• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.319-329
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• 2015

Objectives: Parental socioeconomic status (SES) exerts a substantial influence on children's health. The purpose of this study was to examine factors determining children's private health insurance (PHI) enrolment and children's healthcare utilization according to PHI coverage. Methods: Korea Health Panel data from 2011 (n=3085) was used to explore the factors determining PHI enrolment in children younger than 15 years of age. A logit model contained health status and SES variables for both children and parents. A fixed effects model identified factors influencing healthcare utilization in children aged 10 years or younger, using 2008 to 2011 panel data (n=9084). Results: The factors determining children's PHI enrolment included children's age and sex and parents' educational status, employment status, and household income quintile. PHI exerted a significant effect on outpatient cost, inpatient cost, and number of admissions. Number of outpatient visits and total length of stay were not affected by PHI status. The interaction between PHI and age group increased outpatient cost significantly. Conclusions: Children's PHI enrolment was influenced by parents' SES, while healthcare utilization was affected by health and disability status. Therefore, the results of this study suggest disparities in healthcare utilization according to PHI enrollment.

• Korean Institute of Interior Design Journal
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• v.25 no.4
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• pp.113-124
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• 2016

This research examines domestic and oversea's barrier-free design guidelines provided exclusively for children and their implementations in the common spaces of the outpatient clinics in two pediatric rehabilitation hospitals in Seoul. Based on literature review, a checklist was developed to compare various barrier-free design guidelines in consideration of children's accessibility in space. In addition, four spatial areas in the outpatient clinics of the two hospitals were investigated based on the checklist. As a result, the domestic and Japanese guidelines were aiming primarily to all user groups regardless of ages. Whereas in other oversea's guidelines, a number of barrier-free design standards exclusive for children were found in the facility items such as handrail, sink, urine, toilet, water fountain, chair, table, shelve, and so on, throughout the indoor waiting and sanitary spaces. Concerning implementations, most of the items in the indoor passage, waiting, and sanitary spaces of the two hospitals were not sufficiently facilitated enough to meet with the barrier-free design standards exclusive for children. As such, it is recommended to review and improve the current domestic barrier-free design guideline to accommodate various physical and spatial needs of children in all age groups and regardless of disability types, in the design of a pediatric rehabilitation hospital in the future.

• Korean Parent-Child Health Journal
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• v.13 no.1
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• pp.35-43
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• 2010

Purpose: This study was a descriptive research to provide fundamental data in ensuring a high quality of nursing service needed by children's parent according to perception of uncertainty and care satisfaction of them between pediatric outpatient department and emergency room. Methods: For this study, 192 children's parents were questioned in a general hospital located in Busan from August 1 to 31. 2009. The collected data were scored by use of frequencies, $x^2$ test, t-test, AONVA, Pearson's correlation coefficient via SPSS/WIN 17.0. Results: With the compare of characteristics related to children's parents visiting emergency room and pediatric outpatient department, there were statistically significant difference in relation and age of parent, main caregiver, cause of arrival, and waiting time from arrival to procedure. The perception of uncertainty for parent in the emergency room showed significant difference to outpatient department. In nursing service, the highest score was category of professional skill and technic. In addition, overall parents' perceptions on providing information showed lower than any other nursing service. Last but not least, a significant correlation indicated between the perception of uncertainty and satisfaction of nursing service. Conclusion: Efforts to improve parent satisfaction for nursing service are needed to decrease their perception of uncertainty. Providing information and communication by nurses are necessary to improve quality of nursing service.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.4
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• pp.377-386
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• 2019

Purpose: Percutaneous liver biopsy (PLB), a diagnostic procedure to identify several hepatobiliary disorders, is considered safe with low incidence of associated complications. While postoperative monitoring guidelines are suggested for adults, selection of procedural recovery time for children remains at the discretion of individual operators. We aim to determine if differences exist in frequency of surgical complications, unplanned admissions, and healthcare cost for children undergoing outpatient PLB for cohorts with same-day vs. overnight observation. Methods: We performed a retrospective cohort study in children 1 month to 17 years of age undergoing ultrasound-guided PLB from January 2009 to August 2017 at a tertiary care, pediatric referral center. Cohorts were defined by postprocedural observation duration: same-day (${\leq}8$ hours) vs. overnight observation. Outcomes included surgical complications, medical interventions, unscheduled hospitalization within 7 days, and total encounter costs. Results: One hundred and twelve children met study criteria of which 18 (16.1%) were assigned to same-day observation. No differences were noted in demographics, anthropometrics, comorbidities, biopsy indications, or preoperative coagulation profiles. No major complications or acute hospitalizations after PLB were observed. Administration of analgesia and fluid boluses were isolated and given within 8 hours. Compared to overnight monitoring, same-day observation accrued less total costs (US $992 less per encounter). Conclusion: Same-day observation after PLB in children appears well-tolerated with only minor interventions and complications observed within 8 hours of procedure. We recommend a targeted risk assessment prior to selection of observation duration. Same-day observation appears an appropriate recovery strategy in otherwise low-risk children undergoing outpatient PLB.

• Journal of The Korea Institute of Healthcare Architecture
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• v.16 no.3
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• pp.37-48
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• 2010

This study analyzes the present condition of the elements of a healing environment of the waiting rooms in outpatient clinics of children' hospitals (3 hospitals in Seoul) so as to propose a design to build a healing environment within the children' hospital. And analyzing the importance, satisfaction and preference of the healing environment in the waiting rooms, this paper has come to the following conclusions: 1)The study shows that the space structure of outpatient clinics in children' hospitals are composed of 1 story or 2 stories and designed in a duplication design or a dispersed alcove design. 2)The waiting room of the SC Hospital, with an area of 66.56$m^2$, and the waiting room of the SU Hospital, with an area of 38.78$m^2$ received the highest score for its space. 3)As most patients visit the hospital with their guardian, the waiting room should also be someplace families can rest and share information with others. 4)It is essential to build an environment that eliminates stress elements that patients may come to face by minimizing noise and elements that obstruct the view for mental stability. 5)The results show that those who took part in the survey preferred the following, respectively, healing environment design for the waiting room in the outpatient clinic at children' hospital: Pleasantness>Easiness in finding one' destination>Artificial materials>Natural materials>Environment like that at home>Co-promotion spaces>Space that supports the patients'activities>Openness>Sociality>Safety/Security>Approachability and Privacy. The results also show that healing conditions respect these preferences.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.33 no.12
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• pp.41-52
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• 2017

This study investigates the waiting and resting behaviors of children within a restorative healthcare facility design. In particular, the aim is to compare children with and without disabilities and reveal similarities and differences in terms of their behavioral characteristics and uses of design facilities, related to positive distraction, for restoration in the hospital. Three major common spaces for outpatients in S children's hospital in Seoul were examined including the main lobby and two waiting and resting spaces in the pediatric and rehabilitation medicine departments, respectively. A total of 155 children under the age of 12-67 with physical disabilities and 88 without-were observed while they waited and rested at the three spaces before or after doctors' examination. Basic demographic information and waiting and resting behavioral characteristics were compared between the two groups. The results indicated that the disabled children were more restricted in terms of space, facilities used, and social behaviors. However, regardless of disabilities, the children showed more positive distractions related to cognitive and social behaviors in areas where restorative design elements such as an aquarium, garden, or visual images were available. Based on the results, design implications were discussed to strengthen positive distraction behaviors in children with and without disabilities and to foster the restorative quality of the spaces for waiting and resting in the children's hospital.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.3
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• pp.95-102
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• 2013

Background: Sedation or outpatient general anesthesia is a necessary method for a successful dental treatment for children and the disabled who have a difficulty of cooperation. The aim of this study was to assess the patients who had dental treatment under sedation or outpatient general anesthesia at department of pediatric dentistry, Chonnam national university dental hospital and Gwangju dental clinic for the disabled. Methods: 875 patients who had sedation from January 2009 to September 2013 and 88 patients who had outpatient general anesthesia after May 2011 were assessed for this study. Patient's distribution and treatment patterns were examined. Results: The number of patients has been increasing in both sedation and outpatient general anesthesia. In case of sedation, the proportion of male patients was higher and 4-6 years age group was the highest. Most patients have resided in Gwangju buk-gu and the percentage of restorative treatment was the highest. In case of outpatient general anesthesia, the proportion of male patients was higher than that of sedation. Two groups, 10-19 and 20-29 years age, consisted most of patient. Most patients have resided in Gwangju buk-gu and Jeollanam-do, and the percentage of periodontic and preventive treatment was the highest. Conclusions: Sedation or outpatient general anesthesia for dental treatment has been increasing for children and the disabled who have a difficulty of cooperation. Therefore, it is important to improve treatment environment under sedation and general anesthesia through continuous research and studies.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.34 no.10
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• pp.83-94
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• 2018

In many theoretical and empirical studies on the design issues of therapeutic healthcare facilities, spatial configuration that promotes users' wayfinding behavior, has been emphasized as a significant factor to mitigate stressful experiences and to enhance restorative quality in the healthcare environment. This is also applicable to the healthcare setting for children. However, not much evidence has been reported with regard to the relationship between spatial configuration and wayfinding behaviors in this specific setting. Moreover, healthcare facilities for children with physical disabilities need more attention to provide easy wayfinding due to various physical restrictions. The aim of this study is therefore, to unfold the relationship between spatial configuration and visual cognitive qualities of outpatient spaces in the selected children's rehabilitation hospitals in Seoul, by examining visual cognitive attributes such as visibility, accessibility, and intelligibility. In the first phase, the spatial layout of the hospitals was analyzed, with an emphasis on the major outpatient areas such as the entrance lobby, doctors' examination, and physical therapy zones. In the second phase, a space syntax tool was implemented to examine visual cognitive characteristics of the spatial configuration. The spatial configuration parameters measured were integration, integration core, visual isovist field continuity, correlation between integration and step depth, and the correlation between integration n and integration 3. As a result, the integration was higher in the hall type configuration. Circulation intersections acted mostly as integration cores for better visibility. Some areas showed the lack of continuity in the visual isovist fields overlap and irregular correlation between integration and step depth. The intelligibility was higher in the circulation area and social interaction spaces such as a cafe, reception waiting, and therapy waiting areas. Based on the analysis, design implication and possible future improvement were discussed to enhance wayfinding experiences in the hospitals for children with physical disabilities.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.2
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• pp.45-53
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• 2015

Purpose: This study is to derive the behavioral characteristics of the users appear in the outpatient department of psychiatry. Methods: By referencing John Zeisel's Tools for environment-behavior research, observation of user behavior and expert interviews as a method of the study has been carried out. Results: The results of this study are as follows. First, adjacent placement among children, youth and regular the outpatient department of psychiatry is necessary and easy access to internal medicine department and family medicine department is required in order to allow cooperated treatments. Secondly, depending on the characteristics of the outpatient department of psychiatry treatment, adjustment of space requirement or the change of kinds of necessary space is required. Third, considering the psychological and behavioral characteristics of mental illness and guardians, various search for the environment that can support this. Implications: This study is a basic research for space improvement and evaluation of the outpatient department of psychiatry, and need to be followed by further study using various perspectives and methods.

• The Journal of Pediatrics of Korean Medicine
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• v.28 no.4
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• pp.45-63
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• 2014

Objectives The purpose of this study is to investigate the clinical characteristics in children and adolescents with peripheral facial palsy that was treated with Korean medicine. Methods The study was conducted based on 284 cases that consisted of 261 children (less than 19 years old) who visited the hospital of Korean medicine from August 2010 to August 2014. Then, this study was analyzed by reviewing the patients' charts. Results The incidence of facial palsy in pediatric patients was more common in boys than in girls and the mean age was 11.2 years. The prevalence of facial palsy was more common in winter and most were diagnosed with Bell's palsy. Recurrence was identified in 12.6% of the patients. The average age of the first attack was 9.5 years. It took about 3.2 years for recurrence to occur from the first onset. It took about 5 days to visit the hospital of Korean medicine from the onset. 81% of the patients came within 1 week from the onset. 50.7% of the cases did not receive any treatment before and 49.3% were previously treated at other hospitals. More than half of the patients (65.1%) received Korean medicine first. 54.6% of the patients were hospitalized and 45.4% received outpatient treatments in the hospital of Korean medicine. Outpatient treatments were administered about 11.5 times while hospitalized patients were treated for an average of 16.6 days. In general, hospitalized patients were treated more often than the outpatient group. An overall average duration of treatment was 70.6 days from the onset of facial palsy until the last day of treatment, and 53.0 days from the first day of treatment until the last day of treatment. 41.5% of the cases were treated only with Korean medicine and 49.0% were treated with a combination of Korean and Western medicine. The types of Korean medicine treatment used for facial palsy in descending order of frequency were acupuncture, Infra red, herbal medicine, SSP therapy, electro-acupuncture, carbone, hot pack, cupping, and moxibustion. The treatments that were most frequently used from Western medicines were steroid as monotherapy (61.7%) and a combination of steroids and antiviral therapy (37.6%). Conclusions This result showed that the risk of facial palsy recurrence among children is relatively high and that facial palsy requires a long-term treatment. It's helpful to explain about prognosis, treatment duration, and recurrence potential in children. Facial palsy in children is treated in various ways but more studies about the therapeutic effects of Korean medicine, Western medicine, and combination of Korean-Western medicine in children are needed.