• Korea Journal of Hospital Management
• /
• v.7 no.1
• /
• pp.88-104
• /
• 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 Korean Journal of Community Living Science
• /
• v.17 no.3
• /
• pp.159-174
• /
• 2006

The purpose of this study is to provide information searching for health promotion, nutrition improvement, and health care of the impaired elderly by ADL(Activity of Daily Living) and IADL(Instrumental Activity of Daily Living). The subjects were divided into the Assistant Needed Group and No Assistant Needed Group for living in line with the responses of ADL(10 items like dressing, washing, move etc.) and IADL(10 items like housekeeping, using transportation, shopping, Phone call etc.). Survey was made for health behavior, health risk habit, dietary management status and diet intake by 24 hr-recall and questionnaire method. 242 subjects were collected in 12 cities or Gun districts in Gyeonggi Province, S. Korea. Survey was carried out by regional home extension workers using interview method. Statistical analyses were made using SAS (Version 8.1). Chi-Square Tests and General Linear Models. The subjects of impaired ADL elderly was 26.5% and it composed 30% of the total male and 22.2% of the total female. The demographic status of the impaired ADL elderly showed no difference from that of the normal elders, elementary school educated (73.4%), with spouse (43.8%) or with adult children(37.5%), using monthly living cost of 500-1,000 thousand won(35.9%). Mean age was 74.05 years compared to 72.25 years of normal elders. However, there was no significant difference from the normal and impaired ADL group, regular exercise(60.0%), with walking (90.0%), no-smoke(54.7%) and no-drink(48.4%). Kind of disease was not different from the one in impaired and normal group, with cardiovascular disease(32.3%), with diabetes mellitus(8.1%), joint lumbago neuralgia(32.3%) and osteoporosis(9.7%). Gastrointestinal complaints of the impaired ADL group were nausea(57.8%), chronic indigestion (23.4%), constipation (14,0%) and vomiting(3.7%). Sleeping time required for the impaired was longer than that for the normal group by 10hours(4.7%) or 8-10hours(20.3%), which consisted 1.7% and 16.6% respectively. Nutrient intake of the impaired ADL group was low compared to normal range elders: Energy(1260kca1), Protein(52.75g). There was gender difference in nutrient intake; the male impaired group showed no significant difference from the normal group but it was significantly lower in female impaired group. These results suggest that low quality of life and low economic status of the impaired ADL elderly require congregate meal in village hall to cover the lack of side dishe variety. And nutrition education program including community assistance would be required for the impaired ADL elderly together with the sufficient food and exercise practice. By operating nutrition education program, the impaired ADL elderly would maintain more enhanced quality of life and ameliorate the ADL capability.

• Health Policy and Management
• /
• v.4 no.1
• /
• pp.49-76
• /
• 1994

Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.

• Journal of Genetic Medicine
• /
• v.8 no.2
• /
• pp.89-99
• /
• 2011

Over the years Korean health care system has improved in delivery of quality care to the general population for many areas of the health problems. The system is now being recognized in the world as the most cost effective one. It is covered by the uniform national health insurance policy for which most people in Korea are mandatory policy holders. Genetic counseling service, however, which is well recognized as an integral part of clinical genetics service deals with diagnosis and management of genetic condition as well as genetic information presentation and family support, is yet to be delivered in comprehensive way for the patients and families in need. Two major obstacles in providing genetic counseling service in korean health care system are identified; One is the lack of recognition for the need for genetic counseling service as necessary service by the national health insurance. Genetic counseling consumes a significant time in delivery and the current very low-fee schedule for physician service makes it very difficult to provide meaningful service. Second is the critical shortage of qualified professionals in the field of medical genetics and genetic counseling who can provide the service of genetic counseling in clinical setting. However, recognition and understanding of the fact that the scope and role of genetic counseling is expanding in post genomic era of personalized medicine for delivery of quality health care, will lead to the efforts to overcome obstacles in providing genetic counseling service in korean health care system. Only concerted efforts from health care policy makers of government on clinical genetics service and genetic counseling for establishing adequate reimbursement coverage and professional communities for developing educational program and certification process for professional genetic counselors, are necessary for the delivery of much needed clinical genetic counseling service in Korea.

• Journal of Welding and Joining
• /
• v.35 no.1
• /
• pp.43-48
• /
• 2017

Pulse TIG (Tungsten Inert Gas) welding is often considered the most difficult of all the welding processes commonly used in industry. Because the welder must maintain a short arc length, great care and skill are required to prevent contact between the electrode and the workpiece. Pulse TIG welding is most commonly used to weld thin sections of stainless steel, non-ferrous metals such as aluminum, magnesium and copper alloys. It is significantly slower than most other welding techniques and comparatively more complex and difficult to master as it requires greater welder dexterity than MIG or stick welding. The problems associated with manual TIG welding includes undercutting, tungsten inclusions, porosity, Heat affected zone cracks and also the adverse effect on health of welding gun operator due to amount of tungsten fumes produced during the welding process. This brings the necessity of automation. Hence, In this paper an attempt has been made to build a customerized setup of Pulse TIG welding based on through review of Pulse TIG welding parameters. The cost associated for making automated TIG is found to be low as compared to SPM (Special Purpose machines) available in the market.

• Journal of radiological science and technology
• /
• v.43 no.5
• /
• pp.389-395
• /
• 2020

The evaluation of radioactivated components of heavy-ion accelerator facilities affects the safety of radiation management and the exposure dose for workers. and this is an important issue when predicting the disposal cost of waste during maintenance and dismantling of accelerator facilities. In this study, the FLUKA code was used to simulate the proton treatment device nozzle and classify the radio-nuclides and total radioactivity generated by each component over a short period of time. The source term was evaluated using NIST reference beam data, and the neutron flux generated for each component was calculated using the evaluated beam data. Radioactive isotopes caused by generated neutrons were compared and evaluated using nuclide information from the International Radiation Protection Association and the Korea Radioisotope association. Most of the nuclides produced form of beta rays and electron capture, and short-lived nuclides dominated. However, In the case of ⁵⁴Mn, which is a radioactive product of iron, the effect of gamma rays should be considered. In the case of tritium generated from a material with a low atomic number, it is considered that handling care should be taken due to its long half-life.

• Journal of the Korea Institute of Information and Communication Engineering
• /
• v.14 no.8
• /
• pp.1937-1942
• /
• 2010

In this paper, RFID technology was applied to fitness center and order to exercise the right of each user without the guidance of a personal trainer should be made systematically. for example, excercise sequence, equipment usage, excercise and golas etc. Also, Customers who use the fitness center using RFID is trainer at a low-cost under the guidance of the same effect can be expected. In this paper, Our system will record the movements of time, as well as our system can be analyze of excercise using micro processor and acceleration sensor.

• Journal of Preventive Medicine and Public Health
• /
• v.46 no.4
• /
• pp.173-182
• /
• 2013

Obesity during childhood is a dominant risk factor for noncommunicable diseases (NCDs), and is itself considered a disease that needs to be treated. Recently, the growth in childhood obesity in Korea has become stagnant; however, two in every ten children are still overweight. In addition, 60% or more of overweight children have at least one metabolic syndrome risk factor. Thus, childhood obesity should be controlled through lifestyle modification. This paper reviews studies of the modifiable risk factors of obesity in Korean children. According to the life-course approach, preschool-aged children (<5 years) are influenced by their parents rather than individual habits because they are under mostly parental care. Elementary school-aged children (6 to 11 years) are affected by overlapping individual and parental effects. This may mean that the establishment of individual behavior patterns begins during this period. The conditions of poor eating habits such as skipping meals, eating out, and high fat intake, along with low physical activity, facilitate increased obesity among adolescents (12 to 18 years). Notably, adolescent girls show high rates of both underweight and obesity, which may lead to the development of NCDs in their offspring. Therefore, the problem of NCDs is no longer limited to adults, but is also prevalent among children. In addition, early intervention offers cost-effective opportunities for preventing NCDs. Thus, children need primary consideration, adequate monitoring, diagnosis, and treatment to reduce the burden of NCDs later in adulthood.

• The Korean Journal of Health Service Management
• /
• v.5 no.2
• /
• pp.209-226
• /
• 2011

The purpose of this study is to analyze and find out key success factors and marketing strategies of Bumrungrad Hospital in Bangkok, Thailand. The major success factors of Bumrungrad Hospital are as follows; First, Bumrungrad Hospital had professional medical team and board of directors who had the international career. Second, Bumrungrad was supported by Thai government and they were in a cooperative relationship with each other for the development of the medical industry. Third, Bumrungrad appropriately handled the internal and external changes including Asia Financial Crises in 1997 and others. Fourth, Bumrungrad diversified and broaden its business field such as global medical investing and management, medical technology, anti-age medicine and wellness. Marketing strategies of Bumrungrad analyzed are the following four factors. First, Bumrungrad focused on the quality of services by employing professional medical staffs, who have the international certification, and by constructing IT system for hospital management. Second, Bumrungrad has maintained an equalized price policy to attract the customers bothin the domestic and foreign markets. The cost for care has appealed the foreign customers for its comparatively low price, but it focused mainly on the upper middle class in Thailand. Third, it established, managed, and consulted hospitals in the foreign countries including the Philippines and the Arab Emirates. Fourth, it adopted differentiated promotion strategies suitable for the special needs of domestic and foreign customers, and put emphasis on the buzz marketing.

• Journal of the Korean Institute of Rural Architecture
• /
• v.15 no.4
• /
• pp.95-102
• /
• 2013

Recently (2010), South Korea's aging rate is 11%. and expected to be 32.3% in 2040, and Japan's aging rate in 2010 is 23%, and in 2040 is expected to be 34.5%. As aging progresses, it is increasing with the elderly person with dementia. However, elderly welfare facilities are insufficient. To take care stability of elderly people with mental and physical disabilities, we need to prepare a lot of welfare facilities for the elderly. Whenever physical conditions and service needs change of the disability elderly, Elderly are forced to move to the other facility. They move from familiar places, beloved local base to unfamiliar places. They are under a lot of stress in order to adapt to new environment. This research is to check out the possibility of the systems and the effectiveness of various services and the flexibility of management in Japan. Takurosyo is responsible for a variety function of elderly medical welfare facilities. Within a short time, our country, has entered into a super-aged society, elderly health and welfare facilities are needed. However, because it requires enormous financial, it is difficult to build a new building in reality, However, if remodeling existing buildings, We can build many low-cost small-scale multi-functional welfare facilities such as the takurosyo. Such that facility would be available to us.