• 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.

• Health Policy and Management
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• v.5 no.2
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• pp.35-69
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• 1995

The managerial environment of hospitals in Korea characterized by low levels of medical insurance fees is worsening by increasing government regulations as to the utilization of medical services, rising costs of labor, material, and medical equipments, growing patient expectations concerning the quality of services, and escalating competitions among large hospitals in the market. Hospitals should seek for their survival strategies in this harsh environment and they should have information about costs of their products in doing so. However, it has not been available due to the complexity of the production process of hospital services. The objectives of this study were to develop a service-based cost accounting model and to apply the developed model to a study hospital to obtain cost information of hospital services. A model commonly used for the job-order product cost accounting in the manufacturing industry was modified for the use in hospitals in Korea. Actual costs, instead of standard costs, incurred to produce a unit of services during a given period of time were estimated in the model. Data required to implement the model included financial information, statistics for the allocation of supportive cost center costs to final cost centers, statistics for the allocation of final cost center costs to services, and the volume of each services charged to patients during a study period. The model was executed using data of a university teaching hospital located in Seoul for the fiscal year 1992. Data for financial information, allocation statistics fo supportive service costs, and the volume of services, most of them in electronic form, were available to the study. Data for allocation statistics of final cost center costs were collected in the study. There were 15 types of evaluation and management service, 2, 923 types of technical service, and 2, 608 types of drug and material service charged to patients in the study hospital during the fiscal year 1992. Labor costs of each of seven types of pesonnel, material costs of 611 types of drugs and materials, and depreciation costs of 212 types of medical equipments, miscellaneous costs, and indirect costs incurred in producing a unit of each services were estimated. Medical insurance fees for basic services such as evaluation and management of inpatients and outpatients, injection, and filling prescriptions, and for operating procedures were found to be set lower than costs. Infrequent services which use expensive medical equipments showed negative revenuse as well. On the other hand, fees for services not covered by the insurance such as CT, MRI and Sonogram, and for laboratory tests were higher than costs. This study has a significance in making it possible for a hospital to obtain cost information for all types of services which produced income based on all types of expenses incurred during a given period of time. This information can assist the management of a hospital in finding an effective cost reduction strategy, an efficient service-mix strategy under a given fee structure, and an optimum strategy for within-hospital resource allocations.

• Korea Journal of Hospital Management
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• v.26 no.2
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• pp.68-78
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• 2021

Background:The purpose of this study was to identify factors influencing on hospital choice of the general hospital among customers with loyalty in Mongolia. Methods:This study was divided into 5 types of hospital choice factor such as physical, human, efficiency, accessibility, and hospital image. Data were assessed using 229 patients who visit at a general hospital in Mongolia. The collected data from June 20 to July 20 in 2020 were conducted the self-administered questionnaires and analyzed frequency, t-test, ANOVA, and logistic regression by using SPSS 25.0. Results:The level of education was significant in the mean difference of customer types by demographic characteristics. Expecially, factors affecting hospital choice of loyalty customers were human and hospital image. Conclusion:This study suggests that it is necessary to understand present and potential consumer's needs, wants, and demands. Also, it is important to concern about aspect of marketing strategy of the general hospital in Mongolia.

• Korea Journal of Hospital Management
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• v.13 no.1
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• pp.65-83
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• 2008

Although a variety of customer relationship management (CRM) activities have been provided by many hospitals in Korea, there lacks empirical evidence on the effect of CRM. The present study was conducted to examine the effect of CRM in terms of the customer response to CRM in a woman's hospital setting. A total of 380 patients receiving inpatient or outpatient care from woman's hospital between October 25 and November 4, 2005 were surveyed for the degree of their experience of and preference for CRM activities of the hospital by 5-point Likert-type scale. Patients were also asked about the level of customer loyalty to the hospital. Eighteen CRM activities offered by the hospital was classified into 4 types of CRM strategies according to Berry and Parasuranman: price, social, structural, and relationship recovery strategy. There's a significant positive correlation between the degree of experience of CRM and preference for CRM(r=0.49, p<0.001). Regression analysis results showed the significant positive relationship between the degree of experience of CRM and customer loyalty(${\beta}$=0.448, p<0.05). Among the 4 CRM strategies, only social(${\beta}$=0.127, p<0.05) and structural strategy(${\beta}$=0.266, p<0.05) showed signifiant positive relationship with customer loyalty. Overall, the favorable customer response to CRM in terms of preference for CRM and customer loyalty indicates that there's a positive effect of CRM on the continuity of the relationship between patients and health care providers.

• Journal of Digital Convergence
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• v.20 no.2
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• pp.479-486
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• 2022

This study tried to identify hospital internal marketing, organizational communication, and the degree of organizational performance targeted at nurses working in university hospitals, and apprehend factors affecting organizational performance. A structured questionnaire, where 239 nurses answered, was used to figure out general features, hospital internal marketing, organizational communication, and organizational performance. Descriptive statistics, Indepented t-test, one-way ANOVA, correlation, and multiple regression analyses were used to analyze the data. The analyzing tool was IBM SPSS 21.0 program. The result of this study was as follows: hospital internal marketing 3.13±0.58 points, organizational communication 3.23±0.48 points, and organizational performance 3.34±0.51 points. Organizational performance showed a positive correlation with hospital internal marketing and organizational communication, and those two explained 61.0% of organizational performance. Therefore, hospital internal marketing strategy - encouraging nurses in individual aspect - and integrated strategy - establishing various communication channels in organizational aspect - are required to increase the organizational performance of nurses.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.5
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• pp.1761-1766
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• 2012

Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

• PNF and Movement
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• v.9 no.3
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• pp.41-48
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• 2011

Purpose : The purpose of this study was to describe the Inter-expert cooperation strategy for community ambulation in stroke patient. Methods : The data was collected by stroke patient. We applied the Inter-expert cooperation strategy for community ambulation to stroke patient. Parameters of result were collected for using the 10m walk test, 6 minute walk test and ICF assessment sheet. Results : Significant differences were observed the stroke patient for 10m walk test, 6 minute walk test and ICF assessment sheet. stroke patient improved all test. Conclusions : Inter-expert cooperation strategy applied community ambulation is very useful and effective. It is effective in clinical practice.

• Journal of Chest Surgery
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• v.56 no.3
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• pp.204-205
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• 2023

• The Korean Journal of Pain
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• v.25 no.4
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• pp.267-271
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• 2012

The Nuss procedure for the correction of Pectus Excavatum (PE) is associated with intense postoperative pain. Our strategy to control early postoperative pain is to combine epidural with intravenous analgesia. Our aim was to analyse our pain control strategy by reviewing all the PE cases treated at our institution. Sixty consecutive patients, aged between 12 and 26 years old, received the PE operation at our institution from January, 2007 to September, 2010. The median age was 16 (12-27) with a male/female ratio of about 7/1. An epidural catheter was employed in all the cases, with 38 patients (63%) requiring additional drugs to control pain, which remained in place for 74 hours (72-96). The pain score was higher in male patients, but lower in those younger than 16 years old. Moreover, patients that consumed benzodiazepines had a significant decrease in cumulative opioid intake (P = 0.0408). Both gender and age had an impact on pain control, while we noticed a synergistic effect between opiates and tranquillizers.