• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.47-76
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• 1989

The objectives of this study was to analyze the major causes of decreasing utilization rate of health care institutios in pilot-project area of regional medical insurance, Kwang-hwa and Kun-wi country. After the implementation of medical insurance, utilization rate of health institutions turned out' to be lower than it was estimated, when the pilot-project of regional medical insurance was planned. It might be due to changes in inhabitant's behavioral attitude toward medical insurance. So this study was made to find measures for financial stability by increasing utilization rate of health care institutions and to be available for basic demand-supply program of medical care. The hypothesis of this study was as follows; First. there is difference in understanding health care institutions between Kun-wi and Kwang-hwa. Second. respondesnts of inquiry survey have exact knowledge of their past experience of treatment taken prior to enforcement of medical insurance, Questionaire survey was made as to each 700 household among total 11, 884 households in Kun-wi and 20,919 households in Kwang-hwa. In case of Kun-wi, 70% of inquired households (491) gave their answers. In Kwang-hwa, the number was 560 households (80% of inquireds). Dollected data was processed and analyzed by way of using SPSS batch system. To evaluate facto rs distribution aspects of data and to make comparison between two area, percentage and $X^2$ distribution were applied. The results were as follows; L The utilization rate of health care institutions in Kun-wi and Kwang-hwa was lower than it was estimated. when pilot-project of medical insurance was planned. 2. Prior to the implementation of medical insurance. inhabitants in two area chose the medical institutions considering such factors. First was medical care fee cheap. second in habitant's residence, Third was the institutions conveniently easy of access. 3. After the implementation of medical insurance. 26.1% of inqurieds in Kun-wi and 41.6% in Kwang-hwa, changed medical institutions. In case of Kwn-wi, from health care institution (p 0.05), and in case of Kwang-hwa, vice versa, from general medical institutions to health care institutions. 4. Evaluation by factors were made such as follows. Inquired gave high marks to following facts: In case of Kun-wi, general medical institutions were difficult of access and relation between patients: was not friendly, but burden of medical expenditure was light. Effects of treatment and facilities was good. In case of Kwang-hwa, inquired gave high evaluation marks to the follow ing facts; facilities of medical institutions was not good, but the burden of medical expenditure was light. 5. After the implementation of medical insurance, the services was evaluated as good, but inquired hopec for lessening the burden of medical expenditure. 6. In case of exact understanding of cost-sharing, the evaluation rate in Kwang-hwa was higher than that of Kun-wi (p < 0.005). And positive attitude toward necessity of medical insurance was also good in Kwang-hwa (p < 0.05). 7. In case of inquired's attitude toward medical institutions, Kwang-hwa showed positive response (p < 0.05) 8. In the case of comparison between general medical institution and health care institution, two area showed similar positive response; medical manpower, facilities of medical institutions and effest: of treatement was good. 9. In comprehensive evaluation of benefit-service; the general medical institution's positiveness was higher than that of health care institutions in Kun-wi. But in Kwang-hwa vice-versa. 10. If the medical expenditure of general medical institution and health care institutions was equal 77% of inquireds in Kun-wi and 59.1% in Kwang-hwa answered that they chose general medical insurance. Considering results above mentioned, the conclusion of this study was made as follows. 1. In Kwang-hwa county, where the understanding of health care institutions's was good, the utilization's of health care institutions was shown high. Therefore, in case of Kwang-hwa, betterment: should be made to induce increasing utilization rate for negative factors of health care institutions. 2. In case of Kun-wi, where the understanding of health care institutions was on the decrease, measures for changing such negative factors should be taken by way of strengthening public relations. And cases of Kwang-hwa should also be studied. 3. On the side of financial stabilization and establishing health care delivery system, primary health care should be available. Therefore, the major cause of inhabitant's avoiding health care institutions should be known. And measures for activating that institutions have to be taken. So, the facilities of health care institution have to be improved up to the level of clinic. And supportive measures for securing equipment and improving health care services should also be taken. It is necessary that strategy for public relations should be employed with policy considerations and supports.

• Journal of Preventive Medicine and Public Health
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• v.55 no.6
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• pp.539-548
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• 2022

Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

• Tuberculosis and Respiratory Diseases
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• v.58 no.6
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• pp.600-606
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• 2005

Background : The development of bronchoscopic equipment along with the precision of radiographic techniques had reduced the mortality rate of patients with tracheobronchial foreign bodies but has been no change in the incidence of tracheobronchial foreign bodies since their introduction. The aim of this study was to assess the clinical characteristics of a tracheobronchial foreign body aspiration and to evaluate the efficacy of the treatment modality in children and adults. Methods : This is a retrospective review of 64 patients who underwent bronchoscopic procedures for the treatment of aspirated foreign bodies from December 1994 through March 2004 at the Chonnam national university hospital. Results : There were 47 males and 17 females, aged from 1 month to 78 years. Most of the patients had no underlying illness except for one patient with a cerebrovascular accident that contributed to the foreign body aspiration. The most common symptom was cough, which was noted in 54 patients (84.3%). The other presenting symptoms were dyspnea (48.8%), fever (20.3%), sputum (14%), vomiting (7.8%), and chest pain (4.6%). Those whose tracheobronchial foreign bodies were diagnosed more than 2 days after the aspiration (21 patients) were more likely to have pneumonia than those whose foreign bodies were diagnosed within 2 days (p = 0.009). Foreign bodies were visualized in the plain chest radiographs in 12 cases (18.8%), while others showed air trapping (21, 32.8%), pneumonia (15, 23.4%), atelectasis (7, 10.9%), and normal findings (9, 14.1%). The foreign bodies were more frequently found in the right bronchial tree (36) compared with the left bronchial tree (22, p = 0.04). In order to remove the foreign bodies, twenty (31.2%) cases were removed using flexible bronchoscopy, while 42 (65.6%) and 2 (3.2%) cases required rigid bronchoscopy and surgery, respectively. Conclusions : Tracheobronchial Foreign body aspiration had a bimodal age distribution in the infancy and old age around 60 years. They were found more frequently in the right bronchial tree. In addition, patients whose foreign bodies were diagnosed more than 2 days after the aspiration were more likely have a infection. Rigid bronchoscopy is the procedure of choice for uncooperative children and for those with foreign bodies lodged deeply in the small bronchial tree.

• Journal of Korean society of Dental Hygiene
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• v.17 no.1
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• pp.63-76
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• 2017

Objectives: The purpose of this study is to investigate the factors affecting medical knowledge and practice of dental treatment for systemic disease among dental health care workers. Methods: A self-reported questionnaire was filled out by 222 dental health care workers working in Seoul, Daejeon, Busan, Gyeonggi province, Chungcheong province, and Jeolla province within the period between May 1 - June 30, 2016. Knowledge and medical knowledge about the clinical treatment of patients suffering from systemic disease and their practice were composed of items that were corrected, supplemented, and developed by themselves based on previous research. Results: Factors affecting knowledge about clinical treatment of patients suffering from systemic disease were place of employment, treatment about systemic disease, and practice of dental treatment for systemic diseases. Predictive power was 38.5%. Factors affecting practice of clinical treatment of patients suffering from systemic disease were sex, place of employment, treatment about systemic disease, the basic equipment and drugs needed for emergency care, and knowledge of dental treatment for systemic diseases. Predictive power was 39.1%. Conclusions: Dental health care workers' knowledge and practice of dental treatment of patients suffering from systemic diseases were important factors influencing each other.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.624-632
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• 2000

Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.

• Korean Journal of Digital Imaging in Medicine
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• v.11 no.2
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• pp.85-92
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• 2009

This study, "The study about performance evaluations of mobile cover for X-ray's diffusion and distribution in mobile radiation" is based on the rules of mobile defense apparatus for radiation producer in 2006. To use the mobile cover for X-ray for diagnosis has been compulsory in common wards except operation rooms, emergency rooms and intensive care units. we have confirmed the effect in arbitrary shielding material after Qualitiy Control was carried out for accuracy in an experiment of mobile photographing equipment. The performance evaluation was conducted with the fabrics of selenium, 0.2 mmPb, 0.1 mmPb and aluminiums. Considering the result, we choosed 0.1 mmPb and attached cover to mobile photographing equipment. We have finished making the cover after drew up the draft to attach cover to mobile photographing equipment through the modeling and the structural analysis. the process of the study is that we assembled the manufactured structures and carried out the practical experiment to take the photograph after attaching the fabric of 0.1 mmPb to mobile photographing equipment. It is need of additional thesises hereafter that we compare the result between the part to improve for safety besides convenience in photographic experiment about clinical radiation and the effect of covering the diffusion in condition attached the cover.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.156-175
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• 2000

This study was designed to find out the relations between the major investment decision-making behaviors and profitability of the hospital. A total of 57 hospitals were analyzed on this study. The major findings were as follows; 1. Among the types of the investment decision-making, major factors affecting the profitability were where the top management belongs among the defender, analyzer, prospector, and reactor type. Other factors were whether or not hospital analyzes which is more economical between the purchase by cash and lease of the medical equipment and whether or not hospital changes the decision before the actual investment. 2, Among the types of the investment decision-making, major factors affecting the financial structure and efficient operation of the assets were ranking of the priority and whether or not hospitals can get enough revenue and cash flow when hospitals have to borrow a big amount of fund from outside. 3. Among the financial indices regarding the financial stability, major factor affecting the profitability was fixed assets to long-tenn capital. Other factors affecting the financial structure and efficient operation of the assets were value added to medical equipment, normal profit to medical equipment, liability to total assets, current ratio, value added to payroll expenses. 4. Investment decision-making behaviors are partially influencing on the financial structure and efficient operation of the assets. However it was proved that the profitability was the most influencial factor than other factors related with the operation of the hospital. 5. To improve the irrational investment decision-making behaviors strategic management system should be introduced, and the top mamagement's investment decision-making style should be changed from reactor and analyser styles to prospector and reactor ones.

• Tuberculosis and Respiratory Diseases
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• v.79 no.4
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• pp.234-240
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• 2016

Transmission of tuberculosis (TB) is a recognized risk to patients and healthcare workers in healthcare settings. The literature review suggests that implementation of combination control measures reduces the risk of TB transmission. Guidelines suggest a three-level hierarchy of controls including administrative, environmental, and respiratory protection. Among environmental controls, installation of ventilation systems is a priority because ventilation reduces the number of infectious particles in the air. Natural ventilation is cost-effective but depends on climatic conditions. Supplemented intervention such as air-cleaning methods including high efficiency particulate air filtration and ultraviolet germicidal irradiation should be considered in areas where adequate ventilation is difficult to achieve. Personal protective equipment including particulate respirators provides additional benefit when administrative and environmental controls cannot assure protection.

• Asian Journal of Business Environment
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• v.7 no.3
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• pp.17-22
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• 2017

Purpose - Clarifying one of the biggest public Hospital Costs and incomes according to patients' case mix. It leads to prepare financial information about pubic medical tariffs and hospital operational costs. Research design, data, and methodology - This study calculates the costs both, with and without taking into account capital costs. This holds for comparison of hoteling based on case mix in all medical procedures. The checklists were reviewed and filled by reviewing accounting documents of the hospital, warehouse exclusion list, and daily books of laundry and CSR. Data was analyzed descriptively by using Excel. Results - In both cases, the hospital is losing in terms of hoteling. Because the buildings and equipment are new, this loss is not tangible. However, this will be revealed when costs of reconstruction and replacement of equipment. The loss rate per day of hospitalization was 569318 Rials for Coronary Care Unit (CCU), 528171 Rials for Post Intensive Care Unit (Post ICU), 474570 Rials for ICU, 233183 Rials for Post CCU and 204803 for Surgical ward. Conclusions - Income of hoteling was lower than its costs. ANOVA showed a strong relationship between case mix and hospital costs as well as case mix and its income. This suggests that optimal case mix can minimize the costs and maximize income.

• Korea Journal of Hospital Management
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• v.11 no.1
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• pp.54-90
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• 2006

Medical clinics are core institutes that cover the primary medical care in Korea. Financial viability of the clinics is essential for them to conduct their roles and functions, and can be improved by increasing their operating profitability. On this ground, this study aimed at finding important factors that affect the operating profitability, and thereby at suggesting strategic alternatives that can contribute to the improvement of the profitability. Operating margin was set as a dependent variable, and such factors as general management conditions, number of visits, medical revenue, marketing activities, input resources, medical cost as independent variables. Nineteen hypotheses related to the variables were established and tested using data collected from 138 sample clinics for the year 2003. The results of the study are as follows : Firstly, such variables as percent ratio of the depreciation plus rent costs to total administration costs, type of clinical department manifested whether medical, surgical, or quasi-surgical, percent ratio of the interior facility investment to total fixed assets, and total number of outpatient visit are important factors that affect, positively or negatively, the medical profitability of the clinics. Secondly, following measures are needed to be established and implemented to improve the medical profitability. (1) Administration costs share 53.2% of the total medical costs, and depreciation plus rent costs 16.3% of the total administration costs. This implies that such measures as reinforcement of marketing activities, establishment of the cooperative utilizing system of the facility and equipment, or group practice are needed to increase cost-effectiveness. (2) Occupancy rate of the clinics with inpatient bed is as low as 45.5%, causing high fixed costs and low medical profitability. For its improvement, the resource input structure should be reorganized. Thirdly, in the future, a study that can increase sample representativeness of the study and explanation power of the variables should be performed for each type of clinical department to find more specific determinant factors and to contribute to the improvement of the medical profitability of the clinics.