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A Study on the cost allocation method of the operating room in the hospital (수술실의 원가배부기준 설정연구)

  • Kim, Hwi-Jung;Jung, Key-Sun;Choi, Sung-Woo
    • Korea Journal of Hospital Management
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    • v.8 no.1
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    • pp.135-164
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    • 2003
  • The operating room is the major facility that costs the highest investment per unit area in a hospital. It requires commitment of hospital resources such as manpower, equipments and material. The quantity of these resources committed actually differs from one type of operation to another. Because of this, it is not an easy task to allocate the operating cost to individual clinical departments that share the operating room. A practical way to do so may be to collect and add the operating costs incurred by each clinical department and charge the net cost to the account of the corresponding clinical department. It has been customary to allocate the cost of the operating room to the account of each individual department on the basis of the ratio of the number of operations of the department or the total revenue by each operating room. In an attempt to set up more rational cost allocation method than the customary method, this study proposes a new cost allocation method that calls for itemizing the operation cost into its constituent expenses in detail and adding them up for the operating cost incurred by each individual department. For comparison of the new method with the conventional method, the operating room in the main building of hospital A near Seoul is chosen as a study object. It is selected because it is the biggest operating room in hospital A and most of operations in this hospital are conducted in this room. For this study the one-month operation record performed in January 2001 in this operating room is analyzed to allocate the per-month operation cost to six clinical departments that used this operating room; the departments of general surgery, orthopedic surgery, neuro-surgery, dental surgery, urology, and obstetrics & gynecology. In the new method(or method 1), each operation cost is categorized into three major expenses; personnel expense, material expense, and overhead expense and is allocated into the account of the clinical department that used the operating room. The method 1 shows that, among the total one-month operating cost of 814,054 thousand wons in this hospital, 163,714 thousand won is allocated to GS, 335,084 thousand won to as, 202,772 thousand won to NS, 42,265 thousand won to uno, 33,423 thousand won to OB/GY, and 36.796 thousand won to DS. The allocation of the operating cost to six departments by the new method is quite different from that by the conventional method. According to one conventional allocation method based on the ratio of the number of operations of a department to the total number of operations in the operating room(method 2 hereafter), 329,692 thousand won are allocated to GS, 262,125 thousand won to as, 87,104 thousand won to NS, 59,426 thousand won to URO, 51.285 thousand won to OB/GY, and 24,422 thousand won to DS. According to the other conventional allocation method based on the ratio of the revenue of a department(method 3 hereafter), 148,158 thousand won are allocated to GS, 272,708 thousand won to as, 268.638 thousand won to NS, 45,587 thousand won to uno, 51.285 thousand won to OB/GY, and 27.678 thousand won to DS. As can be noted from these results, the cost allocation to six departments by method 1 is strikingly different from those by method 2 and method 3. The operating cost allocated to GS by method 2 is about twice by method 1. Method 3 makes allocations of the operating cost to individual departments very similarly as method 1. However, there are still discrepancies between the two methods. In particular the cost allocations to OB/GY by the two methods have roughly 53.4% discrepancy. The conventional methods 2 and 3 fail to take into account properly the fact that the average time spent for the operation is different and dependent on the clinical department, whether or not to use expensive clinical material dictate the operating cost, and there is difference between the official operating cost and the actual operating cost. This is why the conventional methods turn out to be inappropriate as the operating cost allocation methods. In conclusion, the new method here may be laborious and cause a complexity in bookkeeping because it requires detailed bookkeeping of the operation cost by its constituent expenses and also by individual clinical department, treating each department as an independent accounting unit. But the method is worth adopting because it will allow the concerned hospital to estimate the operating cost as accurately as practicable. The cost data used in this study such as personnel expense, material cost, overhead cost may not be correct ones. Therefore, the operating cost estimated in the main text may not be the same as the actual cost. Also, the study is focused on the case of only hospital A, which is hardly claimed to represent the hospitals across the nation. In spite of these deficiencies, this study is noteworthy from the standpoint that it proposes a practical allocation method of the operating cost to each individual clinical department.

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Relationship of Maternal Perception of the Infant Temperament and Confidence and Satisfaction of Maternal Role (어머니가 지각한 영아기질과 어머니 역할수행에 대한 자신감 및 만족도의 관계)

  • Lee Young-Eun;Kang Yang-Hee;Park Hae-Sun;Hwang Eun-Ju;Mun Mi-Young
    • Child Health Nursing Research
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    • v.9 no.2
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    • pp.206-220
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    • 2003
  • Purpose: this study was intended to search the relationship between perception of the infant temperament in mother of infant at the age of 1~12 months and maternal confidence and satisfaction in performing maternal role, and to submit a basic data to establish a nursing intervention program which is helpful for determination of infant development and performing maternal role promotion by identify variables associated with infant temperament. Method: The subjects of this study were 300 mothers of infant at the age of 1~12 months who visited well baby clinic in 4 hospitals in Busan city and Kyoung-Nam province. Final analysis was performed in 293 cases. Seven cases was excluded in this study because of its inappropriate data collection. The data was collected from 1st July to 15th August 2002. The questionaries which were fill-up by mother were collected. Infant temperament was measured by using the tool of 'what my baby is like'(WBL) which was developed by Priham et. al.(1994) and translated by Bang(1999). The scale of postpartum self evaluation which was developed by Lederman et al(1981) and translated by Lee(1992) was used for the confidence and satisfaction of maternal role. All statistical analyses were performed using SPSS-PC for window, version 10.0: frequency, percentage, minimum, maximum, mean, SD, t-test, ANOVA, Post-hoc test(Scheffe's test), Pearson Correlation Coefficients. Result: The mean score of maternal perception of the infant temperament was 6.17±1.04, and mother recognized her infant as positive. The mean score of confidence of maternal role was 2.89± .41 and this revealed in an average level. The mean score of satisfaction of maternal role was 3.29± .51 and this revealed in a higher level. There was a weak significant positive correlation between the score of maternal perception of infant temperament and confidence of maternal role(r=0.176, P= .003), but there was no significant correlation between satisfaction of maternal role(P> .05). It revealed the more maternal perception of the infant temperament as positive, the higher confidence of maternal role. There was a moderate significant positive correlation between confidence of maternal role and satisfaction of maternal role(r=0.410, P= .000). It revealed the more confidence of maternal role, the higher satisfaction of maternal role. The variables related with the score of maternal perception of infant temperament were the type of delivery (t=-2.600, P= .010), experience of learning baby care(t=2.382, P= .018), maternal perception on baby's health status(F=3.467, P= .033), maternal perception on her health status(F=3.467, P= .027), baby's age(F=3.080, P= .028). Conclusion: Our result showed the confidence of maternal role was increased as the maternal perception of infant temperament was positive, and conformed that the confidence of maternal role was also related with satisfaction of maternal role. Prenatal education, type of delivery, baby's age were also related with the maternal perception of infant temperament. So, nursing intervention program of developmental stage maybe necessary in order to help maternal perception of infant temperament as positive, and it will be increased the confidence of maternal role and satisfaction of performing maternal role which was considered as real indicate of achievement of maternal role.

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Analysis of Prenatal and Postnatal Factors Associated with Complications and Prognosis in Premature Infants with Leukemoid Reaction (백혈병양반응을 보인 미숙아의 합병증과 예후에 관한 산전과 산후 인자에 대한 분석)

  • Kwon, Se-Ho;Lee, Byoung-Kook;Lee, Heun-Ji;Na, So-Young;Lee, Jung-Ha;Park, Su-Yeon;Kang, Eun-Kyeung;Kim, Do-Hyeon;Lee, Kwan;Kim, Hee-Sup
    • Neonatal Medicine
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    • v.15 no.2
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    • pp.151-159
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    • 2008
  • Purpose : This study determined the prenatal and postnatal factors associated with complications and prognosis in premature infants with leukemoid reaction. Methods : We retrospectively reviewed the medical records of premature infants with gestational ages <37 weeks and low birth weights (<2,500 g) who were admitted immediately after birth to the neonatal intensive care unit at the Dongguk University Ilsan Hospital between June 2005 and July 2006. A leukemoid reaction was defined as an absolute neutrophil count (ANC) >30,000/$mm^3$. The infants who had leukemoid reaction comprised the study group, while the remainder of infants made up the control group. The relationships between maternal and neonatal variables and ANC were studied. Results : Leukemoid reaction was detected in 3.1% of the study infants (8 of 252). Factors more frequently associated with infants with leukemoid reaction were as follows: maternal chorioamnionitis, high levels of maternal and infant C-reactive protein, gestational age <37 weeks, birth weight <2,500 g, low Apgar score, prolonged ventilator support, and a high incidence of bronchopulmonary dysplasia (BPD). However, there were no significant differences with respect to the antenatal usage of steroids, the incidences of patent ductus arteriosus, necrotizing enterocolitis, intraventricular hemorrhage, retinopathy of prematurity, and mortality between the two groups. Conclusion : Leukemoid reaction in premature infants was associated with chorioamnionitis and high levels of serum C-reactive protein in mothers and infants, and BPD in infants. These findings suggest that leukemoid reaction is secondary to inflammation caused by infection.

The Analysis of the Prevention against Virus Infection in Dental Hygienist at Medical Treatment (치과위생사의 진료실 감염방지에 대한 행태 분석)

  • Yoon, Mi-Suk;Choi, Mi-Suk
    • Journal of dental hygiene science
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    • v.7 no.2
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    • pp.101-106
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    • 2007
  • This research was based on self-filling survey which 128 dental hygienists who work in dental clinic and dental hospital on May 2006 through July 2006. This survey was analyzed the prevention against virus infection in dental hygienist at medical treatment. As follows analyzed results The experience of get a hand pricked by an infected needle rate is 76.6 percent and the majority of the dental hygienist are sterilize by disinfectant after wash hand and draw blood. The most of dental hygienist are experienced the education of the prevention infection in student and they think that It is necessary to prevention infection in medical treatment. The proportion of use the glove and mask in medical treatment and disuse the glove after medical treatment and the mask when mask get damped is high but the rate of put on the goggle in medical treatment and use the glove in washing and re-treat is low irrespective of age, clinical career, work place. As a result of Independent-sample T Test, the Hygienist who have experience the education of the prevention against virus infection are more excellent work than in-experience group in medical treatment. So we can find that the experience of the education of the prevention infection is very significant to prevention infection in dental hygienist.

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Quality Characteristics of Meat Batters Containing Dietary Fiber Extracted from Rice Bran (미강 추출 식이섬유 혼합물을 첨가한 돈육 유화물의 품질특성)

  • Choi, Yun-Sang;Jeong, Jong-Youn;Choi, Ji-Hun;Han, Doo-Jeong;Kim, Hack-Youn;Lee, Mi-Ai;Shim, So-Yeon;Paik, Hyun-Dong;Kim, Cheon-Jei
    • Food Science of Animal Resources
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    • v.27 no.2
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    • pp.228-234
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    • 2007
  • The purpose of this study was to investigate quality characteristics of the meat batter containing dietary fiber extracted rice bran. The formulations of meat batters were manufactured in a model system with 2% raw rice bran and 2, 4, 6% levels of dietary fiber extracted rice bran, respectively. The proximate compositions of dietary fiber extracted rice bran were 53.27% dietary fiber, 6.10% crude fat, 22.99% crude protein, 12.78% crude moisture, and 7.41% crude ash. Compared with control of uncooked meat batter, the pH value of all treatments were significantly different(p<0.05). The pH of cooked meat batter were similar to uncooked meat batter. $CIE\;L^*-\;and\;CIE\;b^*-value$ of uncooked meat batter containing dietary fiber extracted rice bran were lower than control, but CIE $a^*-value$ of treatment was higher than those in control(p<0.05). All treatments had significantly lower cooking loss and emulsion stability than control(p<0.05). Compared with control, viscosity of the treatments containing dietary fiber extracted rice bran were observed significantly higher than those in control (p<0.05). And then hardness, cohesiveness, gumminess, and chewiness of treatments were higher than in control(p<0.05). Conclusively, the results of this study showed that addition of dietary fiber extracted rice bran affected the high quality properties of meat batter.

Relevance of Serum Vitamin D and Indices Related To Cardiovascular Disease Among Korean Adults (한국 성인의 혈청 비타민 D 수준과 심혈관 질환 관련 지표와의 관련성)

  • Kim, Han-Soo;Ryu, So-Yeon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.365-374
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    • 2018
  • This study investigated the relationship between Vitamin D levels and indices related to cardiovascular disease in Korean adults aged ${\geq}19years$. The data for analysis were obtained from the sixth Korea National Health Nutrition Examination Survey in 2013 and 2014. The results showed that the incidence of Vitamin D deficiency was 73.1% among Korean adults and that indices related to cardiovascular disease showed an increasing trend (55.6% of Korean adults). The relationship between Vitamin D levels and indices related to cardiovascular disease with controlled physical activity status was also studied. The odds ratios (ORs) for age were 1.72 for the 4-62 years age group (95% CI, 1.53-1.93) and 2.05 for the ${\geq}65years$ age group (95% CI, 1.71-2.45). For blood pressure, the OR for pre-hypertension was 1.30 (95% CI, 1.15-1.47) and that for hypertension was 1.31 (95% CI, 1.11-1.54). For body mass index (BMI), the OR was 1.36 (95% CI, 1.11-1.66) and that for waist circumference (WC) was 1.36 (95% CI, 1.11-1.66). For fasting blood sugar (FBS), the OR for impaired fasting glucose (IFG) was 1.37 (95% CI, 1.21-1.55) and that for diabetes mellitus (DM) was 1.31 (95% CI, 1.05-1.65). The OR for total cholesterol (TC) was 1.30 (95% CI, 1.11-1.52) and that for triglycerides (TG) was 1.20 (95% CI, 1.04-1.37) in Korean adults. There was a significant relationship between Vitamin D and indices related to cardiovascular disease in Korean adults with respect to age, blood pressure, FBS, BMI, TC and TG. Confirmation of a causal relationship between Vitamin D and indices related to cardiovascular disease may require further research consisting of more systematic cohort studies.

Physicochemical and Sensory Properties of Rice Stored in an Unused Tunnel (폐터널 저장 쌀의 이화학적 및 관능적 특성)

  • Moon, Gap-Soon;Kim, Mi-Jeong;Jin, Myung-Hee;Kim, Su-Yeon;Park, So-Young;Ryu, Bog-Mi
    • Korean journal of food and cookery science
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    • v.26 no.2
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    • pp.220-228
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    • 2010
  • This study was designed to examine the effectiveness of an unused tunnel as a rice storage place. The physicochemical changes of rice grains were investigated during 8-months of storage in the tunnel located at Kyungnam province, Korea. Two kinds of tunnel stored rices, NP(rice grown with no pesticides) and LP(rice grown with less pesticides) were compared with $5^{\circ}C$ stored rice as a control. The peroxidase activities, as an index of freshness of rice grains, gradually decreased and NP appeared to be fresher than LP. Whiteness, grain wholeness, and chalkyness were less desirable for the tunnel stored rice than the control, with no significant difference of physicochemical properties, including the broken, damaged, colored rice, and contents of moisture, protein, and amylose. Palatability dropped below 70 in all three groups at later phase. The sensory evaluation showed that overall preference was slightly higher for the control but not significantly different from the other two groups. From all the evidences shown, unused tunnels may be an effective place for a long-term rice storage, since the average temperature inside the tunnel was maintained very constantly around $14.3^{\circ}C$ and relative humidity was optimal for rice storage, especially during spring and summer seasons.

Clinical Utility of Bone Scan in the Diagnosis of Temporomandibular Disorders (측두하악장애의 진단에서 Bone Scan의 유용성)

  • Kim, In-Joo;Kang, Yang-Ho;Son, Seok-Man;Lee, Kyoung-Seog;Lee, Jae-Bok;Kim, Yong-Ki;Seo, Bong-Jik;Park, June-Sang;Ko, Myung-Yun;Son, Seong-Pyo
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.4
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    • pp.511-517
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    • 1995
  • Bone scan is a very sensitive diagnostic imaging test for detecting bone and joint disorders. So it might be useful in the diagnosis of temporomandibular disorders of the joint origin. Thus, the effectiveness of bone scan for detecting temporomandibular joint(TMJ) diseases and differentiating the TMJ disc displacement from the TMJ arthritis was evaluated. Bone scan was done in 21 patients with TMJ disc displacement(13 unilaterally affected, 8 bilaterally affected), 25 patients with TMJ arthritis(23 unilateral, 3 bilateral), and 39 volunteers with no signs, symtoms, or history of TMJ disease. TMJ simple uptake rate(SUR) and difference of both TMJ SUR were calculated from the 100,000 count lateral image of head and neck region in 99mTc MDP bone scan. Transcranial and panorama X-ray examination was also done in all patients. TMJ SUR(%) were $1.673{\pm}0.606$ in TMJs affected with arthritis, $1350{\pm}0.351$ in TMJs affected with disc displacement, and $1.084{\pm}0.172$ in TMJs of controls. Significant differences were demonstrated among them(p<0.01) Difference of bith TMJ SUR was highest in patients with unilateral TMJ arthritis($0.608{\pm}$0.533, p<001), and there is no significant difference between that of controls and that of unilateral TMJ dist displacement patients($0.062{\pm}0.063$ vs $0.122{\pm}0.100$). TMJ SUR of Joint with bone change on X-ray finding was not significantly different from that of joint with normal X-ray finding. Those in patients with unilateral TMJ disc displacement(696% and 87% vs 23.1% and 23%). The proportions of patients with increased TMJ SUR and difference of both TMJ SUR(>mean+2SD of controls) in unilateral TMJ arthritis patients were significantly higher than those in patients with unilateral TMJ disc displacement(69.6% and 87% vs 23.1% and 23%). Conclusively, bone scan nay help to detect TMJ disease and differentiate TMJ disc displacement from TMJ arthritis.

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Conceptual framework for Emotions in Usability of Products (제품 사용성과 감성에 관한 개념적 연구)

  • Lee Kun-Pyo;Jeong Sang-Hoon
    • Science of Emotion and Sensibility
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    • v.8 no.1
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    • pp.17-28
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    • 2005
  • With the advent of computer technology, the fundamental nature of products has shaped from physical forms towards product interactivity, The focus is now on usability of the product with ease and efficiency rather than conversing with just the looks of the product. However, most definitions of usability and contemporary usability-related researches, have focused on the performance-oriented functional aspects of usability (i.e., how well users perform tasks using a product). Today, user expectations are higher; products that bring not only functional benefits but also emotional satisfaction. So far, there have been many studies on human emotions and the emotional side of products in the field of emotional engineering. Contemporary emotion-related researches have focused mainly on the relationship between product aesthetics and the emotional responses elicited by the products, but little is known about emotions elicited from using the products. The main objective of our research is analyzing user's emotional changes while using a product, to reveal the influence of usability on human emotions. In this research, we suggested conceptual framework for the study on the relationship between usability of products, and human emotions with emphasis on mobile phones. We also extracted emotional words for measuring user's emotions expressed not from looking at the product's appearance, but from using the product. First, we assembled a set of emotions that is sufficiently extensive to represent a general overview of the full repertoire of Korean emotions from the literature study. Secondly, we found emotional words in the after note by the users on the websites. Finally, verbal protocols in which the user says out loud what he/she ks feeling while he/she ks carrying out a task were collected. And then, the appropriateness of extracted emotional words was verified by the members of the consumer panel of a company through web survey. It is expected that emotional words extracted in this research will be used to measure user's emotional changes while using a product. Based on the conceptual framework suggested in this research, basic guidelines on interface design methods that reflect user's emotions will be illustrated.

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Selection of RAPD marker to discriminate the bolting-resistant varieties and commercial dried medicinal materials of Angelica species (당귀 내추대성 품종 및 건재약재 판별을 위한 RAPD marker 선발)

  • Bang, Kyong-Hwan;Yu, Hong-Seob;Koo, Dal-Hoe;Cho, Joon-Hyeong;Park, Hee-Woon;Seong, Nak-Sul;Park, Sang-Il;Kim, Hong-Sig
    • Korean Journal of Medicinal Crop Science
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    • v.10 no.1
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    • pp.46-50
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    • 2002
  • In DNA level, genetic study of Angelica species was firstly conducted to discriminate the bolting-resistant or low bolting variety, so called as Manchu, from other Korea collected lines and also this technuque was applied to identify the origin of commercial dried materials obtained from current oriental medicinal market. By RAPD analysis with 72 primers including sixty of 10-mers and twelve of 20-mers, respectively, three primers, which were related to the bolting resistant traits of Angelica gigas, were identified. Comparing the RAPD bands, URP04 primer showed the 1.7 kb specific band, which seemed to be related to delaying bolting traits, since it was observed only in Jinbu elite lines but not in others. On the other hand, since 1.2 kb band amplified by OPD11 was observed in other collected lines but not in Manchu var. and Jinbu line, this primer also could be considered as a selection marker for identifying bolting resistant or delaying bolting traits. In the same manner, since OPP09 did not show 1 kb major band but produced 0.8 kb and 1.2 kb bands in Manchu var., these three bands amplified by the primer could be considered one of the important key specifying Manchu var. related with the trait of Angelica gigas. OPC02 primer showed the same band patterns in all Korean collected lines, but not in other foreign introduced lines, such as A. sinensis from China, and A. acutiloba from Japan. Since these four RAPD primers, OPD11, OPP09, URP04, and OPC02 showed the specific polymorphisms in Angelica species, thus, these were useful to discriminate the three Angelica species, A. gigas, A. sinensis, and A. acutiloba.