Conditions and Performance of Quality Improvement Activity in Korean Dental Hospitals

치과의료 질 향상활동 현황과 개선활동 만족도

  • Kim, Han-Na (Department of Preventive and Community Dentistry, Pusan National University School of Dentistry) ;
  • Kim, Ho (Department of Epidemiology and Biostatistics, Graduate School of Public Health, Seoul National University) ;
  • Kim, Hae-Young (Department of Dental Laboratory Science and Engineering, College of Health Science & Department of Public Health Sciences, Graduate School & BK21+ Program in Public Health Sciences, Korea University)
  • 김한나 (부산대학교 치의학전문대학원 예방치과학교실) ;
  • 김호 (서울대학교 보건대학원 보건통계학교실) ;
  • 김혜영 (고려대학교 보건과학대학 치기공학과, 고려대학교 대학원 보건과학과 및 BK21+ 보건과학사업단)
  • Received : 2013.08.28
  • Accepted : 2013.10.10
  • Published : 2013.12.31

Abstract

This study aimed to evaluate conditions and performance of quality improvement (QI) activity in Korean dental hospitals. Twenty one representative dental hospitals in Korea were selected by the selection criteria. A questionnaire was implemented to measure awareness, perceived needs, educations, conferences, works, activating/obstructive factors and satisfaction related to QI activities. Satisfaction score range from 0 (lowest) to 5 (highest) among 329 dental hygienists who worked in the selected 21 dental hospitals. Implementation rate of programs on external customer satisfaction was the highest 59.9% in QI activities, and reduction of expenses (59.4%), Improvement in health care quality (58.7), risk management (52.8) were followed, while improvement in work efficiency (46.5) showed the lowest implementation rate. The most influencing factor accelerating QI activities was 'active participation of hospital workers' (54.7%), and 'effort to improve customer satisfaction' (44.7%) followed. The most influencing QI related obstructive factor was 'lack of QI-related manpower and support' (47.1%). A balanced development including QI programs with lower implementation rates is necessary. Encouraging participation of workers may be the most important in developing dental QI activities further.

본 연구에서는 치과의료 QI 활동이 활발할 가능성이 있는 21개 대표적인 의료기관을 선정하여 QI 활동의 개괄적인 현황을 조사하고, 동시에 그 기관에 근무하는 치과위생사 전체를 대상으로 치과의료 QI 활동의 시행 실태 및 QI 활동시행 후 개선효과에 대한 만족도를 조사하고 QI 활동의 활성화 요인과 저해요인 등을 알아봄으로써 치과의료 QI 활동의 현황을 파악하고 이에 따른 발전 방안을 제시하고자 하였다. 주요 결과는 다음과 같다. 1. QI 활동 주제별 시행률은 외부고객만족 주제가 59.9%로 가장 높았고 비용절감 59.4%, 의료의 질 향상 58.8%, 위험관리 52.8%, 업무효율성 향상 46.5%의 순으로 나타났다. 2. QI 활동 시행 후 개선 효과에 대한 만족도 점수는 비용절감 3.68점, 의료 질 향상 3.66점, 위험관리 3.65점, 외부고객만족 3.61점, 업무 효율성 향상 3.45점 등의 순으로 나타났다. 3. 의료기관 종류별 비교에서는 일반(종합)병원의 QI 활동 시행률이 유의하게 높았고 만족도 점수에서는 치과대학병원이 여러 항목에서 낮은 만족도 점수를 보였다. 4. 가장 많은 응답자가 지적한 QI 활동을 활성화 하는 요인은 병원종사자들의 적극적인 참여도, 저해하는 요인으로는 QI 활동의 인력과 예산 부족이 있다. 결론적으로 치과의료 QI 활동은 외부고객만족도 등 가시적인 효과가 용이하게 나타나는 주제에 집중되는 반면 복잡하고 가시적인 효과가 빠른 시간 내에 나타나기 어려운 주제에 대한 QI 활동은 소홀한 경향이 있으므로 균형 있는 사업 시행을 도모하고 QI 활동을 활성화하기 위해서 노력하여야 할 것으로 생각된다.

Keywords

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