• Health Policy and Management
• /
• v.21 no.4
• /
• pp.527-540
• /
• 2011

Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.

• The Korean Journal of Health Service Management
• /
• v.8 no.3
• /
• pp.13-25
• /
• 2014

This research was performed to investigate the characteristics and determination factors on tertiary hospital inpatients. The used data was the four waves of Korea Health Panel(2008, 2009, 2010, 2011), and the number of subjects was 4,430 cases of tertiary and general hospital admission. The statistical methodology used in the study is the logistic regression model. The significant affecting factors in utilizing tertiary hospital admission were gender, marital status, education, household income, residence region and ICD-10 classification. Man, graduating college/university, married, high-income were socio-economic affecting factors in tertiary hospital admission. Medical need factor of ICD-10 classification and residence region of inpatients was also significant affecting factors in tertiary hospital admission. The 81.4% of inpatients at tertiary hospital had chronic disease and the 12.9% of inpatients readmitted, the 68.2% had a selecting doctor and the only 26.7% of inpatients reinforced by private medical insurance. This study recommended the Korean government to provide proper rule for tertiary hospital admission in order to improve the equity and efficiency of health care system.

• The Korean Journal of Health Service Management
• /
• v.6 no.4
• /
• pp.83-98
• /
• 2012

The objective of this study is to analyze the utilization patterns of national health insurance and medical aid inpatients in tertiary hospitals. For the analysis, the study utilize the nationwide data on '2010 Survey of Patients' of Ministry of Health & Welfare. The statistical methodology used in the study is the logistic regression model. This study has three major findings. First, utilization rate of national health insurance inpatients was higher than medical aid inpatients in tertiary hospitals. Second, the significant affecting demographic factors in utilizing tertiary hospitals were sex, age, surgery case, treatment result, inpatients residence region and short length of stay. Third, compared to other disease groups, the inpatients on 'congenital malformation, deformity and chromosomal abnormalities', 'factors influencing health status and contact with health services' and 'neoplasm' groups are more likely to utilize tertiary hospitals. Finally, according to residence region, Seoul residence inpatients in both of national health insurance and medical aid more likely to utilize tertiary hospitals than other region inpatients.

• Bulletin of the Korean Chemical Society
• /
• v.14 no.6
• /
• pp.732-739
• /
• 1993

Good yields were usually obtained in Pd(O)-catalyzed Suzuki aryl-aryl coupling reaction, even when both coupling partners had an ortho tertiary benzamide functional group. The direct ortho functionalization of oligomeric tertiary benzamides at Snieckus condition is dependent on the chain length. Tertiary benzamide 1 can be o,o-dilithiated only by metal-halogen exchange of the 2,6-dihalo-compound. Bis-tertiary benzamide 9 can be o,o'-dilithiated with excess(4.1 equivalents) s-butyllithium/TMEDA as the lithiating agent. Tris-tertiary benzamide 21 is hard to o,o"-difunctionalize due to steric interactions among the tertiary benzamide functional groups, and due to steric interactions between these functional groups and others (if present) on the termini of the terphenyl unit.

• Proceedings of the Korean Information Science Society Conference
• /
• 2000.10c
• /
• pp.44-46
• /
• 2000

본 논문은 Tertiary 저장장치를 이용한 대용량 비디오 서버의 설계와 구현에 대해서 기술한다. 서버는 서비스와 프로세스 관리 서브시스템, 자원 관리 서브시스템, 입출력 관리 서브시스템의 세 부분으로 구성된다. 입출력 대역폭이 낮은 Tertiary 저장장치의 효율적인 사용을 위해 디스크 캐쉬 풀 모델을 사용하고, 적절한 스케줄링 정책과 캐슁 알고리즘을 이용하여 가능한 많은 사용자를 수용한다. 서버는 Windows 2000에서 시스템 서비스로 구현되었으며 디스크 캐쉬의 효과적인 사용으로 Tertiary 저장장치의 낮은 대역폭을 최대한 활용하여 접속된 사용자에게 안정된 비디오 스트리밍 서비스를 제공한다.

• Proceedings of the KIEE Conference
• /
• 2001.07a
• /
• pp.458-460
• /
• 2001

This paper described the unbalanced voltage on the tertiary bus of a single Phase auto transformer in the case of parallel operation with different manufacturer at each Phase. The unbalanced capacitances between primary to secondary winding, secondary to tertiary winding and primary to tertiary winding makes unbalanced bus voltage in the tertiary bus side. The unbalanced voltage let the surge arrester to operate in the power frequency range, and it causes the arrester to burn out. The failure of the arrester at one phase makes line to ground fault, which lead to the surge arrester failure of the other two phase on the tertiary bus.

• Korea Journal of Hospital Management
• /
• v.26 no.1
• /
• pp.55-70
• /
• 2021

Purpose: The purpose of this study was to examine the influencing factors of the patient leaning phenomenon in tertiary hospitals. Based on the results of this study, we intended to find implications for improving the problems of the delivery system imbalance in tertiary hospitals caused by patient leaning phenomenon. Methodology/Approach: Qualitative studies were conducted, using focus group interviews and in-depth interviews. The focus group interviews were conducted for 12 users of tertiary hospitals by 2 groups. And in-depth interviews were conducted for 6 tertiary hospital managers. This was considered to be the most effective approach to gather diverse and in-depth information about the influencing factor of patient leaning phenomenon in tertiary hospitals. Findings: In focus group interviews, the reason for choosing tertiary hospitals was the reliability of the hospital(physician, reputation, etc.). And the effect of the policy to strengthen coverage of National Health Insurance and private medical insurance was relatively small. In other words, we found that the individual's desire to receive medical services suitable for one's health status and disease condition was the biggest factor, rather than the cost and policy factors. Practical Implications: We suggested that the appropriate medical care provision should be strengthened according to the role and function of medical institutions. In addition, the education system needs to be reorganized to activate the referral program, expand community medical capabilities, and foster quality primary medical care.

• Clinical and Experimental Reproductive Medicine
• /
• v.39 no.3
• /
• pp.95-106
• /
• 2012

It has been revealed that multiple cohorts of tertiary follicles develop during some animal estrous cycle and the human menstrual cycle. To reach developmental competence, oocytes need the support of somatic cells. During embryogenesis, the primordial germ cells appear, travel to the gonadal rudiments, and form follicles. The female germ cells develop within the somatic cells of the ovary, granulosa cells, and theca cells. How the oocyte and follicle cells support each other has been seriously studied. The latest technologies in genes and proteins and genetic engineering have allowed us to collect a great deal of information about folliculogenesis. For example, a few web pages (http://www.ncbi.nlm. nih.gov; http://mrg.genetics.washington.edu) provide access to databases of genomes, sequences of transcriptomes, and various tools for analyzing and discovering genes important in ovarian development. Formation of the antrum (tertiary follicle) is the final phase of folliculogenesis and the transition from intraovarian to extraovian regulation. This final step coordinates with the hypothalamic-pituitary-ovarian axis. On the other hand, currently, follicle physiology is under intense investigation, as little is known about how to overcome women's ovarian problems or how to develop competent oocytes from in vitro follicle culture or transplantation. In this review, some of the known roles of hormones and some of the genes involved in tertiary follicle growth and the general characteristics of tertiary follicles are summarized. In addition, in vitro culture of tertiary follicles is also discussed as a study model and an assisted reproductive technology model.

• Journal of Preventive Medicine and Public Health
• /
• v.52 no.1
• /
• pp.41-50
• /
• 2019

Objectives: The aim of this study was to investigate cancer patients' utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013. Methods: This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul). Results: The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect. Conclusions: The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

• Economic and Environmental Geology
• /
• v.9 no.1
• /
• pp.1-11
• /
• 1976

It is believed that geological survey, drilling and geophysical survey which was carried out on Tertiary deposits in Pohang is a valuable but through the studying of many Tertiary sediments in Japan discovered many questions on analysis of final report prepared by National geological survey. The main reason is: 1. The seismic sound velocity which have regulated in the final report prepared by geological survey for Tertiary deposits in Pohang was 1,500-2,000m/sec in spite of oil bearing sediments of same age in Japan are 2,000-3,800m/sec. These may means the requirement of reconsideration of seismic velocity for Tertiary deposits in Pohang and required to have a dipper drilling. 2. Stratigraphically, geophysically, and paleontologically, the Tertiary deposits in Pahang land area is similar with that of Nishiyama-Hunakawa formations of Akita oil field in Japan. Nishiyama-Hunakawa formation is the main oil bearing formation in Japan. 3. Those valcanic rock including andestitic rock and liparitic rock which have extensively distributed over either at land area or at sea bottom, assumed by geological survey as the base of Tertiary sediments. But in case of Japan many oil bearing deposits are in over laid by these kind of volcanic rock. Therefore a possible of same condition with Japan is presumable on Tertiary sediments in Pohang. 4. It is believed that the Tertiary sediments of land area in Pohang is the extension of offshore basin but is wandering that the final report submitted by geologic survey have not remain any word on report of ECAFE discribed so much problematics as followed: A. Although it was assumed that no great thickness exceeding 1,000 meters, or major structures would be encountered in the Tertiary offshore sequence, it was hoped that shallow hydrocarbon deposits might be found, because these sediment are lithologically similar to those of the same age in the producing area of the northwest Honshu region of Japan where hydrocarbon are extracted from depths of only 500 to 600 meters. B. Four possible hydrocarbon trap conditions are represented in the survey area: anticlinal folds, faults, pinch outs, along the igneous basement and lateral facies changes. C. Most of the prime possible reservoir area are beyond the 50 meter water depth mark, except for the structures in Yonil Bay. D. Despite the shallowness of the offshore basin, sufficient trap condition exist in the area to warrant further exploration for hydrocarbon. 5. All of the problems mentioned above have gave us a strong reasons to have us hesitating to make a final conclusion on Tertiary problems in Pohang, before to have a drill to a depth to 3,000 meters or more whatever it is the Tertiary or a Mesozoics below 1,000 meters.