• 한국석유지질학회:학술대회논문집
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• autumn
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• pp.55-55
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• 2001

• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.184-185
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• 2002

• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.99-109
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• 2022

Purpose: More than 60% of patients with advanced cancer experience pain, and uncontrolled pain reduces the quality of life. Nurses are the closest healthcare providers to the patient and are suitable for managing cancer pain using pharmacological and non-pharmacological interventions. This study aimed to identify factors affecting the performance of cancer pain management among nurses. Methods: This study was conducted among 155 participating nurses working at a tertiary hospital who had experience with cancer pain management. Data collection was performed between October 18, 2021 and October 25, 2021. Data analysis was conducted using descriptive statistics, the independent-sample t-test, one-way analysis of variance, and hierarchical regression analysis. Results: There were 110 subjects (71.0%) who had no experience of cancer pain management education. The results of regression analysis indicated that barriers included medical staff, patients, and the hospital system for cancer pain management (𝛽=0.28, P<0.001). The performance of cancer pain management was also affected by experience of cancer pain management training (𝛽=0.22, P=0.007), and cancer pain management knowledge (𝛽=0.21, P=0.006). The explanatory power of the variable was 16.6%. Conclusion: It is crucial to assess system-related obstacles, as well as patients and medical staff, in order to improve nurses' cancer pain management performance. A systematic approach incorporating multidisciplinary interventions from interprofessional teams is required for effective pain management. Furthermore, pain management education is required both for cancer ward nurses and nurses in other wards.

• Korea Journal of Hospital Management
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• v.28 no.1
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• pp.1-13
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• 2023

Purpose: This study purposed to analyze the economic feasibility of introducing a third party logistics system as a strategic alternative to hospital management. Methods: Economic analysis was performed by measuring changes in costs and benefits before and after implement the third party logistics system and estimating the size of net benefits for the next five years for the target hospital. A questionnaire survey and in-depth interview with stake-holders were conducted to find out the satisfaction and effectiveness of the system. Findings: According to results, the cost-benefit ratio for the implementation of the system was 1.18. For the next five years, the cost-benefit ratio was 1.48, the net present value was about 1.7 billion won, and the internal rate of return was 64%. The satisfaction of internal stake-holders was relatively high, in terms of improving the concentration of unique tasks and increasing the efficiency of inventory management. Practical Implications: It was found that the increase in benefits had a greater effect on the change in the cost-benefit ratio than the increase in costs resulting from the expansion of logistics, and the increase in the present value of net benefits gradually decreased as the cost increased. In addition, overall job satisfaction and satisfaction with outsourcing companies were relatively low, which means that stabilization of the new system is important. Further study is needed for more accurate economic analysis.

• Journal of the Korean Society of Manufacturing Technology Engineers
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• v.5 no.3
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• pp.66-72
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• 1996

The applicability of a new method, termed the whirling motion concept, for the improvement of the surface finish in milling three-dimensional sculptured surfaces has been investigated. A method for implementing this concept o conventional NC machines that utilize a suitably configured attachment has been proposed. The tool path equation for the ball-end milling process, based on the surface-shaping system, has been obtained. Both results of the computer simulation and the experiment verified the proposed approach.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3541-3547
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• 2013

Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.88-104
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• 2002

According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

• The KIPS Transactions:PartD
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• v.11D no.7 s.96
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• pp.1517-1526
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• 2004

Entering the post genome era with an increasing amount of protein data available in public databases, the study of tertiary structure of pro-teins has been artively in progress. To analyze the structure of a protein effectively, it is necessary to visualize the tertiary structure of a protein. Rececntly, many visualization tools based on Java technology have been developed to visualize a protein whose structure has been known. In this paper, we describe a new protein visualization system, named JProtein. It is designed to be an easy-to-use, platform neutral melocular visualization tool. The JProtein system is developed using Java3D technology. Java3D is an API providing a programming interface for 3D representations. The system informs us the angle and the distance of the interacting atoms in amino acids which are visualized, providing several 3D representation models of a protein molecule. In particular, the JProtein system presents synchronous stereo view as well as asynchronous one.

• Korean Institute of Interior Design Journal
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• v.17 no.4
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• pp.92-101
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• 2008

A new paradigm of design lays stress on the world of metaphysical concepts, and various attempts are being made to give meaning to psychological values. Hotel is a memorable place to remind of a special moment in one's life such as travel, marriage, meeting and so on. It also contains even more symbolism than other spaces as it is the place where the most primary and private act takes place apart from one's residence. As a result, it is also possible to communicate the message which a designer intends to convey through the user's recognition in the form of various symbolic expressions in space design. The designer communicates a meaning into a space through a symbolic system and creates a mutual consensus by means of the understanding structure of "designer-space-user". The user's diverse interpretations through a symbol are based on epistemology and consist of the primary, the secondary and the tertiary recognition structure system in the aspect of their contents. The primary structure depends on sensual perception, impressive idea and transcendental recognition based on metaphysical and perceptional association. The secondary structure includes casualty, continuous deduction and rational(integral) recognition. Finally, the tertiary structure is sublimation to the transcendental mental world beyond the boundary of emotion and it is classified into fundamental recognition structure on an object and archetypical recognition structure on an ego. These characteristics can derive systematic understandings and diverse interpretations on the symbol from the space of a hotel through the frame of analysis based on the artistic form of monosemous, polysemous and multidimensional frameworks and symbols. The framework of this analysis includes all the cases, and various methods which haven't been attempted in practice are presented. Therefore this study is not just a simple analysis of space but rather it will serve as a methodological tool for design that allows for various attempts of symbolic design concepts in the recognition structure system.