• Radiation Oncology Journal
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• v.15 no.2
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• pp.167-174
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• 1997

Purpose : The main Purpose of this study is to develop new payment rates for services of Radiation Oncology, considering costs of treating patients. Material and Methods : A survey of forty hospitals has been conducted in order to analyze the costs of treating patients. Before conducting the survey, we evaluated and reclassified the individual service items currently using as Payments units on the fee-for-service reimbursement system. This study embodies the analysis of replies received from the twenty four hospitals. The survey contains informations about the hospitals' costs of 1995 for the reclassified service items on Radiation Oncology. After we adjust the hospital costs by the operating rate of medical equipment, we compare the adjusted costs with the current Payment rates of individual services. Results : The current payment rates were 5.05-6.58 times lower than the adjusted costs in treatment planning services, 2.22 times lower in block making service, 1.57-2.86 times lower in external beam irradiation services, 3.82-5.01 times lower in intracavitary and interstitial irradiation and 1.12-2.55 times lower in total body irradiation. Conclusion : We could conclude that the current payment system on Radiation Oncology does not only reflect the costs of treating patients appropriately but also classify the service items correctly. For an example, when the appropriate costs and classification are applied to TBI, the payment rates of TBI should be increased five times more than current level.

• The Korean Journal of Health Service Management
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• v.11 no.3
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• pp.37-49
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• 2017

Objectives : This study analyzes the characteristics of prescription drugs for acute upper respiratory tract infection in outpatient clinics and provides basis for establishing the correct evaluation project on appropriate prescribing indicators. Methods : Research data were collected from two for each family medicine, internal medicine, pediatric, otorhinolaryngology and general practitioner clinics with a total of 10 clinics with diseases classifications codes J00-J06, J20 on patients receiving treatment between January 1, 2013 and December 31, 2013 every Monday in Busan City. Results : The antibiotic prescription rate in evaluating the project on appropriate prescribing indicators of Health Insurance Review & Assessment Service was 44.3%, whereas this study was approximately 30% higher because analysis to target the entire cold-related diagnosis. Conclusions : The correct antibiotic prescription by expanding the current assessment standard should be identified as a minor diagnosis because the evaluation project on appropriate prescribing indicators targets the major diagnosis only.

• Spatial Information Research
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• v.12 no.2
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• pp.193-209
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• 2004

The purpose of this study is to analyze the service area of emergency medical centers using GIS-based spatial analysis methods in Seoul, focusing on the behaviour of patients on the choosing of emergency centers. For this analysis, six emergency centers were selected to collect data for the information on the addresses of patients from September to November hi 2003. Analysis on the service area, which was carried out by measuring the distribution of patients in terms of distance from emergency medical centers, clearly reveals that the majority of patients was located within or adjacent districts at the emergency medical center. However, the size of the primary service area f3r six emergency medical centers was much different, implying that the decision to visit specific emergency medical center by patients was closely related to the size, perception, and preference of the emergency medical center. Based on the results of the spatial characteristics of emergency medical service area, this research tries to construct the surface map of the emergency medical service level supplied by 32 regional emergency medical centers located in Seoul. Considering the levels of infrastructure for emergency medical centers, the coverage for the degree of supply of emergency medical service by each emergency medical center was constructed in terms of a distance decaying in the distribution of patients from emergency medical center imposing different weights on distance bands. Spatial overlay utilizing map algebra function was performed in order to calculate total supply level of emergency service. The results clearly show that spatial inequality exists in the supply levels of the emergency medical service among local areas of Seoul.

• Journal of Hospice and Palliative Care
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• v.15 no.1
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• pp.10-17
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• 2012

Purpose: This study was conducted to identify the perception regarding palliative care among Korean doctors and referral barriers toward palliative care for terminal cancer patients. Methods: Between May and June 2010, 477 specialists mainly caring cancer patients using a web-based, self-administered questionnaire. Results: A total of 128 doctors (26.8%) responded. All respondents (100%) deemed palliative care a necessary service for terminal cancer patients. More than 80% of the respondents agreed to each of the following statements: all cancer centers should provide palliative care service (80.5%); all terminal cancer patients should receive concurrent palliative care along with anti-cancer therapies (89.1%) and caring for terminal cancer patients requires interdisciplinary approach (96.9). While more than 58% of the respondents were satisfied with their performance of physical and psychological symptoms management and emotional support provided by patient's family members, 64% of the responded answered that their general management of the end-of-life care was less than satisfactory. Doctors without prior experience in referring their patients to palliative care specialists accounted for 26.6% of the respondents. The most common barrier to hospice referral, cited by 47.7% of the respondents, was "refusal of patient or family member", followed by "lack of available palliative care resources" (46.1%). Conclusion: Although most doctors do recognize the importance of palliative care for advanced cancer patients, comprehensive and sufficient palliative medicine, including interdisciplinary cooperation and end-of-life care, has not been put into practice. Thus, more active palliative consultation or referral is needed for effective care of terminal cancer patients.

• The Journal of the Korea Contents Association
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• v.15 no.9
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• pp.257-272
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• 2015

This study is to verify how the economic, social and moderating effect factors of baby boomer generation workers' affect the subjective health evaluation. The subjective of this study was 1,202 workers of baby boomer generation by using the 4th data of Korea longitudinal study of aging(KLoSA) from Korea Labor Institute in 2012. Economic and social factors were selected as scales to analyze if there is meaningful difference in subjective health evaluation. Method of frequency analysis, t-test, ANOVA and correlation analysis was used, and multi regression analysis was also conducted to verify whether the private health insurance has control effect over the relation between the subjective health evaluation and the economic & social factor. As a result of the study, age, education, home ownership, peer group meeting, overall satisfaction, private health insurance were major factors affecting the subjective health evaluation of baby boomer generation. Moreover private health care were turned out to have a moderation effect in relation between economic, social factor and subjective health evaluation.

• Journal of Hospice and Palliative Care
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• v.13 no.2
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• pp.76-80
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• 2010

Purpose: As a part of analysis of home-based cancer patients management of public health centers, regional cancer center, and hospice institution in Jeju, this study was undertaken to establish their role. Methods: We investigated current status of hospice palliative care, especially home-based cancer patients management and summary demand of public health centers. Results: Services provided through the home-based cancer patients management project included physical, emotional, spiritual and education/informative services, even though there was little difference between them. The result showed that in the view of patients there was little relationship between public health centers, regional cancer center and hospice palliative institution. Conclusion: The relationship between home-based cancer patients management and institutions should be reinforced. Patients in acute state and difficulty care of patients should be referred to regional cancer center whereas maintenance state of patients should be referred to public health center.

• The Journal of the Korea Contents Association
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• v.21 no.8
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• pp.329-336
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• 2021

This study selected indicators that can represent the characteristics of general hospitals, including local medical centers and Red Cross hospitals, which are representative public health institutions, and analyzed clusters. And we present to benchmark in each cluster. According to the analysis, 276 general hospitals were classified into 13 clusters, and local medical centers and Red Cross hospitals were classified into clusters between 1 and 7 of the total 13 clusters because of their small size. Local medical centers and Red Cross hospitals, selected as excellent hospitals in each cluster, showed significant differences in management performance despite similar regional environment and medical performance, and among them, surgical consultation and internal medical care rates, inpatient and outpatient rates. In order for local medical centers and Red Cross hospitals to play their role as secondary acute hospitals in the region, inpatient care services and surgical functions must be activated.

• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.277-282
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• 1999

Background: For effective and systematic management of patients in the emergency department(ED), the data on patient arrival and status in ED of Yeungnam University Hospital were evaluated. Materials and Methods: During the seven days from Apr. 1 to Apr. 7, 1998, the general patient information such as onset time and place, factors associated with transportation, causes of admission, cared department and patient disposition were recorded. Results: Total of 464 patients visited the ED during the seven days, and the mean number of patients per day was 66.3. Male to female ratio was 1:0.71. Daily staying patients were 17.3, and 83.6 patients were cared totally each day. The methods of transportation and distribution of patients according to region and event were as follows: visit by walk(57.3%). transportation by car(58.0%), place of event in residence(85.3%), regional distribution in Taegu(81.5%), and direct visit(97.4%). Cause of admission due to diseases was 74.6%. The percentages of departments which cared the patients were internal medicine 26.6%, pediatrics 16.8%, orthopedics 8.6%, neurology 8.2%, neurosurgery 7.8% and other department including emergency medicine 8.2%, respectively. Patient dispositions were admission 38.4%, discharge 61.0% and death on arrival(DOA) 0.6%, but referred patient-to-another-hospital was zero. Conclusion: Improvements in several aspects of ED's caring system such as "fast tracking" system and reinforcement of disease and trauma caring system, would be helpful for effective management of emergency patients.

• Journal of Cadastre & Land InformatiX
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• v.53 no.2
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• pp.67-77
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• 2023

As cities become overcrowded and concentrated, the demand for public services continues to increase due to the improvement of the living standards of urban residents. Among them, fire service can be seen as one of the important public services by reducing damage caused by accidents in emergency situations and affecting the improvement of access to medical services for urban residents. Rapid movement of patients and medical institutions within golden time and proper first aid are essential elements in emergency situations, and Seoul is a super-large city with a large population of about 10 million people and has a large number of emergency medical patients. Therefore, this study used spatial regression analysis to examine the factors affecting the delay factors of emergency dispatch in Seoul to secure golden time, and derived management priorities, and suggested implications for the management of emergency vehicle dispatch delay factors. As a result of the main analysis, land-use characteristics were the most influential factor in emergency vehicle dispatch time, and land-use mixing, commercial area density, average patient age, and average road length were found to affect emergency vehicle dispatch time in order. This study can be used as important basic data for an accurate understanding of the delay factors for emergency dispatch and preparing countermeasures according to priorities.

• Journal of Hospice and Palliative Care
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• v.21 no.2
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• pp.51-57
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• 2018

Purpose: End-of-life (EoL) decisions are challenging and multifaceted for patients and physicians. This study was aimed to explore how EoL care is practiced for patients with a do-not-resuscitate (DNR) order. Methods: We retrospectively analyzed medical records of patients who died after agreeing to a DNR order in 2016 at a university hospital. Characteristics including cause of death, intensity of EoL care, and other factors were reviewed and statistically analyzed. Results: Of total 375 patients, 170 patients (45.3%) died with malignancies, and 205 patients (54.6%) with other causes involving the central nervous system (19.2%), pulmonary (14.7%), cardiologic (6.7%) and infectious (6.4%) conditions. Both the cancer and non-cancer patient groups showed a short duration from DNR to death (median 3 days vs 2 days, P=0.629). An intensive care group comprising patients who received one or more intensive treatments such as ventilator (n=205) showed a higher number of non-cancer patients and a shorter duration from DNR to death than a group that withheld treatment before DNR (P<0.05). Conclusion: EoL decisions were made very late by both cancer and non-cancer patients. About half of the patients did not have cancer, and two-thirds of them decided DNR during intensive treatment. To make a good EoL decision, a shared decision making with patients should be done at an earlier stage.