• Korea Journal of Hospital Management
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• v.27 no.3
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• pp.26-38
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• 2022

Purposes: We analyzed the profitability determinants of regional public hospitals during the entire period between 2010 and 2020 and the period before and after COVID-19. We intended to provide fundamental data for developing publicness evaluation index and task of establishing and expanding regional public hospitals. Methodology: The financial and non-financial information of the regional public hospitals were used as the main analysis data; The financial data was established by the Center for Public Healthcare Policy of National Medical Center, and the non-financial data by the Health Insurance Review and Assessment Service. T-test and regression analysis were used. Findings: The results can be summarized in two. First, the main determinants of profitability of the regional public hospitals were appeared to be the total asset turnover rate and the labor cost rate. Second, during the COVID-19 pandemic in the regional public hospitals, the number of sickbeds, the number of isolation rooms, the total asset turnover rate and the labor cost rate appeared to be the factor worsening the profitability. Practical Implication: The results of this study suggests that the management of the regional public hospitals is not aiming for the profit making, but it performs the functions as the community healthcare safety net such as controlling infectious diseases.

• Korea Journal of Hospital Management
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• v.1 no.1
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• pp.188-202
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• 1996

Telehealth is widely tested in the U.S.A and other developed countries. This system is expected to solve rural health problems reducing professional isolation. Some demonstration projects showed that the system can provide quality care in reasonable prices to rural residents. However, few study has been done on whether telehealth system can attract physicians by reducing professional isolation. The system is not available to most of the rural hospitals because the price for the equipment and telephone charges are not low enough. It is promising that the system cost and telephone charges are decreasing gradually. As time passes, rural hospitals will be more viable for the system. Satisfaction of the physicians and patients is a key factor for the implementation of the system. The physicians need to understand more about telecommunication and computer systems. After physicians are well-versed about the system, we can expect wide use of telehealth in rural areas. Effort for the confidentiality and standardization should be devoted to assure patient's privacy and compatibility of patient records and exam results. In Korea, two projects are being operated in Uljin and Kurye. A study evaluated the economic efficiency of the projects suggesting that increase of the number of patients up to three times of current number or decrease in hardware costs and telecommunication charges into two thirds of the current costs. The hardware and telecommunication charges are decreasing. Another area telehealth system can be applied is psychiatric accommodation facilities. Establishment of telehealth in the psychiatric facilities will increase the access of psychiatric care for patients and is expected to be economically efficient.

• The Journal of the Korean Society for Microbiology
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• v.10 no.1
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• pp.19-24
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• 1975

Anaerobic bacteria are the major residents of human skin and mucous membrane. The importance, as opportunistic pathogens, of anaerobic bacteria are well recognized because of more population. with decreased defense against bacterial invasion due to chemotherapy, rediation therapy, extensive surgical operation etc. are dealt at hospitals. An analysis of the anaerobe isolation results at Yonsei University Medical Center during the January 1974-May 1975 period was made and the following results were obtained. 1) From 118 patients 146 strains of anaerobes were isolated. Among these 81.3% were nonsporforming anaerobes. Most frequently isolated anaerobes were Pc. asaccharolyticus, Ps. anaerobius, Ps. intermedius, B. fragilis and Cl. perfringens. 2) Anaerobes were frequently isolated from wound, female genital, intraabdominal, and pleuropulmonary specimens. Fewer anaerobes were isolated from blood, spinal fluid and liver specimens. 3) The ratio of anaerobe isolation to total bacteria isolation were; liver 66.7%, intraabdominal 33.3%, pleuropulmonary 28.9%, spinal fluid 5.0% and blood 4.2%. 4) Among the 118 anaerobe isolated patients, 48.3% yielded anaerobes only and rest of them yielded anaerobes together with aerobes. 5) Most of the gram-positive anaerobes were susceptible to the antibiotics tested. Exception was to tetracycline to which appreciable number showed resistance. It was noteworthy that only 48% of B. fragilis was susceptible to tetracycline.

• Earthquakes and Structures
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• v.19 no.6
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• pp.471-484
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• 2020

Previous earthquakes show that, structural safety evaluations should include the evaluation of nonstructural components. Failure of nonstructural components can affect the operational capacity of critical facilities, such as hospitals and fire stations, which can cause an increase in number of deaths. Additionally, failure of nonstructural components may result in economic, architectural, and historical losses of community. Accelerations and random vibrations must be under the predefined limitations in structures with high technological equipment, data centers in this case. Failure of server equipment and anchored server racks are investigated in this study. A probabilistic study is completed for a low-rise rigid sample structure. The structure is investigated in two versions, (i) conventional fixed-based structure and (ii) with a base isolation system. Seismic hazard assessment is completed for the selected site. Monte Carlo simulations are generated with selected parameters. Uncertainties in both structural parameters and mechanical properties of isolation system are included in simulations. Anchorage failure and vibration failures are investigated. Different methods to generate fragility curves are used. The site-specific annual hazard curve is used to generate risk curves for two different structures. A risk matrix is proposed for the design of data centers. Results show that base isolation systems reduce the failure probability significantly in higher floors. It was also understood that, base isolation systems are highly sensitive to earthquake characteristics rather than variability in structural and mechanical properties, in terms of accelerations. Another outcome is that code-provided anchorage failure limitations are more vulnerable than the random vibration failure limitations of server equipment.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.1
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• pp.46-57
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• 2018

Purpose: The purposes of the study were to examine the knowledge and practice about Middle East Respiratory Syndrome (MERS) isolation precaution, and to explore influencing factors of the isolation practice among hospital nurses. Methods: A total of 182 nurses were recruited from four general hospitals where MERS patients had been treated. The knowledge and practice of MERS isolation precaution were measured by the scales developed based on the CDC guidelines. The collected data were analyzed by SPSS/WIN 22 with descriptive statistics, T-test, One-way ANOVA, Pearson correlation coefficients, and hierachical multiple regression analysis. Results: The nurses were 30 years old in average, and half of them had less than 5 years of clinical experience. and knowledge on droplet precautions (${\beta}=.171$, p=.019) were the significant predictors, explaining 19.6% of variance in the MERS isolation guideline practice. Clinical experience (${\beta}=.225$, p=.002), working at infection unit (${\beta}=-.203$, p=.011). Conclusion: The knowledge on droplet precaution and general knowledge on MERS were the important modifiable factor to improve the MERS isolation guideline practice among hospital nurses, even after adjusting clinical experience and demographic variables. It is necessary to develop an efficient education program on specific guidelines for prevention and management of infection by improving the knowledge on infectious disease such as MERS as well as droplet precaution which are modifiable factors.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.3
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• pp.39-49
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• 2021

Purpose: The negative pressure isolation ward is a key facility in preparedness and response to infectious diseases. For the sustainable operation of the facility, appropriate facility improvement is required. The experience of medical staff responding to infectious diseases in the COVID-19 pandemic provides effective informations for facility planning. Methods: The post occupancy evaluation (POE) was conducted by interviewing medical staff who is working on Nationally designated negative pressure isolation ward in general hospital. Floor plan analysis was conducted before field surveys for identifying facility characteristic and spatial composition. After that, field surveys were conducted at 3 hospitals, and interviews and fieldwork were conducted together. Results: It is necessary to increase the standard size of ward area from 15m² to 20m². The size of the doffing room has to be planned for accommodation of two or more people. Equipment storage, clean storage and waste storage also should be properly planned. There were almost no problems with the circulation in the ward. There was not enough space for medical staff. Implications: For a sustainable and safe negative pressure isolation ward planning, it is necessary to exploit learning from the medical staffs who have many experiences of coping with infectious diseases.

• Journal of the Korean Society of Radiology
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• v.84 no.4
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• pp.891-899
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• 2023

Purpose To survey perceptions of certified physicians on the protocol of chest CT in patients with coronavirus (COVID-19) using a negative pressure isolation stretcher (NPIS). Materials and Methods This study collected questionnaire responses from a total of 27 certified physicians who had previously performed chest CT with NPIS in COVID-19 isolation hospitals. Results The nine surveyed hospitals performed an average of 116 chest CT examinations with NPIS each year. Of these, an average of 24 cases (21%) were contrast chest CT. Of the 9 pulmonologists we surveyed, 5 (56%) agreed that patients who showed abnormalities in serum D-dimer required contrast chest CT. All 9 surveyed radiologists agreed that the image quality of the chest CT with NPIS was sufficient for CT image interpretation regarding pneumonia or pulmonary embolism. Furthermore, in our 9 surveyed infectionologists, 5 (56%) agreed that a risk of secondary infection in the CT room after temporary opening of NPIS could be prevented through a process of disinfection. Conclusion Experienced physicians considered that the effects of NIPS on chest CT image quality was minimal in patients with COVID-19, and the risk of CT room contamination was easily controlled.

• The Journal of the Korea Contents Association
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• v.19 no.1
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• pp.60-73
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• 2019

This study is a descriptive research study to identify the role conflicts, positive psychological capital, organizational effectiveness, and factors affecting organizational effectiveness of nurses in small hospitals. The subjects of the study were nurses working in three small and medium-sized hospitals located in A city and 255 copies were used for final data analysis. The results showed that the roles of role conflict, isolation, role ambiguity, and resource shortage had a significant negative effect on organizational effectiveness. Role ambiguity and resource shortage of role conflict were significant (-) on positive psychological capital. Positive optimism, positive self efficacy, hope and optimism have a positive (+) effect on organizational effectiveness. Based on the results of this study, it is necessary to develop a variety of programs to reduce role conflict and demonstrate positive psychological capital in order to improve the organizational effectiveness of nurses in small and medium-sized hospitals.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.2
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.

• Mycobiology
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• v.44 no.2
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• pp.99-104
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• 2016

Candida spp. is an invasive infectious fungus, a major risk factor that can increase morbidity and mortality in hospitalized patients. In this study, 2,508 Candida spp. were isolated from various clinical specimens collected from university hospitals from July 2011 to October 2014. They were identified in order to determine isolation frequencies and characteristics by specimen, gender, age group, year, season, and month. The strain-specific isolation rate of Candida spp. is in the order of Candida albicans (1,218 strains, 48.56%), Candida glabrata (416 strains, 16.59%), Candida utilis (305 strains, 12.16%), Candida tropicalis (304 strains, 12.12%), and Candida parapsilosis (116 strains, 4.63%) and these five species accounted for more than 94% of the total strains. Of the specimens, Candida spp. were most frequently isolated from urine-catheter, followed by urinevoided, blood, sputum, other, open pus, vaginal discharge, Tip, ear discharge, bronchial aspiration and bile, in that order. Looking at the age distribution, the detection rate of patients in their 60s and older was significantly higher at 75.8% (1,900/2,508). The detection rate of patients in their 20s and younger was shown to be very low at 2.55% (64/2,508). By year, the detection rate of non-albicans Candida spp. showed a tendency to gradually increase each year compared with C. albicans. As isolation of Candida spp. from clinical samples at the specie level can vary depending on characteristics of the patient, sample, season, etc., continual studies are required.