• Health Policy and Management
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• v.7 no.1
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• pp.100-124
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• 1997

In order to suggest the strategies for participation in the PPS(Prospective Payment System), analyses were performed based on variations in utilization pattern and changes in revenues of hospitals in 10 selected KDRGs. The data was collected from the claims data of a tertiary hospital in Kyunggido from September 1, 1995 to August 31, 1996. The studies consisted of 1, 718 inpatients diagnosed for lens procedures, tonsilectomy &/or adenoidectomy, appendectomy with complicated principal diagnosis, Cesarean section, or vaginal delivery without any complications. The resources used in each KDRG were measured including average length of stay, total charges, number of orders, intensity of medical services, frequencies of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders. Then, the changes in hopital revenues due to the composition of medical fee schedules under the PPS were estimated as follows: 1) The variations in average lenght of stay, total charges, number of orders, the intensity of medical services, the frequency of medical services, the rate of non-reimbursable charges, and the rate of non-reimbursable orders among the 10 KDRGs were comparatively small. 2) The average lenght of stay was the longest(6.0 days) for appendectomy with complicated principal diagnosis, while it was the shortest(2.1 days) for two vaginal deliveries. Statistically differences existed in the average length of stay among physicians and among the dates of admission in several KDRGs. 3) The total charges were the highest for lens procedures(1, 716, 000 won), while the lowest charges were for two vaginal deliveries(558, 000 won). Statistically differences in the total charges were found among physicians in several KDRGs: however, there were no differences with the dates of admission. 4) The number of orders was the greatest(155) for appendectomy with complicated principal diagnosis, while it was the smallest(75) for the two vaginal deliveries. Statistical differences in the number of orders did not exist among physicians in the KDRGs. 5) Significant differences were found in the intensity of medical services, and in the frequency of medical services among physicians in the KDRGs. 6) The rate of non-reimbursable charges for each KDRG was not related to the rate of non-reimbursable orders. The rate of non-reimbursable orders was the highest(36.0%) for lens procedures, while the lowest rate(11.6%) was for appendectomy with complicated principal diagnosis. The rate of non-reimbursable charges was the highest(39.4-39.7%) for vaginal deliveries, while the lowest rate(13.1%) was for tonsillectomy &/or adenoidectomy(<17 ages). 7) If the physician's practicing style were not change under the PPS, the hospital revenuses could be increased by 10%, and the portion of patient payment could be decreased by 1.4-22.4%. However, the non-reimbursable charges for showed little change between two reimbursement systems. Based upon the above findings, this hospital could be eligible for participation in the PPS(Prospective Payment Systm). However, the process of diagnosis and treatment should be standardized, inentifying methods to reduce cost and to assure quality of medical care. Furthermore, consideration should be given to finding ways to increase patient volume.

• Economic and Environmental Geology
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• v.40 no.4
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• pp.473-490
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• 2007

Strata of the Kachi-1 well, Kunsan Basin, offshore western Korea, were analyzed by using integrated stratigraphy approach. As a result, five distinct unconformity-bounded units are recognized in the well: Triassic, Late Jurassic-Early Cretaceous, Early Cretaceous, Late Cretaceous, and Middle Miocene units. Each unit represents a tectono-stratigraphic unit that provides time-sliced information on basin-forming tectonics, sedimentation, and basin-modifying tectonics of the Kunsan Basin. In the late Late Jurassic, development of second- or third-order wrench faults along the Tan-Lu fault system probably initiated a series of small-scale strike-slip extensional basins. Continued sinistral movement of these wrench faults until the Late Cretaceous caused a mega-shear in the basin, forming a large-scale pull-apart basin. However, in the Early Tertiary, the Indian Plate began to collide with the Eurasian Plate, forming a mega-suture zone. This orogenic event, namely the Himalayan Orogeny, continued by late Eocene and was probably responsible for initiation of right-lateral motion of the Tan-Lu fault system. The right-lateral strike-slip movement of the Tan-Lu fault caused the tectonic inversion of the Kunsan Basin. Thus, the late Eocene to Oligocene was the main period of severe tectonic modification of the basin. After the Oligocene, the Kunsan Basin has maintained thermal subsidence up to the present with short periods of marine transgressions extending into the land part of the present basin.

• The Korean Society of Law and Medicine
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• v.9 no.1
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• pp.385-411
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• 2008

The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

• Journal of Trauma and Injury
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• v.24 no.2
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate the quality of the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency intensive care unit (ICU) in consultation with intervention radiologists and surgeons. Methods: This was a retrospective observational study conducted in an emergency ICU of a tertiary referral hospital. We enrolled consecutive patients who had been admitted to our emergency ICU with major trauma from March 2007 to September 2010. We collected data with respect to demographic findings, mechanisms of injury, the trauma and injury severity score (TRISS), emergency surgery, angiographic intervention, and 6-month mortality. Then, we compared the observed and predicted survivals of the patients. The Hosmer-Lemeshow test and calibration plots by using 10 groups, one for each decile, of predicted mortality were used to evaluate the fitness of TRISS. P-values of greater than 0.05 represent a fair calibration. Results: Among 116 patients, 12 (10.34%) were dead within 6 months after admission to the ICU, and 29 (25.00%) and 38 (32.80%) patients received emergency surgery and angiographic intervention, respectively. The mean injury severity score and revised trauma score were $36.97{\pm}17.73$ and $7.84{\pm}6.75$, respectively. The observed survival and the predicted survival of the TRISS were 89.66% (95% confidence interval [CI]: 84.03~95.28%) and 69.85% (95% CI: 63.80~75.91%), respectively. The calibration plots showed that the observed survival of our patients was consistently higher than the predicted survival of the TRISS ($p$ <0.001). Conclusion: The observed survival for the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency ICU in consultation with intervention radiologists and surgeons, was higher than the predicted survival of the TRISS.

• Journal of Christian Education in Korea
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• v.63
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• pp.13-37
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• 2020

The World Health Organisation(WHO), paying attention to the spread and fatality of the coronavirus(COVID-19), which first occurred in Wuhan, China, declared a global emergency. Although many countries implement strict measures to slow down the spread, WHO officially declared a pandemic. COVID-19 has sparked fears of an impending economic crisis and recession. Due to the economic crisis caused by social distancing, self-isolation and travel restrictions, the collapse of the world economic system centered on free trade and the decline of globalization are mentioned. Political leadership that has not responded properly to the pandemic is challenged, and nearly all of society is rapidly changing to a non-contact and immobile culture. COVID-19 has seriously affected all levels of the education system, from preschool to tertiary education. The so-called old concept of deschooling is realizing in the field of education through digital media paradoxically. Church education is facing a serious crisis as well. Churches are seeking now a new normal that includes theological reflection on the pandemic, online worship, education, and non-face-to-face ministry to overcome the worst unexpected crisis. In the post-corona era, church education must actively seek alternatives in response to rapidly changing surrounding conditions and reconstruct educational philosophy(theology) that focuses on Christian values. In addition, it is necessary to start operating a mobile(or online) church school that combines offline and online. It is necessary to introduce 'Blended Learning' method that combines non-face-to-face and face-to-face learning, and by combining church school and homeschooling, churches and families need to share the responsibility of education in faith.

• Journal of Astronomy and Space Sciences
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• v.28 no.3
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• pp.163-172
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• 2011

An intensive analysis of 185 timings of WZ Cep, including our new three timings, was made to understand the dynamical picture of this active W UMa-type binary. It was found that the orbital period of the system has complexly varied in two cyclical components superposed on a secularly downward parabola over about 80y. The downward parabola, corresponding to a secular period decrease of $-9.{^d}97{\times}10^{-8}y^{-1}$, is most probably produced by the action of both angular momentum loss (AML) due to magnetic braking and mass-transfer from the massive primary component to the secondary. The period decrease rate of $-6.^{d}72{\times}10^{-8}y^{-1}$ due to AML contributes about 67% to the observed period decrease. The mass flow of about $5.16{\times}10^{-8}M_{\odot}y^{-1}$ from the primary to the secondary results the remaining 33% period decrease. Two cyclical components have an $11.^{y}8$ period with amplitude of $0.^{d}0054$ and a $41.^{y}3$ period with amplitude of $0.^{d}0178$. It is very interesting that there seems to be exactly in a commensurable 7:2 relation between their mean motions. As the possible causes, two rival interpretations (i.e., light-time effects (LTE) by additional bodies and the Applegate model) were considered. In the LTE interpretation, the minimum masses of $0.30M_{\odot}$ for the shorter period and $0.49M_{\odot}$ for the longer one were calculated. Their contributions to the total light were at most within 2%, if they were assumed to be main-sequence stars. If the LTE explanation is true for the WZ Cep system, the 7:2 relation found between their mean motions would be interpreted as a stable 7:2 orbit resonance produced by a long-term gravitational interaction between two tertiary bodies. In the Applegate model interpretation, the deduced model parameters indicate that the mechanism could work only in the primary star for both of the two period modulations, but could not in the secondary. However, we couldn't find any meaningful relation between the light variation and the period variability from the historical light curve data. At present, we prefer the interpretation of the mechanical perturbation from the third and fourth stars as the possible cause of two cycling period changes.

• Journal of Nutrition and Health
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• v.34 no.4
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• pp.458-471
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• 2001

To evaluate the infra structure supporting hospital nutrition services, we conducted a survey on the unit of organization, unit of dietitians work system, number of personnel engaged on nutrition services, productivity of food service, management of dietitians works, computerization of nutrition services etc. Total ninety-six hospitals were participated in the survey, and they were varied in terms of hospital classification, location, number of beds and type of food service management. All of the large hospitals with more than 400 beds conducted nutrition services under the department of nutrition, but some of the middle and small hospitals with less than 400 beds conducted nutrition services under the other department such as administration. In most of the tertiary hospitals, the work of dietitians were separated in which food services and medical nutrition services were conducted independently by different dietitians, whereas, in most of general hospitals and all the hospital, food services and medical nutrition services were conducted by the same dietitians in all time. The numbers of dietitians and cooks per 100 beds were fewer in the large hospitals with more than 400 beds than the hospitals with less than 400 beds, and the number of cooking and meal serving assistants were the just opposit. The average productivity of food service was 44.5 meals per hour for each dietitian, 84.8 meals per hour for a cook and 7.0 meals per hour for a cooking and meal serving assistant. The productivities for dietitians and cooks tend to be higher in large hospitals than middle and small hospitals, whereas the productivities for cooking and meal serving assistants were just opposite. The large hospitals seemed to solve the problem on the lack of working personnels by hiring part-time workers and by utilization of computer system for their works. The pattern of daily work management in food service area was not much different between dietitians duties, but the pattern of daily work management in medical nutrition service area was different in a way which the analysis of patients nutrient intakes was almost not conducted by dietitians handling both food services and medical nutrition services. Therefore, this study demonstrates that there are significant differences in the infra structures conducting nutrition services among hospitals, suggesting that the strategies to improve this improve this structure in relation to the improvement of service qualities need to be investigated in the future. (Korean J Nutrition 34(4) : 458∼471, 2001)

• Journal of Astronomy and Space Sciences
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• v.23 no.2
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• pp.105-116
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• 2006

New eight times of minimum light of the near-contact binary EG Cep were presented. All times of minimum light for EG Cep, including ours, were collected and analyzed to study it's orbital period variation. It was found that the orbital period have varied in a cyclical way superposed on an upward parabola. A secular period increase of $3.22{\times}10^{-8}d/y$ was calculated. Under the assumption of a conservative mass transfer, it implied that the stellar gaseous material of about $3.18{\times}10^{-8}M_{\odot}$ /year is transferring from the less massive secondary component to the primary. The cyclical period variation was interpreted as light-time effect due to an unseen third body in the system. The resultant period, semi-amplitude and eccentricity of the light time orbit were calculated to be $38.^y4,\;0.^d0034$ and 0.29, respectively. The mass range of the tertiary proposed in the system is deduced to be quite small as $0.10M_{\odot}{\leq}M_3{\leq}0.21M_{\odot}$ for $i_3{\geq}30^{\circ}$.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.6
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• pp.1590-1596
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• 2007

Complementary and alternative medicine (CAM) has gained in popularity among cancer patients in recent years. The use of CAM in cancer patients is common with about one third of patients using some form of CAM in Western countries. The purpose of this study was to analyze the use of CAM and determine what factors affect to use CAM among cancer patients to provide CAM therapy information and assist therapy selection among various CAM therapies to cancer patients. The design of the study was descriptive cross-sectional, and data were collected using a 16-item questionnaire. This study was conducted in subjects with confirmed diagnosis of stomach, colon, liver, or pancreas cancer, in both out-patients clinics and inpatients setting in a tertiary hospital in Seoul Korea. As a result, among the participants, past or current CAM use was reported by 75%, which shows a statistically significant difference in income groups(P<0.05), but no difference in age and religion groups. The most common therapies use by cancer patients included traditional Korean medicine (32.1%), folk remedies (26.6%), exercise (14%), dietary supplements (11.6%), physical therapy (9.9%), diet therapy (5%), and meditation (4%). 77.8% of patients show satisfaction and 64.4% shows perceived effectiveness of CAM. Male patients with higher income, and previous treatment were more likely to use CAM. The main benefits from CAM reported by cancer patients were psychological improvement and symptom improvement. Of the cancer patients used CAM, 30.9% were dissatisfied, 25.8% did not have benefits from the use, and 7.6% experience side effects. Cancer patients who prefer CAM (more than 3 kinds) used it to cure cancer, on the contrary, the one who do not prefer CAM used to improve symptoms and psychological stability. The main sources of information about CAM were family and friends(54.4%), and media(24.5%), doctor and nurse(18.3%), and religion group(2.6%). Findings suggest that due to the relatively high use of CAM among cancer patients in Korea, this topic should be taken into account in the development of a holistic approach to cancer patients and efficient cancer patients management system and proactive and consistent management of CAM is necessary in the health care system in Korea.

• Journal of Korean Academy of Nursing
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• v.20 no.1
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• pp.16-37
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• 1990

A cost analysis for hospitalized patients was carried out based upon Patient Classification System(PCS) in order to determine an appropriate nursing fee. The data were collected from 21 nursing units of three teaching hospitals from April 1 to June 30, 1989. first, all of the 22,056 inpatients were classified into mildly ill(Class Ⅰ), moderately ill(Class Ⅱ), acutely ill(Class Ⅲ), and critically ill(Class Ⅳ) by the PCS which had been carefully developed to be suitable for the Korean nursing units. Second. PCS cost accounting was applied to the above data. The distribution of inpatients, nursing costs, and nursing productivity were as follows : 1) Patient distribution ranged from 45% to class Ⅰ, 36% to class Ⅱ, 15% to class Ⅲ, and 4% to class Ⅳ, the proportion of class Ⅳ in ‘H’ Hospital was greater than that of the other two hospitals. 2) The proportion of Class Ⅲ and Ⅳ in the medical nursing units was greater than that of surgical nursing units. 3) The number of inpatients was greatest on Tuesdays, and least on Sundays. 4) The average nursing cost per hour was W 3,164 for ‘S’ hospital, W 3,511 for ‘H’ hospital and W 4,824 for ‘K’ hospital. The average nursing cost per patient per day was W 14,126 for ‘S’ Hospital, W 15,842 for ‘H’ hospital and W 21,525 for ‘K’ hospital. 5) The average nursing cost calculated by the PCS was W 13,232 for class Ⅰ, W 18,478 for class Ⅱ, W 23,000 for class Ⅲ, and W 25,469 for class Ⅳ. 6) The average nursing cost for the medical and surgical nursing units was W 13,180 and W 13,303 respetively for class Ⅰ, W 18,248 and W 18,707 for class Ⅱ, W 22,303 and W 23,696 for class Ⅲ, and W 24,331 and W 26,606 for class Ⅳ. 7) The nursing costs were composed of 85% for wages and fringe benefits, 3% for material supplies and 12% for overhead. The proportion of wages and fringe benefits among the three Hospitals ranged from 75%, 92% and 98% for the ‘S’, ‘H’, ‘K’ hospitals respectively These findings explain why the average nursing cost of ‘K’ hospital was higher than the others. 8) According to a multi- regression analysis, wages and fringe benefits, material supplies, and overhead had an equal influence on determining the nursing cost while the nursing hours had less influence. 9) The productivity of the medical nursing units were higher than the surgical nursing units, productivity of the D(TS) - nursing units was the lowest while the K(Med) - nursing unit was the highest in 'S' hospital. In ‘H’ hospital, productivity was related to the number of inpatients rather than to the characteristics of the nursing units. The ‘K’ hospital showed the same trend as ‘S’ hospital, that the productivity of the medical nursing unit was higher than the surgical nursing unit. The productivity of ‘S’ hospital was evaluated the highest followed by ‘H’ hospital and ‘K’ hospital. Future research on nursing costs should be extended to the other special nursing areas such as pediatric and psychiatric nursing units, and to ICU or operating rooms. Further, the PCS tool should be carefully evaluated for its appropriateness to all levels of institutions(primary, secondary, tertiary). This study took account only of the quantity of nursing services when developing the PCS tool for evaluating the productivity of nursing units. Future research should also consider the quality of nursing services including the appropriateness of nursing activities.