• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.399-407
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• 2001

Objectives : To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. Methods : We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. Results : 100 of 125 hospitals responding (84.8%) had mere than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. Conclusion . Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.

• The Journal of Korean Obstetrics and Gynecology
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• v.23 no.1
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• pp.108-123
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• 2010

Purpose: We analyzed the characteristics of women who gave birth at an obstetrician and those who received oriental medicine postpartum care, and investigated the level of their satisfaction to obtain fundamental data for Oriental-Western cooperative medicine treatment for postpartum care. Methods: The review was based on a 5-months' data, from August 1 through December 31, 2009. Information on age, labor record, level of education, and occupation of the patients who had received postpartum oriental-western cooperative medicine treatment was based on Electric Medical Record(EMR) of O O Oriental Medicine Hospital. The questionnaires were completed by the patients at the time of their discharge from the hospital. Results: The patients who were admitted to oriental medicine hospitals tended to be primiparae, and they were more likely to be younger women with higher education levels. The level of satisfaction on postpartum care program of oriental medicine hospitals was high. Conclusion: It is necessary to specialize the facilities, dietary formula, and staff training of oriental medicine hospitals through a survey of postpartum patients' demand and satisfaction level. In oriental-western cooperative medicine hospitals, it is needed to specialize the postpartum program for creating demand of premature delivery mothers.

• The Journal of Korean Medicine
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• v.28 no.2 s.70
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• pp.205-212
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• 2007

Objectives : Combined treatment (CT) of oriental herbal medicine and prescribed drugs is now being increasingly used among cancer patients around the world. However, in Korea, clinical information on the frequency, efficacy and safety of CT among cancer patients has not yet been thoroughly reported. This study aimed to identify the status and adverse effects of CT for the management of cancer patients. Methods : A questionnaire and medical record survey by oriental medical doctors or physicians were performed at two oriental medical hospitals and one general hospital. Of the initial 400 in-patients, 368 participated in this survey, representing a response rate of 92.0%. Results : Among cancer patients in oriental medical hospitals, the proportion of CT was 45.9%. In contrast, the proportion of CT in the general hospital was only 0.6%. The proportion of CT among breast cancer patients (20) and gastric cancer patients (35) were 85.0% and 51.4%, respectively. The proportion of CT among cancer patients was high in younger, female or married patients groups. 10 respondents (11.1%) among 90 cancer patients experienced several adverse effects including nausea, fatigue, etc. Conclusions : This study suggests that many more patients in oriental medical hospitals than general hospitals use combined treatment of oriental herbal medicine and prescribed drugs for management of cancer. Therefore, medical professionals should provide comprehensive and up-to-date clinical information about potential benefits and risks of CT to cancer patients in Korea.

• Quality Improvement in Health Care
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• v.1 no.2
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• pp.34-43
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• 1994

Background: The average hospital stay in most Korean teaching hospitals is longer than that of hospitals in developed countries. The investigation of average hospital stay of teaching hospitals is considered as an important measure to evaluate the effectiveness of hospital management. In this article authors analyzed the relationship of several variables (hospital ownership, number of beds, location of hospitals, number of physician) to length of hospital stay in each clinical department. Methods: The average hospital stay of each clinical department of 184 teaching hospitals was investigated. Authors reviewed the papers of teaching hospitals, that was reported to the Korean Association of Hospitals. Results: The means of hospital stay day of hospitals were not significantly different according to the number of hospital beds and location of hospitals. Only the difference of hospital stay according to ownerships was significant. The length of stay was the highest in public hospitals and the lowest in juridical hospitals. Conclusions: The number of beds and location of hospitals were not associated with the average hospital stay. But ownerships affected the average hospital stay. The national or public hospitals had the longest length of hospital stay. Number of specialists and number of all physicians were closely related to the average hospital stay.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.2-17
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• 2021

Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases. Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.

• Journal of Environmental Health Sciences
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• v.44 no.5
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• pp.452-459
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• 2018

Objectives: We aimed to examine whether dental waste was being managed adequately at different types of dental institutions in City D in South Korea. Methods: The staff responsible for disinfection at 101 dental offices and clinics (six dentistry departments of general hospitals, 12 dental hospitals, and 83 dental clinics) was interviewed. Results: Solid suction pump waste was handled appropriately at four of the general hospital dentistry departments (66.7%), six dental hospitals (50.0%), and 15 dental clinics (18.1%). Solid spittoon waste was handled appropriately at four general hospital dentistry departments (66.7%), seven dental hospitals (58.3%), and 14 dental clinics (16.9%). Developer and fixer were handled appropriately by a subcontractor at two general hospital dentistry departments (100.0%), five dental hospitals (100.0%), and 24 dental clinics (75.0%). Impression materials were handled appropriately at four general hospital dentistry departments (66.7%), six dental hospitals (50.0%), and 11 dental clinics (13.3%). The plastic covers of intra-oral radiography films were handled appropriately at five general hospital dentistry departments (100.0%), eight dental hospitals (72.7%), and 22 dental clinics (30.1%). Conclusion: South Korea must implement detailed and specialized guidelines for the disposal of solid and general medical waste from dental institutions. Moreover, waste disposal training should be provided annually, and not only once every three years.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.20-27
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• 2016

Background: This study analyzed the association between the volume of heart surgeries and treatment outcomes for hospitals in the last five years. Methods: Hospitals that perform heart surgeries were chosen throughout Korea as subjects using from the Health Insurance Review and Assessment Service. The treatment outcome of the heart surgeries was defined as the mortality within 30 postoperative days, while the annual volume of the surgeries was categorized. Logistic regression was used as the statistical analysis method, and the impacts of the variables on the heart surgery treatment outcomes were then analyzed. Results: The chance of death of patients who received surgery in a hospital that performed 50 or more surgeries annually was noticeably lower than patients receiving operations from hospitals that performed fewer than 50 surgeries annually, indicating that the chance of death decreases as the annual volume of heart surgeries in the hospital increases. In particular, the mortality rate in hospitals that performed more than 200 surgeries annually was less than half of that in hospitals that performed 49 or fewer surgeries annually. Conclusion: These results indicate that accumulation of a certain level of heart surgery experience is critical in improving or maintaining the quality of heart surgeries. In order to improve the treatment outcomes of small hospitals, a support policy must be implemented that allows for cooperation with experienced professionals.

• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.337-346
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• 2001

Objective : To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. Methods Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. Results : The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. Conclusions : Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.

• Journal of Korean Medical Science
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• v.33 no.49
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• pp.308.1-308.10
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• 2018

Background: The aim of this study was to describe the structure, organization, management, and staffing of pediatric critical care (PCC) in Korea. Methods: We directed a questionnaire survey for all Upper Grade General Hospitals (n = 43) in Korea in 2015. The first questionnaire was mainly about structure, organization, and staffing and responses were obtained from 32 hospitals. The second questionnaire was mainly about patients and management. Responses to second questionnaire were obtained from 18 hospitals. Results: Twelve from 32 Upper Grade General Hospitals had pediatric intensive care units (PICUs) and 11 of them had the PICU which was exclusive for children. Total number of PICU beds in Korea was 113. The ratio of the number of PICU beds to the number of children was 1:77,460 in Korea and this ratio is lower than that of other developed countries. The mean number of beds in the PICUs was $9.4{\pm}9.3$ (range, 2-30). There were 16 medical doctors who were assigned for PCC and only 5 of them were full time pediatric intensivists. In the 18 Upper Grade General Hospitals that responded to the second questionnaire survey, there were 97 patients in the PICUs with an average number of $5.7{\pm}7.2$ (range, 0-22) on the survey day. The mean age of the patients was $3.4{\pm}5.6$ years. The mean length of hospital stay was $82{\pm}271days$. The mean Pediatric Risk of Mortality score III was $9.4{\pm}7.8$ at the time of admission to the PICUs. Conclusion: There is a considerable shortage of PICU beds compared to those in developed countries. In addition, the proportion of PICUs with PCC specialists is much lower than those in the US and European countries.

• Journal of Society of Preventive Korean Medicine
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• v.1 no.1
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• pp.42-47
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• 1997

Despite of increasing market share, oriental hospitals are now facing profit deterioration. In order to contribute to both better policy making of the Government Md corporate planning in the part of the individual hospitals this study attempted to identify the oriental hospital's financial characteristics. financial performance data for 1995, published by the Korea Institute of Health Services Management, were analysed from the structural perspective of patient composition, capital and resources input, medical revenue and costs, and financial efficiency and profitability. Some financial characteristics were drawn based on the results of the analysis. The areas that require corrective action and future study were also suggested.