• Korea Journal of Hospital Management
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• v.1 no.1
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• pp.37-55
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• 1996

This study attempts to analyze the factors affecting the intention of transferring to another hospitals among radiology technologists. 344 cases were reviewed in 5 university hospitals and 1 general hospital. Self-administered questionaire were given to study the socioeconomic characteristics, working conditions, job satisfaction level, and the reasons for transfer among the technologists. The major findings were as follows : 1. Job position and hospital characteristics had a statistically significant relationship with the intention of transferring to another hospital. 2. Those who were not satisfied with their salaries and promotional opportunity showed a higher tendency towards to transfer. 3. Those who were less satisfied with the opportunity for developing the personal ability and had the negative attitude on their job showed a higher tendency to transfer. 4. Those who did not sustain good relationship with their superiors and co-workers scored high on the tendency to transfer. 5. In the result of mutiple regression, recognition of radiation hazard, job satisfaction, satisfaction with salary levels, job attitude were significantly related to transfer. The above indicate that besides economic incentives, job satisfaction and organizational culture to promote their ability and form a good relationship with organization members were very important to decrease the intention of transfer. Since these results represent only 6 hospitals from a limited area, more hospitals nationwide, especially small and medium-sized institutions where there is a high turnover rate of employment, need to be examined in order to investigate the various factors that affect the intention of transferring.

• Journal of Korean Clinical Health Science
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• v.7 no.1
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• pp.1215-1223
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• 2019

Purpose: This study is to figure out not only the characteristics relating to transfer time of inter-hospital transfer patient which is transferred by a private ambulance, but also factors influencing the transfer time. Methods: In this study, an analysis of 750 patients with high severity levels among those transferred to another hospital by a private ambulance in Busan for whole year of 2017. Results: The results showed that the following factors significantly influence the total inter-hospital transfer time: Ambulance crew (${\beta}=10.525$, p=.001) and patient and carer (${\beta}=37.606$, p<.001) when setting a doctor (selecting a medical institution) as a criterion; availability of the specialized care (${\beta}=12.435$, p=.008) when setting the near distance (reason for selecting a hospital for transfer) as a criterion. The explanatory power of this analysis was R2=0.423, whereas the explanatory power of calibration was R2=0.411. Conclusions: Factors that increase the total inter-hospital transfer time were the ambulance crew, and patient and carer's selecting a medical institution, and the reason for selecting a hospital where enables to offer the specialized care services.

• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.281-313
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• 2013

A physician has to do his best for the better treatment of his patiensts. But, if a physician cannot remedy his patients because of the lack of hospital facilities, the lack of medical knowledge and etc., the physician must transfer his patients to another suitable hospital immediately. This is called the duty of interhospital transfer of patients. The necessity of interhospital transfer of patients is primarily ocurred in emergency medical care situations. The Supreme Court Decision 2010DO7070 delivered on April 29, 2010 is one of the important decisions related to the duty of interhospital transfer of patients. The Supreme Court ruled that there were the physician's medical malpractice and the causation between the physician's medical malpractice and the death of patient, as the physician has left the patient without due observations for 1 hour and 30 minutes after the caesarean operation inspite of mass bleeding during the operation, and has transferred the patient to another suitable hospital later. And the Supreme Court ruled that the transferring physician has to explain the situation of the patient in detail to the physician being transferred. I agree with the Supreme Court Decision. As decided by the Supreme Court, physicians will treat their patients more carefully and in case of necessity for transfer, physicians will transfer their patients with more caustion. However, the study for this issue should be continued hereafter because concrete standards are not given to lawers and physicians just by the Supreme Court Decisions itself.

• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.163-201
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• 2019

Doctor has the duty of an inter-hospital transfer, known as inter-facility or secondary transfer, when the diagnostic and therapeutic facilities required for a patient are not available at the given hospital. Also, the decision to transfer the patient to an another facility is rely on whether ill patient is the benefits of care, including clinical and non-clinical reasons, available at the another facility against the potential risks. Crucial point to note is that issues about 'inter-hospital transfer' is limited to questions occurred in the course of transfer between emergency medicals (facilities). 'emergency medical (facility)' is specified by Medical Law, article 3 and the duty of an inter-hospital transfer includes any possible adverse events, medical or technical, during the transfer. Because each medical facility has an different ability to care for a patient in an emergency condition, coordination between the referring and receiving hospitals' emergency medicals would be important to ensure prompt transfer to the definitive destination avoiding delay at an emergency. Simultaneously, transfer of documents about the transfer process, medical record and investigation reports are important materials for maintaining continuity of medical care. Although the duty of an inter-hospital transfer is recognized as one of duty of doctor and more often than not it occurs, there is constant legal conflict between a doctor and a patient related to the duty of the inter-hospital transfer. Therefore, we need clear and specific legal standard about the inter-hospital transfer. This paper attempts to review the Supreme Court's cases associated to the inter-hospital transfer and to compare opinion of the cases with guideline for an inter-hospital transfer already given. Furthermore, this article is intended to broaden our horizons of understanding the duty of an inter-hospital transfer and I wish this article helps to resolve the settlement and case dealt with the duty of inter-hospital transfer.

• The Korean Society of Law and Medicine
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• v.13 no.1
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• pp.249-293
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• 2012

Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.116-133
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• 2002

Background : It is very common in Korea to take care of non-acute patients in an acute setting, due to the lack of long-term facilities. Long term hospitalization increase medical expenses and decreases the bed utilization, which can affect the urgent and emergent admissions, and eventually jeopardize the hospital financially. In this study, strategies for effective transfers to the lower levels of care, and to decrease the length of stay were presented by surveying and analyzing the patient's knowledge of the transfer needs, and the willingness to transfer those whose hospital length of stay was more than 30days. Method : The survey is subject to a group of 251 patients who have been hospitalized over 30 days in a general hospital in Seoul. Excluding those that were in the Intensive Care Unit and psychiatric ward, 214 in-patients were used as participants. They were surveyed from April 9, 2002 to April 17, 2002. One hundred and thirty seven out of 214 were responded which made the response rate 64%. Data were analyzed by SAS and SPSS. Result : Multi-variable Logistic Regression Analysis showed a significant effect in medical expenses, knowledge of referral system and the information of the receiving hospital. The financial burden in medical expenses made the patient 10.7 times more willing to be transferred, knowledge of the referral system made them 5 times more willing to be transferred, and the information of receiving hospital makes 6.5 times more willing to be transferred. Reasons for willing to be transferred to a lower level of care were the phase of physical therapy, the distance from home, the attending physician's advice and being unable to be treated as an out patient. Reasons for refusing to be transferred were the following. The attending physician's competency, not being ready to be discharged, not trusting the receiving hospital's competency due to the lack of information, or never hearing about the referring system by the attending physician. Conclusion : Based on this, strategies for the effective transfer to the lower levels of care were suggested. It is desirable for the attending physician to be actively involved by making an effort to explain the transfer need, and referring to the Healthcare Coordinating Center, which can help the patient make the right decision. Nationwide networking for the referral system is the another key factor that may need to be suggested as an alternative to decrease the medical expenses. Collaborating with the Home Health Agency for the early discharge planning and the Social Service Department for financial aid are also needed. It is recommended that the hospital should expedite the transfer process by prioritizing the cost and the information as medical expenses, knowledge of referring system and the information of the receiving hospital, are the most important factors to the willingness to transfer to a lower level of care.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.261-265
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• 2013

Purpose: The aim of this study is to evaluate the transfer pattern of multiple trauma patients after acute phase management and to determine whether the time between the surgeon's decision and the actual transfer correlates with the patient's insurance type. Methods: Three hundred ninety-two(392) multiple trauma patients visited the emergency room from January 2011 to April 2013. Among the 143 patients who were admitted by a trauma surgeon, 47 were transferred to another hospital after acute phase management. The age, gender, trauma mechanism, Revised trauma score (RTS), Injury severity score (ISS), insurance type, length of ICU stay and hospital stay were analyzed through a retrospective chart review. Results: The mean age was 47.7 years, and traffic accident was the most common mechanism(26, 55.3%). The mean RTS and ISS were 6.93 and 22.7, respectively. Twenty-five patients(53%) were covered by National health insurance, and 20 patients(42.6%) were covered by automobile insurance. Patients were transferred to primary (4.3%), secondary(80.9%), tertiary(4.3%) and care(10.6%) hospitals. The mean time from transfer decision to actual transfer was significantly longer for patients who were covered by automobile insurance than it was for patients who were covered by national health insurance (p=0.038). Conclusion: An appropriate transfer system at the end of acute phase care is essential for managing trauma centers with limited staffing and facilities. In addition, the mean time from transfer decision to actual transfer seemed to be definitely related to the type of insurance covering the patient.

• Journal of The Korea Institute of Healthcare Architecture
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• v.16 no.2
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• pp.65-75
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• 2010

Space transformation of hospital architecture happens more rapidly than other types such as school and office buildings. This requirement is caused by medical demand, service transformation, technical development and equipment changes. Grand scale extension and rapid change in hospital architecture affects whole planning; therefore, it is important to design in the macro perspective such like Life Cycle. Grand scale extension is difficult process to rebuild growth and transfer of hospital architecture and to adapt to the future change. That's why simple planning gives limits to some departments in a short-term and brings another reform such as more extension or interior renovation in a long-term. This study surveys various space transformation and grand scale extension of EB hospital extended recently, and it is to find planning condition in extension.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.3
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• pp.361-370
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• 2007

Purpose: With the increasing opportunities for students to transfer into nursing from other departments or after graduation, it is important to examine how these students adapt to clinical work in the hospital setting after graduation. This study was done to describe the adaptation experience of older graduate nurses in hospital settings and to understand the meanings and search the nature of their experience. Method: For this study, the participants were 6 nurses who entered nursing after having graduated from college or university in another field. The data were collected through in-depth interviews from March to April 2007 and analyzed by Colaizzi's phenomenological method. Results: The essential themes of the adaptation experience for older graduate nurses were the following 6 categories: taking responsibilities for the expected role according to one's age, following the rules of senior-junior hierarchy, being ambivalent about one's older age, expanding one's support system, getting rid of the concept of age difference and establishing the expected position appropriate for one's career. Conclusion: For older graduate nurses, interpersonal relationship factors were more important than work related factors. Therefore, it is important to create a more flexible nursing culture to ease the adaptation of these older graduate nurses.

• Journal of Korean Foot and Ankle Society
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• v.6 no.2
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• pp.190-194
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• 2002

Purpose: We present our experience about the clinical aspect and treatment modalities of ostechondritis dissecans of the talus. Material and Method: This study included 35 patients, 38 cases diagnosed as ostechondritis dissecans of the talus that were proved by clinical and radiologic finding. The methods of treatment were conservative (2 cases), multiple drilling (1 case), excision (1 case), excision, curettage & multiple drilling (23 cases), curettage & bone peg fixation (2 cases), curettage & bone graft (2 cases), and autogenous osteochondral transfer(Mosaicplasty) (7 cases). Results: Of the 38 cases, 30 cases were associated with a history of trauma (17 cases of medial lesion, 13 cases of lateral lesion), and 9 cases of which had major trauma history and 21 cases, minor repetitive trauma history. According to O'Farrel grading system, 21 cases (55%) had good results, 11 cases (29%) had fair results, and 6 cases (16%) had poor results. Of the medial lesion 16 cases had good results, 6 cases, fair results, and 2 cases, poor results. Of the lateral lesion 5 cases had good results, 5 cases, fair results, and 4 cases, poor results. Conclusion: There were fair or good results in 84% of patients with surgical treatment. Curettage and multiple drilling reveals a good result in medial lesion in grade I, II, III and lateral lesion in grade I, II. Autogenous osteochondral transfer(Mosaicplasty) is considered for the cases in grade III, IV(medial and lateral), lesion exceeds 1Cm of size and poor result with another treatment modality.