• 한국임상보건과학회지
• /
• 제2권1호
• /
• pp.1-16
• /
• 2014

Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

• 대한간호학회지
• /
• 제31권1호
• /
• pp.68-80
• /
• 2001

The purpose of this study is to analyze ER patient's Triage and other statistical data. The subjects were 12,618 patients who visited the ER during the year 1998. The study showed the following results; 1. The male vs female ratio was 1.3 : 1.0, the male were in the majority (56.6%), and the age range of 20-29 old was the majority (15.3). The patients who visited ER at 8-10 pm were the majority (11.5%). On Sunday the number of patients who visited the ER were 2,189, and the majority were 17.4%. On Saturday the number of patients was visited the ER were 1,944 patients the second majority (15.4%). Their traffic means : the general passenger cars (75.5%), 119 or hospital ambulance (11.3%). 2.The reasons of visiting ER were : diseases (59.2%), injuries (23.7%). The disease vs injury ratio was 100 : 69. 3. Triage : urgent 40.7%, non-urgent 38.2%, acute 17.8%, and critical 3.2%. 4. The time of waiting and staying in the ER by the Triaget: the average time was 572 minutes (9.53 hrs.). The majority of critical patients (20.5%), acute patients (24.7%) and urgent patients (21.2%) stayed 12-24 hrs., but the majority of non-emergent (27.8%) stayed not longer than one hour. 5. Treatments by the Triage : the 42.9% of critical patients, and 61.3% of acute patients, 57.5% of urgent patients were admitted. But 91.8% of the non-emergents were discharged and 4.7% was admitted. Mortality of total ER visiter were 1.7%. DAA portion was 0.86%. 26.6% of the critical patients were DAA. DAA vs DOA ratio was 1.3 : 1.0. 6. Visiting time, monthly and seasonal distribution by the Triage : the majority of critical patients (12.2%), visited 10-12 am. The majority of acute (12.9%) and urgent (11.7%) visited 4-6 pm, but the majority of non-emergents (15.1%) visited during 8-10 pm. Autumn visiter were the majority (27.6%). The percentage of non-emergent visited in Spring was 41.4% and Autumn was 41.3%. The percentage of urgents who visited in the Summer was 45.3% and the Winter was 40.4%. By clinical departments: the 48.0% of critical patients was NS. The 45.5% of acute and the 33.6% of urgent patients were IM. But the majority of non-emergent patients was PS (21.2%), and the second majority of non-emergent patients was oral Surgery (12.8%).

• 대한간호학회지
• /
• 제16권1호
• /
• pp.67-80
• /
• 1986

The use of intravenous solutions for fluid replacement has become an integral part of patient care, This widespread use of intravenous solutions has increased the risk of contamination that can lead to septicemia and phlebitis. The literature regarding contamination of in use intravenous solutions recommends a standard 24-hour time limit on the use of these fluids. But the desings of these studies did not incorporate a time variable related to contamination. In other studies, however, time was a manipulated variable: but data regarding the onset of contamination were conflicting. Because published reports conflict with regard to a time standard related to the use of intravenous therapy, additional empirical data are needed upon which to base the standards of care regulating use of intravenous therapy. This study investigated rate of contamination in simulated in-use intravenous solutions to obtain data from which to recomend a standard time period for the administration of intravenous solutions. In this study samples were drawn from 60 bottles of 5% D/W solution at predetermined time intervals over 48 hours and samples were inoculated to Thio-glychollate Broth. After 10 days' culturing in that Broth, samples were cultured on blood agar plates for 18∼48 hours to determine the rate of contamination. was found at all time Period, regardless of the presence or absence of nurse's gloving in the preparation of fluids, the location in which the experimentations were performed, the contamination level of surrounding air, or the length of time during which solutions were opened. Data from this study support the use of a 48-hour time period on which to base the standard involved in ready-to-use simple intravenous solutions without additives. In emergency departments and critical care areas where intravenous solutions are prepared in advance, the suggested time standard supported by the data generated from this study is 48 hours, not 24 hour. Data from this study support a 24-hour time standard for changing in-use intravenous solutions when the contamination results from the manipulation of intravenous infusion system by hospital personnel, or from some other exogenous sources during administration. Because contamination that does occur within 48 hours in intravenous solutions must be introduced from some exogenous sources, further empirical studies based on the identification of sources of contamination and factors that affect the rate of contamination, are needed to investigate the currently employed standard of intravenous therapy and to provide the patient with more efficient and safer intravenous thereapy.

• 한국의료질향상학회지
• /
• 제8권2호
• /
• pp.208-217
• /
• 2001

Background : The objective of this study is proving the basic data for developing a management system for the discharges against medical advice(AMA) by identifying the characteristics of the AMA patients of an university hospital for 10 years. Methods : By using discharge abstract data base, we divided the total discharges(435,254) into two groups, discharge against medical advice and discharge with discharge order. We confirmed the characteristics of AMA group by analyzing discharge abstract data of the both groups by SAS software V6.12 and $x^2$ test. Medical records of AMA patients in the year 2000 were reviewed to identify the reasons for AMA which we couldn't extract from discharge abstract DB. Result : The total number of AMA for 10 years were 9,358(2.15%) and the AMA rate has been continuously decreased for 10 years. Male, admission through emergency room, discharges admission via other hospital, patients without operation during hospitalization, discharges in hopeless or not improved condition showed higher AMA rate. The AMA rate was higher as the age of the patients was higher, and the average length of stay was longer in AMA patients than in those with discharge order. The AMA rate in psychiatry was highest(14.3%) and it was higher in surgery departments than those of medical or other sections. The AMA rate varied by attending physicians even in the same department and it was statistically significant. Patients with the principal diagnosis of "medical observation and evaluation for suspected diseases" showed the highest AMA rate(15.5%), and that of schizophrenia or psychosis was the nest. One hundred twenty-one patients(19.5%) out of 622 AMA in 2000 discharged against medical advice for transfer to order health care facilities. Among them 71 patients(58.7%) discharged with their medical care information, such as copies of medical record, medical certificates, summaries, etc. Written oath of the patients discharged AMA was filed in their medical records in 466 cases(74.9%) although some of them were incomplete. Conclusion : Characteristics of AMA discharge could be used as the basic data in developing a system to manage the patients who have risk factors to leave the hospital against medical advice. By reducing number of patients leaving the hospital against medical advice we can increase satisfaction of medical providers and consumers.

• 한국콘텐츠학회논문지
• /
• 제10권2호
• /
• pp.421-432
• /
• 2010

한국의 소방학 관련 학과는 전국에 80여개가 운영되고 있지만, 교육과학기술부가 인정하는 학문분류체계표상의 분과 학문으로 등록되어 있지 않고, 한국연구재단의 학문 연구 분야별 분류표에도 등재되어 있지 못하다. 이에 최근 소방학의 학문적 정체성을 확립하여 소방학 전반에 걸친 학문적 발전 및 성숙과 소방정책의 발전을 도모하려는 노력이 진행되고 있다. 그러나 소방정책에 대한 기존 선행 연구 및 이론서의 부족으로 인해 소방정책론 정립에 많은 어려움이 있는 것이 사실이다. 따라서 행정학, 경찰행정학, 정치학 등 인접학문의 논의를 기초로 소방정책의 특수성을 감안한 소방정책론 정립이 요구되고 있다. 또한 기존의 화재진압, 화재예방, 구조 및 구급 정책에 국한하지 않고, 최근 소방정책 분야의 패러다임 변화를 적극 반영하여, 대국민 안전예방정책, 소방보험정책 등을 포함하는 소방정책론이 요구되고 있다. 이 연구는 소방정책론의 바람직한 정립 방향을 논의하는데 목적이 있다. 구체적으로 소방학에서의 소방정책론 정립의 필요성과 소방정책론 구성에 대한 논의를 바탕으로 하여, 바람직한 소방정책론 구성의 방향을 총론 및 각론으로 구분하며, 소방정책론 정립을 통하여 향후 한국소방정책의 발전방향을 살펴보고자 한다.

• Journal of Hospice and Palliative Care
• /
• 제16권2호
• /
• pp.108-117
• /
• 2013

목적: 본 연구의 목적은 1) 죽음에 대한 태도와 대처정도, 생애 말기환자 간호인식 및 간호수행 정도를 파악하고, 2) 그들 간의 상관관계를 살펴보고, 3) 생애 말기환자 간호수행에 영향을 미치는 요인을 파악하고자 함이다. 방법: 3개 대학병원의 임종 다빈도 부서인 종양내과병동, 중환자실, 응급실에 근무하는 187명의 간호사를 대상으로 하였다. 연구 도구로는 '다차원 죽음에 대한 태도 척도', '죽음에 대한 대처정도 척도', '생애 말기환자 간호에 대한 인식 척도', '생애 말기환자 간호에 대한 수행 척도'를 사용하였다. 자료는 기술 통계, 상관관계, 다중 회귀분석을 수행하였다. 결과: 첫째, 생애 말기환자 간호수행은 결혼 유무, 종교, 근무 부서, 말기환자 간호에 대한 교육 참여 여부에 따라 의미 있는 차이를 보였다. 둘째, 생애 말기환자 간호수행은 죽음에 대한 태도(P=0.014), 죽음에 대한 대처(P=0.003), 생애 말기환자 간호인식(P<0.001)과 양의 상관관계를 보였다. 셋째, 생애 말기환자 간호수행이 근무부서(P<0.001), 생애 말기환자 간호인식(P<0.001)에 영향을 받는 것으로 나타났다. 결론: 생애 말기환자 간호수행이 근무 부서, 생애 말기환자 간호인식에 영향을 받으므로, 근무 부서에 따라 차별화된 생애 말기환자 간호인식을 향상시킬 수 있는 교육이 필요하다.

• 시큐리티연구
• /
• 제61호
• /
• pp.59-85
• /
• 2019

4차 산업혁명으로 현실세계와 가상세계의 경계가 사라지는 현실에서 시공간을 초월하여 발생하는 사이버범죄에 대하여 실정법 체계 하에 구축된 정부조직의 경찰 공권력으로만 경찰의 임무를 다 하는데 분명한 한계를 갖고 있다. 본 논문은 문헌적 연구와 보안업무 경험을 토대로 사이버범죄에 대하여 실시간 대응할 수 있도록 각 사회분야의 집단지성이 자발적으로 참여할 수 있는 사회적 시스템을 구축하여 사이버공간에서의 범죄를 예방하고 사회적 공감대를 형성할 수 있는 대책방안을 제시하는 것을 목적으로 연구하였다. 집단지성 네트워크형 사이버폴리스 자원봉사시스템 구축을 위한 방안으로 우선, 집단지성 네트워크형 사이버폴리스 자원봉사시스템 구축이 필요하다. 이 구성은 제반 안전관리 전문가 등으로 구성한다. 그리고 경찰청의 경비업법상 민간조사업무 규정이 신설되어야 한다. 또한 집단지성 사이버폴리스 자원봉사시스템의 안전지킴이 봉사활동을 강화해야 하며, 선진국들의 사이버범죄에 대한 연구교훈 및 법적 대응방안이 도입되어야 한다. 끝으로 개인정보 보호법, 정보통신망 이용촉진 및 정보보호 등에 관한 법률, 신용정보의 이용 및 보호에 관한 법률 등의 과도한 규제 규정을 개정하여야 하며, 경찰관은 사전예방활동을 위한 사이버범죄 위해 인지능력을 배양해야 한다.

• 예술인문사회 융합 멀티미디어 논문지
• /
• 제7권11호
• /
• pp.525-536
• /
• 2017

연구목적: 본 연구는 성인 통합 중환자실에 입실 환자를 대상으로 중환자실 체류기간에 영향을 미치는 요인을 인구사회학적, 질병관련 특성을 중심으로 파악하여 효율적인 중환자 간호 중재 개발의 기초적 자료를 제공하기 위하여 실시하였다. 연구방법: 서울특별시에 소재한 일 종합병원의 성인 통합 중환자실에 입실한 환자 최종 270명을 분석한 후향적 조사연구이다. 연구결과: 분석대상 270명 환자 중 중환자실 체류기간이 5일 이상 그룹이 116명(43%)이었으며, 중환자실 체류기간은 FCI score (r=0.33, p<.001), APACHE II(r=0.19, p=.001)와 통계적으로 유의한 상관관계가 있는 것으로 나타났다.로지스틱 회귀분석 결과 중환자실 체류기간의 영향요인은 일반적 특성을 통제한 상태에서 대상자의 중환자실 입실경로(p=0.013), FCI score(p<0.001), APACHE II(p=0.012)로 나타났다. 결론: 중환자실 입실시 응급실 경유나 중증도가 높은 환자의 경우, 입실 초기 보다 집중적인 환자간호를 통해 환자의 체류기간을 줄이도록 하는 다양한 중재개발이 모색되어야 하겠다.

• Journal of Korean Neurosurgical Society
• /
• 제67권1호
• /
• pp.84-93
• /
• 2024

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

• 한국직업건강간호학회지
• /
• 제6권2호
• /
• pp.144-155
• /
• 1997

In December 1990, Occupational Safety and Health Law was amended to reinforce employer's responsibilities on employees' health and safety. Among the amended law it was important to expand the role of an occupational health nurse to the role of an occupational health manager. An occupational health manager should take charge of coordinating periodic health examination and environmental hazard evaluation, providing primary care, monitoring employees' health status, giving the workplace walk-through, selecting safe protection equipment, providing health information, counseling and health education, independently. This position of occupational health nurse is equivalent to the role of doctors or occupational hygienists. In 1991, government made a master plan to prevent occupational disease and injury. Under the plan, Korea Industrial Nursing Association (KINA) was established in 1994 with the purpose of improving health services and upgrading career opportunities for members. Therefore, this study was designed to analyze the transition of occupational health nursing education with the changes of law and policy in Korea between 1991 and 1996. In details, it was to analyze the rate of school providing occupational health nursing practice based lecture, lecture hours, lecture contents in undergraduate curriculum, program contents of graduate school, kinds of continuing education, etc. For this purpose, we conducted survey two times. In February 1991, baseline study was conducted with all nursing programs in Korea (19 BSN programs and 43 nursing departments of junior college). From April to May in 1996, the second survey was conducted with all nursing programs (38 BSN programs and 69 junior colleges). The first response rate was 66.1% and the second was 40.6%. Structured questionnaires were mailed to the deans or the community health nursing faculties. In the case of graduate school, telephone survey was conducted with 10 school of public health or environmental health area. Data from the yearbook of Industrial Safety Training Institute (ISTI), the history of Korea Industrial Health Association, and the journals of KINA were also included in the analysis. As the results, we found that there were remarkable improvement in undergraduate and graduate programs, obligatory as well as voluntary continuing education in terms of occupational health nursing expertise between 1991 and 1996. 1) The number of school providing occupational health nursing practice-based lecture was increased with the rate from 7.3% to 25.6%. The rate of school giving over 15 class-hours was increased from 33.3% to 46.6%. 2) Content areas were composed of introduction of occupational health, occupational epidemiology, industrial hygiene, occupational disease and injury, law and policy, health education, concept of occupational health nursing, role of occupational health nurse, occupational health nursing process, etc. Of content areas, occupational health nursing process was more emphasized with the increased rate from 43.9% to 88.4%. 3) In the case of graduate school, occupational health programs were increased from 4 to 10. One of them has developed occupational health nursing program as an independent course since 1991. 4) The law increased educational hours from 28 hours to 36 hours for introductory course at the time of appointment, and from 14 hours to 24 hours every 2 years for continuing education. Course contents were Occupational safety and health law, introduction of occupational health, health education methodology, planning and evaluation, periodic health exam, occupational disease care, primary care, emergency care, management, industrial environment evaluation, etc. In 1996, Korea Industrial Nursing Association has begun to provide continuing education after Industrial Safety Training Institute. 5) Various educational programs in voluntary base were developed such as monthly seminar, CE articles, annual academic symposium, etc. It was shown that changes of law and policy led rapid growth of occupational health nursing education in various levels. From this trend, it is expected that occupational health nurse expertise be continuously to be enhanced in Korea. Legal and political supports should proceed for the development of occupational health nursing in early stage.