• Journal of the Korea Society for Simulation
• /
• v.18 no.3
• /
• pp.35-45
• /
• 2009

Emergency medical center(EMC) is the place for patients who need medical treatment immediately due to a disease, childbirth, or all sorts of accidents. Currently, most of EMCs use temporary beds because regular EMC beds cannot afford to serve all incoming patients. However, since it decreases the quality of service(QoS) of EMC patients and their guardians and efficiency of the EMC, some improvements are highly required to diminish the usage of temporary beds. The system duration time is one of the typical QoSs. This thesis proposes the information which is critical to make a better decision for cut down the number of temporary beds without sacrificing QoS of patients. The key point is to control the duration time of medical treatments for the consultation and hospitalization process, since it is the major reason of overcrowding in EMC and the usage of temporary beds. In this paper, we proposed an Arena simulation model reflecting real world substantially. Arena is one of the most widely accepted simulation softwares in the world. Using the developed model, we can obtain the optimal EMC operation parameters through simulation experiments. Optquest, included in the Arena, is used to make the developed simulation model collaborate with an optimization model. The results showed one can determine the set of optimal operation parameters decreasing the required number of temporary beds without deteriorating EMC patient's QoS.

• Journal of Hospice and Palliative Care
• /
• v.12 no.4
• /
• pp.228-233
• /
• 2009

Purpose: The purpose of this study was to retrospectively examine the factors and characteristics of cancer patients who visited the emergency room, as well as to offer some educational materials for to manage acute symptoms. Methods: Data for this study were selected from the period of January to December, 2006. A total of 564 patients were examined using the tool which we developed by ourselves for the study. The collected data were analyzed using the SAS program for frequencies and percentage. Results: As for disease-related characteristics of the subjects, 28.9% of them had gastric and colorectal cancer; 66.9% were in stage 4; 51.6% had been in chemotherapy prior to visiting the emergency room; and 82.5% had their anticancer drug administrated average 1~5 times. As for the characteristics in regard to visit the emergency room, 62.9% were admitted to hospital within 2 weeks of being treated. As for chief complaints for visiting the emergency room, the worst symptom was pain, followed by symptoms such as gastro-intestinal symptoms, respiratory symptoms, high fever, and weakness. As for the disease-related symptoms, the worst symptom that gastric, colorectal, pancreatic, liver and gallbladder cancer patients complained of was pain, high fever for lymphoma patients was respiratory symptoms for lung cancer patients, and gastrointestinal symptoms for head and neck cancer and other patients. Conclusion: Therefore, according to their need and background, an individualized consultation and teaching program should be provided to cancer patients.

• Journal of Service Research and Studies
• /
• v.13 no.1
• /
• pp.63-75
• /
• 2023

Due to the development of industry, interest in air pollutants has increased. Air pollutants have affected various fields such as environmental pollution and global warming. Among them, environmental diseases are one of the fields affected by air pollutants. Air pollutants can affect the human body's skin or respiratory tract due to their small molecular size. As a result, various studies on air pollutants and environmental diseases have been conducted. Asthma, part of an environmental disease, can be life-threatening if symptoms worsen and cause asthma attacks, and in the case of adult asthma, it is difficult to cure once it occurs. Factors that worsen asthma include particulate matter and air pollution. Asthma is an increasing prevalence worldwide. In this paper, we study how air pollutants correlate with the number of emergency room admissions in asthma patients and predict the number of future asthma emergency patients using highly correlated air pollutants. Air pollutants used concentrations of five pollutants: sulfur dioxide(SO₂), carbon monoxide(CO), ozone(O₃), nitrogen dioxide(NO₂), and fine dust(PM₁₀), and environmental diseases used data on the number of hospitalizations of asthma patients in the emergency room. Data on the number of emergency patients of air pollutants and asthma were used for a total of 5 years from January 1, 2013 to December 31, 2017. The model made predictions using two models, Informer and LTSF-Linear, and performance indicators of MAE, MAPE, and RMSE were used to measure the performance of the model. The results were compared by making predictions for both cases including and not including the number of emergency patients. This paper presents air pollutants that improve the model's performance in predicting the number of asthma emergency patients using Informer and LTSF-Linear models.

• The Korean Journal of Food And Nutrition
• /
• v.22 no.1
• /
• pp.141-149
• /
• 2009

The elderly population in Korea is growing rapidly and their needs for long-term care has also increased. By the year 2018, our society will be approaching aged society and by 2026 it will be a super-aged society. The purpose of this study was to employ conjoint analysis to establish the relative importance of foodservice encounters in terms of determining the utility values of hospital foodservice for elderly patients. According to the results pearson's R(0.420) and Kendall's tau(0.402) statistics showed that the model fits the data well(p<0.05). The relative importance scores of hospital foodservice encounters were as follows: dietary counseling with dietetics(51.2%), foodservice personnel(48.7%), and food(0.1%). A soft cooking method(0.001) was preferred to a general cooking method(0.001), and kind foodservice personnel(0.086) were preferred to quick service(-0.086). Finally, counseling with a dietitian once a week(-0.138) was preferred to counseling twice a week (-0.276). Based on this conjoint analysis, the most preferable model for foodservice at a long-term care facility would be; soft cooking methods, kind service by foodservice personnel, and dietetic counseling once a week. Overall, a better understanding of the specific needs of our institutionalized elderly is one of the key elements that can help our long-term care system develop improved foodservice programs.

• The Journal of the Korea Contents Association
• /
• v.12 no.1
• /
• pp.416-429
• /
• 2012

This study was to assess the effects of a recovery oriented integrated rehabilitation program on cognitive social function, rehabilitation motivation, and mental health recovery. This program is involved motivation enhancement program with 4 subprograms composed of cognitive rehabilitation, emotion management, vocational rehabilitation, family education program. The subjects were 34 patirents with schizophrenia who had been hospitalized at National Mental Hospital on local area. The study was a non-equivalent control group non-synchronized design with two groups, an experimental group(18 patients) and a control group(16 patients). The collected data were analyzed using SPSS 12. 0. The results of the data show that there was not a significant increase in the symptom, cognitive and social function. But there was a significant increase in readiness of rehabilitation(maintenance, p=.027) and mental health recovery (p=.039). Short term recovery oriented integrated rehabilitation programs in inpatient settings are more available for motivation of rehabilitation and mental health recovery than symptom reduction or functional improvement. Therefore there should be more efforts to create more recovery oriented service provision in clinical settings.

• Korean Journal of Community Nutrition
• /
• v.10 no.6
• /
• pp.943-951
• /
• 2005

The purposes of this study were to analyze the gap between foodservice personnel and inpatients, to urge foodservice providers to reconsider by identifying the problems in service delivery for customer satisfaction, and to deduce the priority for foodservice quality improvement. The results of this study can be summarized as follows : the average perception score of personnel (4.32 out of 5) was higher than that of customers (3.90). In particular, the customers' perceptions of 17 attributes, which included 'removal service of tray by foodservice personnel', 'nutrition and health-related information service', 'handling inpatient's complaint ASAP', 'delicious meals' and 'salty enough meals' and so on, was significantly lower than personnel's. Both service providers and customers perceived that 'personnel attitude' was the highest and 'meal quality' was the lowest among the 4 factors, but there was significant difference on 'meal quality'(p < .001), 'customer reception' (p < .001) and 'personnel attitude' (p < .05) between the two groups. As a results of quadrant analysis, 'removal service of tray by foodservice personnel', 'handling inpatient's complaints ASAP' and 'meal service according to doctor's orders were categorized into Quadrant A with meaning of high personnel's perceptions and low customers'. Therefore service providers have to perceive the gap between the two viewpoints and grant priority to these attributes in improving foodservice qualify. (Korean J Community Nutrition 10(6) $943\∼951$, 2005)

• Korea Journal of Hospital Management
• /
• v.18 no.1
• /
• pp.18-41
• /
• 2013

This study was aimed to identify the current status of medical service quality of medical institutes; propose improvements; and find out the impact of medical service quality by its attribute on overall customer satisfaction. The research was conducted on the out-patients and in-patients in a high-level general hospital located in A city. To examine the research, the IPA was utilized to identify the priority requirements for improving the medical service quality. The study also applied an extended theory to the analysis on mismatch between the level of satisfaction and importance recognized by the clients, to examine the impact of the above mentioned factors on the overall satisfaction and intention to revisit and recommend the hospital. For out-patients, the result showed that "hospital hygiene" had a positive and negative impact on the clients' intention to revisit the hospital in priority improvements. In terms of the sustainable improvements, "doctor's skill" had a negative impact on the overall service satisfaction, whereas "state-of-the-art facility" and "nurse's instruction" had a positive impact on the intention to revisit the hospital. In long-term improvements,"complaint remedy" had a positive impact on the intention to recommend the hospital but there were no relevant factors in excessive investment. On the other hand, for in-patients, the result demonstrated that there were no relevant factors in priority improvements and sustainable improvements. The factor of"service procedure speed"had a positive as well as negative impact on the intention to revisit the hospital. In excessive investment,"nurse's empathy"had a positive impact on the intention to recommend the hospital.

• Journal of Preventive Medicine and Public Health
• /
• v.23 no.4 s.32
• /
• pp.451-464
• /
• 1990

The variation in resource utilization for hospitalized patients who had a group of similar diseases -- a Korean Diagnosis Related Group (KDRG) -- among the same type of hospitals was studied to assess the utillization variation due to the practice pattern of hospitals. Information about inpatients who were beneficiaries of the medical insurance for teachers and government officials discharged from 20 large university teaching hospitals in Seoul during 1986 and information about the hospitals were analyzed to achieve the study objective. A total of 20,223 non-outlier patients in 100 most frequent KDRGs were included in the analysis. Case charges after the review and length of stay (LOS) were used as measures of resource utilization during a hospitalization. A substantial variation among hospitals was found in most KDRGs : o the ratio of the maximum and the minimum among the mean case charges of hospitals was greater than 2 in 83 KDRGs ; o the difference between the maximum and the minimum among the mean case charges of hospitals was greater than 100,000 Won in 94 KDRGs : o the ratio of the maximum and the minimum among the mom LOS of hospitals was greater than 2 in 82 KDRGs ; o the difference between the maximum and the minimum among the mean LOS of hospitals was greater than 3 days in 94 KDRGs. The practice pattern of hospitals explained more than 20% of charge variation in 49 KDRGs and more than 20% of LOS variation in 43 KDRGs. The study results indicated need for a new health policy initiative for cost containment and quality assurance.

• Health Policy and Management
• /
• v.29 no.4
• /
• pp.445-453
• /
• 2019

Background: This study is to investigate the association between the distribution of multimorbidity and length of stay and medical expenses among inpatients in a municipal hospital to achieve an integrated care setting. Methods: We used the exploratory factor analysis and the generalized estimating equation model to analyze the data from patients living in the northeast region of Seoul, who were hospitalized from January 2017 to December 2017 in a municipal hospital. Results: As a result of the factor analysis, seven types of multiple chronic diseases were classified. Among the elderly patients admitted to municipal hospitals, the burden of medical expenses was mainly influenced by the length of stay (B=310,719, p-value <0.0001), not the type of disease (all not significant). Length of stay were mainly due to psychiatric illness (factor 1: B=4.323, p-value <0.0001) related to the brain and metabolic diseases (factor 2: B=2.364, p-value=0.003). Conclusion: This study showed that the medical expenses of the elderly patients were largely due to prolonged hospitalization, not multimorbidity. Therefore, it is necessary to develop an integrated care paradigm strategy cope with the multimorbidity of the elderly in the community and to alleviate the socio-economic burden.

• Korea Journal of Hospital Management
• /
• v.25 no.1
• /
• pp.46-57
• /
• 2020

Objectives: The purpose of this study is to evaluate the factors affecting patient satisfaction for the nursing service of comprehensive nursing care service unit in Tertiary hospital Methods: This study employed a descriptive survey to investigate the nursing satisfaction and the study data was collected from 74 patients among 83 patient who were admitted to the nursing care integration service ward of an tertiary hospital for 10 days from May 9, 2018 to May 19, 2018. Data was analyzed by descriptive statistics, t-test, ANOVA, and multiple linear regression using SPSS 21 program. Results: The average with nursing satisfaction was significantly different according to marriage type and KPCS level. It was found that physical factor and educational factor have statistically significant effect on nursing satisfaction. As physical care increase by one unit, patient satisfaction increase by 0.226(95% CI; 0.061-0.390) and also satisfaction increase by 0.443(95% CI; 0.070-0.816) as education care increase by one unit. Conclusions: As a result of study, it was found that it is necessary to provide patients with more careful nursing service in physical and educational perspective, in order to improve the service quality of comprehensive nursing care service unit.