Journal of The Korea Institute of Healthcare Architecture
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제6권11호
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pp.59-70
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2000
Nowadays, according as hospitals are not only large and sprawling, but also they are continually being remodeled and expanded, their architectural spaces are becoming more complex. In the face of the development of the medical technology and the present focus of administrators who have showed much interests on reducing health care cost, the human need of patients and visitors is often forgotten. Recently, wayfinding and healing environment is proposed as a general concept in the hospital architecture. The purpose of this study is to find out the design guideline for hospital, focusing on the characteristics of wayfinding at the general hospital outpatient department.
The Universal Design is introduced as the universal principle to satisfy people's requirements for various environment. The public space of general hospitals should be designed with consideration of specific requirements of customers. The purpose of our research is to develop and propose the Universal Design checklist which considers the circulation in the public space. We investigated that the consideration for universal design was lacked by actual survey with the checklist made according to 'The law for improving convenience of the disabled, old people and pregnant women'. Furthermore, we found the problems of the checklist. We correct the checklist considering the measurements of the user's body and action. In addition, we propose the Universal Design Checklist by adding the new references in the article about the installation.
Journal of Korean Academy of Nursing Administration
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제4권2호
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pp.363-385
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1998
The purpose of this study is to investigate the relationship between organizational culture types and organizational effectiveness in the hospitals and to identify the cultural and organizational characteristics of the hospitals with high organizational effectiveness. Data were collected from May 12 to June 14. 1997 through questionnaire taken by 1.118 nurses working in 10 hospitals with more than 800 beds and from annual reports published by the hospitals. The instruments were used for collecting the data: Organizational Culture Questionnatire and Organizational Characteristics Questionnatire developed by the researcher. Mowday's Organizational Commitment Questionnaire. Taylor & Bovver's General Satisfaction Scale. The Results were as follows: 1. The meta culture of the hospital organizations was the conservative culture. 2. There were significant differences of the four organizational cultural types - affiliative culture. innovative culture. conservative culture. task culture among the hospitals(p=.00). 3. The hospital organizations were classified in to three cultural patterns. each of which had similar cultural composition. on the basis of the scores indicating the similarity and difference of the foul' organizational cultural types among the hospitals. The organization of each group represents conservative- dominant culture. innovative-dominant culture and competitive culture. 4. Nurses' organizational commitment and job satisfaction were significantly different among the cultural patterns(p=.00). In other words. the hospitals with innovative-dominant culture showed higher organizational commitment and job satisfaction than ones with conservative-dominant culture and competitive culture. And also. the growth rate of outpatients and inpatients were significantly different among the cultural patterns(p<.05). The hospitals with innovative -dominant culture showed higher growth rate of outpatients and inpatients than ones with conservative-dominant culture and competitive culture. 5. The hospitals with conservative-dominant culture and competitive culture showed higher level of centralization than ones with innovative -dominant culture(p=.00) And the hospitals with competitive and innovative-dominant culture showed higher level of communication than those with conservative-dominant culture(p=.00) Finally. the hospitals with innovative-dominant culture showed higher level of managerial strategy than those with conservative-dominant and competitive culture. among which the latter showed higher level of managerial strategy than the former(p=.00).
Journal of The Korea Institute of Healthcare Architecture
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제24권3호
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pp.39-47
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2018
Purpose: The purpose of this study is to examine the deployment types and characteristics of mobile hospitals with it's historical backgrounds. Methods: Since the disaster can not be classified by country, the scope of the study is to include both domestic and foreign mobile hospitals. In order to minimize the casualties from the field hospitals used at the time of the First World War, which is the mother of mobile hospitals, we analyzed the mobile hospitals which are more compact and changed to the target areas and analyzed the mobile hospitals. Results: Historically, mobile hospitals have been transformed in a way that they are close to the target area and rapidly inject essential elements, and the deployment of wards has evolved to be able to combine in any form with center corridor. In the case of hospitals that can deal with infectious diseases, each treatment room was installed separately to thoroughly separate the copper wire. Implications: As disaster damage increases and incidence increases, field response should be quick. However, research on mobile hospitals, which are indispensable for field response in Korea, has not been conducted in various ways. From the origins of mobile hospitals, the development process is reviewed, and research is carried out to clarify the grounds and backgrounds for the planning of mobile hospitals that are quick and appropriate to the situation in Korea and abroad.
The main objective of this paper is to perform an empirical analysis on the relationship between various marketing activities and financial performance of Korean hospitals. A survey was conducted through structured questionnaire for 495 hospitals, and data from 218 hospitals were utilized in the final anaylsis.(response rate: 44%) Survey items include general characteristics of the hospitals(size, type, location), degree of competition, financial performance. marketing organization! budget, and level of various marketing activities in service development, access improvement, promotion, and pricing. We examine descriptive statistics of the response scores on marketing activities to evaluate the current status of marketing management of Korean hospitals, compare the results across hospital size, type and location, and perform regression analysis to investigate the relaionship between marketing and financial performance. Major findings are as follows: 1) About 46% of the responding hospitals have marketing departments although they are named as 'planning' or 'PR' departments, and the marketing budget on average represents 1.74% of the total expenditures. 2) Average level of marketing activities is calculated to be about 3.32 on 5-point scale, meaning that Korean hospitals implement their marketing programs 'somewhat actively'; however, the scores on the areas of marketing plannning and strategy are relatively low. 3) Large hospitals tend to be more active in marketing than small hospitals, and public hospitals' activities in marketing are not lower compared to private hospitals. 4) Level of overall marketing activities is positively related with financial performance measured by various finacial indicators except for profitability, implying that marketing is successful in revenue generation but needs to be more cost-effective. Also, when the marketing variables are separately included in the regression, no significant relationship is found, which means that various marketing activities are more effective when they are collectively implemented.
Journal of the Earthquake Engineering Society of Korea
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제23권3호
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pp.159-167
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2019
2016 Gyeongju and 2017 Pohang earthquakes led Koreans to acknowledge that the Korean peninsula is not an earthquake-free zone anymore. Among various buildings crucial to after-shock recovery, general hospital buildings, especially existing old ones, are very significant so seismic retrofitting of those must be an important issue. Self-centering energy dissipative(SCED) brace is one of retrofitting methods, which consists of tendon with restoring force and friction device capable of dissipating seismic energy. The strength of the SCED brace is that the tendon forces a structure to go back to the original position, which means residual drift can be negligible. The residual drift is a very important parameter to determine usableness of general hospitals after shock. To the contrary, buckling-restrained braces(BRB) are also a very effective way to retrofit because they can resist both compressive and tensile, but residual drift may exist when the steel core yields. On this background, the seismic retrofitting effect of general hospitals reinforced with SCED braces was investigated and compared to that of the BRD in this study. As a result, although the floor acceleration cannot be reduced, the story drift and residual drift, and the shear demand of walls significantly decreased. Consequently, seismic retrofitting by SCED braces are very effective for domestic low-rise general hospitals.
Kim, Chang-Yup;Kim, Yoon;Kwon, Young-Dae;Kim, Yong-Ik;Shin, Young-Soo;Ahn, Hyeong-Sik
Journal of Preventive Medicine and Public Health
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제26권3호
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pp.400-411
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1993
The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.
The Korean government achieved the universal coverage of health insurance in July 1989, and concomitantly introduced a new measure of regulated health care delivery system in using medical care. There are three reasons why the government took the new health care delivery system. Firstly, there was ample room for improving the allocative efficiency in the use of medical facilities. And the second one was to constrain the dramatic increase of medical demand under health insurance. Thirdly, and the most important reason was to alleviate the patient crowdedness in big general hospitals, particularly tertiary hospitals. There are essentially two different ways to control the use of health care : one is to cut the demand for health care, and the other to regulate behaviors of providers through the use of incentives/disincentives, demand-side approach or supply-side approach. The objective of this study is to examine whether or not medical care utilization behaviors under health insurance scheme have been changed among medical facilities such as clinic, hospital, general hospital and tertiary hospital in comparison with those before and after the introduction, particularly whether the patient crowdedness in tertiary hospitals has been alleviated or not. In order to conduct this study, the insurance claim data during the period of January 1989 and July 1992 were analyzed by focusing on diagnosis of both inpatients and outpatients, and especially the fifteen most frequent diseases in ambulatory care and the seven most frequent diseases in hospitalizatio. In addition, the same analyses were made on the changes in medical care utilization by specialty department. This was because the five departments, such as family medicine, ENT, eye, dermatology and rehabilitation, were exempted from applying the regulated health care delivery system in tertiary hospitals. The study revealed that a remarkable alleviation effect in the crowdness was noted for tertiary hospitals. This effect was most conspicuous for the most frequent mild diseases of both inpatient and outpatient care. For example, the fifteen most frequent OPD care at tertiary facilities have decreased as much as by 40%, of which 34% belonged to the cut in initial visits. Meanwhile, the proportion of those who used general hospitals and private practitioner's clinics have increased due to the shift of patients. The cases from the five special departments were also decreased, but not so much as other departments. A problem was noted that, as time passed by, the decreasing tendencies of crowdness at tertiary hospitals due to the regulated system became slightly smaller. Therefore, through complementary remedies are needed for the future implementation.
To identify the changes in professional care patterns after the introduction of medical insurance in Korea, professional care in hospitals and clinics of two succeeding years were compared. The hospitals and clinics selected for this study were those which located in Seoul city. Hospitals were classified into 3 categories: university hospital, general hospital and hospital. The diseases selected for this study were acute appendicitis and normal delivery. They were selected because their disease courses are considered to be fairly stable. The variables used for this study were length of stay, total hospital costs, costs of each components of cares. The information used for this study was obtained from the official forms requested by the medical facilities to the Korea Medical Insurance Corporation. The two periods studied were 3 months of each year from March 1st to May 31st in 1979 and 1980, The total number of normal delivery studied was 289 in 1979, 301 in 1980 respectively and the acute appendicitis was 92 and 111 respectively. In order to compare the quantity of medical care between 2 study periods the insurance price scores of 1979 were converted to prices of 1980. For statistical test of difference between 2 periods T-test and Welch's test were used. The result of the study were briefly summarized in below. 1. No significant difference was observed in the average length of stay of both disease between two study periods in all types of hospitals. 2. No significant difference was observed in the average total hospital costs of both diseases in all types of hospital, but in the private clinic the average clinic costs was rather decreased significantly in 1980. 3. More cost decrease were seen than cost increase in 1980 in all types of facilities, More cost changes by items were seen in acute appendicitis than in normal delivery between two study periods. The total hospital costs can be devided into 2 portions: charges for drug and material and for physician. In normal delivery, costs for physician's charges was significantly decreased in almost all the hospitals and costs for drug and material were not changed significantly in all the hospitals in 1980. In the university hospitals, however, the costs for drug and material were increased significantly in 1980. The cost decrease for physician's charge were mainly due to the decrease in the costs of laboratory test, treatment and physical therapy. The increase in the costs for the drug and material in the university hospitals was mainly due to the increase in the cost for drugs for oral administration and injection. 4. The proportion of components of medical care in the hospital has not been changed significantly, however, the cost for injection in normal delivery was characteristically increased in 1980 in all hospitals studied. In general the proportion of the costs for drug and material was tended to increase and the costs for physician was tended to decrease in 1980. The increase in the costs for drug and material were considered to be due to increase in the cost for drugs for oral administration and injection. The decrease in the costs for physician were due to decrease in the costs of laboratory test, treatment and physical therapy. Above mentioned changes in hospital and clinic care patterns are considered to be mostly influenced by the review criteria set by the K.I.C. for the assessment of the fee request made by clinics and hospitals.
The main purpose of this study was to investigate relationship between WRMD (Work Related Musculoskeletal Disorders) symptoms and dangerous factors in medical technologistes who work in Gwang-ju city and Jeollanam-do province. Experimental group was 74 medical technologistes at hospital centers, hospitals, general hospitals, university hospitals. From the this survey, we found that significant statistical difference in WRMD symptoms by general characteristics (sex, exercise) and working environmental characteristics (examination numbers, time of margin, repetition, intensity of work, time of using PC). In the general factors, Odds ration in male vs female, do exercise vs do not exercise were 4.557 (95% CI=1.003-20.713), 2.747 (95% CI=0.59-12.783). In working environment factors, Odds ration in little of examination numbers vs a lot of examination numbers, little of time margin vs a lot of time margin, non repetitive vs repetitive, non intensity of work vs intensity of work, little of pc using time vs a lot of pc using time were 1.901 (95% CI=0.828-4.363), 1.15 (95% CI=0.335-3.944), 3.952 (95% CI=1.095-14.262), 1.411 (95% CI=0252-7.891), 2.606 (95% CI=1.055-6.437) respectively. For prevention of WRMD symptoms, Most of hospitals should improve medical technologists of working circumstances, especially control a intensive of work, working speed and guarantee enough break time. Therefore, This study suggests that increasing workers and examination of automation, streching during working be needed.
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