This study purports to find the predictor of hospital bankruptcy in Korea and to examine the predictive power of the discriminant function model of hospital bankruptcy. Data on 17 financial and 4 non-financial indicators of 31 bankrupt and 31 profitable hospitals of 1, 2, and 3 years before bankruptcy were obtained from the hospital performance databank of Korea Institute of Health Services Management. Significant variables were identified through mean comparison of each indicator between bankrupt and profitable hospitals, and the discriminant function model of hospital bankruptcy was developed. The major findings are as follows 1. As for profitability indicators, net worth to total assets, operating profit to total capital, operating profit ratio to gross revenues, normal profit to total assets, normal profit to gross revenues, net profit to total assets were significantly different in mean comparison test in 1, 2, and 3 years before hospital bankruptcy. With regard to liquidity indicators, current ratio and quick ratio were significant in 1 year before bankruptcy. For activity indicators, patients receivable turnover was significant in 2 and 3 years before bankruptcy and added value per adjusted inpatient days was significant in 3 years before bankruptcy. 2. The discriminant function in 1, 2, and 3 years before bankruptcy were; $Z=-0.0166{\times}quick$ ratio-$0.1356{\times}normal$ profit to total assets-$1.545{\times}total$ assets turnrounds in 1 year before bankruptcy, $Z=-0.0119{\times}quick$ ratio-$0.1433{\times}operating$ profit to total assets-$0.0227{\times}value$ added to total assets in 2 years before bankruptcy, and $Z=-0.3533{\times}net$ profit to total assets-$0.1336{\times}patients$ receivables turn-rounds-$0.04301{\times}added$ value per adjusted $patient+0.00119{\times}average$ daily inpatient census in 3 years before bankruptcy. 3. The discriminant function's discriminant power in 1, 2, and 3 years before bankruptcy was 77.42, 79.03, 82.25% respectively.
Rubella is a viral disease with mild constitutional symptoms and generalized rashes. In childhood, it is an inconsequential illness, but when it occurs during early pregnant period, there are significant risks of heart defects, cataract, mental retardation to the fetus. The series of congenital defects induced by rubella is called 'congenital rubella syndrome'. Many research have been performed to find out more effective prevention program on rubella. The objectives of this study are, first, to calculate the incidence rate of acute rubella infection and congenital rubella syndrome in Korea, second, to evaluate economic efficiency of several rubella vaccination policies and to offer data for the most reasonable decision on vaccination policy. Study populations are 663,312 children of one year-old in 1992. The author has performed cost-benefit analyses according to the three vaccination policies-U.S.A.'s. U.K.'s and Sweden's. In this Study, the author got the incidence rate of acute rubella infection using the catalytic model. In the meantime, the author used 50 per 100,000 live births as the incidence rate of congenital rubella syndrome. The discount rate used in this study was 5 percent per annum. The sensitivity analyses were done with different discount rates (4%, 7%) and different incidence rate of congenital rubella syndrome (10,100 per 100,000 live births) : The study results are as follows: 1. Without vaccination, lifetime expenditures per patient for acute rubella infeciton amount to 14,822 won and the total expenditures to about 3.1 billion won. Meanwhile, lifetime expenditures per patient for congenital rubella syndrome amount to about 91 million won and the total expenditures to about 16.3 billion won without vaccination. 2. The cost of vaccination for a child of one year old was 2,322 won and the total cost for the one year old children was about 1.5 billion won (American style). The cost for vaccination of female children at fifteen was about 339 million won (Birtish style). And the cost of vaccination at one for both sex and female children at fifteen was about 1.9 billion won (Swedish style). 3. The benefit to cost ratios of vaccination of female children at fifteen that is the british mode of rubella vaccination, was 60.0 at the level of 80% population coverage and 48.6 at 100% coverage. It shows much higher benefit to cost ratio than those of the other two vaccination policies. 4. Both net benefits of vaccination at one (American style) and that of vaccinations at one and fifteen (Swedish style) range from about 17.0 billion to 17.8 billion won, those were larger than that of vaccinations of female children at fifteen (Birtish style, about 16.0 billion). 5. In marginal cost-benefit analysis of only additional program of revaccination, the benefit to cost ratios were 3.6 (80% coverage rate) or 0.6 (100% coverage rate). It implies that additional program was less efficient or inefficient. 6. In sensitivity analysis with different discount rates(4% or 7%) and different incidence rates of congenital rubella syndrome (10 or 100 per 100,000 live births), the benefit to cost ratios has fluctuated in wide range. However, all the ratios of vaccination of female children at fifteen were higher than those of the others. Even under the most conservative assumption, the benefit to cost ratios of all the rubella vaccination policies were higher than 3.3. In conclusion, all the rubella vaccination policies found to be cost-effective and particularly the vaccination of female children at fifteen was strongly recommended.
Journal of agricultural medicine and community health
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v.33
no.2
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pp.204-220
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2008
Objectives: This study was performed to determine the levels of depression symptoms among the community elderlies and to reveal its related factors, specifically aimed at revealing psycho-social factors such as social support net-work, sense of self-esteem, state anxiety, interpersonal behavior trait and locus of control.
Methods: The interviews were performed during the period from April 1st to June 30th, 2007 to the 790 elderlies in urban and rural areas.
Results: The mean scores of depression (CES-D) among all subjects were 16.65±10.97(urban: 18.81±10.31, rural: 14.49±11.20) and they were higher in urban than rural. The level of depression symptoms was influenced by the variables of educational level, with or without spouse, bear for living expenses, sense of satisfaction in daily life. As for health related behaviors, they were influenced by the variables of with or
without regular exercise. As for health status, they were influenced by the subjective health status, with or without disability of body, visual acuity, hearing ability, ability of food mastication, urinary incontinence, with or without help in activity of daily living (ADL) and instrumental activity of daily living (IADL). As for social support net-work and social activities, they were influenced by number of offspring, frequency of offspring contents, frequency of going out and activity of hobbies. As for psycho-social factors, they were influenced by sense of self-esteem, state anxiety and social support, especially, the level of depression symptoms was higher influenced by the variables of psycho-social factors than other variables. Conclusions: Lower of the level of depression symptoms among the community elderlies would require development and application of programs to keep under management psycho-social factors as well as looking for ways to promoting the present health status.
Floods are becoming more severe and frequent due to global warming-induced climate change. Water disasters are rising in Korea due to severe rainfall and wet seasons. This makes preventive climate change measures and efficient water catastrophe responses crucial, and synthetic aperture radar satellite imagery can help. This research created 1,423 water body learning datasets for individual water body regions along the Han and Nakdong waterways to reflect domestic water body properties discovered by Sentinel-1 satellite radar imagery. We created a document with exact data annotation criteria for many situations. After the dataset was processed, U-Net, a deep learning model, analyzed water body detection results. The results from applying the learned model to water body locations not involved in the learning process were studied to validate soil water body monitoring on a national scale. The analysis showed that the created water body area detected water bodies accurately (F1-Score: 0.987, Intersection over Union [IoU]: 0.955). Other domestic water body regions not used for training and evaluation showed similar accuracy (F1-Score: 0.941, IoU: 0.89). Both outcomes showed that the computer accurately spotted water bodies in most areas, however tiny streams and gloomy areas had problems. This work should improve water resource change and disaster damage surveillance. Future studies will likely include more water body attribute datasets. Such databases could help manage and monitor water bodies nationwide and shed light on misclassified regions.
Background: In order to emphasize the importance of clinical dental hygienists-led dental hygiene management processes for those with systemic diseases, we tried to identify systemic diseases affecting dental implants based on clinical data. Methods: In order to identify systemic diseases affecting dental implants, literature review was conducted from March 1 to May 31, 2023, and the search period was for research papers published in domestic and foreign academic journals from January 2000 to December 2020. Domestic databases used for search use RISS, Nuri Media(DBpia), and Korea Academic Information (http://www.papersearch.net ; KISS), while overseas databases searched Pubmed for dental implant failures, implants, systemic diseases, and Dental implant and system disease. Results: The cumulative survival rate of implants averaged 94.3 percent and the failure rate was 5.7 percent. Clinical analysis of systemic diseases related to implants accounted for the highest frequency with 13 (100.0%), followed by 8 (61.5%) studies on high blood pressure and smoking, 7 (53.8%) cardiovascular diseases, and 5 (38.5%). In addition, liver disease, thyroid abnormalities, blood abnormalities, organ transplants and infectious diseases were confirmed. Conclusion: Since unregulated systemic diseases are a risk factor for implant failure, clinical dental hygienists should continue to maintain healthy oral conditions by sharing information with patients during periodic preventive dental hygiene management processes such as dental hygiene assessment.
Chang, Hsien Pin;Hong, Jong Won;Lee, Won Jai;Kim, Young Seok;Koh, Yoon Woo;Kim, Se-Heon;Lew, Dae Hyun;Roh, Tae Suk
Archives of Plastic Surgery
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v.45
no.5
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pp.449-457
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2018
Background Although previous studies have focused on determining prognostic and causative variables associated with fistula-related complications after head and neck reconstructive surgery, only a few studies have addressed preventive measures. Noting that pooled saliva complicates wound healing and precipitates fistula-related complications, we devised a continuous suction system to remove saliva during early postoperative recovery. Methods A continuous suction system was implemented in 20 patients after head and neck reconstructive surgery between January 2012 and October 2017. This group was compared to a control group of 16 patients at the same institution. The system was placed orally when the lesion was on the anterior side of the retromolar trigone area, and when glossectomy or resection of the mouth floor was performed. When the orohypopharynx and/or larynx were eradicated, the irrigation system was placed in the pharyngeal area. Results The mean follow-up period was $9.2{\pm}2.4$ months. The Hemovac system was applied for an average of 7.5 days. On average, 6.5 days were needed for the net drain output to fall below 10 mL. Complications were analyzed according to their causes and rates. A fistula occurred in two cases in the suction group. Compared to the control group, a significant difference was noted in the surgical site infection rate (P<0.031). Conclusions Clinical observations showed reduced saliva pooling and a reduction in the infection rate. This resulted in improved wound healing through the application of a continuous suction system.
Objectives : Because elementary school children are sensitive and prevalent to dental caries, oral health care program for the elementary school children (ESOHCP) should be met the first priority for the national oral health care program. This study was performed to proposed the guidelines for executing the efficient ESOHCP through the evaluation of present oral health care and education status based on the attitudes and opinions of health teachers. Methods : Subjects were 181 health teachers those are a part of the total 273 elementary school health teachers in Busan. From April to June 2001, questionnaire survey on the teacher's attitude and opinion, present status of oral health care and education in their own school was done. Data was analyzed by $\chi^2$-test, t-test, ANOVA using SAS (ver 6.21) program. Results : Mean age of the teachers was 40 years (24~58 years) and mean scale of the subject school was 32 classes (5~58 classes). Above 90% of them agreed with the necessity and importance of ESOHCP, but actual level of concerning was lower. They gained the informations about oral health mainly from media (33%), PC net (26%), academic society (25%), and more used internet (p=0.012) in younger generation. Though most of them (96%) had a specified school dentist, only 58% had the experience of periodic oral health examinations in their own school. The major experienced ESOHCP was fluoride brushing and contest to choose the best healthy teeth. Oral health education given by the teachers was not professional but their own. About half (42%) of the teachers had never taken education during last one year. Major education materials were VTR tape (79%), teeth model (64%), CD (55%), booklet (50%), etc., and the teachers' preference was also VTR tape (43%) and CD (41%). When they need education materials, they frequently request to dentist's association (36%), academic society (35%), but rarely to dental clinics or dentists (6%). They prefer that two times (46%) of annual oral health education, with the contents of regular brushing (53%), but lower regular visit to clinics (13%). The interest to oral health care (p=0.016) increased with teacher's age. And, they agreed regular students education in case of higher interest(p=0.044). Intention about join in the model school program was decreased with scale of school (p=0.002). Conclusions : This result showed that the present status of ESOHCP is still insufficient. It considered that the health teachers' interest and role is most important for the maintenance and success of ESOHCP. The professional and efficient education program would be focused on the health teachers to induce drive on ESOHCP.
Objectives: This study aims to examine if a garbage dumping site has real and negative influence on the quality of life (QOL) for the nearby residents. The net effects of the residential distance from the garbage dumping site and from the garbage truck route were investigated for five domains of the QOL. Methods: Two hundred fifty seven Shin-dong Myeon residents, Chun-cheon Si, participated in a self-administrated survey. The Shin-dong Myeon garbage dumping site began operating in 1996. ANCOV A with generalized linear models and multiple regression analysis were performed. Results: Descriptive analyses show that a residence nearby a garbage dumping site is negatively associated with the physical and environmental domains of the QOL. The residential distance from the garbage truck route does not exert any significant effect on various domains of QOL, except for the environmental domain. On the multivariate analysis, the residents living near the garbage dumping site tended to have a significantly negative QOL in the physical and environmental domains. However, the distance from the garbage truck route did not show a significant nor substantial effect on the QOL. The demographic and socioeconomic control variables are associated with a number of the QOL domains, and their patterns are consistent with the general expectations. Conclusions: The results indicated that a garbage dumping site is considered to be an environmental hazard among the nearby residents according to the lower scores on the physical and environmental domains of the QOL. The findings from this study provide comprehensive understanding on the residents' QOL, and they may help politicians and policy makers make decisions for appropriate interventions.
Journal of Korean Academy of Nursing Administration
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v.6
no.1
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pp.83-96
/
2000
With the increased use of computers in medical fields, we can consider introducing computer mediated communication into the area of patient care such as medical or health counseling and education. But little was known about what problems can be counseled, what is the main direction of counseling, and what difficulties are met during the computer mediated counseling. So I conducted this study. This is a fundamental study concerning the health counseling by the inter-net. In this study, medical counseling using a method of questioning -answering through a computer mediated communication system was carried out from June 1998 to May 1999. I analyzed the contents of questions and answers by the ICPC classification. The ICPC classification emerged as a standard for information categorization in Primary Health Care within a few years. One of the most prominent features of this classification is the inclusion of the complaints of the patients (symptoms & complaints) and the social problems (Chapter Z). Thus, and for the first time, the demand of patients may be assessed such as it is expressed in the reality. The ICPC list is now an international standard whose validity is not questioned any more. It is translated in more than twenty different languages. The data collected were analyzed by descriptive statistical method, c2 test by cross tabulations. Followings are the results of this study. 1. The 3,054 users composed of 64% of males and 36% of females. The highest number of users was showed in the age group of $25{\sim}29$ (39.4%). 2. During the one-year period, the average number of counseling per user was 2.5 cases and per day was 21.1 cases. 3. In classifying symptoms and complaints by 17 chapter, digestive(17.6%), general and unspecified (12.7%), skin(12.7%) and musculoskeletal system (9.6%) were most common questions. 4. The distribution of diagnosis by 17 chapter, general and unspecified (21.4%), digestive (15.3%), skin (11.9%) and mus- culoskeletal system (8.9%) were most common answers. 5. Many users wanted to know symptoms and complaints(3,609 cases), treatment principles (2,928 cases), prognosis and preventive methods for health problems which were previously diagnosed (284 cases).
Journal of agricultural medicine and community health
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v.25
no.2
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pp.217-230
/
2000
For the longest time, our government has played an inconsiderable role in the public health services of Korea, especially as it relates to their investment. Voices have cried out against increases in national health expenditure and for more establishment of public medical facilities. In light of this, the necessity and importance of public medical facilities have come into focus amidst the recent medical crisis. When public medical facilities filled in the gap created by the suspension or closure of private hospitals and clinics as a result of this national crisis and acted as a safety net, the demand for more establishment of such facilities increased. Although patient diagnosis and treatment are the first priority of public medical facilities, they must also deal with scopes that private medical facilities do not deal with, dislike, or have difficulty with. In this respect, the closure or privatization of public hospitals to reduce their number just because of their low profits or financial burdens that must be carried by the government is to ignore their innate importance and social role; therefore, we must do all we can to block such efforts and further empower these public health facilities according to demands of the time. The improvement of public health services can be realized by redefining its goals and roles, increasing government funding, strengthening of existing public health facilities and reorganizing the public health services system. Even if public health facilities were to increase their medical services and be reinforced, they cannot take on all the services related to public health services, Therefore, in a country like ours where public health services come second to private health services in the health care system, the health of citizens can be safeguarded only when private and public facilities cooperate and private medical facilities share the social responsibilities. Only the show of interest and effort by government, politicians, health professionals, professional organizations and public can initiate the improvement that is sought.
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