This study was conducted to follow the patient referral system operated from the primary health care facilities to the hospital in a rural area of Korea. The subject for this study was sampled from a community health development project carried out by the Korea University in Yeoju Kun, Kyonggi Province. The data of referred patients from primary health care facilities were collected during the period from January 1989 to December 1989. The data was sorted out by a computer system using Database package. The results of this study were summarized as follows: 1. Characteristics of the referred patients were: males $32.0\%$. and females $68.0\%$. The more elderly of the patients visited to the hospital after having been referred there by CHPs or public physicians, $25.9\%$ has been to hospital on at least one previous occasion as against $74.1\%$ for whom it was there first visit. 2. The majority of patients who were referred to a hospital where: medicine $44.3\%$ and orthopedics$16.4\%$, major diseases were : diseases of digestive system $(21.3\%)$ ; symptoms and ill defined conditions $(17.3\%)$ ; diseases of the muscular skeletal system and connective tissue$(14.2\%)$. chronic illness was $82.0\%$ and acute illlness was $18.0\%$. 3. From Community health practitioners more patients referred than the public physicians. Categoris of diseases of the referred patients were different between community health practitioners and public physicians. Due to the. respective differences between the medical restrictions put on the nursing staffs at the community health practitioners and public physicians. From this study it was recommended to define the reason of differences between ~he two groups in futher study. Study as to 1) why one group should be referring more for hospital treatment than the other. And 2) why the two agencies should be referring different diseases.
Lee, J.S.;Choi, M.S.;Sung, C.M.;Lee, J.Y.;Lee, K.H.;Sohn, I.
The Korean Journal of Nuclear Medicine
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v.23
no.2
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pp.189-193
/
1989
To observe the effect of gastric filling on the images of hepatic scintigraphy, we performed hepatic scintigraphy using $^{99m}Tc-tin$ colloid in twenty patients both in the fasting state and after meal, and made the visual comparison of both images. We found that gastric filling could cause some of the following changes in individual patients. 1) In the anterior view, the distance between the liver and the spleen increased and the interlobar notch of the inferior hepatic border was obliterated. The spleen was displaced downwards, its radioactivity in the upper medial part was reduced, and its upper pole was laterally displaced. 2) In the posterior view, the left lobe of the liver was separated from the spleen and the distance between the liver and the spleen increased. 3) In the right lateral view, the notch separating the right and the left lobes of the liver was well demarcated. 4) In the left lateral view, the spleen was separated from the liver and the distance between the liver and the spleen increased. The shape of the spleen was also changed. In case of the follow-up study, above changes should make one consider the possibility of the effect of gastric filling.
Proceedings of the Korea Contents Association Conference
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2008.05a
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pp.352-355
/
2008
I argue that the National University Hospital has to take its responsibility as the third health care service center for leading other public health care corporations, as well as its responsibility for educating, researching, and serving as a health center, as it written on its act of incorporation. As its management system had changed from a state-owned enterprise system to a self-supporting accounting system of a special corporation, the National University Hospital has pursued more heavily upon the profitability without showing any differences with the private university hospitals, even though the National University Hospital is a state-owned and public health care corporation. Therefore, after I have specifically analyzed the correlation between public service and profitability in a National University Hospital, I present my ideas on how to assign the public health care responsibilities to the National University Hospital in the current situation of pursuing heavily on profitability. Also how to partake in the service roles of the National University Hospitals in harmony with other health care corporations, and how to balance public service and profitability in the National University Hospitals.
The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance. From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we devided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in Korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in Korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be needed to reduce hospital cost in Korea. We thought that the Korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the United States. This study presents some limitations such as no insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can. possibly affect LOS. However, this study reports an important trend in LOS from 1984 to 1994.
Eun Hye Choi;Jung Hee Cho;Kyoung Eun Yeob;Bo Hui Park;So Young Kim;Jong Hyock Park
Health Policy and Management
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v.34
no.2
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pp.211-221
/
2024
Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.
The aim of this study is to analyze the differences in the publicness indices depending on the environmental factors of regional public hospitals to derive the policy implications for improving management for regional public hospitals. The data of the 34 regional public hospitals from 2016 was used for the analysis. Major results of this study are as follows. First, the analysis of the differences in the scores of the medical safety net function showed significantly higher scores for regional public hospitals with a larger location, a larger number of hospitals in a unit area, a larger number of nurses per 100 beds, and the lower management fee ratio. Second, the analysis of the differences in the scores of the unmet healthcare needs showed significantly higher scores for regional public hospitals with a larger number of hospitals in a unit area, and a larger number of beds. Third, the analysis of the differences in the scores of the hospital-specialized services showed significantly higher scores for regional public hospitals with a larger location, a higher financial independence of the local government, a larger number of hospitals in a unit area, a larger number of beds, and a larger number of nurses per 100 beds. Major conclusions of this study are as follows. Consideration should be given to the appropriate number of nurses for each regional public hospital to maximize publicness by providing the appropriate amount of medical services, but not to incur unnecessary labor costs. In addition, efforts should be made to enhance profitability, which can be a means of strengthening publicness, by identifying the minimum administrative expenses required for efficient operation and reducing unnecessary administrative expenses. Finally, it is necessary to identify the appropriate number of beds to meet the needs of the customers and to create maximum profits.
The Journal of the Convergence on Culture Technology
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v.8
no.5
/
pp.619-629
/
2022
This study aims to investigate the relationship among public service motivation, hospital organizational culture type, job-esteem, and turnover intention of public hospital nurses. A cross-sectional study was conducted on 124 nurses at four public hospitals in the Gyeonggi Province (Icheon, Anseong, Suwon, Paju). Data were analyzed using descriptive statistics, t-tests, ANOVA, and Pearson correlation coefficient. Mann-Whitney U test and the Kruskal-Wallis test were used with the Bonferroni test for post hoc comparison when the data were not normally distributed. The turnover intention of the subjects was public service motivation (r=-.30, p<.001), affiliative culture (r=-.28, p=.002), innovative culture (r=-.34, p< .001) and task culture (r=-.30, p=.001) were negatively correlated. Study findings suggest that public service motivation must be increased to reduce the turnover intention of nurses in public hospitals.
The administration of a regional public hospitals are expending from profit preference to publicity preference. The weight rate for a profitability and publicity of performance assessment has changed from 84:16 which was resulted by the assessment executed firstly in 1989 to 39:61 as resulted in 2004, the final assessment execution in 2005. Regional public hospitals are exerting and promoting a magnification in public sector to raise up the public-score. With comparison between publicity scores and profitability scores in original scores basis excluding weight rate, the publicity scores ranked higher than profitability scores although the latter was higher by 2002. However, for the administration performance of the regional public hospitals, the deficits increased 11 times from \92.6billion deficits with \460.3billion cost increased by 457% although income as \367.7billion increased by 394% comparing the last 2004 year to the first 1989 year for profit & loss statement of a regional public hospitals. There was analysis for the relation in yearly basis partitioning publicity and profitability for the assessment scores of the to regional public hospitals confirm the accumulated deficits of the hospitals like this attribute to the extension of public sector. The result showed that there was distinct plus relationship from 1999 although a minus relationship in general until 1997 except 1992 and there is a more plus relationship as approaching 2004. That is, it is hard to tell that the accumulated deficits increase of regional government medical center attributed to extension of public sector. On the contrary, the analysis showed the extension of public sector has a mutual relationship with uplift of profitability Meanwhile, it showed that operation cost rate and labor cost are the factors which influence a revenue & expenditure rate among the profitability index according to the results of relation analysis for the representative index of profitability and that of publicity.
Background: Colorectal cancer is one of the leading causes of mortality worldwide. Genome wide analysis studies have identified sequence mutations causing loss-of-function that are associated with disease occurrence and severity. Epigenetic modifications, such DNA methylation, have also been implicated in many cancers but have yet to be examined in the East Asian population of colorectal cancer patients. Methods: Biopsies of tumors and matched non-cancerous tissue types were obtained and genomic DNA was isolated and subjected to the bisulphite conversion method for comparative DNA methylation analysis on the Illumina Infinium HumanMethylation27 BeadChip. Results: Totals of 258 and 74 genes were found to be hyper- and hypo-methylated as compared to the individual's matched control tissue. Interestingly, three genes that exhibited hypermethylation in their promoter regions, CMTM2, ECRG4, and SH3GL3, were shown to be significantly associated with colorectal cancer in previous studies. Using heatmap cluster analysis, eight hypermethylated and 10 hypomethylated genes were identified as significantly differentially methylated genes in the tumour tissues. Conclusions: Genome-wide methylation profiling facilitates rapid and simultaneous analysis of cancerous cells which may help to identify methylation markers with high sensitivity and specificity for diagnosis and prognosis. Our results show the promise of the microarray technology in identification of potential methylation biomarkers for colorectal cancers.
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