• Journal of Preventive Medicine and Public Health
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• v.29 no.1 s.52
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• pp.51-65
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• 1996

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.

• Health Policy and Management
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• v.32 no.4
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• pp.356-367
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• 2022

Background: The emergence of new infectious diseases threatens public health, increasing socioeconomic damage, and national risks. This study aimed to develop an evidence-based risk assessment tool to quickly respond to new infectious diseases. Methods: The risk elements were extracted by reviewing the risk assessment methods of the World Health Organization, United States, Europe, United Kingdom, and Germany, and the validity and priority of elements were determined through expert meetings and Delphi surveys. Then, the scale and level for each risk element were defined and a final score calculation method according to the risk evaluation result was derived. The developed risk assessment tool was verified using data at the time of domestic transmission of an emerging infectious disease. Results: In case of spread of actual infectious diseases, priority is determined based on the criticality of the elements in each area of transmissibility and severity, from which the weighted score of the risk assessment is derived. Then, the risk score for each element was calculated by multiplying the average value of the risk evaluation by its weight and the evaluation risk assessment score for the two areas was calculated. At last, the final score is plotted in a matrix where the x-axis indicates the transmissibility and the y-axis the severity and plotted on the coordinate plane for time series use. Conclusion: With respect to transmissibility and severity, this risk assessment method to respond to new and re-emerging infectious diseases enables rapid and evidence-based evaluation by quantitatively and qualitatively assessing various risk elements.

• Journal of Preventive Medicine and Public Health
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• v.29 no.2 s.53
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• pp.311-329
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• 1996

This study was designed to compare the level of medical utilization between the urban and rural areas of Korea and to explain the differences between the two regions. Data from the National Health Interview Survey performed by the Korean Institute of Health & Social Affairs in 1992 were used for this study utilizing a sample size of 21,841 people. The level of medical utilization such as the number of physician visits and the number of hospital admissions was compared between the regions with ANOVA. Various determinants for medical use were also compared by univariate analysis. Statistical models which included enabling factors, predisposing factors, need factors and region were constructed for bivariate analysis in order to further elucidate the level of medical utilization. The results were as follows: 1. There was greater medical use, both in terms of physician visits and inpatient care in the rural areas in spite of insufficient health resources. The particular reasons for higher medical utilization in rural areas were attributed to a higher number of initial physician visits as well as a longer the length of stay per hospital admission. Therefore, indicators representing the degree of met need (utilization/need) showed no significant difference between rural and urban areas in spite of the fact that the medical need is larger in rural areas. 2. Use of public health facilities received a significant portion of physician visits in the rural area. The government's effort to enhance primary health care through health centers, health subcenters and the nurse practitioner's post in rural areas has contributed to the increase of access to medical care in the rural areas. 3. There were some differences in the socio-demographic characteristics between two regions ; There were more elderly people over the age of 65: unstable marital status, less education and lower incomes also characterized the rural areas. Therefore, among rural people, there were more predisposing factors for medical use. Additionaly, need factors such as poor self-reported health status and high morbidity level were also high in the rural area. 4. In contrast it was learned that, the supply of health resources was mostly concentrated in the urban areas except for public health facilities. Therefore, geographical access to medical care was lower in the rural area both in terms travel time and travel cost. 5. The coefficient of the region variable was insignificant in the regression model which controlled the supply factor only. However, utilization was significantly higher in urban areas if the model included predisposing factors and need factors in addition to the supply factor. The results were interpreted as rural people have greater medical needs.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.1981-1987
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• 2014

Objective: To establish the prevalence and distribution profile of esophageal squamous cell carcinomas (ESCCs) over a 22-yr period in North China. Methods: Using endoscopy for primary diagnosis and histological analysis for the further confirmation, a total of 74,854 ESCC patients aged 20-89 between January 1985 and December 2006 were investigated to analyze the epidemiological profile including prevalence rates, distribution of age-of-onset, gender and geographical area of ESCC in Luoyang, the highest incidence area of North China. Results: A total of 4092 cases of ESCC were finally diagnosed among 74,854 patients who had their first endoscopies. The prevalence among males was higher than that among females (p<0.01), resulting in an overall male:female OR of 1.2 (95%CI, 1.2-1.3). The prevalence in rural areas was higher than in urban areas (p<0.01), resulting in an overall rural:urban OR of 2.6 (95%CI, 2.4-2.9). The rural:urban ORs and the 95% CI increased continuously from 2.6, 2.3-3.0 to 2.7, 2.2-3.3, respectively, for 4 consecutive periods during the 22-yr study period. Moreover, the median age of onset among females was higher than that among males (p<0.01). For both sexes and in both areas, the prevalence rates declined and the median age of onset rose for 4 consecutive periods in the 22-yrs time frame (p<0.01). Conculsions: These data reveal the epidemiological profile of ESCC in the area of North China, and suggest that urban areas and rural people account for a growing proportion of the ESCC patients although the prevalence of ESCC significantly declined and the median age-of-onset postponed over the 22-yrs period. Moreover, the prevalence status of ESCC in rural areas also underlines the need for public health initiatives aimed at reducing risk factors of this fatal disease.

• Journal of Preventive Medicine and Public Health
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• v.24 no.3 s.35
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• pp.400-413
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• 1991

The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows : (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and in-patient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity (3) In case of physician's inpatient and adjusted-patient service, nurses' role is greater than nursing aides'. Therefore, more extensive utilization of nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.

• Journal of Korean Public Health Nursing
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• v.35 no.2
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• pp.254-267
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• 2021

Purpose: This study aimed at identifying the factors affecting the service satisfaction of urban elderly, focusing on the outreach community health service in Seoul, and suggesting policy directions for the successful implementation of community care. Method: Individuals aged 65 and 70 who used the outreach community health service from July 2017 to June 2019 were eligible for the survey. A total of 2,028 people were sampled using a proportional allocation method for each autonomous district in the survey which covered 25 districts. A multi-level logistic regression analysis was conducted, taking into account the individual's socioeconomic level, health status, type of service provided, and the healthcare-related environment and service provision period of the autonomous district. Result: The results revealed that the health status of the urban elderly, the type of services provided (health screening, linkage to community health center and clinic/hospital, medical checkup results counseling, frailty evaluation), and personal experience of the service were the major factors associated with the satisfaction with the outreach health services. Conclusion: The development of customized health services based on the close relationship between visiting nurses and the elderly may be considered to promote a sustainable community health care model.

• Journal of Preventive Medicine and Public Health
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• v.39 no.3
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• pp.263-269
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• 2006

Objectives: As the number of people with disabilities is increasing and their needs for care are varied, the continuum and comprehensiveness of their rehabilitative care are getting more important. This study was performed to understand the utilization of rehabilitation services and requirements of care among the people with severe disabilities in Korea. Methods: We interviewed 578 disabled persons who had severe extremity and cerebral impairment in the urban and rural areas of Korea. The questionnaire included questions on their general characteristics, the type of disability, their physical function (ADL, IADL), their use of rehabilitation services after discharge and their requirements for rehabilitation care Results: Only 12.6% of people with disability in the community continuously used the available medical rehabilitation care. The associated factors for utilization of rehabilitation services were pain and admission for rehabilitative treatment in the acute phase. There was a great need for rehabilitation services in community and this varied according to gender, the socio-economic status, the functional status and the geographic region. The gap between utilization and need for rehabilitation services was largest in the economic support. The gap of primary health care was larger in the rural area than in the urban area. Conclusions: The needs for rehabilitation service were diverse according to the individual functional status, the regional characteristics and other general characteristics of people with disability. Strategies should be considered to eliminate the barriers to obtain rehabilitation services for the people with disability in the community.

• Proceedings of the Korean Institute of Interior Design Conference
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• 2005.05a
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• pp.196-202
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• 2005

Recently, hospital architecture has acknowledged remedial value of environment and atmosphere, which consider patient's statement of physical, spiritual, psychological and social focus, escape from the past focus of functional and rational space composition. The many research of hospital architecture just analyze elements of architectural planing which focus how to make a healing environment for patients. The purpose of this study is to abstract the design principle of architectural space composition for healing environment significance, through case study which follow up space composition. To abstract healing environment significance by space composition, each case study hospitals should be analyzed and estimated on the spatial composition elements. It is to provide the basic data for effective architectural planning of the hospital.

• Journal of Preventive Medicine and Public Health
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• v.23 no.4 s.32
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• pp.428-435
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• 1990

This study was designed to investigate whether recruitment of physicians and dentists has been restricted to a social network, such as familial or kinship groups. The data was collected through a self-administered questionnaire survey distributed to a sampling of general physicians, specialists (internists, surgeons, other specialists), and dentists in August 1990. The major findings are as follows : 1) Total number of respondents was 405 ; of these, general physicians made up 48.9%, internists 10.4%, surgeons 15.8%, other specialists 4.9%, and dentists 20.0%. 2) 38.5% of the respondents had physicians or dentists in their immediate family or were related in some way to one. Those from urban areas, whose parents were highly educated, and whose father was a professional had more physicians or dentists in their family or kinship. 3) Parents of 7.1% of the respondents, brothers or sisters of 10.1%, grand parents of 1.7%, uncles or aunts of 7.9%, and cousins of 22.0% were physicians or dentists. 4) The majority of physicians or dentists in familial or kinship network specialized n surge, 32.3%, followed by internal medicine ; current worksites were noted as clinics by 30.8%, followed by general hospital, university hospital, and so on. The respondent's ma discipline tended to follow familial or kinship example. Consequently, it was concluded that physicians and dentists have been recruited within restricted familial or kinship network.

• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.70-77
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• 2012

Objectives: Identify the characteristics related to the suicide rates in rural and urban areas of Korea and discover the factors that influence the suicide rate of the rural and urban areas. Methods: Using the data on causes of death from 2006 to 2008, the suicide rates were calculated and compared after age-standardization based on gender, age group and urbanicity. And, in order to understand the factors that influence suicide rate, total 10 local characteristics in four domains - public service, social integration, residential environment, and economic status - were selected for multiple regression analysis. Results: The suicide rates were higher in men than women, in rural areas than urban, and in older people than the younger. Generally, although there were variations according to age group and urbanicity, suicide rates were significantly related to residential environment and regional economic status but not related to regional welfare spending and social integration. In addition, the population over the age of 65 years, only regional economic status has significantly influence on their suicide rates. Conclusions: The influence of characteristics of regions on suicide rate is various by age-group, gender, and urbanicity. Therefore, in order to lower suicide rate and reduce the gap between regions, various approaches must be adopted by taking into account the socioeconomic characteristics of the regions.