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A Study on the Archtectural Planning Compared with Space for Before and After Remodeling of General Hospitals in Korea (국내 종합병원의 리모델링 전.후 공간비교에 관한 건축계획적 연구)

  • Lee, Joo-Young;Kim, Sang-Bok;Yang, Nae-Won
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.16 no.2
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    • pp.7-15
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    • 2010
  • An early stage of general hospital in Korea was the quantitative growth period. Remodeling has been required to meet the increasing medical demands. To accept the change of paradigm and management operation method, remodeling occurred from the 20th century. Remodeling plans are difficult to define the direction of the detailed plan due to various factors in the beginning of the construction, Therefore, it is necessary to analyze the possibility and limitation of a feasible remodeling plan of general hospitals through the comparison of existing hospital before remodeling and after the remodeling takes effect. A comparison of the researched hospital's blue prints before and after the remodeling and recently built hospital's blue print, analyzed characteristic of the space variation by the remodeling. The purpose of research is to confirm a possibility and limitation of remodeling of general hospitals comparing with merits and faults of extension, reconstruction, and construction. In conclusion, the area of remodeling hospitals increase mostly medical department(ward, outpatient department, inpatient department) and subsidiary facilities, but the area of ward and inpatient department are less than the new hospitals. Especially, public area is greatly increased by the diversification of corridor function. Also, remodeling hospitals represent a limitation to plan departments in need of equipment-intensive space. To address this problem, expansion space is used mainly with inpatient department and existing space is placed mainly with low-impact department by equipment ; outpatient department, administration department.

Factors Influencing Medical Care Utilization according to Decline of Region: Urban Decline Index and Medical Vulnerability Index as Indicators (지역쇠퇴 유형별 의료이용행태 영향요인: 도시쇠퇴 지표와 의료취약지 지표를 활용하여)

  • Jeong, Ji Yun;Jeong, Jae Yeon;Yoon, In Hye;Choi, Hwa Young;Lee, Hae Jong
    • Health Policy and Management
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    • v.32 no.2
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    • pp.205-215
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    • 2022
  • Background: The purpose of this study is to identify the factors infecting the medical care utilization from a new perspective by newly classifying the categories of administrative districts using the urban decline index and medical vulnerability index as indicators. Methods: This study targeted 150,940 people who used medical services using the 2015 cohort database (DB), 2010-2015 urban regeneration analysis index DB, and 2014-2015 public health and medical statistics DB. The decline of the region was classified using the urban decline index typed using k-means clustering and the medical vulnerability index typed using the quantile score calculation. Regression analysis was performed 3 times with medical expenditure, length of stay, and the number of outpatient visits as dependent variables. Results: There were 37 stable region (47.4%), 29 health vulnerable region (37.2%), and 12 decline region (15.4%). The health vulnerable region had lower medical expenditure, fewer outpatient visits, and a higher length of stay than the stable region. The decline region was all higher than the stable region but had no significant effect. Conclusion: The factors that cause the health disparity between regions are not only factors related to individual health behavior but also environmental factors of the local community. Therefore, there is a need for a systematic alternative that properly considers the resources within the community and reflects the characteristics of the population.

A study for the relationship between the cognition difference and satisfaction for the medical service and the revisiting (의료서비스의 인식차이와 만족이 재방문에 미치는 영향에 관한 연구)

  • Lee, Kyoung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.3
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    • pp.143-160
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    • 2003
  • Due to the dramatic and situational change in medical industry, it has became very important to keep existing patients and to attract new patients by monitoring the medical consumer's expectation and various needs and ensuring the patients' satisfaction. This study regards the patients' satisfaction as the final object of medical service. So the object of this study is to provide useful data for the decision making and medical service marketing by exploring the problems generated by the cognition difference for the medical service between inpatients and outpatients, by responding for the problems and by examining the relationship between the satisfaction with the medical service and revisiting. To achieve the object of this study, literature research and empirical analysis were used. I establish the research model based on the existing service marketing and some hypotheses were chosen for the empirical analysis. As a result of empirical analysis for the five hypotheses, two hypotheses were chosen. First, there was cognition difference about accessibility and convenience between inpatient and outpatient. I guess that the satisfaction degree of inpatient is higher than the outpatient because the inpatient has the reliability for the hospital and determines the hospitalization or emergent coming to hospital. Second, the fifth hypothesis, "the satisfaction of patient will influence the revisiting." was chosen. The hypothesis is not only coincident with existing scholars and studies but also it provides the meaningful points for medical service marketing. The result shows that the parties concerned with hospital management should endeavor for the patient satisfaction in medical service, and that hospital management should be medical consumer centered. To measure the quality of medical service, the cognition differences for accessibility, convenience, physical environment, and human service were evaluated and the result shows that the cognition difference for the accessibility and convenience was outstanding. The analysis shows that there was cognition difference in the four categories among six subcategories in the human service -- the attitude of medical technologist, the attitude of doctor, the length of time for doctor's diagnosis for the patient and doctor's explanation. Therefore, I think that further study is required for the cause analysis for service categories which have cognition difference between inpatient and outpatient. I think the result will be very useful. Through this study, the relationship between patient satisfaction with the medical service and revisiting was verified. And it suggests that, to face the changing medical environment actively and to improve the quality of medical service, marketing strategy should be focused not on medical service providers but on medical service consumers and that the further studies for the medical consumer should be continued.

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Abnormality on Liver Function Test

  • Kang, Ki-Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.16 no.4
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    • pp.225-232
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    • 2013
  • Children with abnormal liver function can often be seen in outpatient clinics or inpatients wards. Most of them have respiratory disease, or gastroenteritis by virus infection, accompanying fever. Occasionally, hepatitis by the viruses causing systemic infection may occur, and screening tests are required. In patients with jaundice, the tests for differential diagnosis and appropriate treatment are important. In the case of a child with hepatitis B virus infection vertically from a hepatitis B surface antigen positive mother, the importance of the recognition of immune clearance can't be overstressed, for the decision of time to begin treatment. Early diagnosis changes the fate of a child with Wilson disease. So, screening test for the disease should not be omitted. Non-alcoholic fatty liver disease, which is mainly discovered in obese children, is a new strong candidate triggering abnormal liver function. Muscular dystrophy is a representative disease mimicking liver dysfunction. Although muscular dystrophy is a progressive disorder, and early diagnosis can't change the fate of patients, it will be better to avoid parent's blame for delayed diagnosis.

Profitability determinants of hospitals (병원의 수익성 관련 요인)

  • 이윤석;유승흠
    • Health Policy and Management
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    • v.13 no.3
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    • pp.129-147
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    • 2003
  • This study is to grasp a trend of profitability classified by characteristics of hospitals and to analyze related factors. Subjects are 145 hospitals which have gotten the standardization audit by Korean Hospital Association during 1998-200l. Profitability was measured in the aspect of operation profit rate with operating margin to gross revenue as proxy variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, competition), financial factors (liabilities to total assets, current ratio, fixed ratio, total asset turnover, inventories turnover), and factors related to patient treatment (average length of stay, bed occupancy rate, new outpatient ratio, admission ratio of outpatients, number of patients per specialist, personnel costs per adjusted inpatient, administrative costs per adjusted inpatient). Hierarchical multiple regression analysis model was used in this study. As a result of hierarchical multiple regression analyzation of operating margin to gross revenue, adjustive $R^2$ of general factors was relatively more powerful. The factors had significant effect on operating margin to gross revenue were ownership(+), number of beds(+), competition(+), current ratio(+), fixed ratio(+), total asset turnover(+), personnel costs per adjusted inpatient(-).

Estimation of lifetime dental expenditures for periodontitis (치주질환 유병자의 생애 치과의료비 추정)

  • Kim, Yun-Jeong;Kwang, Jung-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.3
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    • pp.245-253
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    • 2021
  • Objectives: The objective of this paper was to estimate a South Korean's lifetime dental expenditures for periodontitis. Methods: For our study, we collected data from the Korea Health Panel Survey (KHPS), from 2010 to 2016. The outpatient dental care data of 1,919,608 samples of periodontitis were extracted using R version 3.0 and estimations of lifetime dental expenditures for them were generated using Excel. Results: Over 50% of the lifetime dental expenditure of South Koreans was spent for periodontitis, and incurred after the age of 40. The results showed that an estimate of average per capita lifetime dental expenditure for men (approximately 13 million won) was greater than that for women (approximately 8.8 million won) for periodontitis. Conclusions: Efficient methods for the prevention and management of periodontitis are necessary, and a new paradigm of health care system is required to reduce dental expenditure through its prevention.

The Management of Chronic Wound with Modified Portable Negative Pressure Therapy (만성 창상의 치료에서 이동식 음압요법의 신고안)

  • Kim, Jee Soo;Yoon, In Mo;Yoo, Jung Seok
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.223-228
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    • 2008
  • Purpose: V.A.C. is a new concept which is closed dressing with negative pressure to promote wound healing. It has been widely used as the treatment of chronic and acute wounds such as pressure sores, burns, stasis ulcers, and other complicated wounds. However It has disadvantages such as high cost and the need of specific equipment. In this article, we described new method to overcome these disadvantages. Methods: We made newly innovated equipment with 50 cc syringe and spring to create negative pressure. From May 2006 to May 2007, we applied it to two patients with chronic wound. Results: The treatment period was 5 weeks for one case and 3 weeks for the other case. Both patients were healed completely without admission and wound healing was accelerated. During follow-ups, there were no complications. The mean cost for single dressing was 9,590 won. Conclusion: Modified portable negative therapy using newly innovated equipment could accelerate wound healing better than conventional dressing. It lowers the number of dressings, saves cost of treatment, and enables treatment as outpatient basis.

Premedication & Anesthesia for OPD Based Laryngeal Procedures (외래 후두 수술의 술전처치 및 마취)

  • Lee, Seung-Won;Kim, Jae-Wook;Koh, Yoon-Woo;Lee, Jun-Ho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.11-16
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    • 2009
  • OPD based laryngeal procedures offers a new avenue to the modern laryngologist, incorporating new technology in the office setting. With the development of flexible fiberoptic endoscopes, compact video system, and short acting anesthetics and sedatives allow these procedures. The success or failure of procedures are depend on excellent topical anesthesia. An inadequately anesthetized patient is apt to be uncomfortable, anxious and hyperresponsive and therefore unlikely to tolerate the procedure. On the other hand, a patient who is well informed, reassured, and thoroughly anesthetized can complete procedures. Therefore, optimal anesthesia is obligatory for excellent surgical results. The phonosurgeon should choose the anesthetic and sedative agents based on duration of action, time of onset of action, and any medical contraindications that the patient may have. And should be familiar with the properties and interaction of the agents used, as well as the signs of toxicity.

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A Study on the Remodeling Strategy for the Equipment Intensive Areas of General Hospitals - Focused on the Diagnosis/Treatment Areas, the Supply Areas - (종합병원 설비집약적인 부문의 리모델링 방안에 관한 연구 - 중앙진료부와 공급부를 중심으로 -)

  • Kim Ha-Jin
    • Korean Institute of Interior Design Journal
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    • v.14 no.1
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    • pp.100-108
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    • 2005
  • If remodeling is defined as activities that restore the overall function of a building up to the standards currently demanded rather than as a simple replacement or repair of old facilities and equipment, the main task of remodeling should be the reduction in differences between areas, establishment of a functional linkage between departments and setup of a smooth circulation system. Therefore, this study is an analysis of remodeling strategies and construction processes to resolve major tasks of remodeling. Through this research we acquire concluding remarks. 1) The remodeling strategies of equipment-intensive areas can be divided into two measures: utilizing the existing buildings (the main buildings) the most, and of concentrated relocation in the new buildings. The former method is advantageous in that the main building serves as a center in hospital layouts because concentrated placement of the diagnosis/ treatment area and the supply area benefit the overall operation in terms of functions. However, the measure has limits in that it is difficult to install the facilities and equipment of the new demands due to the low ceilings, which serve as a potential challenge in future growth and changes. 2) The latter measure is the one in which equipment-intensive areas and the areas that are absolutely short of space are first placed in the new buildings while other areas (the outpatient area, the administration area and the miscellaneous areas) are in the existing building (main building). Given the possibility of development In the future, concentrated placement in the new buildings can be said to be more effective order to actively address future growth and changes.

A Clinical Survey of the Patients in Neuro-Pain Clinic at Ajou University (신경통증클리닉 환자의 1년간 통계고찰)

  • Park, Eun Jung;Han, Kyung Ream;Kim, Do Wan;Kim, Chan
    • The Korean Journal of Pain
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    • v.20 no.2
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    • pp.181-185
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    • 2007
  • Background: The first pain clinic opened in korea in 1973 at Yonsei University Hospital, however, since then the number of pain clinics has gradually increased, as has the number of patients visiting them. This increase in patient has caused concerns about the way in which pain is managed, therefore, we conducted a retrospective review of data according to the sex, age and disease in an attept to aid us in planning for the future of our pain clinic. Methods: We analyzed 1,282 new patients who had visited our pain clinic and 828 inpatients who were admitted to our pain clinic between March 2006 and February 2007. Results: The most frequent age group was in the sixties in outpatient and in the seventies in inpatient. In addition, the incidence of disease in new patients and inpatients was as follows: in new patients, lumbar herniated intervertebral disc 16.5%, hyperhidrosis 12.3%, cervical disc disorder 10.5%, acute herpes zoster 8.2%, postherpetic neuralgia 7.9%, and trigeminal neuralgia 7.0%; in admitted patients, acute herpes zoster 17.6%, trigeminal neuralgia 15.6%, lumbar herniated intervertebral disc 13.0%, postherpetic neuralgia 11.2%, hyperhidrosis 9.8%, and complex regional pain syndrome 7.0%. Conclusions: The patients visiting our pain clinic have presented with a wide variety of diseases. This improved care reflects an effort to expand our fields not only to the management of outpatients but also inpatients, as well as to the treatment of new fields of disease. In the future, We need to manage various pain patients not only in outpatients but also in inpatients to expand our field even through pain clinic is rapidly growing in Korea.