• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.326-333
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• 2022

The purpose of this study was to evaluate the radiographic positioning techniques used in local animal hospitals, identify the most common positioning problem, and determine whether there were changes after teleradiology consultations. From September 2016 to April 2021, 15 local animal hospitals that requested radiographic interpretation more than 10 times and for more than six cases of thoracic radiographs were selected. Six sets of two-views of (lateral and ventrodorsal [VD] or dorsoventral [DV] views) digital thoracic radiographs from six dogs per hospital were evaluated in four categories. For the lateral view, radiographic technique scores used in ten local animal hospitals improved, one remained the same, and four became worse. For the VD/DV view, the score for eleven hospitals improved and worsened for four. The most common problem was rotation (57/90) for the lateral view, followed by an inappropriate field of view (59/90), and incorrect beam center (71/90). For the VD/DV view, an inappropriate field of view (54/90) was the most common problem, followed by asymmetry (63/90), and incorrect beam center (73/90). Every factor, except rotation in the lateral view, improved after obtaining technical consultation; however, the degrees of improvement were not remarkable. There was no significant correlation between the number of requests and the degree of improvement. According to the results, the radiographic technique used in local animal hospitals was improved by technical advice on teleradiology. These changes make it possible to provide accurate diagnoses of the requested images. There are some limitations regarding the indicators of evaluation and the number of cases; therefore, further studies that use detailed indicators in large cohort group are needed. In addition, an effective method of teaching should be developed to improve radiographic techniques in local animal hospitals.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.279-294
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• 1996

This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

• The Korean Journal of Health Service Management
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• v.10 no.3
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• pp.1-12
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• 2016

Objectives : This study examined relations between investment efficiency and management performance as indexes related to productivity of Korean regional public hospitals. Methods : The analysis data are financial information of Korean regional public hospitals from 2011 to 2014. For the indicators, value added to total assets, value added to productive activity tangible fixed assets, and value added to personnel expenses, operating margin to revenues, net profit to total earnings, and ratio of value added. Results : Significant relevance was not shown among indicators of investment efficiency. However, Significant relevance was shown between value added to personnel expense and productivity per value added. Conclusions : It confirmed that outside support funds like subsidy did not have effect on improving the management performance. Also, it could be known that availability about input of capital and labor was not realized organically.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• Korea Journal of Hospital Management
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• v.8 no.1
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• pp.42-63
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• 2003

There is a rapidly growing expansion of internet-based infrastructure throughout industries in Korea. The internet-based Electronic Purchase and Supply System(EPSS) is being considered a supportive tool to increase the economic efficiency of hospital management. In this study, we conducted an economic evaluation of the system, analyzing data on four hospitals in Korea. According to the results, four hospitals was estimated to make net benefit of about 611 million Won in one year and about 2,809 million Won in the next five years. Further, the adoption of all hospitals in Korea to the system may generate net benefit of about 31,575 million Won in one year and about 166,938 million Won in the next five years. Furthermore, we expect that as the system covered many kinds of inputs in hospitals like pharmaceuticals, the benefit of the system would go up by a considerable degree.

• Journal of Preventive Medicine and Public Health
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• v.56 no.2
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• pp.180-189
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• 2023

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic. Methods: This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients' in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type. Results: The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4). Conclusions: This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.400-413
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• 1991

The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows : (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and in-patient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity (3) In case of physician's inpatient and adjusted-patient service, nurses' role is greater than nursing aides'. Therefore, more extensive utilization of nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.

• Quality Improvement in Health Care
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• v.22 no.1
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• pp.59-69
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• 2016

Objectives: Healthcare Accreditation Program in Korea started in 2011. The aim of this study is to contribute to the development of the Healthcare Accreditation Program in Korea by comparing the perception of the Healthcare Accreditation Program for the accredited hospitals and the surveyors. Methods: This study was performed targeting 77 accredited acute care hospitals and 245 surveyors who have surveyed acute care hospitals from 2010 to February 2014. They responded to our questionnaire via a survey website, and we analyzed the results. Results: We found that the hospitals rated the professionalism of surveyors more positively than surveyors. While average score of the hospitals was higher for 'The understanding of the accreditation standards and survey methods was correct' than that of the surveyors (p<0.01), average score of the surveyors was higher for 'Mediation and collaboration between surveyors were smooth' than that of the hospitals (p<0.05). And we found that the surveyors rated the Accreditation Program more positively than hospitals. While average score of the hospitals was higher for 'Surveyors have the professionalism' than that of the surveyors (p<0.05), average score of the surveyors was higher for 'It is easy to understand the accreditation standards and evaluation items' than that of the hospitals (p<0.01). Conclusion: In order to development of the accreditation program, it is necessary to strengthen the professionalism of surveyors and improve the acceptability of the accreditation program.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.10-20
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• 1988

This study was conducted to compare the maternal charactristics, and birth weight of infants delivered at five different categories of medical facility in Taegu to examine the risk level of pregnant women and children by the medical facility for delivery. The study population included 1,410 pregnant women who delivered a baby at one of nine medical facilities (3 university hospitals, 2 general hospitals, 2 private clinics, 1 midwife clinic, 1 MCH center) in Taegu in April, 1987(April and May, 1987 for K university hospital), Pregnant women were interviewed to ask the age and educational level of woman, payment of medical fee, birth order, delivery method. Birth weight of infant was obtained from medical record. Mean ages of the women delivering at the university hospitals(27.5 years) and at general hospitals(26.7 years) were higher than those at midwife clinic(25.4 years) and at MCH center(26.1 years). Also, mean years of school education were higher in women of university hospitals(12.7 years) and general hospitals (12.2 years) than in women of midwife clinic(9.2 years) and MCH center (9.3 years). The percentages of women covered by the medical insurance were far greater in the university hospitals(78.1%) and general hospitals(82.9%) than in private clinics(44.3%) , midwife clinic(29.1%) and MCH center (5.4%). Infants born at the MCH center were mostly the second birth (47.3%) while 56.0% to 61.7% of infants born at all the other medical facilities were the first birth more women delivering at the university hospitals had history of spontaneous abortion as well as still birth than the women delivering at the other medical facilities. The preform birth rate (11.4%) and low birthweight incidence rates(5.8-13.0%) in university hospitals were significantly higher than those of other medical facilities. Accordingly, c-section rates showed a wide variation among the medical facilities. Study findings revealed that most of women delivering at the university hospitals and general hospitals are in the middle of or upper socio-economic class and obstetrically high risk group regardless of socioeconomic class while the wome delivering at the midwife clinic and MCH center are low risk group of low socioeconomic class. Therefore, the data of a specific medical facility are highly limited in interpretation and can not be generalized.

• Journal of Preventive Medicine and Public Health
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• v.54 no.6
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• pp.385-394
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• 2021

Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs). Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression. Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS. Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.