Mi Hyang Um; Eun Soon Lyu; Song Mi Lee; Seung Min Lee; Eun Lee; Jin A Cha; Mi Sun Park; Ho Sun Lee; Mi Yong Rha; Yoo Kyoung Park

doi:10.5720/kjcn.2015.20.3.220

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Clinical Nutrition Services of a Long-term Care Hospital in Korea: Mi Hyang Um, Eun Soon Lyu, Song Mi Lee, Seung Min Lee, Eun Lee, Jin A Cha, Mi Sun Park, Ho Sun Lee, Mi Yong Rha, Yoo Kyoung Park; Korean Journal of Community Nutrition 2015;20(3):220-235.
DOI: https://doi.org/10.5720/kjcn.2015.20.3.220
Published online: June 30, 2015

¹Depatment of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Korea.

²Division of Food Science & Biotechnology, Pukyong National University, Busan, Korea.

³Depatment of Nutrition Service, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

⁴Depatment of Food & Nutrition, Sungshin Women's University, Seoul, Korea.

⁵Depatment of Health Care Center, Konkuk University Medical Center, Seoul, Korea.

⁶Depatment of Korean Cuisine, Jeonju University, Jeonju, Korea.

⁷Depatment of Food & Nutritional Care, Seoul National University Hospital, Seoul, Korea.

⁸Depatment of Nutrition and Dietetics, Severance Hospital, Seoul, Korea.

⁹Depatment of Dietetics, Samsung Medical Center, Seoul, Korea.

Corresponding author: Yoo Kyoung Park. Department of Medical Nutrition, Graduate School of East-West Medical Science, Kyung Hee University, Yongin, Gyeonggi 446-701, Korea. Tel: (031) 201-3816, Fax: (031) 203-3816, ypark@khu.ac.kr

• Received: April 27, 2015 • Revised: June 12, 2015 • Accepted: June 12, 2015

This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Abstract
Acknowledgments
Acknowledgments
REFERENCES

Abstract

Objectives
The purpose of this study was to investigate how clinical nutrition services is provided at a long term care hospital in Korea and to investigate job satisfaction levels of the clinical dietitians.
Methods
Survey questionnaire was sent to dietitians working at a long term care hospital in Korea. The participating hospitals (n=240) were randomly selected from 1,180 long- term care hospitals using a stratified sampling method. A total of 134 long term care hospital s and 223 dietitians completed the survey of clinical nutrition service s and job satisfaction questionnaires The job satisfaction questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas.
Results
The average nutritional screening rate was 17.9% and the rate of computerized nutritional screening system was 9.7% in the participating hospitals. Nutritional intervention rate was only 3.2% of all patients. KOIHA (Korea Institute for Healthcare Accreditation) accreditated hospitals showed only 50% performance rate of nutrition service evaluation area. This shows that after achieving KOIHA accredition, many hospitals do not emphasize the performance of nutritional services. The job satisfaction scores in all four areas ranged from 2/5 to 3/5, implying generally low job satisfaction level in hospital dietitians. Linear regression analysis results showed that the "hospital adequacy grade" type was a significant predictor of job satisfaction level for two areas (working conditions & relationship).
Conclusions
There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service s in long term care hospitals. Therefore, government and local hospitals have to work on implementing nutritional programs and policies for improved service and care.
Keywords: long term care hospital; clinical nutrition service; KOIHA; job satisfaction levels

Acknowledgments

This study was supported by the Health Promotion Fund, Ministry of Health & Welfare, Republic of Korea (13-37).

REFERENCES

1. Statistics Korea. Future population projections 2010-2060 [internet]. 2012; cited 2015 Apr 13]. Available from: http://kostat.go.kr/.
2. Statistics Korea. Social statistical survey report [internet]. 2005; cited 2015 Apr 13]. Available from: http://kosis.kr/.
3. Kwon CY, Lee YH, Lim MT. A study on the architectural planning of skilled nursing facilities for the elderly. Proceedings of 2004 Fall Symposium of the Architectural Institute of Korea; 2004 Oct 29; Gangwon. p. 654-659.
4. Korea Ministry of Government Legislation. Medical law [internet]. 2015; cited 2015 Apr 13]. Available from: http://www.law.go.kr/.
5. Kim YK, Kim JS. A study on healthcare institution selection of healthcare consumers using theory of consumption values: Focusing on relations among clinics or small sized hospitals, general hospitals, and large-sized hospitals. J Korean Soc Qual Manag 2009; 37(4): 71-86.
6. Organization for Economic Co-operation and Development. OECD Health data 2011 [internet]. 2011; cited 2015 Apr 13]. Available from: http://www.moleg.go.kr/.
7. Korea Ministry of Government Legislation. National health insurance [internet]. 2015; 2015]. cited 2015 Apr 13]. Available from: http://www.moleg.go.kr/.
8. Health Insurance Review and Assessment Service. Convalescent hospitals nationwide assessment in 2012 [internet]. 2012; cited 2015 Apr 13]. Available from: http://www.hira.or.kr/.
9. Korea Health Industry Statistics System. Statistical report in 2012 [internet]. 2012; cited 2015 Apr 13]. Available from: http://www.khiss.go.kr/.
10. Health Insurance Review and Assessment Service. Long term care hospital statistics [internet]. 2014; cited 2015 Apr 13]. Available from: http://www.hira.or.kr/.
11. Yoo HJ. Geriatric medicine. 1st ed. Busan: Yeoleumsa; 1999. p. 237-254.
12. White JV, Young E, Lasswell A. Position of the American dietetic association: Nutrition -an essential component of medical education. J Am Diet Assoc 1994; 94(5): 555-557.Article PubMed
13. Lee HY, Kim HA, Yang IS, Nam CM, Park EC. Effectiveness of nutrition intervention: systematic review & meta-analysis. Korean J Community Nutr 2004; 9(1): 81-89.
14. Franz MJ, Boucher JL, Evert AB. Evidence-based diabetes nutrition therapy recommendations are effective: the key is individualization. Diabetes Metab Syndr Obes 2014; 2014(7): 65-72.Article
15. Franz MJ, Monk A, Barry B, McClain K, Weaver T, Cooper N. Effectiveness of medical nutrition therapy provided by dietitians in the management of non-insulin-dependent diabetes mellitus: a randomized, controlled clinical trial. J Am Diet Assoc 1995; 95(9): 1009-1017.PubMed
16. Lemon CC, Lacey K, Lohse B, Hubacher DO, Klawitter B, Palta M. Outcomes monitoring of health, behavior, and quality of life after nutrition intervention in adults with type 2 diabetes. J Am Diet Assoc 2004; 104(12): 1805-1815.Article PubMed
17. Woo YJ, Lee HS, Kim WY. Individual diabetes nutrition education can help management for type II diabetes. Korean J Nutr 2006; 39(7): 641-648.
18. Cho Y, Lee M, Jang H, Rha M, Kim J, Park Y. The clinical and cost effectiveness of medical nutrition therapy for patients with type 2 diabetes mellitus. Korean J Nutr 2008; 41(2): 147-155.
19. McGehee MM, Johnson EQ, Rasmussen HM, Sahyoun N, Lynch MM, Carey M. Benefits and costs of medical nutrition therapy by registered dietitians for patients with hypercholesterolemia. J Am Diet Assoc 1995; 95(9): 1041-1043.Article PubMed
20. Sikand G, Kashyap ML, Yang I. Medical nutrition therapy lowers serum cholesterol and saves medication costs in men with hypercholesterolemia. J Am Diet Assoc 1998; 98(8): 889-894.Article PubMed
21. Shon CM, Nho MR, Lee YH, Lim JH. The clinical and cost effectiveness of medical nutrition therapy in persons with hypercholesterolemia. J Korean Diet Assoc 2003; 9(1): 32-39.
22. Park MS. Nutrition care and dietitian's perception of job importance and performance at long term care hospital in Pusan-Kyungnam area [master's thesis]. Pukyong University; 2011.
23. Lyu ES. Demand and Supply Outlook of Clinical Dietitians. Korea Health Promotion Foundation; 2013 12. Report No. 13-37.
24. Choi KB, Lee SM, Lyu ES. Perceptions of clinical nutrition service. J Korean Diet Assoc 2012; 18(1): 59-71.
25. Ministry of Health and Welfare. Press release [internet]. 2015; cited 2015 Apr 13]. Available from: http://www.mw.go.kr/.
26. Lee C, Lee SK. Clinical nutrition management status in convalescent hospitals before and after healthcare accreditation process. J Korean Diet Assoc 2014; 20(3): 199-211.Article
27. Um MH, Park YK, Lee SM, Lee E, Cha JA, Park MS. Clinical nutrition service in Korean tertiary hospitals and general hospitals: Result of nationwide cross-sectional Survey. J Korean Diet Assoc 2014; 20(3): 183-198.Article
28. Kim KJ. Study about work force of hospital food service dietitians. Proceedings of Korean Diet Assoc's Symposium; 1992 Sep 22; Seoul. 1992; p. 179-192.
29. Yoon MO, Moon HK, Jeon JY, Sohn CM. Nutritional management by dietitian at elderly nursing homes in Gyeonggido. J Korean Diet Assoc 2013; 19(4): 400-415.Article
30. Mo YH. Effectiveness analysis of nutrition support team in the intensive care unit [master's thesis]. Sungkyunkwan University; 2010.
31. Kim HJ, Kim EM, Lee GJ, Lee JJ, Lim JH, Lee JM. Clinical nutrition service at medical centers in Seoul. J Korean Diet Assoc 2011; 17(2): 176-189.
32. Kim NY, Seong GM, Lee JS. Job performance, perception of job importance, and job satisfaction in dietitians working in geriatric hospitals in Busan. J Korean Diet Assoc 2012; 18(4): 356-371.Article
33. Korea Institute for Healthcare Accreditation. Standards for convalescent hospital accreditation [internet]. 2013; cited 2015 Apr 13]. Available from: https://www.koiha.or.kr/.
34. Lee MJ, Lee YK. Effects of job characteristics, job performance and organizational commitment on job satisfaction of hospital dietitians in the Taegu Kyungpook area. Korean J Community Nutr 2000; 5(4): 672-682.
35. Ministry of Health and Welfare. Ministry of health and welfare trends [internet]. 2006; cited 2015 Apr 13]. Available from: https://www.kihasa.re.kr/.
36. Hwang RI, Kwon JH. A study of hospital foodservice satisfaction after covering hospital foodservice in the national health insurance. Korean J Community Nutr 2008; 13(3): 396-404.
37. Lee YS. Ways to improve human resources issues the hospital [internet]. 2013; cited 2015 Apr 13]. Available from: https://www.kihasa.re.kr/.
38. Cho EH. Job-analysis of dietitians in the elderly healthcare facilities [master's thesis]. Yonsei University; 2006.
39. Ministry of Employment and Labor. Salary statistics [internet]. 2012; cited 2015 Apr 13]. Available from: http://laborstat.molab.go.kr/.
40. Lyu ES, Lee SM, Hyh KY. A study on the current of hospital practices in clinical dietetics. J Korean Diet Assoc 1995; 1(1): 10-20.
41. Kim YH, Kim MK, Seo AR, Lee YM. Relationship of nutritional status at the time of admission to length of hospital stay (LOS) and mortality: A prospective study based on computerized nutrition screening. J Korean Diet Assoc 1999; 5(1): 48-53.
42. Chung HT, Kim YS, Kwak SM, Lee YK. The system dynamics model development for management performance forecasting of small and medium hospital. Korean Syst Dyn Rev 2007; 8(2): 209-234.
43. Lee MS, Kim MH. Medical service satisfactions of main caregivers of elderly inpatients according to the grades of longterm care hospitals. Global Health Nurs 2013; 3(2): 73-81.
44. Han WJ. Trends and current issues in health services quality improvement: Case of the united states. Qual Improv Health Care 2008; 14(2): 101-114.
45. Choi J, Park E. Different perceptions of clinical nutrition services between doctors and dietitians in the Busan-Gyeongnam Area. J Korean Diet Assoc 2013; 19(1): 69-81.Article
46. Lee HS, Kim JI. A study on the factors of job satisfaction of the dietitians working in hospitals. Korean J Nutr 1996; 29(6): 651-660.
47. Yun HJ, Lee JE, Hong WS. A study on factors of job satisfaction and burnout of hospital dietitians. Korean J Community Nutr 2009; 14(1): 100-113.
48. Park MS, Lyu ES. Importance and performance of dietitian's task at long term care hospital foodservice in Busan, Kyungnam Area. Korean J Community Nutr 2011; 16(5): 602-612.Article
49. Park EC, Kim HA, Lee HY, Lee YE, Yang IS. A review of the medical nutrition therapy (MNT) of the U.S. medicare system. Korean J Community Nutr 2002; 7(6): 852-862.

Table 1

General statistics of the dietitians (n=223)

1) Respondent dietitian

Table 2

General statistics of the long-term care hospitals

1) Mean ±SD

2) Number of patients divided by the number of available beds.

3) 1grade (good)~5grade (bad) in 2012

4) Korean institute for healthcare accrediation in 2013

5) N (%)

abcd: Duncan's multiple comparison

^*: P < 0.05 ^**: P < 0.01, ^***: P < 0.001

Table 3

General statistics of the clinical nutrition service in long-term care hospitals

1) N (%)

2) N: respondent hospital

3) Mean ±SD

4) The number of patients in nutrition intervention divided by nutrition screening.

ab: Duncan's multiple comparison (a < b)

^**: P < 0.01

Table 4

General statistics of the clinical nutrition service according to hospital adequacy grades of long-term care hospitals

1) N (%)

2) N: respondent hospital

3) Mean ±SD

4) The number of patients in nutrition intervention divided by nutrition screening.

ab: Duncan's multiple comparison (a<b)

^***: P < 0.001

Table 5

Current statistics of the clinical nutrition service according to KOIHA accreditation of long-term care hospitals

1) N (%)

Table 6

Improvement area of clinical dietitian's task according to the KOIHA accreditation of long-term care hospitals

Subjects were guided to select 5 items out of response options.

Table 7

Job satisfaction levels in long-term care hospitals' dietitians by hospital adequacy grades

1) Linear regression analysis

2) Mean ±SD

ab: Duncan's multiple comparison(a<b)

^*: P < 0.05 ^**: P < 0.01

Table 8

Job satisfaction levels in tertiary hospitals' dietitians by KOIHA

Scale score 1 (not at all) ~ 5 (very much)

^*: P < 0.05 by independent t-test

Table 9

National Registration data on long term care hospital and dietitian

1) Numbers of long term care hospital admission in Health Insurance Review & Assessment Service by 2013.

2) Numbers of long term care hospital's dietitian admission in Health Insurance Review & Assessment Service by 2013.

3) Calculated numbers of dietitian/hospital : the number of dietitian divided by number of long term care hospital.

Figure & Data

REFERENCES

Citations

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Clinical Nutrition Services of a Long-term Care Hospital in Korea

Korean J Community Nutr. 2015;20(3):220-235. Published online June 30, 2015

DOI: https://doi.org/10.5720/kjcn.2015.20.3.220

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Clinical Nutrition Services of a Long-term Care Hospital in Korea

Table 1

General statistics of the dietitians (n=223)

1) Respondent dietitian

Table 2

General statistics of the long-term care hospitals

1) Mean ±SD

2) Number of patients divided by the number of available beds.

3) 1grade (good)~5grade (bad) in 2012

4) Korean institute for healthcare accrediation in 2013

5) N (%)

abcd: Duncan's multiple comparison

^*: P < 0.05 ^**: P < 0.01, ^***: P < 0.001

Table 3

General statistics of the clinical nutrition service in long-term care hospitals

1) N (%)

2) N: respondent hospital

3) Mean ±SD

4) The number of patients in nutrition intervention divided by nutrition screening.

ab: Duncan's multiple comparison (a < b)

^**: P < 0.01

Table 4

General statistics of the clinical nutrition service according to hospital adequacy grades of long-term care hospitals

1) N (%)

2) N: respondent hospital

3) Mean ±SD

4) The number of patients in nutrition intervention divided by nutrition screening.

ab: Duncan's multiple comparison (a<b)

^***: P < 0.001

Table 5

Current statistics of the clinical nutrition service according to KOIHA accreditation of long-term care hospitals

1) N (%)

Table 6

Improvement area of clinical dietitian's task according to the KOIHA accreditation of long-term care hospitals

Subjects were guided to select 5 items out of response options.

Table 7

Job satisfaction levels in long-term care hospitals' dietitians by hospital adequacy grades

1) Linear regression analysis

2) Mean ±SD

ab: Duncan's multiple comparison(a<b)

^*: P < 0.05 ^**: P < 0.01

Table 8

Job satisfaction levels in tertiary hospitals' dietitians by KOIHA

Scale score 1 (not at all) ~ 5 (very much)

^*: P < 0.05 by independent t-test

Table 9

National Registration data on long term care hospital and dietitian

1) Numbers of long term care hospital admission in Health Insurance Review & Assessment Service by 2013.

2) Numbers of long term care hospital's dietitian admission in Health Insurance Review & Assessment Service by 2013.

3) Calculated numbers of dietitian/hospital : the number of dietitian divided by number of long term care hospital.

Table 1 General statistics of the dietitians (n=223)

1) Respondent dietitian

Table 2 General statistics of the long-term care hospitals

1) Mean ±SD

2) Number of patients divided by the number of available beds.

3) 1grade (good)~5grade (bad) in 2012

4) Korean institute for healthcare accrediation in 2013

5) N (%)

abcd: Duncan's multiple comparison

^*: P < 0.05 ^**: P < 0.01, ^***: P < 0.001

Table 3 General statistics of the clinical nutrition service in long-term care hospitals

1) N (%)

2) N: respondent hospital

3) Mean ±SD

4) The number of patients in nutrition intervention divided by nutrition screening.

ab: Duncan's multiple comparison (a < b)

^**: P < 0.01

Table 4 General statistics of the clinical nutrition service according to hospital adequacy grades of long-term care hospitals

1) N (%)

2) N: respondent hospital

3) Mean ±SD

4) The number of patients in nutrition intervention divided by nutrition screening.

ab: Duncan's multiple comparison (a<b)

^***: P < 0.001

Table 5 Current statistics of the clinical nutrition service according to KOIHA accreditation of long-term care hospitals

1) N (%)

Table 6 Improvement area of clinical dietitian's task according to the KOIHA accreditation of long-term care hospitals

Subjects were guided to select 5 items out of response options.

Table 7 Job satisfaction levels in long-term care hospitals' dietitians by hospital adequacy grades

1) Linear regression analysis

2) Mean ±SD

ab: Duncan's multiple comparison(a<b)

^*: P < 0.05 ^**: P < 0.01

Table 8 Job satisfaction levels in tertiary hospitals' dietitians by KOIHA

Scale score 1 (not at all) ~ 5 (very much)

^*: P < 0.05 by independent t-test

Table 9 National Registration data on long term care hospital and dietitian

1) Numbers of long term care hospital admission in Health Insurance Review & Assessment Service by 2013.

2) Numbers of long term care hospital's dietitian admission in Health Insurance Review & Assessment Service by 2013.

3) Calculated numbers of dietitian/hospital : the number of dietitian divided by number of long term care hospital.