• Archives of Plastic Surgery
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• v.49 no.6
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• pp.769-772
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• 2022

Femoral nerve injuries are devastating injuries that lead to paralysis of the quadriceps muscles, weakening knee extension to prohibit ambulation. We report a devastating case of electrical injury-induced femoral neuropathy, where no apparent site of nerve disruption can be identified, thus inhibiting the traditional choices of nerve reconstruction such as nerve repair, grafting, or transfer. Concomitant spinal cord injury resulted in spastic myopathy of the antagonist muscles that further restricted knee extension. Our strategy was to perform (1) supercharge end-to-side technique (SETS) to augment the function of target muscles and (2) fractional tendon lengthening to release the spastic muscles. Dramatic postoperative improvement in passive and active range of motion highlights the effectiveness of this strategy to manage partial femoral nerve injuries.

• Korea Journal of Hospital Management
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• v.17 no.2
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• pp.21-33
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• 2012

Purpose : This study aims to suggest application of patients DB to hospital marketing by performing market segmentation and selecting target market. Consequently help to establish suited strategy of marketing. Method : 14,072 patients hospitalized in a University Medical Center were recruited into this study. In order to classify the customer groups, cluster analysis was used with RFM(Recency, Frequency, Monetary) model, and 1-way ANOVA verified the differences among groups. And then, sociodemographical status, healthcare utilization and diagnosis(ICD-10) of each group were compared to draw a marketing strategy. Results : Four groups were classified through clustering analysis, and'high use and high profit' and'low use and high profit' groups were selected as a target market. The features of target market were as follows, the female proportion was high; used a private room; hospitalized through the emergency room; had operation; length of stay was long; had many comorbidity and cooperative treatment. There was difference in each feature of target market: as for the'high use and high profit' group, many patients were diagnosed with 'certain infectious and parasitic diseases'; and as for the'low use and high profit'group, the proportion of patients who purchased'industrial accident compensation insurance'and'auto insurance'was relatively high; many patients were diagnosed with'Injury, poisoning and certain other consequences of external causes'. Conclusion : It is needed to establish'positioning' strategy by monitoring and communicating with'high use and high profit' group. And for the case of'low use and high profit' group, it is necessary to make a follow-up management and lead them to have a medical check-up.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.297-307
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• 2015

This study reviews equipped with enhanced capability of medical care, quality service, accessibility, and consumer awareness to be a competitive and representative local healthcare service provider with improved administrative efficiency. The method of analysis are ANOVA and Structural Equation Modeling. The results which revealed the significant difference among demographic factors in determining the preference or degree of satisfaction at medical service to select local healthcare institutions suggest that the close review on the needs of groups of major customers of local healthcare institutions are necessary when preparing the strategy of specialized medical service of local healthcare institutions. this suggests that both images would be important factors to secure the competitive advantage of local healthcare institution and therefore the strategy maximized the enhancement of medical service with embossed image of hospital to attract customers of medical service is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6857-6862
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• 2015

Background: To identify the optimal cost effective strategy for the management of women having ASC-US who attended at King Chulalongkorn Memorial Hospital (KMCH). Design: An Economical Analysis based on a retrospective study. Subject: The women who were referred to the gynecological department due to screening result of ASC-US at King Chulalongkorn Memorial Hospital, a general and tertiary referral center in Bangkok Thailand, from Jan 2008 - Dec 2012. Materials and Methods: A decision tree-based was constructed to evaluate the cost effectiveness of three follow up strategies in the management of ASC-US results: repeat cytology, triage with HPV testing and immediate colposcopy. Each ASC-US woman made the decision of each strategy after receiving all details about this algorithm, advantages and disadvantages of each strategy from a doctor. The model compared the incremental costs per case of high-grade cervical intraepithelial neoplasia (CIN2+) detected as measured by incremental cost-effectiveness ratio (ICER). Results: From the provider's perspective, immediate colposcopy is the least costly strategy and also the most effective option among the three follow up strategies. Compared with HPV triage, repeat cytology triage is less costly than HPV triage, whereas the latter provides a more effective option at an incremental cost-effectiveness ratio (ICER) of 56,048 Baht per additional case of CIN 2+ detected. From the patient's perspective, the least costly and least effective is repeat cytology triage. Repeat colposcopy has an incremental cost-effectiveness (ICER) of 2,500 Baht per additional case of CIN2+ detected when compared to colposcopy. From the sensitivity analysis, immediate colposcopy triage is no longer cost effective when the cost exceeds 2,250 Baht or the cost of cytology is less than 50 Baht (1USD = 31.58 THB). Conclusions: In women with ASC-US cytology, colposcopy is more cost-effective than repeat cytology or triage with HPV testing for both provider and patient perspectives.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.10
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• pp.212-221
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• 2020

This study examined the cognitive emotion regulation strategies and professional quality of life to identify factors affecting the professional quality of life in hospital nurses. The participants were 176 staff nurses working at a university hospital in Seoul. Data were collected using a structured online questionnaire from March 3 to 16, 2020. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis using SPSS 25.0. The cognitive emotion regulation strategies of hospital nurses were identified as factors affecting the professional quality of life. Adaptive cognitive emotion regulation strategy (β=.501, p<.001) had significant effects on the participants' compassion satisfaction, and the explanatory power was 24.8%. The variables affecting burnout were adaptive cognitive emotion regulation strategy (β=-.435, p<.001), maladaptive cognitive emotion regulation strategy (β=.427, p<.001), and educational level (β=.188, p=.046), and the explanatory power was 36.8%. In addition, the maladaptive cognitive emotion regulation strategy (β=.502, p<.001) had significant effects on secondary traumatic stress of the participants, and the explanatory power was 24.4%. Based on this, it is necessary to develop programs to improve the professional quality of life of hospital nurses, focusing on acquiring adaptive cognitive emotion regulation strategies and using less maladaptive strategies.

• The Korean Journal of Health Service Management
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• v.11 no.2
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• pp.29-42
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• 2017

Objectives : This study aimed to identify the impact of social responsibility(CSR) activities by the hospital on the organizational commitment and value of the hospital by the internal members, to recognize the importance of staff carry out social responsibility activities effectively in the relevant departments, and use planning as a vital element or establishing a long-term hospital management strategy. Methods : Data were collected from 800 the administrative practioners of the hospitals in 200 hospitals nationwide. A structured questionnaire was used to measure the research variables using a 5-point Likert scale. The final sample consisting of 230 was analyzed using SPSS. Results : It was found that economic, legal, and charitable CSR have a statistically significant effect on organizational commitment and value of hospital Conclusions : The results suggest that hospitals should a fulfilling the obligation to abide by the norms and rules to be strictly observed, social services and charitable activities for the community are a strategy to increase the organizational commitment and hospital value in the long run. These activities should be actively pursued in a way that is sustainable and long-term so that they can improve to management performance.

• The Korean Journal of Health Service Management
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• v.5 no.4
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• pp.149-159
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• 2011

The purpose of this research is to provide an available basis for marketing strategy by defining the cause-effect relation between the service level of staff members in dental clinic and purchasing behavior of the customers. This study was done in 10 days from November 2, 2009 to November 11, 2009 and the total 172 copies were used for the analysis. As a result of the correlation analysis, a significant positive correlation among all the measured variables was found. As a result of the structural model analysis, I found that the fair service among the variables of the service level significantly affects the building of relationship and the hospital image. The building of relationship and the hospital image significantly affect the positive oral spread. The building of relationship significantly affects the repurchase intentions but the hospital image does not affects the repurchase intentions. To sum up the result of this study, I found that the fair service and the building of relationship with patients are important variables in order to attract new patients and maintain existing customers. I recommend that the hospital continues to motivate staffs through internal marketing and conduct regular trainings. It is necessary to have patients satisfied with broadening responsibility and authority and set marketing strategy for the relationship with patients.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.25 no.1
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• pp.75-80
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• 2023

The prevalence of aneurysm formation in adults with Moyamoya disease (MMD) is higher than that in the general population. The treatment strategy is often individualized based on the patient's disease characteristics. A 22-year-old man was diagnosed with MMD after presenting a small thalamic intracerebral and subarachnoid hemorrhage in the quadrigeminal cistern. Cerebral angiography revealed a small aneurysm (2.42 mm) in the left anterior choroidal artery. Since the hemodynamics in the left hemisphere was compromised, an indirect bypass surgery was performed. The patient's condition deteriorated postoperatively because of poor perfusion of the internal carotid artery, and massive hydration was required. During neurocritical care, the aneurysm increased in size (5.33 mm). An observation strategy was adopted because of the distal aneurysmal location and the high risk involved. Subsequently, the patient recovered, and newly developed collateral flow appeared from the external carotid artery. Additionally, a dramatic size reduction of the aneurysm (1.51 mm) was noticed. Our case suggests that MMD-related dissecting aneurysms on a distal cerebral artery, which present a high risk of embolization, could be managed by indirectly reducing the hemodynamic burden. Massive hydration in such cases should be avoided or balanced to avoid the risk of rapid growth and aneurysm rupture.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.4
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• pp.17-25
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• 2019

Purpose: Despite the fact that the needs for disaster emergency medical facilities to minimize casualties are increasing, research for emergency medical facilities is insufficient compared to research for DMAT investment. A management strategy for emergency medical facilities in disaster site needs to be proposed. Methods: Recently there was introduction of mobile hospital system using unit modular method, but it was found out to be used only in disaster emergency training. Emergency medical facilities in disaster site require various tasks. Examination for our research was carried out through consultations with emergency medical and mobile hospital expert because there is no practical use case to apply Emergency Medical Facilities in Korea. Result: In this research we proposed a management strategy to manage and operate emergency medical facilities composed of tent, unit module and container in the aspects of management efficiency. Implications: It is highly expected to establish a foundation for fast and accurate disaster emergency medical facilities deployment by applying the results of our research to Emergency response manual of disaster emergency medical service.

• Clinical Endoscopy
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• v.55 no.3
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• pp.417-425
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• 2022

Background/Aims: Endoscopic submucosal dissection (ESD) for diverticulum-associated colorectal lesions is generally contraindicated because of the high risk of perforation. Several studies on patients with such lesions treated with ESD have been reported recently. However, the feasibility and safety of ESD for lesions in proximity to a colonic diverticulum (D-ESD) have not been fully clarified. The aim of this study was to evaluate the feasibility and safety of D-ESD. Methods: D-ESD was defined as ESD for lesions within approximately 3 mm of a diverticulum. Twenty-six consecutive patients who underwent D-ESD were included. Two strategic approaches were used depending on whether submucosal dissection of the diverticulum-related part was required (strategy B) or not (strategy A). Treatment outcomes and adverse events associated with each strategy were analyzed. Results: The en bloc resection rate was 96.2%. The R0 and curative resection rates were 76.4% and 70.6% in strategy A and 88.9% and 77.8% in strategy B, respectively. Two cases of intraoperative perforation and one case of delayed perforation occurred. The delayed perforation case required emergency surgery, but the other cases were managed conservatively. Conclusions: D-ESD may be a feasible treatment option. However, it should be performed in a high-volume center by expert hands because it requires highly skilled endoscopic techniques.