patient visited them. They wanted that the replies would be mailed to them after the final diagnosis. The return of the patients was the significant factor affecting their selection of the hospitals for referral. Secondly, as a result of reviewing subjects' post-referral satisfaction, they were most satisfied with the proper treatment costs, followed by care cooperation center staff's kindness and reply about patients' treatment in their order. In contrast, they were less satisfied with - 56 -
consultation about the medical knowledge, return and free and open medial information network. Thirdly, as a result of reviewing subjects' expectation of the care cooperation center, subjects' expectation of the reply about the results of the treatment was highest, and they expect their emergency patients to be cared promptly. In contrast, their expectation of an agreement signed was low. Fourthly, as a result of analyzing subjects' post-referral satisfaction depending on their demographic variables and the factors affecting their selection of the hospitals, it was found that female doctors and those who had signed the agreement of medical cooperation with one hospital or more were satisfied more. When their patients should be referred to a hospital, the reservation through the care cooperation center and the selection of the hospital were affected by patients' satisfaction and preference, subjects' post-referral satisfaction was low. Fifthly, as a result of analyzing the factor affecting the expectation of the care cooperation center's role depending on subjects' demographic variables and factors affecting the selection of the hospital, it was found that subjects' expectation of the center's roles was low in case of surgery department, and that the expectation was high, when the hospital was a medical corporation and an exclusive agreement had been signed between the hospital and the clinic. In addition, return of patients affected subjects' expectation of the centers' roles. In conclusion, if the selection of the hospital depends on patient's satisfaction and preferences, subjects' post-referral satisfaction was low. - 57 -
In addition, when the treatment was reserved through the care cooperation center, the post-referral satisfaction was low, and the factor of an cooperative agreement between subjects and the center was not significantly correlated with subjects' post-referral satisfaction and expectation of center's roles. As discussed above, the factors affecting the patient's centered selection of the hospital are important, but since the medical professionalism cannot overlooked, it is deemed necessary to suggest some specific and practical ways to reinforce the care cooperation so that referral and return can be cycled smoothly. Key words : referral for treatment, factors affecting the selection of the hospital for referral, return, expectation of role, satisfaction - 58 -