Lee, Tae Hoon;Lee, Joo Ho;Chang, Ji Hyun;Ye, Sung-Joon;Kim, Tae Min;Park, Chul-Kee;Kim, Il Han;Kim, Byoung Hyuck;Wee, Chan Woo
Radiation Oncology Journal
/
v.38
no.1
/
pp.35-43
/
2020
Purpose: This retrospective study compares higher-dose whole-brain radiotherapy (hdWBRT) with reduced-dose WBRT (rdWBRT) in terms of clinical efficacy and toxicity profile in patients treated for primary central nervous system lymphoma (PCNSL). Materials and Methods: Radiotherapy followed by high-dose methotrexate (HD-MTX)-based chemotherapy was administered to immunocompetent patients with histologically confirmed PCNSL between 2000 and 2016. Response to chemotherapy was taken into account when prescribing the radiation dose to the whole brain and primary tumor bed. The whole brain dose was ≤23.4 Gy for rdWBRT (n = 20) and >23.4 Gy for hdWBRT (n = 68). Patients manifesting cognitive disturbance, memory impairment and dysarthria were considered to have neurotoxicity. A median follow-up was 3.62 years. Results: The 3-year overall survival (OS) and progression-free survival (PFS) were 70.0% and 48.9% with rdWBRT, and 63.2% and 43.2% with hdWBRT. The 3-year OS and PFS among patients with partial response (n = 45) after chemotherapy were 77.8% and 53.3% with rdWBRT, and 58.3% and 45.8% with hdWBRT (p > 0.05). Among patients with complete response achieved during follow-up, the 3-year freedom from neurotoxicity (FFNT) rate was 94.1% with rdWBRT and 62.4% with hdWBRT. Among patients aged ≥60 years, the 3-year FFNT rate was 87.5% with rdWBRT and 39.1% with hdWBRT (p = 0.49). Neurotoxicity was not observed after rdWBRT in patients aged below 60 years. Conclusion: rdWBRT with tumor bed boost combined with upfront HD-MTX is less neurotoxic and results in effective survival as higher-dose radiotherapy even in partial response after chemotherapy.
Journal of The Korea Institute of Healthcare Architecture
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v.17
no.3
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pp.27-33
/
2011
The purpose of this study is to propose reasonable standards related to securing the number of parking lots of university hospital in Korea. High proportion of visitors use their cars in order to receive consultation and treatment from doctors and feel the shortage of parking capacity of hospital, resulting to the low satisfaction level in using hospital. Of course, every hospital meets the parking regulation of the government. Therefore it is necessary to consider another parking demand factors besides the parking regulation of the government in order to secure proper number of parking lots in hospital. This study proposes number of hospital beds, vicinity of public transportation, number of doctors and staffs of hospital, and peak time parking demand as the parking demand factors.
The purpose of this study is to analyze the relative importance of three factor -socioeconomic development, public health development, egalitarian nature of socioeconomic development- affecting mortality declines. Infant mortality rate and life expectancy at birth are used as the mortality index, that is the dependent variables, while GNP is used as the indicator of socioeconomic development, primary school enrollment ratio of female as the indicator of egalitarian nature of socioeconomic development, population per hospital bed as the indicator of public health. The data of these variables are collected two time-periods -before 1970 and during 1970-1980- over 50 countries. The explanatory data analysis is used as the statistical technique. We can find whether the relationship between dependent variable and independent variables are linear or nonlinear, and which case is the influential case in our model. The main results of this study are followings. First, the association between infant mortality rates and four indices are not linear. The most important factor explaining the variation of infant mortality is GNP, while primary enrollment of female is the second and GINI is the third important factor. However, population per hospital bed does not have a significant effect on the infant mortality rates in this study. Second, life expectancy at birth is log-linearly related to GNP. Unlike infant mortality rates, the most important factor explaining the variation of life expectance at birth is women's education and the next important factor GNP, and then the third one GINI. But, still population per hospital bed is not significantly related to the variation of life expectance in this study.
Bed for elderly and disabled, including the United States developed the industry Americas, and European countries, mainly in the production of products has dominated the world market. In large hospitals, and dependent products are sold at high prices. On the other hand, improvement of living standards of our country and to the advancement of residential culture of the demand for luxury products is increasing. The study of the elderly Edition mattresses have been developed mainly in Europe to maximize the use of sleep can increase the efficiency of products has been studied. Due to the increase in elderly population Elderly Hospital, which is installed in the elderly silver town Edition requires the dissemination of the mattress in the bedroom several times a day resting and sleeping, eating, etc. Designing a variety of actions are needed. Edition of the elderly in Korea developed the design of bed with bed design and the manufacturer and the Institute for Ergonomics, welfare agencies and to build organic cooperation system under the direction of a professional designer to develop and you need to configure the space and the results of such actions by the distribution of cheap materials, ergonomic mattress for optimal development of behavior analysis to the need to promote the convenience of the user.
Journal of The Korea Institute of Healthcare Architecture
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v.25
no.4
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pp.93-104
/
2019
Purpose: To establish the building guidelines and to analyze the function of Regional Public Hospitals, the survey was conducted primarily on the current status focusing on the location and relationship of the department, area composition ratio, area per bed, and area per operating room. Methods: The research methods of this paper are as follows. 1) A literature survey on the function of the operating and related departments, 2) A drawing analysis for spatial composition and net area calculation. Results: The area of the Operation Department in the Regional Public Hospitals with 200 to 300 beds are as follows. Area ratio: 3.35%, area per Bed: 2.53㎡/bed, the number of beds per operating room: 64.37bed, area per operating room: 146.46㎡/n, area per operating room by plan type: integration corridor 133.84㎡/n, separation corridor 184.82㎡/n. Implications: This paper analyzed data on the current state of Operation Departments for setting up the function and role for the Regional Public Hospital. In the future, it is also required to provide size that takes into account user behavior and the user's psychological aspect in order to suggest appropriate area.
Journal of Korean Academy of Nursing Administration
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v.17
no.3
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pp.327-335
/
2011
Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.
Kim, Jungae;Lee, Youngdae;Seon, Minju;Lim, Jae-Young
International journal of advanced smart convergence
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v.10
no.1
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pp.151-158
/
2021
The main cause of ulcer is pressure, which starts to develop when the critical body pressure (32mmHg) is exceeded, and when the critical time elapses, ulcer occurs. In this study, the keyboard mechanism of the medical bed with 4 bar links was adopted, and each key can be controlled vertically. A key has one servo drive and one sensor controller which hasseveral body pressure sensors. The sensor controllers and the servo drives are connected to the main controller by two CAN (Car Are Network) in series, respectively. By reading the maximum body pressure value of each keyboard sensor, and by calculating the error value based on the critical body pressure, the fuzzy controller moves each key so that the total error becomes zero. If the fuzzy controller fails, then it prevents ulcer by lifting and lowering the keys of the bed alternatively within a short time. Thus, the controller operates in two-stage. The validity and effectiveness of the proposed approach have been verified through experiments.
Kim, Ji-Hyoung;Ha, Ho-Wook;Lee, Hae-Jong;Sohn, Tae-Yong
Korea Journal of Hospital Management
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v.10
no.3
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pp.45-66
/
2005
The purpose of this study was to analyze related factors affecting profitability on general hospitals(300-499 beds). The data were derived from survey by the Korean Hospital Association on 33 hospitals during 10 years (from 1993 to 2002). Profitability was measured by 3 ratios - net profit to total assets, normal profit to total assets and operating margin to gross revenue - as dependent variables. Independent variables were classified by general factors (ownership, number of bed, period of establishment, region), financial factors (total asset turnover, current ratio, liabilities to total assets, personnel costs per operation profit, material costs per operation profits), productivity index(number of daily patient per nurse), the score of quality assurance activity and the time lag score. Multiple regression model was used in this study. First, Number of bed, region was not statistically significant for profitability. But ownership was affect positively to normal profit to total assets and operating margin to gross revenue. Private hospitals had higher profitability than that of public hospitals Second, the score of quality assurance activity was not statistically significant to profitability. Third, Those hospitals having more daily patient per nurse had significantly higher profitability than the others. Fourth, Those hospitals having higher proportion in total asset turnover had significantly higher profitability than other hospitals. But liabilities to total assets and liquidity ratio had no difference to the profitability. Those hospitals having higher proportion in personnel costs and material costs per operation profits had significantly lower hospital profitability than others.
Background : To estimate fall incidence rate and associated factors in inpatients from a general hospital. Method : The data were collected from 104 fall incident reports developed by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristics of patients, factors related to fall, types, places, circumstances and outcomes of fall. Result : The incidence rate of fall, which was 4.4 per 1,000 total discharged patients and 0.5 per 1,000 patient-days, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting system of each hospital. Fall-prone patients were, in general, $$\geq_-$$65 years of age, had an alert mental status, were ambulatory with some assistance, and were dependent on and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall events usually occurred in bed or at the bedside in the patient's room, and occurred more often during the night than during the day or evening. Risk factors of fall were use of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly high bed height, surrounding objects, inadequate fitness shoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injury and treatment such as suturing. Risk factors for repeated falls were use of a neuropsychiatric drug (odds ratio=13.9) and gait disturbance (odds ratio=91.2). Risk factors for fall-related injury were alert mental status (odds ratio=3.3 times more likely to fall than those who were drowsy or in a stupor) and general weakness(odds ratio=3.3 times more likely to fall than those who were not generally weak). Conclusion : Medical and nursing staff should be aware of the fall risk factors of hospitalized patients and should intensively pursue preventative strategies. Development of fall prevention education based on these results is recommended.
Background: This study is designed to estimate the factors that affect the level of three different performance (publicity, efficiency, profitability) among regional public hospitals. Methods: The units of analysis are the regional 30 hospitals, which have the operating data during 22 years (from 1933 to 2014). The research method is used by fixed panel analysis. The publicity is measured by medicaid outpatient proportion and medicaid inpatient proportion. The efficiency is measured by two types of efficient score by DEA (data envelopment analysis). The profitability is measured by medical income to medical revenue and ROA (return on total asset). Results: At first, the increase of bed gives negative affect to the publicity but give positive effect to the efficiency and profitability. Because it means the increase of the region population, it gives more profitability compare to hospital with small number of beds. The more the operating period is the higher effect to the publicity and efficiency because of it's refutation. The debt ratio gives negative effect to publicity, but positive effect to profitability. It is the normal belief that there is inverse relationship between publicity and profitability. The turnover rate of bed gives the negative affect to the publicity, but positive affect to the efficiency and profitability. That give us the implication that type of the inpatient make different effect the hospital performance. The ratio of labor cost give negative effect to all kind of performance. That means that the higher labor cost don't mean the higher publicity and labor cost control is very important factors to hospital performance. So the region hospital have to focus the labor factors more to make higher performance. Conclusion: As the conclusion, the independent variables give similar effect to the efficiency and the profitability, but give inverse effect to the publicity. That means that if an region hospital want to make the more publicity, it loss the higher efficiency and profitability. Specially publicity is higher negative relation with the profitability.
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