• Journal of Preventive Medicine and Public Health
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• v.23 no.4 s.32
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• pp.451-464
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• 1990

The variation in resource utilization for hospitalized patients who had a group of similar diseases -- a Korean Diagnosis Related Group (KDRG) -- among the same type of hospitals was studied to assess the utillization variation due to the practice pattern of hospitals. Information about inpatients who were beneficiaries of the medical insurance for teachers and government officials discharged from 20 large university teaching hospitals in Seoul during 1986 and information about the hospitals were analyzed to achieve the study objective. A total of 20,223 non-outlier patients in 100 most frequent KDRGs were included in the analysis. Case charges after the review and length of stay (LOS) were used as measures of resource utilization during a hospitalization. A substantial variation among hospitals was found in most KDRGs : o the ratio of the maximum and the minimum among the mean case charges of hospitals was greater than 2 in 83 KDRGs ; o the difference between the maximum and the minimum among the mean case charges of hospitals was greater than 100,000 Won in 94 KDRGs : o the ratio of the maximum and the minimum among the mom LOS of hospitals was greater than 2 in 82 KDRGs ; o the difference between the maximum and the minimum among the mean LOS of hospitals was greater than 3 days in 94 KDRGs. The practice pattern of hospitals explained more than 20% of charge variation in 49 KDRGs and more than 20% of LOS variation in 43 KDRGs. The study results indicated need for a new health policy initiative for cost containment and quality assurance.

• The Journal of Korean Medicine
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• v.33 no.2
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• pp.56-63
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• 2012

Objectives: To undertake manpower-related improvements based on a comparison between specialists in the traditional Korean medicine hospitals(TKMH) and their counterparts in Western medicine Methods: A survey of the TKMH based on questionnaire sheets dispatched to them by mail(57 of 142 responded) in the June December, 2008 period, and on almanac statistics provided by the Ministry for Health, Welfare and Family Affairs of Korean Government. Results: Overall, the workforce engaged in the traditional Korean medicine hospitals comprises traditional Korean medical doctors(28%), nurses(23%), administrative staffs(19%), assistant nurses(9%), medical record keepers(2%), nutritionists(2%), herbal pharmacists(1%), and others(16%). Each hospital has 16.5 traditional Korean medical doctors on average, which can be broken down into 6.2 specialists, 1.3 generalists, and 9.3 residents/interns. Only 10.7% of whole of traditional Korean medical doctors work in the hospitals, compared to 54.5% of Western medicine doctors. The ratio of traditional Korean medical doctors to the entirety of employees in the TKMH is 2.5 times higher than their Western medicine counterparts, while the ratio of medical technicians to the entire employees in the TKMH is 20 times lower than in the Western medicine counterparts. Conclusions: To provide more qualified medical service in the TKMH, they will be required to increase the proportion of non medical doctor employees, like Western medicine counterparts.

• Journal of the Korean hospital association
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• v.37 no.3 s.313
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• pp.74-87
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• 2008

As healthcare environment being more complex and turbulent, strategic approach of hospitals became more important. This study was to investigate strategic orientation of Korean hospitals and their related characteristics. We surveyed managers of 360 hospitals randomly selected from all hospitals in Korea. For typology of strategic orientation, we used that developed by Miles and Snow, and results are as follows. Firstly, major types of organizational strategic orientation of Korean hospitals were analyzer(42.0%) and prospector(34.0%). Secondly, characteristics affecting to hospitals' strategic orientation significantly were hospital ownership and sex of managers. Medical corporation had a high tendency of prospector strategic orientation by 2.7 times compared to personal ownership. Female managers had a low tendency of prospector strategic orientation by 0.2, which was statistically significant. Though 60+ age group (compared to twenties and thirties) and middle managers (compared to CEO) had a tendency of being more prospector strategic orientation, but insignificant. The study result that majority of strategic orientation were prospector and analyzer reflects Korean hospital environment are complex and unstable. Hospital managers need to more focus on environment and boundary spanning function for maintenance and survival of their organizations.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.21-27
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• 2019

Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.363-371
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• 2001

Objectives : To assess the degree of quality improvement (QI) implementation and to identify its associated factors. Methods : A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used in our analysis. The degree of QI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors evaluated for association with the degree of QI implementation were cultural, technical, strategic, and structural factors of the hospitals. Results : The average 01 implementation score across the 7 dimensions of MBNQAC was 3.34 on a 5-point scale, with the highest score for the area of customer satisfaction (3.88) followed by information and analysis (3.59) and quality management (3.35). The results of regression analysis showed that hospitals with a ofter information system (p<0.05) and using scientific and systematic problem solving approach (p<0.01) tended to perform a higher degree of QI implementation. While statistically insignificant, positive associations were observed for the factors of group or developmental culture, the degree of employee empowerment, and the use of prospective strategy. Conclusions : It appears that the most important factors contributing to active implementation of QI in Korean hospitals were the use of scientific skills in decision making, and having a quality information system to produce precise and valid information.

• Quality Improvement in Health Care
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• v.8 no.2
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• pp.232-243
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• 2001

Background : the hospitals in Korea are in a situation of a severe competition than the past. This situation was resulted from the increase in the number of hospitals and also from the government policy controlling the medical insurance fee. Moreover, consumer's desire for the high quality medical service g\has been significantly increased. Many programs to improve the quality of medical services are being performed in hospitals since the middle of 1990's. Studies up to now reported that more than 10 programs are being performed per hospital in Korea. So far studies have been performed to measure only the number of such programs in a hospital. The purposes of this study are to examine a specific area involved in the programs designed to improve the medical service quality and to suggest a future direction of the such programs. In addition, we hope that the results from this study could assist the programs for the medical service quality. Methods : A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 69 participated, yielding a response rate of 63.9%. Excluding 7 hospital which are not responsed about activities of hospital then 62 hospitals were used for the analysis. Result : The total number of programs was 1,081 from the 62 hospitals participated in the survey. The highest number (24.8 programs) was found in the hospital having more than 800 beds and performing the programs more than 5 years. The 1,081 programs were consisted of 445 from the medical examination area, 343 from the medical examination support area, and 296 from the management area. Conclusion : This study showed the present situation of hospitals in Korea regarding to the quality improvement programs. The results from this study suggest that the pattern of the program for the medical service improvement is being changed to service process and result-centered programs from the structural area.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.199-208
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• 2020

Purpose: This study was performed to introduce an in vivo hybrid multimodality technique involving the coregistration of micro-computed tomography (micro-CT) and high-resolution magnetic resonance imaging (HR-MRI) to concomitantly visualize and quantify mineralization and vascularization at follow-up in a rat model. Materials and Methods: Three adult female rats were randomly assigned as test subjects, with 1 rat serving as a control subject. For 20 weeks, the test rats received a weekly intravenous injection of 30 ㎍/kg zoledronic acid, and the control rat was administered a similar dose of normal saline. Bilateral extraction of the lower first and second molars was performed after 10 weeks. All rats were scanned once every 4 weeks with both micro-CT and HR-MRI. Micro-CT and HR-MRI images were registered and fused in the same 3-dimensional region to quantify blood flow velocity and trabecular bone thickness at T0 (baseline), T4 (4 weeks), T8 (8 weeks), T12 (12 weeks), T16 (16 weeks), and T20 (20 weeks). Histological assessment was the gold standard with which the findings were compared. Results: The histomorphometric images at T20 aligned with the HR-MRI findings, with both test and control rats demonstrating reduced trabecular bone vasculature and blood vessel density. The micro-CT findings were also consistent with the histomorphometric changes, which revealed that the test rats had thicker trabecular bone and smaller marrow spaces than the control rat. Conclusion: The combination of micro-CT and HR-MRI may be considered a powerful non-invasive novel technique for the longitudinal quantification of localized mineralization and vascularization.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.437-445
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• 1994

The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE III scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE III score rised (p<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. When the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. When we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (p<0.05).

• Korea Journal of Hospital Management
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• v.1 no.1
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• pp.21-36
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• 1996

The purpose of this study is to evaluate the level of fixed assets management of the factors affecting its management level. The surveyed data were gathered from 105 general hospitals among 263 general hospitals nationwide. The level of fixed assets management was measured by 11 dimensions of assets management. The results were as follows : 1. According to general characteristics of hospitals, the management level of public hospitals and corporatized hospitals was better than that of private hospitals. The management level was better as increasing beds. 2. In the structural characteristics of assets management, the management level of the hospitals which had the responsible person for assets management was better than that of the hospitals which had not. 3. In the operating characteristics of assets management, the hospitals that conducted education for the job had better level of assets management that did not it. The hospital that the discard of assets was decided by engineering department or management department were better in management level than the hospitals that it was decided by user department. The management level of hospitals which were computerized for assets management was better. 4. In the full model, the most factors affecting the level of assets management were the factors that were characterized by operation pattern of assets management, and the operating characteristics of assets management were explained to 23.1% of total 45.7%. Conclusively, the level of assets management was mostly affected by the operating characteristics of assets management which were education for the job, discard decision not by user department, computerization for assets management. Therefore, hospitals perform education of the job, discard decision by engineering or management department, and computerization for better level of fixed assets management

• Journal of Oriental Neuropsychiatry
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• v.34 no.1
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• pp.1-12
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• 2023

Objectives: To standardize treatment, improve quality of medical service, and reduce medical costs of patients with depression by developing a clinical pathway (CP) of Korean medicine. Methods: CP was developed based on clinical practice guideline (CPG) for depression. To consider the degree of economic burden and satisfaction, the current status of management for patients with depression was examined. After CP was primarily developed, contents of the CP were supplemented by referring to previously developed CPs. Results: Based on CPG, current status survey and previous CP, four types of CP (Korean medicine clinics, Korean medicine hospitals, Western-Korean medicine collaborative hospitals, public medical center) were developed and shown in the algorithm version. However, in the case of Korean medicine hospitals and Western-Korean medicine collaborative hospitals, CPs were detailed according to different clinical scenes of outpatients and inpatients. This study also shows six different time task matrix version. Conclusions: CP for depression is expected to not only reduce financial burden of patients and health insurance, but also increase the quality of treatment and satisfaction.