• 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.

• Journal of Korean Society of Transportation
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• v.26 no.3
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• pp.233-243
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• 2008

Recognition for the importance and roles of public transportation is increasing because of traffic problems in many cities. In spite of this paradigm change, previous researches related with public transportation trip assignment have limits in some aspects. Especially, in case of multimodal public transportation networks, many characters should be considered such as transfers. operational time schedules, waiting time and travel cost. After metropolitan integrated transfer discount system was carried out, transfer trips are increasing among traffic modes and this takes the variation of users' route choices. Moreover, the advent of high-technology public transportation card called smart card, public transportation users' travel information can be recorded automatically and this gives many researchers new analytical methodology for multimodal public transportation networks. In this paper, it is suggested that the methodology for establishment of brand new multimodal public transportation networks based on computer programming methods using transportation card data. First, we propose the building method of integrated transportation networks based on bus and urban railroad stations in order to make full use of travel information from transportation card data. Second, it is offered how to connect the broken transfer links by computer-based programming techniques. This is very helpful to solve the transfer problems that existing transportation networks have. Lastly, we give the methodology for users' paths finding and network establishment among multi-modes in multimodal public transportation networks. By using proposed methodology in this research, it becomes easy to build multimodal public transportation networks with existing bus and urban railroad station coordinates. Also, without extra works including transfer links connection, it is possible to make large-scaled multimodal public transportation networks. In the end, this study can contribute to solve users' paths finding problem among multi-modes which is regarded as an unsolved issue in existing transportation networks.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.24-30
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• 2009

Purpose: Today, Prostate cancer has been gradually increasing, according to the change of internal incidence rate of cancer. Generally, prostate cancer has lead to dead over 90%, in case of metastasis of lymph node and bone. So, innovative development of new radiopharmaceutical and imaging modality is progressed for detection of that metastasis, in nuclear medicine, now. Therefore, this study shows the usefulness of $^{18}F$-Fluoride PET/CT improved diagnosability on bone metastasis of prostate cancer. Materials and Methods: In this study, 33 male patients with prostate cancer were examined (The mean age: $67.8{\pm}10.2$ years old). Every patient was done each whole body bone scan (WBBS) and $^{18}F$-Fluoride positron emission tomography/computed tomography ($^{18}F$-Fluoride PET/CT). And then, using Receiver Operating Characteristic Curve (ROC curve), each sensitivity and specificity of two modalities was measured and compared with. Results: In 22 patients (66.6%) of all, bone metastasis was detected. And, in WBBS, sensitivity was 63.6%, specificity, 81.8%; in $^{18}F$-Fluoride PET/CT, sensitivity was 100% and specificity was 90.9%. As a result of ROC curve, AUROC (The Area under an ROC) of WBBS was 0.778, and that of $^{18}F$-Fluoride PET/CT, 0.942. Conclusions: $^{18}F$-Fluoride PET/CT was higher both sensitivity and specificity than WBBS, and it was valuable to detect bone metastasis of prostate cancer more definitely, with 3D imaging realization. Also, in $^{18}F$-Fluoride PET/CT, physiological images were acquired in more short time than WBBS, so, it was possible to reduce patient's waiting time and complaint. Therefore, it is considered that $^{18}F$-Fluoride PET/CT is able to improve diagnosability by offering more accurate images, as cuts in a share of high cost.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.4-17
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• 2000

Purpose : This study aimed to investigate and to evaluate the present conditions of hospice programs in Korea for supplying data useful in making policy in hospice, which is not institutionalized yet. Method : For this purpose we surveyed 59 hospice programs regarding the general characteristics, manpower, patients, services, financial conditions, and facilities. Thirty-seven hospice programs answered the questionnaires. Result : They were 11 tertiary hospitals, 11 other hospitals, 3 clinics, 12 home care hospice, and 1 freestanding hospice. Only 9 hospice programs have all of the essential professionals: physicians, nurses, social workers, clergies, and volunteers. In some hospice programs, volunteers who had not been trained for hospice provided services to terminal patients. More than half of the hospice said they provided services to the patients who lost their consciousness and were not suitable for hospice care. 16% of the hospice said they did not keep the patients' record. Some hospitals including tertiary hospitals provided such intensive care as radiotherapy, TPN, injections to hospice patients. Many hospice programs other than hospitals didn't charge patients for hospice care. 60% of the hospice said they suffered from financial problems. Most of the hospice wards were not built for hospice use at first. So they did not have such supplementary facilities as dayroom, waiting room, special bathing facilities etc. Conclusion : For improving the quality of terminal patients and promoting the cost effective use of health care resources, it is necessary to consider the institutionalization of hospice. The institutionalization of hospice programs can improve the quality of hospice care and the standardization of the hospice program can hasten its institutionalization.

• Korean Journal of Heritage: History & Science
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• v.55 no.1
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• pp.281-304
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• 2022

Heungdeokjeon was the first pavilion built on the site of Sueocheong during the expansion of Gyeongungung. In this study, we tried to clarify the specific construction process of Heungdeokjeon, which was used for various purposes such as the copy location for Portraits of ancestors, temporary enshrinement site, and the funeral building for the rest of the body, which is Binjeon. In addition, we tried to confirm the historical value based on the characteristics derived by the history of the building and the rituals performed. Heungdeokjeon began to be built in the second half of 1899, and is estimated to have been completed between mid-February and mid-March 1900. It was a ritual facility equipped with waiting rooms for the emperor and royal ladies as an annex. The relocation work was planned in April 1901 and began in earnest after June, and it was closely linked to the construction of attached buildings of Seonwonjeon. In addition, comparing the records on the construction and relocation cost of Heungdeokjeon with those related to the reconstruction of Seonwonjeon, it was confirmed that annex buildings of Heungdeokjeon were relocated and used as annex buildings of Seonwonjeon. The characteristics identified in the process of Heungdeokjeon used as a place to copy portraits are as follows. First, it was used as a place to copy portraits twice in a short period of time. Second, it was the place where the first unprecedented works were carried out in relation to the copying of portraits. Third, the pavilion, which was specially built for imperial rituals, was used as a place to copy portraits. Since then, it has been used as a funeral building for the rest of the body, and features different from those of the previous period are identified. It was the building dedicated to rituals for use as Binjeon, and was also a multipurpose building for copying portraits. In other words, Heungdeokjeon, along with Gyeongbokgung Taewonjeon, is the building that shows the changes in the operation of Binjeon in the late Joseon Dynasty. Characteristics are also confirmed in portrait-related rituals performed at Heungdeokjeon. The first is that Jakheonlye was practiced frequently in a short period of time. The second is that the ancestral rites of Sokjeolje and Bunhyang in Sakmangil, which are mainly held in the provincial Jinjeon, were identified. This is a very rare case in Jinjeon of the palace. The last is that Jeonbae, jeonal, and Bongsim were implemented mutiple times. In conclusion, Heungdeokjeon can be said to be a very symbolic building that shows the intention of Gojong, who valued imperial rituals, and the characteristics of the reconstruction process of Gyeongungung.