• The Korean Journal of Pain
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• v.30 no.1
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• pp.44-50
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• 2017

Background: Low back pain is a frequent condition that results in substantial disability and causes admission of patients to neurosurgery clinics. To evaluate and present the therapeutic outcomes in lumbar disc hernia (LDH) patients treated by means of a conservative approach, consisting of bed rest and medical therapy. Methods: This retrospective cohort was carried out in the neurosurgery departments of hospitals in KahramanmaraŞ city and 23 patients diagnosed with LDH at the levels of L3-L4, L4-L5 or L5-S1 were enrolled. Results: The average age was $38.4{\pm}8.0$ and the chief complaint was low back pain and sciatica radiating to one or both lower extremities. Conservative treatment was administered. Neurological examination findings, durations of treatment and intervals until symptomatic recovery were recorded. $Las{\grave{e}}gue$ tests and neurosensory examination revealed that mild neurological deficits existed in 16 of our patients. Previously, 5 patients had received physiotherapy and 7 patients had been on medical treatment. The number of patients with LDH at the level of L3-L4, L4-L5, and L5-S1 were 1, 13, and 9, respectively. All patients reported that they had benefit from medical treatment and bed rest, and radiologic improvement was observed simultaneously on MRI scans. The average duration until symptomatic recovery and/or regression of LDH symptoms was $13.6{\pm}5.4$ months (range: 5-22). Conclusions: It should be kept in mind that lumbar disc hernias could regress with medical treatment and rest without surgery, and there should be an awareness that these patients could recover radiologically. This condition must be taken into account during decision making for surgical intervention in LDH patients devoid of indications for emergent surgery.

• Journal of radiological science and technology
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• v.15 no.2
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• pp.37-47
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• 1992

Magnetic Resonance Imaging(MRI) is one of the most expensive and sophisticated diagnostic tool and has been hailed as the most exciting event in medical imaging "since the introduction of X-rays", but a major disadvantage, high cost, is coming into focus especially in our country. To determine the status of distribution of MR imagers in Korea and to serve as a basic material for an efficient utilization of this Imaging machine, a retrospective survey of nationwide and regional(3 hospitals in Pusan) installations was performed. The results were as follows : 1. As of April 30, 1991, a total of 33 MRI units(24 for superconducting, 6 for permanent and 3 for resistive units) were set up and operated. 91% of the units were distributed in big cities with no one installation in 7 provinces among 12 provinces in our country. 85% of the units were imported. 2. Although 42.4% of the units were operated in Seoul, Taejeon had the best condition for the distribution of this imaging machine per population, hospital, and bed in Korea. 3. In Pusan : a) 5 units were operated with all superconducting magnet and medium magnetic field in type of machine. b) 80.1 % of the examinations were central nervous system(CNS). c) MRI examination occupied 1.4% of all radiographic examinations and the patients referred from other hospitals were composed of 23.4%% of all patients. 4. The average days under operating of MRI unit a week in Puasn were higher(5.5) than that of Seoul(4.5), but the average number of examinations and hours a week and a day, respectively(33, 8.4), was less than that of Seoul(57, 12.9). 5. The patients with positive MRI findings in a hospital(B) in Pusan was 74.5% on an average.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.59-67
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• 2017

This study analyzes the efficiency of oriental hospitals using DEA(Data Envelopment Analysis). The input variables include the numbers of doctors, nurses, medical technicians, and beds. The output variable iscomprised of the sales account. The analysis tools used are EnPas and IBM SPSS Statistics 19. As a result of efficiency analysis, the private hospitals(establishment), less than 10 years in operation(operating period), containing less than 50 beds (number of the beds), located in the metropolitan area(location) showed high efficiency in the BCC(Banker, Charnes & Cooper) model, but indicated relatively low efficiency in CCR(Charnes, Cooper & Rhodes) model. This contradictory result is caused by inefficiencies in hospital size. The logistic regression analysis conducted to analyze the variables that affect the efficiency of oriental hospitals found that the efficiency decreased by 0.955 with each increase of 1 bed in the hospital.

• Tuberculosis and Respiratory Diseases
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• v.66 no.4
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• pp.300-308
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• 2009

Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

• The Journal of the Korea Contents Association
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• v.14 no.12
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• pp.808-817
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• 2014

Purpose: This study was to investigate the recognition of skin infection (RSI) and management practice (MP) on caregivers in geriatric hospital. Methods: The subjects were 209 caregivers who work at geriatric hospital in G city and J do. Data were analyzed with ${\chi}^2$-test, t-test. and ANOVA using SPSS 18.0 program. Results: Prevalence rate of caregivers' skin diseases was 76.6%. Diagnosis of Skin disease was contact dermatitis 42.5%, scabies 26.9%, and skin xerosis 25.0%. The Mean RSI score was 3.81 and MP was 4.12. In addition, MP was significantly different by number of bed hospitals (F=4.63, p=.011) and number of caring patients (F=2.67, p=.049). Conclusion: This study will be a useful on continuing education for caregivers and basis for the guidance of medical infection control standards development.

• Journal of Preventive Medicine and Public Health
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• v.24 no.4 s.36
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• pp.485-495
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• 1991

This study examined the effects of referral requirements for insurance patients which have been enforced since July 1, 1989 when medical insurance coverage was extended to the whole population except beneficiaries of medical assistance program. The requirements are mainly aimed at discouraging the use of tertiary care hospitals by imposing restrictions on the patient's choice of a medical service facility. The expectation is that such change in the pattern of medical care utilization would produce several desirable effects including increased efficiency in patient care and balanced development of various types of medical service facilities. In this study, these effects were assessed by the change in the number of out-patient visits and bed-days per illness episode and the share of each type of facility in the volume of services and the amount of expenditures after the implementation of the new referral system. The data for analysis were obtained from the claims to the insurance for government and school employees. The sample was drawn from the claims for the patients treated during the first six months of 1989, prior to the enforcement of referral requirements, and those of the patients treated during the first six months of 1990, after the enforcement. The 1989 sample included 299,824 claims (3.6% of total) and the 1990 sample included 332,131 (3.7% of total). The data were processed to make the unit of analysis an illness episode instead of an insurance claim. The facilities and types of care utilized for a given illness episode are defined to make up the pathway of medical care utilization. This pathway was conceived of as a Markov Chain process for further analysis. The conclusion emerged from the analysis is that the enforcement of referral requirements resulted in less use of tertiary care hospitals, and thereby decreased the volume of services and the amount of insurance expenses per illness episode. However, there are a few points that have to be taken into account in relation to the conclusion. The new referral system is likely to increase the use of medical services not covered by insurance, so that its impact on national health expenditures would be different from that on insurance expenditures. The extension of insurance coverage must have inereased patient load for all types of medical service organizations, and this increase may be partly responsible for producing the effects attributed to the new referral system. For example, excessive patient load for tertiary care hospitals may lead to the transfer of their patients to other types of facilities. Another point is that the data for this study correspond to very early phase of the new system. But both patients and medical care providers would adapt themselves to the new system to avoid or overcome its disadvantages for them, so as that its effects could change over time. Therefore, it is still necessary to closely monitor the impact of the referral requirements.

• Journal of Hospice and Palliative Care
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• v.13 no.3
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• pp.143-152
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• 2010

Purpose: This study aimed to evaluate the current status of hospice palliative care facilities in Korea. Based on the result, we attempted to suggest activation plans of hospice palliative in Korea. Methods: To conduct a survey, we obtained a list of hospice palliative care facilities from related agencies and academic societies. A survey was conducted from February, 2009 to March, 2009. The survey was consisted of general characteristics of organizations, manpower, facilities & equipments, and so on. In addition, we used data from Statistics Korea to estimate the number of beds required and the bed occupancy rate. Results: Total number of facilities responded to the questionnaire were 53. Forty-two facilities were general hospitals and 6 facilities were clinics among the total 53 facilities, and 18.8% of facilities were located in Seoul, Incheon and Gyeonggido. Overall bed occupancy rate was rather low as 21.9%, and there were 4 provinces where bed occupancy rates were 0%. Deaths in hospice palliative care facilities during 2008 were 6.3% of total deaths from cancers. As for the questions about the financial status of facilities, 86% of facilities were answered financial insufficiency. Also more than half of the facilities gave financial insufficiency as the reason for shortage of human resource supplies and inability to achieve the standard for authorization by the government. Facilities answered in order to activate the hospice palliative care, governmental support is needed, mostly in financial support (71.2%), donation tax deduction (43.1%), and setting up a public utility foundation (23.5%). Conclusion: This study showed low rates of hospice palliative care use and bed occupancy in Korea. Regional variance in bed occupancy rate was significantly high. As a roadblock for these problems, most of the facilities cited financial insufficiency. Therefore, there must be some action plans to boost financial support to activate hospice palliative care in Korea. Finally, efforts to improve these circumstances including lack of understanding about hospice and palliative care, are needed as well.

• The Journal of the Korea Contents Association
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• v.13 no.8
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• pp.314-323
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• 2013

This study analyzed the relationship between the level of hospital caseloads and length of stay for the delivery patients. The differences of hospital caseloads were measured by the Internal Herfindahl Index, which measured the concentration of delivery patient in a hospital. And the structure variables of hospitals such as the number of bed, the number of treatment, and the number of doctors and nurses per 100 beds were included as control variables. And average length of stay of delivery patients was used as the dependent variable. Concentration status of delivery patients was measured in two models: (1) first model represents the concentration level of delivery patient in all hospital patients, (2) second model represents the concentration level of delivery patient in all obstetrics and gynecology patients. In regression analysis, patient concentration index was not statistically significant in explaining the variation of average length of stay in two models. But the number of delivery patients and number of beds were statistically significant. The number of delivery patient variable showed negative regression coefficient with average length of stay and the number of beds showed positive coefficient with average length of stay. This study result indicated that the volume of delivery patients in a hospital will play a significant role in reducing the length of stay of delivery patients. Patient volume could contribute in improving the efficiency of patient care in a hospital.

• Journal of Digital Convergence
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• v.13 no.7
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• pp.259-268
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• 2015

This research grasped the difference of between the daily medical expenses and the medical expenses reduction rate also the cause of change. In the centre, it was conducted in order to offer the necessary basic data to a recuperation pay management solution's establishment. This research surveyed across the country's urban region 50-general hospital's the infective enteritis disease for a year. Then it was conducted the average daily medical expenses and the average medical expenses reduction rate as a distinguishable survey that is a hospitalization and an outpatient the result is followed. The inpatient daily medical expenses correlated with the total number of medical institution personnel, and the outpatient daily medical expenses correlated with the number of beds.. Inpatient medical expense reduction rate was correlated with number of beds and the total number of medical institution personnel. The interaction between medical institution information and daily medical expenses was found to have a positive (+) effect on the total number of medical institution personnel, as well as the numbers of inpatients vs. outpatient. This research about the medical expense reduction rate and daily medical expense help medical institution's efficient, rational decision making and it will be an important basis of a priority recuperation pay's policy.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.46-68
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• 2001

The study was to examine the relationships among those variables related to total quality management and to reveal those variables affecting total quality management in Health-Care Organizations. To study the relationship, a questionaire was designed and sent to 220 hospitals of which the number of beds is over 200 beds. Out of 660 questionaire, 263 questionaire were collected. Data analysis were conducted by using t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression. The result were as follows: 1. TQM was significantly different according to activities of QI, department of QI, age, and position. 2. Leadership was significantly different according to activities of QI, department of QI, age, and position. 3. Significant differences in the level of satisfaction of employee were found according to activities of QI, department of QI, age, position, and duration of employ. 4. Significant differences in the level of participation of employee were found according to activities of QI, department of QI, and position. 5. Education trainning was significantly different according to amount of bed, activities of QI, department of QI, level of education, kind of job, and position. 6. Medical technique was significantly different according to activities of QI, department of QI, and position. 7. Quality of work was significantly different according to activities of QI, department of QI, age, and position. 8. Significant differences in the level of investigation's system in satisfaction of client were found according to activities of QI, department of QI, kind of job, and position. 9. Positive correlations were observed between TQM and those variables related to TQM. 10. TQM was significantly predicted by the level of satisfaction of employee(40.9%), participation of employee(7.0%), investigation's system in satisfaction of client(2.7%), leadership(1.4%), and medical technique(1.1%), respectively.