• Quality Improvement in Health Care
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• v.15 no.2
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• pp.83-86
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• 2009

연구배경: 수술적 치료가 필요한 척추관 협착증 환자들은 주로 60세 이상의 고령환자로 장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술 후 환자들의 재원일수의 증가는 병원의 병상가동률을 감소시키고, 전공의에게는 불필요한 업무를 증가시킨다. 연구목적: 비용 효과면에서 최적화된 진료 지침의 개발은 불필요한 의료비의 감소 및 Hospital Induced Complication을 줄여 환자 만족도를 증진시킬 수 있으며, 각 환자에 대한 전공의 업무를 줄일 수 있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문요양기관 연구방법: 정형외과 및 신경외과의 척추관 협착증 환자의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program(EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과: CP 적용 전, 후 비교를 통해 재원일수는 3.8일이 감소하였으며, 이에 따라 병상 가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교 검토 중이다. 또한, CP 개발 및 CP Master Program의 사용을 통한 전공의 업무 감소에 대해 검토하고 있다.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.143-152
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• 2010

Purpose: This study aimed to evaluate the current status of hospice palliative care facilities in Korea. Based on the result, we attempted to suggest activation plans of hospice palliative in Korea. Methods: To conduct a survey, we obtained a list of hospice palliative care facilities from related agencies and academic societies. A survey was conducted from February, 2009 to March, 2009. The survey was consisted of general characteristics of organizations, manpower, facilities & equipments, and so on. In addition, we used data from Statistics Korea to estimate the number of beds required and the bed occupancy rate. Results: Total number of facilities responded to the questionnaire were 53. Forty-two facilities were general hospitals and 6 facilities were clinics among the total 53 facilities, and 18.8% of facilities were located in Seoul, Incheon and Gyeonggido. Overall bed occupancy rate was rather low as 21.9%, and there were 4 provinces where bed occupancy rates were 0%. Deaths in hospice palliative care facilities during 2008 were 6.3% of total deaths from cancers. As for the questions about the financial status of facilities, 86% of facilities were answered financial insufficiency. Also more than half of the facilities gave financial insufficiency as the reason for shortage of human resource supplies and inability to achieve the standard for authorization by the government. Facilities answered in order to activate the hospice palliative care, governmental support is needed, mostly in financial support (71.2%), donation tax deduction (43.1%), and setting up a public utility foundation (23.5%). Conclusion: This study showed low rates of hospice palliative care use and bed occupancy in Korea. Regional variance in bed occupancy rate was significantly high. As a roadblock for these problems, most of the facilities cited financial insufficiency. Therefore, there must be some action plans to boost financial support to activate hospice palliative care in Korea. Finally, efforts to improve these circumstances including lack of understanding about hospice and palliative care, are needed as well.

• The Journal of the Korea Contents Association
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• v.20 no.10
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• pp.510-521
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• 2020

Recently, transparency in accounting for medical institutions has been emphasized. However, due to the current system problems and structural limitations, there is a lack of diagnosis on the financial status of domestic hospitals. This study is based on the financial statements per 100 beds of 374 including domestic hospital level to tertiary hospital, and analyzed the Free Cash Flow(FCF) by hospital size from the perspective of Free Cash Flow Hypothesis. After deriving Operating Cash Flow(OCF) through the profit or loss statement of medical institutions, FCFs were analyzed through the prior and current financial statements and OCFs, and the correlation between financial variables was confirmed. According to the analysis, first, hospitals with 160 to 299 beds and 300 beds or more have relatively high FCFs. Second, certified tertiary hospitals, hospitals with less than 160 beds, and general hospitals have negative(-) FCFs. Thus, there's a need to narrow the FCF gap based on the size of the hospital, maintaining an appropriate level of FCF. This study is meaningful in that it was the first FCF analysis based on hospital size. This study is also expected to offer an informative resources in setting differentiated strategies according to the size of medical institutions when establishing new accounting policies in the future.

• Korean journal of food and cookery science
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• v.32 no.1
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• pp.107-113
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• 2016

The purpose of this study was to analyze factors that influence prerequisite program (PRP) performance of hospital foodservice operation. Data was collected through surveys given to 65 dietitians working in general hospital with ${\geq}100beds$. Importance score of sanitary management for the self-operated establishments was significantly higher than that of contract-managed in the areas of working environment management (p<0.01), waste management (p<0.05), clean disinfection management (p<0.05). Performance score of hospitals with ${\leq}300beds$ was significantly lower than that of hospitals with ${\geq}300beds$ in personal hygiene management (p<0.05). Moreover, importance score of dietitians spending ${\geq}3hours$ on inspection time was significantly higher than that of dieticians spending ${\leq}3hr$ in waste management area. According to the results of Pearson correlation analysis, PRP performance score was positively related with dietitian's career (p<0.05), number of submitted beds (p<0.05), cooking process inspection time (p<0.05), dietitian's job satisfaction (p<0.01), and holding rate of utensil and equipment (p<0.05). In addition, the results of multiple regression analysis showed that dietitian's job satisfaction (p<0.001) and holding rate of utensil and equipment (p<0.05) had a significant positive effect on prerequisite program performance. In conclusion, improvement of working condition to increase dietitian's job satisfaction and securing of utensils and equipments are high priorities for improvement of PRP performance.

• Journal of The Korea Institute of Healthcare Architecture
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• v.23 no.2
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• pp.73-82
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• 2017

Purpose: Since the facility guidelines for National Designated Isolation Unit wards(NDIUs) had been edited since 2016, all hospital who want to expand or install NDIU should adapt the new guidelines. Instead of providing area requirement, by the way, only essential or optional facility requirements are suggested except patient bedroom in the guidelines. So, as analyze area and area composition of the NDIUs, it could be expected that this study has a role as an area planing reference for not only NDIU but also another airborne infection isolation room. Methods: For the area analysis, 18 sample hospitals are selected among 2016 year applicants. All rooms in NDIUs are grouped as zones whether those are negative air pressurized or not and programed room or not. At the end, area of the zones are summarized and analysed a relationship between area increase and bed number by both correlation analysis and regression analysis. In addition, department usable and gross area per bed, N/G ratio, G/N ratio, and average area ratio of each zone is calculated. Results: First of all, rooms in none negative air pressurized zone of the NDIUs haven't shown a regular installation so that only those in negative air pressurized zone are targeted for the area analysis. Second of all, patient room unit(0.92) and support area(0.79), by correlation analysis, are correlated with total net area. Patient room unit(0.94) and total net area(0.79) are also shown a correlation with bed number. Department usable area($R^2=0.63$, y=36.278x + 102) and patient room unit area($R^2=0.89$, y= 27.993x - 0.8924) has a relationship with bed number by regression analysis. Average N/G is shown as 0.85 and G/N 1.36. Average area ratio of circulation, doffing area, patient room unit, and support area are 25.4%, 9.1%, 50.9%, and 14.6% in order. Implications: This study is a basic research for exploring the NDIUs guidelines to find resonable evidence to develop it for its practical use. Still, it is possibly expected that the guideline is to be developed by post occupancy evaluation in the area of where minimum requirement or facility grade needs to be defined, and by further studies with various perspectives.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.9
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• pp.134-143
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• 2020

This study investigated the status of infectious disease inpatients at long-term care hospitals in Korea. A descriptive study was conducted on patients with 14 infectious diseases at 798 long-term care hospitals during 2016-2017. The number of infected patients, total admission days, and total medical expenses were higher in 2017 than in 2016. The most common infectious diseases were enterocolitis due to Clostridium difficile, influenza, and scabies. The number of hospitals with patients who had enterocolitis due to C. difficile and resistance to carbapenem was higher in 2017 than in 2016. Hospitals with 150-299 beds had higher numbers of infectious disease patients than those with under 150 or over 300 beds. Therefore, intensive efforts are needed to control the most common diseases at long-term care hospitals, such as enterocolitis due to C. difficile, influenza, and scabies. It is recommended to apply relevant guidelines related to infection control management as well as implement educational programs. It will also be necessary to develop applicable infection monitoring standards and support the facilities and health workforce of long-term care hospitals under 300 beds through an effective infection surveillance system.

• Journal of Digital Convergence
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• v.12 no.5
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• pp.353-366
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• 2014

The purpose was to describe the state of healthcare-associated infection(HAI) control. Data were collected from 134 hospitals. The questionnaire developed by Kang[8] were modified. The mean of hospital beds was 556.4, 26.9% of hospitals were less than 300 beds. 99.3% of hospitals had infection control committee(ICC). ICC met 3.4 times a year. 54.5% of hospitals had one infection control practitioner(ICP). 95.5% of ICPs were nurse, 48.7% of ICPs had more than master's degree. Hospital experience of ICPs was 13.5 years. ICP experience was 3.2 years. 30.8% of ICPs worked for less than 1 year. All hospitals investigated HAI, 75.4% performed improvement activities. There are significant differences in existence of ICD, negative pressure room, computer program, numbers of ICPs according to hospital size. Manpower, organization, and facilities lacked in less than 300 beds. This conclusions will give baseline data to establish infection control system, manpower and practice in small-medium hospitals.

• Journal of Digital Convergence
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• v.17 no.12
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• pp.345-352
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• 2019

This study aims to analyze the factors affecting the length of stay in elderly pediatric inpatients in traffic accidents. We used Korean National Hospital Discharge In-depth Injury data on the discharged from 2012 to 2016. Statistically significant factors affecting the length of stay are admission route, Charlson Comorbidity Index(CCI), injury parts, operation, results, hospital area, and beds for hospitals. The length of stay was shorter in the case of the admission route of the outpatient department than the emergency room, the results were not improved or death rather than improved, and the bed size was 500-999 beds or over 1000 beds rather than 100-299 beds. However, the length of stay was longer in the case of CCI score was 1-2 or over 3 rather than 0, injury parts were other parts rather than head/neck, when the operation was yes, and when the hospital area was a province, metropolitan rather than Seoul. This study intends to understand the medical characteristics of inpatient to prevent pedestrian traffic accidents in accordance with the population aging. Based on this finding, we wish to be used as the basic data for the establishment of policies to effectively manage traffic safety and medical resources in consideration of the characteristics of the elderly people.

• Journal of Digital Convergence
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• v.17 no.3
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• pp.261-269
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• 2019

The purpose of this study is to present the effective management strategy of RI based on the results of research on the causal relationship between the regional medical care capacity and the hospital management performance by calculating the RI of the general hospitals in Korea, This research has significance. The results of this study are as follows: First, statistically significant differences were found in Number of beds and recurring profits in urban areas by the general characteristics. Second, the correlations between the RI and the variables of the regional medical use are as follows: Recurring profit ratio, New Outpatient Visits, Operating Margin, Daily Outpatient Visits per 100 Beds, Daily Inpatient Days per 100 Beds, and Average Charge per Inpatient Day. Based on the results of this study, the significance of this study is as follows. First, we calculated the affinity for local medical use, which is the index of local medical utilization. Secondly, it is analyzed according to internal and external environmental factors such as city size, hospital size, etc. It can be said that the hospital provided basic data for establishment of hospital management strategy to increase the utilization rate of local medical care.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2007.11a
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• pp.285-286
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• 2007