• Korea Journal of Hospital Management
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• v.6 no.2
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• pp.138-155
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• 2001

This study was designed to find out the factors which influence on the financial performance of the hospital. Out of 32 provincial hospitals which were established by the government, 10 hospitals were selected as sample hospitals. Ten hospitals were divided into two groups(5 hospitals each), one of which was profit-making and the other loss-making. The criteria in selecting profit or loss-making hospitals was net profit to total revenue. The major finding of the study was as follows; 1. Whether or not a hospital had specialized in certain departments was proved to be the major factor influencing on the financial performance. Three out of five profit-making hospitals could harvest following results by operating specific departments. (1) Man powers needed for the operation of specific departments were 14.6 persons per 100 bed, which was only 1/7 of the general hospital. (2) The number of doctors has not increased in proportion to the increase of the number of beds. (3) Ratio of total revenue to MD.'s payroll expenses of the profit-making hospitals was 75.0% higher than the loss-making hospitals. (4) The average length of stay of specific department was very long(388.1 days). However, the specific departments were found to have contributed much to the financial performance because the occupancy rate of such departments was very high(94.5%). 2. The headcount per 100 bed of the profit-making hospitals was 23.9 persons(24.0%) less than the loss-making hospitals and the ratio of payroll expenses to total revenue 15.1% less. 3. Averagel revenue per specialist of the profit-making hospitals was 100 million(25.1%) more than loss-making hospitals and the ratio of total revenue to MD's payroll expenses of profit-making hospital was 75.0% higher. 4. Profit-making hospitals have introduced new systems or renovation in 36 fields, such as incentive payment system, utilization of contracted man powers, change of the payroll structure of the nurses, specialization in certain departments, etc; however, loss-making hospitals introduced only 25 new systems or renovations. These kind of renovation could not be achieved without the cooperation of the labor union and the strong will of the top management. Therefore, it could be said that the labor union of the profit-making hospitals seems to have been very cooperative compared with that of loss-making hospitals.

• Parasites, Hosts and Diseases
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• v.23 no.2
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• pp.300-304
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• 1985

A total of 377 pregnant women, 43 pelvic tumor patients and 80 of multiphysic health center persons as controls were examined by indirect latex agglutination test in order to evaluate Toxoplasma antibody titers at Kang-Nam St. Mary's Hospital in Seoul. Throughout this survey, 1 : 32 or more titers of diluted sera were regarded as positive. 1. The 377 samples of test sera in pregnant women showed negatives in 319 cases (84.6%), 1 : 2 in 44 cases (11.7%), 1:4 in 9 cases (2.4%), 1:8 in 2 cases (0.5%), 1:16 in 1 case (0.3%) and 1 : 32 in 2 cases (0.5%) respectively. 2. The 43 samples of test sera in pelvic tumor patients showed negatives in 29 cases (67.4%), 1:2 in 8 cases(18.6%), 1:4 in 1 case(2.3%), 1:16 in 2 cases (4.7%), 1:32 in 1 case(2.3%) and 1 : 128 in 2 cases (4.7%). 3. The 80 samples of test sera in multiphysic health center persons as controls negatives in 56 cases (70.0%), 1.2 in 19 cases (23.8%), 1:4 in 3 cases (3.8%), 1:8 in 1 case (1.3%) and 1 : 128 in 1 case (1.3%). 4. Among total 420 study cases, 5 cases (1.2%) showed Positives, and they were 2 cases (0.5%) of pregnant women and 3 cases (7.0%) of pelvic tumor patients. 5. One case (1.3%) out of 80 control sera showed positive result.

• Korea journal of population studies
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• v.3 no.1
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• pp.5-41
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• 1979

Vast volumes of studies of the medical and public health aspects of fertility and family planning have been published by the various institutes of health related research and university scholars in Korea. None of them, however, have dealed with the population problems associated with biologically and mentally handicapped people. It must be emphasized that the purpose of Korea's population policy should be to improve the quality of the population rather than to decrease its rate of increase. In this spirit, the first report of this study is to identify problems related with mentally and physically less fitted population, and to attempt to offer the possible solutions to the health planners and policy-makers. Several nation-wide surveys of the handicapped people in Korea have been compared. Each survey shows a wide range of difference in the prevalence of the handicaps(see Table 13). In this study, the data on the handicaps are collected by two independent system ; one by the nation-wide survey and the other by the reporting system existing at the Seoul National University Demonstration Health Project. The Chandrasekar-Deming technique was used to estimate the total number of handicaps. The estimates are summarized in the tables 8, 9 and 10. Estimate of total number of handicapped people in Korea is 601, 400 with the prevalence rate of 16.1 per thousand persons. Even if taking a number of conditions which may result in a biased estimate of the total number of the handicaps into consideration, the proportion of handicapped people in Korea has increased in the past two decade as the result of the rapid decline in fertility and childhood mortality, which consequently prolonged life expectancy of persons with congenital or acquired impediment. An increase in the proportion of handicapped people will eventually bring about serious problems of social welfare, medical care, and population qualities from various aspects including eugenics. To tackle the problem, there must be an increased emphasis on the prevention of handicaps from the government and private sector. Based on the amount and quality of data, and from the practical point of view, this study prepared a set of recommendations for the government to strengthen its programs of the preventive activities during the prenatal period and early childhood, early finding from routine examinations, and proper social and medical rehabilitation.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.460-470
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• 1998

By expanding health insurance, customers will carry a smaller burden of medical costs. As a result, the number of visits to a physician increase and this result in the improvement of medical accessibility. But medical care utilization may be changed not only by insurance status but also by socio-demographic factor, economic status and other factors. The question thus remains, at which level of accessibility and what price of medical care service in health insurance will the customer and the medical care service be satisfied. The price of medical care service ls comprised of the customer's out-of-pocket money and the costs not covered by health insurance. If the price of medical care services in health insurance are appropriate, medical care utilization should not differ because of the difference in income status or the acuteness of illness. But If the price is not adequate, low income groups will receive relatively low medical care utilization, particularly in the case of chronic disease. The purpose of this study is to evaluate the differences in medical care utilization among the various income groups and those with varying acuteness of illness. The major hypotheses to test in this study are : (i) whether there are differences in medical care utilization among different income groups exist, (ii) whether differences in medical care utilization among different income groups exist with the hospital type. (iii) whether differences in medical care utilization among different income groups exist with the acuteness of illness and with age. The data was collected from the JongRo District Health Insurance Society in Seoul. A total of 118,336 persons were selected as the final sample for this study. The major findings of this study were as follows; 1. The volume of ambulatory utilization among users was statistically significant by income level. 2. Among different income groups, the volume of ambulatory utilization was statistically significant by the acuteness of illness. 3. Higher income groups with chronic diseases had a greater volume of ambulatory utilization than other groups.

• Radiation Oncology Journal
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• v.18 no.2
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• pp.157-166
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• 2000

Purpose : This investigation was peformed in order to improve the health care of radiation workers, to predict a risk, to minimize the radiation exposure hazard to them and for them to realize radiation exposure danger when they work in radiation area in hospital. Methods and Materials : The documentations checked regularly for personal radiation exposure in four university hospitals in Pusan city in Korea between January 1, 1993 and December 31, 1997 were analyzed. There were 458 persons in this documented but 111 persons who worked less then one year were excluded and only 347 persons were included in this study. Results : The average of yearly radiation exposure of 347 persons was 1.52$\pm$1.35 mSv. Though it was less than 50mSv, the limitaion of radiation in law but 125 (36%) people received higher radiation exposure than non-radiation workers. Radiation workers under 30 year old have received radiation exposure of mean 1.87$\pm$1.01 mSv/year, mean 1.22$\pm$0.69 mSv between 31 and 40 year old and mean 0.97$\pm$0.43 mSv/year over 41year old (p<0.001). Men received mean 1.67$\pm$1.54 mSv/year were higher than women who received mean 1.13$\pm$0.61 mSv/year (p<0.01). Radiation exposure in the department of nuclear modicine department in spite of low energy sources is higher than other departments that use radiations in hospital (p<0.05). And the workers who received mean 3.59$\pm$1.81 msv/year in parts of management of radiation sources and injection of sources to patient receive high radiation exposure in nuclear medicine department (p<0.01). In department of diagnostic radiology high radiation exposure is in barium enema rooms where workers received mean 3.74$\pm$1.74 mSv/year and other parts where they all use fluoroscopy such as angiography room of mean 1.17$\pm$0.35 mSv/year and upper gastrointestinal room of mean 1.74$\pm$1.34 mSv/year represented higher radiation exposure than average radiation exposure in diagnostic radiology (p<0.01). Doctors and radiation technologists received higher radiation exposure of each mean 1.75$\pm$1.17 mSv/year and mean 1.50$\pm$1.39 mSv/year than other people who work in radiation area in hospital (p<0.05). Especially young doctors and technologists have the high opportunity to receive higher radiation exposure. Conclusions : The training and education of radiation workers for radiation exposure risks are important and it is necessary to rotate worker in short period in high risk area. The hospital management has to concern health of radiation workers more and to put an effort to reduce radiation exposure as low as possible in radiation areas in hospital.

• Journal of Preventive Medicine and Public Health
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• v.33 no.1
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• pp.76-82
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• 2000

Objectives : We attempted to assess He accuracy of ICD codes for cerebrovascular diseases in medical insurance claims (ICMIC) and to investigate the reasons for error. This study was designed as a preliminary study to establish a nationwide surveillance system. Methods : A total of 626 patients with medical insurance claims who indicated a diagnosis of cerebrovascular diseases during the period from 1993 to 1997 was selected from the Korea Medical Insurance Corporation cohort (KMIC cohort: 115,600 persons). The KMIC cohort was 10% of those insured who had taken health examinations in 1990 and 1992 consecutively. The registered medical record administrators were trained in the survey technique and gathered data from March to May 1999. The definition of cerebrovascular diseases in this study included cases which met ore of two criteria (Minnesota, WHO) or 'definite stroke' in CT/MRI finding. We questioned the medical record administrators to explain the error if the final diagnoses were not coded as stroke. Results : The accuracy rate of the ICMIC was 83.0% (425 cases) Medical records were not available for 8.2% (51 cases) due to the closing of hospitals, the absence of a computer system or omission of medical record, etc. Sixty-three cases (10.0%) were classified as impossible to interpret due to insufficient records in 'major clinical symptoms' or 'neurological deficits'. The most common reason was 'to meet review criteria of medical insurance benefits (52.9%)'. The department where errors in the ICMIC occurred most frequently was the department for medical insurance claims in the hospital. Conclusion : The accuracy rate of the ICMIC was 83.0%.

• The Korean Journal of Nuclear Medicine
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• v.26 no.2
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.11
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• pp.4617-4622
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• 2014

Background: Several studies have previously focused on associations between the (GT)n repeat polymorphism of the heme oxygenase-1 (HO-1) gene promoter region and risk of cancers, but results are complex. We conducted the present meta-analysis to integrate relevant findings and evaluate the association between HO-1(GT)n repeat polymorphism and cancer susceptibility. Materials and Methods: Published literature was retrieved from the PubMed/MEDLINE, EMBASE and ISI Web of Science databases before November 2013. For all alleles and genogypes, odds ratios were pooled to assess the strength of the associations using either fixed-effects or random-effects models according to heterogeneity. Subgroup analysis was conducted according to ethnicity and histopathology. Results: A total of 10 studies involving 2,367 cases and 2,870 controls were identified. The results showed there was no association between HO-1 (GT)n repeat polymorphism and the cancer risk both at the allelic and genotypic level. However, in the stratified analysis, we observed an increased risk of squamous cell carcinoma in persons carrying the LL genotype and the LL+LS genotype as compared with those carrying the SS genotype. When the LS and SS genotypes were combined, the odds ratio for squamous cell carcinoma in LL-genotype carriers, were also significantly increased. No publication bias was observed. Conclusions: The LL genotype and L-allele carrying genotypes (LL+LS) of HO-1 (GT)n repeat polymorphism are potential genetic factors for developing squamous cell carcinoma. More large and well-designed studies are required for further validations.

• Journal of Preventive Medicine and Public Health
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• v.29 no.3 s.54
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• pp.471-482
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• 1996

Early recognition of coalescence in pneumoconiotic lesions is important because such coalescence is associated with the respiratory symptoms and deterioration of lung function. This complicated form of pneumoconiosis also has worse prognosis than does simple pneumoconiosis. High resolution computerized tomography(HRCT) provides significant additional information on the stage of the pneumoconiosis because it easily detects coalescence of nodules and emphysema that may not be apparent on the simple radiograph. The purpose of this study is to clarify the role of HRCT in detection of large opacity and the relationship of change between the coalescence of nodules or emphysema and lung function in dust exposed workers. 1. There was good correlation between the HRCT grade of pneumoconiosis and ILO category of profusion. 5(9.09%) in 55 study population had confluent nodule extending eve, two o, more cuts on HRCT. HRCT could identify the pneumoconiotic nodules which was not found by simple radiogrphy in 6 workers with category 0/0. 2. No significant difference was observed coalescence of nodules and emphysema by dust type. 3. There was no significant difference in pulmonary function according to ILO and HRCT classification. 4. HRCT could detect the significant reduction in $FEV_1,\;FEV_1/FVC$, PEFR, $FEF_{25},\;FEF_{50},\;and\;FEF_{75}$ and remarkable increase in RV and TLC in study persons with emphysema compared with non-emphysema group. 5. Emphysema was found more often in nodules-coalescence group than small opacity group by HRCT. We found that HRCT could easily detect areas of coalescence and complicated emphysema compared to plain chest X-ray. Also our data suggest that it is primarily the degree of emphysema rather than the degree of pneumoconiosis that determines the level of pulmonary function.

• Journal of Korean Medical classics
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• v.3
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• pp.444-500
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• 1989

I have felt seriously a desire to study and analyse the medicine of the period of the Three Kingdoms when I thought and studied the ancient medical history. Therefore in Chapter II I inquired into the background of Politico-social and the currency of thought. In the Chapter III inquired into the system of Medical politics in the period of the Three Kingdoms. In the Chapter IV inquired into the general view of the period of the Three Kingdoms. In the Chapter V inquired into the writings of Medicine and Doctors. From this study, I reached at following-conclusions. 1. The Three Kingdoms are politically opposed to each other, but socialo culturaly cooperated, connected each other to import the technique and thought which developed in China, so generally their system and life pattern are alike. 2. On the system of medical politcics Goguryeo(高句麗) had the system of court phisician, Baek jeo(百濟) had medical doctor and collector in the Ministry of Drug which took charge of teaching and medical treatment and specially had spellchanting doctor who treat epidermic and psychological diease untreated with herb and acupuncture, Shilla(新羅) had the system of Yak chun which was charge of teaching and treatment, and had the Chimbang(針房) which assist doctor in the system of Yagchun(藥典制度). 3. The medical interchange with China made the Three Kingdoms to import the medical books. So the theory of medicine was systematized and the art of treatment developed. In the aspect of Herb the Three Kingdoms and China actively exchange their own district product. 4. The medicine of Three Kingdoms accommodated Yin Yang Ohang theory(陰陽五行說), the theory of body compose with four element(四大 : 地水火風) and the theory of life cultivation and breathing(導引養生說) with Therefore in many aspect of oriental medicine basic theory and treatment would improved. 5. The epidermic diease occurred in period of Three Kingdoms, is represented Yeok(疫), that is after all Ohn Diease(溫病), and epidermic diease, is relfected by earthquake, heavy rain, terrible droughty and eclipse of sun. The treatment of this diease did not developed in that time, we presume that there are many persons killed. 6. As the record of five starr(五星), comet(彗星) and eclipse of sun was showed, the astronomy of oriental medicine in the Three Kingdoms was high level and it became the mothers womb of Korean astronomy. 7. The medicine of the Three Kingdoms, concreted with Chinese medicine and their own ancient one, was reflect on Japanese medicine to improve the medical theory and treatment. 8. The Three Kingdoms peculiarly published Korea Nosabang(高麗老師方) Baekjyeo Shinjipbang(百濟新集方), so this independent medicine reflected on the development of natural hurb(鄕約) of the period of Korea(高麗).