• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권2호
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• pp.7-15
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• 2015

Purpose: The purpose of this study is analyze linkage and spatial and structural characteristics of outpatient department and diagnosis/treatment area of geriatric hospitals based on quantitative analysis, according to function and corridor types. Methods: To examine structural characteristics and correlation of outpatient department and diagnosis/treatment area of six geriatric hospitals according to the corridor type, were systemized according to the function and corridor type and made into a j-graph, and an index was created by using space syntax to understand spatial characteristics. Results: 1) Different functional spaces are connected by a corridor, which, therefore, can be an axis of the connectivity and linkage of functional spaces and an important element in a clear hierarchy. 2) Treatment areas were disconnected from different functional spaces and, therefore, the accessibility was low. Many hospitals had an arrangement plan for treatment and diagnosis areas, and recent hospitals have segmented treatment areas within the rehabilitation space, which resulted in deeper space. 3) In terms of the level of integration, more integrated reception area meant shallower spatial depth, and deeper space for treatment and diagnosis areas. Implications: Spatial relation of outpatient department of geriatric hospitals was analyzed based on characteristics of the elderly.

• 한국병원경영학회지
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• 제23권2호
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• pp.42-53
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• 2018

Purpose: this study investigates the effect of private health insurance on healthcare utilization. Methodology: For the analysis, we employed the three level nested two part model. Findings: the private health insurance adoption was associated with higher health care utilization. In particular, indemnity and fixed insurances adoption was associated with higher probability of outpatient visit, the number of outpatient visit and outpatient cost. While indemnity insurance adoption was associated with higher inpatient admission probability and inpatient days, fixed insurance adoption was associated only with higher inpatient admission probability. Practical Implications: indemnity and fixed insurance adoption were related with the adverse selection as well as moral hazard.

• 보건행정학회지
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• 제29권2호
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• pp.160-171
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• 2019

Background: This study purposed to compare the difference on medical utilization and health expenditure of baby boomer generation by depression between gender. Methods: Korea Welfare Panel Survey 2016, provided by the Korea Institute for Health and Social Affairs, was used for the analysis. For the research, we used the two-part model, yes or no of use (part 1), and frequency of use (part 2) for medical utilization. The dependent variables are the whether or not to use of hospitalization services, outpatient services, length of stay, outpatient service visits, and health expenditure. And the independent variables are used as the predisposing (education, spouse presence), enabling (insurance type, private insurance, economic activity, income), and need (chronic disease, self-rated health, disability) factors in the Andersen behavior model. Depression was used as intervening variables. Structural equation model and multiple group analysis by gender were used. Results: There were differences in the medical care usage and cost between men and women in baby boomer. For men, mediating effects of depression were present at the hospitalization (yes/no), length of stay, and health expenditure. On the other hand, for women, the mediating effect of depression was found only at the outpatient visits. Specially, depression was working at the medical services by the different way between gender. The size of effect (multiple group analysis) was affected by significant differences between men and women. Conclusion: This study found that the mediating effect of depression is increased medical usage and health expenditure and the effect factors are different by gender. Therefore, it is necessary to establish a medical care policy considering the socio-economic characteristics of baby boomers.

• 보건행정학회지
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• 제3권2호
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• pp.159-176
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• 1993

The utilization of outpatient care services involves two steps of sequential decisions. The first step decision is about whether to initiate the utilization and the second one is about how many more visits to make after the initiation. Presumably, the initiation decision is largely made by the patient and his or her family, while the number of additional visits is decided under a strong influence of the physician. Implication is that the analysis of the outpatient care utilization requires to specify each of the two decisions underlying the utilization as a distinct stochastic process. This paper is concerned with the number of physician visits, which is, by definition, a discrete variable that can take only non-negative integer values. Since the initial visit is considered in the analysis of whether or not having made any physician visit, the focus on the number of visits made in addition to the initial one must be enough. The number of additional visits, being a kind of count data, could be assumed to exhibit a Poisson distribution. However, it is likely that the distribution is over dispersed since the number of physician visits tends to cluster around a few values but still vary widely. A recently reported study of outpatient care utilization employed an analysis based upon the assumption of a negative binomial distribution which is a type of overdispersed Poisson distribution. But there is an indication that the use of Poisson distribution making adjustments for over-dispersion results in less loss of efficiency in parameter estimation compared to the use of a certain type of distribution like a negative binomial distribution. An analysis of the data for outpatient care utilization was performed focusing on an assessment of appropriateness of available techniques. The data used in the analysis were collected by a community survey in Hwachon Gun, Kangwon Do in 1990. It was observed that a Poisson regression with adjustments for over-dispersion is superior to either an ordinary regression or a Poisson regression without adjustments oor over-dispersion. In conclusion, it seems the most approprite to assume that the number of physician visits made in addition to the initial visist exhibits an overdispersed Poisson distribution when outpatient care utilization is studied based upon a model which embodies the two-part character of the decision process uderlying the utilization.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제16권3호
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• pp.37-48
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• 2010

This study analyzes the present condition of the elements of a healing environment of the waiting rooms in outpatient clinics of children' hospitals (3 hospitals in Seoul) so as to propose a design to build a healing environment within the children' hospital. And analyzing the importance, satisfaction and preference of the healing environment in the waiting rooms, this paper has come to the following conclusions: 1)The study shows that the space structure of outpatient clinics in children' hospitals are composed of 1 story or 2 stories and designed in a duplication design or a dispersed alcove design. 2)The waiting room of the SC Hospital, with an area of 66.56$m^2$, and the waiting room of the SU Hospital, with an area of 38.78$m^2$ received the highest score for its space. 3)As most patients visit the hospital with their guardian, the waiting room should also be someplace families can rest and share information with others. 4)It is essential to build an environment that eliminates stress elements that patients may come to face by minimizing noise and elements that obstruct the view for mental stability. 5)The results show that those who took part in the survey preferred the following, respectively, healing environment design for the waiting room in the outpatient clinic at children' hospital: Pleasantness>Easiness in finding one' destination>Artificial materials>Natural materials>Environment like that at home>Co-promotion spaces>Space that supports the patients'activities>Openness>Sociality>Safety/Security>Approachability and Privacy. The results also show that healing conditions respect these preferences.

• 대한한방소아과학회지
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• 제32권1호
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• pp.54-74
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• 2018

Objectives The purpose of this study is to investigate recent trend of diseases in Korean pediatrics and adolescent patients treated with oriental medicine. Methods Using data from the Korean statistical information service and healthcare bigdata hub, top 500 diseases pediatrics and adolescents that were treated with oriental medicine from 2012 to 2016 in admission and outpatient department was collected. Results From the inpatient study, majority of the subjects were between 15 to 19 years old (62.74%), followed by 10 to 14 years old, 5 to 9 years old and under 5 years old. In the outpatient department study, majority was 15 to 19 years old (36.51%), followed by 10 to 14 years old, under 5 years old, 5 to 9 years old. In systemic division of admission part, the most common disease was musculoskeletal related which was 72.32%, followed by brain, nerve, respiratory, dermatology and digestive related diseases. In systemic division of outpatient department, respiratory disease was the most common (41.81%), followed by digestive, dermatology, brain and nerve diseases. For under 5 years old patient group, respiratory disease was the most common, 29.86%, followed by dermatology, musculoskeletal, digestive related diseases. For 5 to 19 years old group of patients, musculoskeletal disease was most common. For the 5 to 14 years old patient group, respiratory related disease was the most common followed by dermatology and digestive diseases. For 15 to 19 years old patient group, digestive disease was the most common followed by respiratory and dermatology related diseases. For under 5 to 9 years old outpatient group, respiratory disease was the most common, and for under 5-year-old group, digestive, growth development, and dermatology disease were common. For the 5 to 9 years old group of patients, musculoskeletal related disease was the most common followed by digestive and dermatology related diseases. For the 10 to 19 years old patient group, musculoskeletal was the most common. For the 10 to 14 years old patient group, respiratory related disease was the most common followed by digestive, dermatology disease. For the 15 to 19 years old patient group, digestive related disease was the most common followed by respiratory, dermatology diseases. Musculoskeletal disease increased every year, in both inpatient and outpatient. Respiratory, brain, nerve, digestive related diseases were generally decreased. In outpatient, respiratory diseases were increased every year but brain, nerve, digestive related diseases were generally decreased. Conclusions More studies about the oriental medicine in chronic disease, such as allergy, metabolic syndrome, in Korean pediatrics and adolescents are needed.

• 보건교육건강증진학회지
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• 제1권1호
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• pp.72-82
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• 1983

The purpose of this study is to provide the basic data necessary for the effective performance of administrative readjustment and demend and suppley medical care service by of analysing the extent of satisfaction of outpatient toward hospital. The subjects of this study are the 832 outpatients (398 male and 434 female) visit to 2 different university hospital in Seoul. The data were collected through self-administered techniques with a structured questionnaire from Oct.21 to Nov. 9, 1982. All the collected data were analyzed by means of percentage, mean and standard deviation. The results were as follows: 1. Those who are between :30 and 39 of age constitute the largest part of them as being 31.7 percent of the whole body. 40.0 percent of them graduated from the college and they take the lergest part of those who answered the questionnaire. 43.3 percent of the patients visit to the hospital by the reason for the reputation of a doctor and they take the largest part of the subjects. 2. The extent of satisfaction for hospital system. The mean extent of satisfaction for hospital system was revealed 2.50 scores, which is evaluated to neutral. The mean extent of satisfaction for waiting time of prescribed medicine presented 1.51 scores, the lowest among the component of hospital system, which is evaluated to high dissatisfaction. 3. The extent of satisfaction for the environment and facilities of hospital. The mean extent of satisfaction for the environment and facilities of hospital was revealed 3.08 scores, which is evaluated to moderate satisfaction. 4. The extent of satisfaction for doctor and other hospital employees. The mean extent of satisfaction for doctor and other hospital employees was revealed 3.05 scores which is evaluated to moderate satisfaction. The mean extent of satisfaction for doctor presented 3.39 scores, the highest among the components of doctor and other hospital employees. 5. The extent of satisfaction for charge of hospital. The mean extent of satisfaction for charge of hospital was revealed 2.74 scores, which is evaluated to neutral. 6. The extent of whole satisfaction for hospital. The mean extent of whole satisfaction for hospital was revealed 2.84 scores which is evaluated to neutral.

• 한국노년학
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• 제31권1호
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• pp.171-188
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• 2011

본 연구는 Andersen의 의료서비스 이용에 관한 행동모형을 근거로 2008년 장애인실태조사 자료를 분석하여 만 65세 이상 장애노인의 외래 및 입원이용에 영향을 미치는 요인을 파악하고자 하였다. 연구방법은 two-part 모델을 활용하여 장애노인의 외래 및 입원 이용 여부에 대해서는 로지스틱 회귀분석을, 의료 이용량 및 의료비 지출에 대해서는 다중 회귀분석을 실시하였다. 분석결과 외래와 입원의 이용에 공통적으로 만성질환과 주관적 건강상태 등의 질병요인의 영향이 유의하였고, 의료비 지출에는 의료보장 유형이 결정적 역할을 하고 있었다. 외래에서는 신장장애를 가졌을 때 이용량과 지출이 높았고, 입원에서는 일상생활의 수행에 도움이 필요할 때 입원일수가 증가하였으며, 심장장애와 호흡기장애를 가진 경우 입원료 지출이 유의하게 높았다. 이상의 결과는 장애노인들에게 만성질환 이환이나 일상생활 활동의 전적인 의존을 예방하는 보건의료 서비스의 제공, 의료이용이 높은 내부 장애를 가진 노인에 대한 지속적 보건관리체계의 구축, 그리고 저소득층 장애노인의 보건 의료 접근성 향상을 위한 경제적 지원의 필요성을 시사한다.

• Clinics in Shoulder and Elbow
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• 제21권4호
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• pp.252-255
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• 2018

A 51-year-old male who is right-handed visited the outpatient for right fingers-drop. The patient's fingers, including thumb, were not extended on metacarpophalangeal joint. The active motion of the right wrist was available. The electromyography and nerve conduction velocity study were consistent with the posterior interosseous neuropathy. Further evaluation was done with the magnetic resonance imaging for finding the space-occupying lesion or any possible soft tissue lesion around the radial nerve pathway. On magnetic resonance imaging, the ganglion cyst, which was about 1.8 cm in diameter, was observed on the proximal part of the superficial layer of the supinator muscle (Arcade of Frohse). The surgical excision was done on the base of ganglion cyst at the base of stalk of cyst which looked to be connected with proximal radioulnar joint capsule. The palsy had completely resolved when the patient was observed on the outpatient department a month after the operation.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권4호
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• pp.47-60
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• 2013

Purpose: This study examines construction core plans for the users of vertical-typed general hospitals to effectivly use the flow line. Methods: The study sampled representative 9 hospitals, calculated the depth value through Convex Map of Space Syntax and Justified Graph according to the determination of form of construction cire, and analyzed its functional connectivity. Results: The analysis of the connectivity between operation core part and emergency part of core space with high importance in the hospitals showed that the types of hospital and hospital have the lowest depth value in the spatial phase diagram, where central treatment part and outpatient part are arranged well vertically. Elevators for patients at these hospitals are close to operation and emergency parts actually separated from the elevators for passengers. For shortening of flow line of patients and private movement environment, however, it is desirable to arrange the elevators for patients to be adjacent to the operation parts and to arrange the emergent patient entrances more effectively to separate them from the flow line of visitors and guardians. Implications: Consideration should be taken into account for the effective flow line design. This study hopefully may serve as a stepping stone for the standard design of horizontal/vertical flow line.