[논문]의료기관 평가제도 영양부문 기준 및 결과의 시계열 변화 분석

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doi:10.14373/jkda.2013.19.4.317

의료기관 평가제도 영양부문 기준 및 결과의 시계열 변화 분석
The Time Series Analysis of Standards and Results of Nutritional Domain in Hospital Evaluation Program 원문보기

대한영양사협회 학술지 = Journal of the Korean dietetic association, v.19 no.4, 2013년, pp.317 - 342

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The purpose of this study was to evaluate the current state of foodservice and clinical nutrition management in a hospital-based nutrition department. Nutritional guidelines and survey reports of hospital evaluation programs from 2004 to 2009 were analyzed. In total, 275 hospitals in the first period and 288 hospitals in the second period were evaluated. The division of knife and chopping board use decreased from 97.2% in 2005 to 89.7% in 2008, the maintenance of a proper freezer temperature (below $-18^{\circ}C$) increased from 82.1% in 2004 to 97.7% in 2007 (88.9% to 97.4% from large hospitals and 69.8% to 86.5% from small/medium hospitals in 2005 and 2008, respectively). In tube-feeding management, the performance rate of material cold storage and the offer rate of tube-feeding were 65.9% and 94.2% in 2007, respectively. The cold storage of material, proper use within 24 hours after opening or production, and the use of an appropriate label were 47.3%, 71.2% and 67.2% in 2009, respectively. The rate of a management system for undernourished patients was 86.0% in 2007 (56.4% for large hospitals, 18.9% for small/medium hospitals) and 14.3% in 2009. In standards of nutrition support management, the performance rates of constructing a nutrition support team, the nutrition support team activity, and organizing multidisciplinary team were 66.7%, 43.6%, and 64.1% respectively, in 2004. For large hospitals, those rates were 61.1%, 36.1%, and 58.3%, in 2005, 93.0%, 62.8%, and 91.9% in 2007, and 69.2%, 43.6%, and 69.2% in 2008, respectively. The results of this study suggest standards on sanitary foodservice preparation, production, and tube-feeding production need to correspond with HACCP regulations for small/meidium hospitals in standards of a healthcare accreditation system. It will be necessary to understand the operating conditions of nutrition departments in convalescent hospitals, psychiatric hospitals, and geriatrics hospitals. As the application of accreditation is required from 2013, standards will need to be improved and continuously updated for healthcare accreditation.

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핵심어	질문	논문에서 추출한 답변
	의료보장개혁위원회에서 실시한 의료기관 서비스평가는 언제 처음 실시되었는가?	1994년 6월 의료보장개혁위원회에서 처음으로 의료기관 평가제도에 관한 건의를 하여 ‘의료기관 서비스평가’를 1995년부터 실시하였다가 2002년 의료 기관 평가 관련 의료법이 신설됨에 따라 그 명칭을‘의료기관 평가’라고 수정하였다. 2004년부터 3년간을 1주기로 정하고 병상규모별로 대형병원과 중소 병원에 대한 평가 기준을 차별화하여 실시하였고, 2007년부터 2009년은 2주기로 기존의 평가가 부서및 서비스, 시설, 구조 중심이었다면 2주기부터는 임상의 질 지표를 도입하여 평가를 환자진료 중심으로 전환하였다(MHW 2007a).
	의료기관 평가 제도가 실시된 기간은 언제인가?	우리나라는 국민들의 의료서비스에 대한 관심이 높아지고 소비자로서 의료에 대한 권리의식이 신장 됨에 따라 의료기관들이 시설이나 인력, 체계 등을 강화하여 전반적인 의료 수준을 높일 수 있도록 하는 목적과 의미를 지닌 국가적 차원의 의료기관 평가 제도를 2004년∼2009년까지 실시하게 되었다 (MHW 2004a).
	1995년부터 시행된 의료기관 서비스 평가는 2005년 몇 개소의 병원을 평가하였는가?	또 2003년에는 의료법 시행령 중 의료기관 평가와 관련된 개정령과 개정시행 규칙을 공포하고 2004년에 500병상 이상 상급종합병원과 종합병원 78개소를 대상으로 1주기 의료기관 평가를 시작하였다. 이어 2005년에는 260∼500병상 종합병원 79개소를, 2006년에는 260병상 미만 종합병원과 300병상 이상 병원 118개소를 평가하여 1주기를 마감하였고, 2주기의 시작인 2007년 500병상 이상 상급종합병원과 종합병원 86개소를 시작으로, 2008년 260∼500병상 종합병원 76개소, 2009년 260병상 미만 종합병원과 300병상 이상 병원 126개소 평가를 끝으로 의료기관 평가의 1주기와 2주기를 모두 완료하였다(MHW 2009a).

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의료기관 평가제도 영양부문 기준 및 결과의 시계열 변화 분석
The Time Series Analysis of Standards and Results of Nutritional Domain in Hospital Evaluation Program 원문보기

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의료기관 평가제도 영양부문 기준 및 결과의 시계열 변화 분석 The Time Series Analysis of Standards and Results of Nutritional Domain in Hospital Evaluation Program 원문보기

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의료기관 평가제도 영양부문 기준 및 결과의 시계열 변화 분석
The Time Series Analysis of Standards and Results of Nutritional Domain in Hospital Evaluation Program 원문보기