• Safety and Health at Work
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• 제13권3호
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• pp.279-285
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• 2022

Background; In the event of an industrial accident, the appropriate choice of hospital is important for worker health and prognosis. This study investigates whether the choice of hospital by the employer in the case of industrial accidents affects the prognosis of injured employees. Methods; Data from the 2018 Panel Study of Workers' Compensation Insurance in Korea were used in an unmatched case-controlled study. The exposure variable is "hospital selection by an employer," and the outcome variable is 'worker's disability." Odds ratios (ORs) were estimated by modified Poisson regression and adjusted for age, gender, underlying disease, injury severity, and workplace size and stratified by industrial classification. The group at increased risk was analyzed and stratified by age, gender, and area. Results; In the construction industry, hospital selection by the employer was significantly associated with increased risk of disability (adjusted OR 1.26; 95% confidence interval [CI]; 1.20-1.32) and severe disability (adjusted OR 1.38; 95% CI; 1.08-1.76) among the injured. Female and younger workers not living in the Seoul capital area were more at risk of disability and severe disability than those living in the Seoul capital area. Conclusions; Hospital selection by employers affects the prognosis of workers injured in an industrial accident. For protecting workers' health and safety, workplace emergency medical systems should be improved, and the selection of appropriate hospitals to supply treatment should be reviewed.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제15권2호
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• pp.59-66
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• 2009

The purpose of this study is to define the concept of sustainability, to understand the traditional belief system, to comprehend user-focused healing environment, to understand the current status of Korean Hospitals, to analyze the selected case studies, and to point the way toward enhanced architectural solutions for healing environment in hospitals. The research results indicate that the design of healthcare facilities with healing effects depend on the considerations of 5 senses of patients. In other words, the sustainable design approach to create a healthy healing environment is very important, and architects must be aware of diverse sensory needs of the patients. In addition, the following factors affection healthcare facilities must be considered to create healing environment for users: - "Emphasis on sustainable Design" for harmony among nature, man, and building. - Creation of user Focused Healing Environment reflecting the suers' senses. - Search for New Hospital Forms through various design experiments to create the most suitable healing environment. - "Perception of Paradigm Shift" form a focus on sickness-oriented to wellness-oriented healthcare facility design. - "Awareness of Creating User-Friendly Environment" covering the entire age group form youth to elderly.

• 보건행정학회지
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• 제13권1호
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• pp.98-115
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• 2003

Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4％ of KDRGs had a CV of charges from tertiary care hospitals less than 100％ and 95.43％ of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80％ for non-outlier claims from tertiary care hospitals, 51.98％ for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

• Asian Pacific Journal of Cancer Prevention
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• 제16권6호
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• pp.2403-2407
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• 2015

Background: Very few analytical studies are available on any association between stressful life events (SLE) and colorectal cancer (CRC), at least in Iran. The aim of this case control study was to determine the association between stressful life events (SLE) and colorectal cancer. Materials and Methods: This study was conducted in four hospital colonoscopy units in Tabriz city of Iran including 414 participants aged 40-75 years: 207 cases with CRC confirmed by pathology and colonoscopy findings and 207 controls free of neoplastic conditions were selected (from the same hospitals at the same period for the cases and after matching for age and sex). Stressful life events were assessed using a 43-item Holmes and Rahe Life Events Questionnaire. Multivariate logistic regression was used to estimate adjusted odds ratios for SLE and risk of CRC. Results: The stressful life event mean score in the case group was 141.3, in contrast to 63.8 in the control group (p<0.011). After adjusting for confounders, death of dear ones increased the risk of CRC (OR: 2.49; 95%CI: 1.41-5.13). Other types of stressful life events (family and husband disputes, serious occupational problems, unemployment of > 6 months, and Serious financial problems) were also associated with CRC, but without statistical significance. Conclusions: According to our findings, it seems that SLE may increase the risk of CRC.

• 한국병원경영학회지
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• 제17권1호
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• pp.79-112
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• 2012

The purpose of this study is to examine the differences of profitability based on the analysis of business and medical service performances of four hospitals in Incheon area with similar size. and to compare hospitals with the best and the worst performances and analyze the factors behind the differences. The differences could be caused by differences in medical service statistics, number of staff, and financial results, etc. The data was acquired through the homepage of the National Tax Service(financial statements for the fiscal year 2009) and the Medical Record Association of Incheon(medical service statistics for the years 2008 and 2009) along with questionnaire survey to the hospitals(personnel data for the year 2009). The results of the study are as follows. Medical profits to medical revenues ratio for the hospitals(referred as Hospital A, B, C, and D) shows, in order, C(8.2%), A(8.0%), B(7.8%), and D(7.4%). However, net income to medical revenues ratio shows otherwise: C(8.5%), D(5.8%), A(3.0%), and B(0.6%). Hospital B shows a high medical profit to revenue ratio but the lowest net income to revenue ratio due to large interest expenses. The leverage ratio of Hospital B is the highest (419.6%), resulting in a very low interest coverage ratio(1.1). On the other hand, Hospital C shows favorable results in both profit ratios, with 8.2% and 8.5% each. Hospital C has the lowest leverage ratio(53.0%) and the highest interest coverage ratio(34.9). Therefore, the results show Hospital C has the best performance while Hospital B the worst. The two hospitals(B and C) show similar results in certain areas and big differences in other areas. The area that has the biggest influence on financial results turns out leverage ratio. Hospital B shows 'very good' to 'good' results in terms of medical service statistics in general. However, the leverage ratio is too high and the liquidity ratio too low, resulting in a very low profit ratio. The results of this study have some limitations in terms of generalization as only four hospitals in Incheon area were selected for the study, resulting in a deficiency in the representativeness of the sample. Further studies with bigger sample size and deeper analysis are expected in this area.

• Asian Pacific Journal of Cancer Prevention
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• 제13권7호
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• pp.3329-3334
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• 2012

Background: Several potential risk factors have been identified for diffuse large B-cell lymphoma (DLBCL); however, epidemiological studies investigating the association between these risk factors and DLBCL have yielded inconsistent results. Objectives: To investigate potential medical, lifestyle, and environmental risk factors of DLBCL in Shanghai, China through a hospital-based case-control study. Method: One-hundred-and-forty-seven newly diagnosed DLBCL patients and 294 sex- and age-matched controls were recruited from 11 hospitals in Shanghai between 2003 and 2007. A standardized structured questionnaire was used to obtain patient data on demographics, medical history, family history, lifestyle, and environmental exposures. Conditional logistic regression models were used to estimate odds ratios (ORs), with 95% confidence intervals (CIs), for risk associated with each data category. Results: History of tuberculosis (TB) infection and "living on a farm" were positively associated with DLBCL (TB: OR=3.05, 95% CI: 1.19-7.80; farm: OR=1.82, 95% CI: 1.21-2.73). In contrast, taking traditional Chinese medicine was negatively associated with DLBCL (OR=0.36, 95% CI: 0.14-0.89). No significant correlation with DLBCL risk was found for any of the other potential risk factors (p>0.05), including but not limited to hair dyes, alcohol drinking, smoking, and home/workplace renovation within one year. Conclusions: Consistent with results from previous studies in other DLBCL case populations, traditional Chinese medicine appeared to have a direct or indirect protective effect against DLBCL. However, this study also identified a possible predisposition for DLBCL in TB sufferers and farmers.

• 대한미생물학회지
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• 제19권1호
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• pp.55-64
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• 1984

The clinical specimens used in this study were collected during the period from March 4, to December 30, 1983, from children's hospitals in Seoul area. They came from clinically apparent cases of diarrheal disease in hospitals. Many specimens were taken from rectal Swabs. During this period, 2166 stool cultures were streaked onto MacConkey plate and were them deposited in selenite broth. Colonies resembling pathogens on MacConkey medium were picked to KIA, Urea agar, malonate broth, ONPG broth, SIM. Reaction on those media cultures were identified biochemically with using API 20E test kit and confirmed serologically with commercially avabile Salmonella antisera(Difco) or Shigella antisera(Denka, Japan). The sensitivity of Salmonella and Shigella tested to ampicillin cephalosporin, chloramphenicol, colistin, gentamicin, tetracycline, streptomycin, nalidixic acid, neomycin, polymyxin B was performed by means of disc diffusion method recommended by Bauer-Kirby, using the discs prepared in BBL Laboratory. 1. There were 34 (1.6%) isolations of Salmonella cultures and 52(2.4%) isolations of Shigella from the 2,116 specimens. Only 53%of Salmonella were isolated by direct streaking on MacConkey plating media, by contrast, 80% of the Shigella were isolated directly. 2. Shigella flexneri types comprised 56% of the Shigellae isolate from 52 Shigellae identified 24% of Salmonella enteritidis ser typhimurium were identified. 3. Concerning to Salmonella and Shigella occurance according to month and sex, They shows relatively higher for the male than in case of female, and 2-3 age were shown the highest group. 4. October is the month with highest incidences. 5. In the sensitivity patterns of Shigellae, most of them were appeared to be resistant ampicillin, streptomycin, tetracycline, in case of Salmonella, 15% of them were resistant to chloramphenicol.

• 한국콘텐츠학회논문지
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• 제22권2호
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• pp.752-761
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• 2022

본 연구는 의성지역 내에서 치매 노인시설 중 요양병원 3곳에 종사하는 간병인을 대상으로 치매노인의 문제행동에 대한 간병인의 보호관리 실태와 문제점을 파악함으로써 대상자 중심 돌봄을 개발하기 위한 기초 자료를 제시하려는 데 그 목적이 있다. 2021년 1월부터 2021년 7월까지 요양병원에 근무하는 임상에서 치매노인들의 돌봄을 직접 하고 있는 1년차 미만 간병인 1명과 1-3년차 간병인 5명, 4년차 이상 간병인 2명, 이들을 관리, 감독하는 간호사 3명, 사무국장 2명 등 총 13명을 대상으로 하였다. 질적 사례 연구로 치매노인의 문제행동에 대한 간병인의 보호관리 실태를 정신적인 측면, 신체적인 측면, 관계적인 측면으로 결과를 나열하였으며, 간호사 및 병원관리자 입장에서의 간병인의 보호관리 실태에서는 간호사의 돌봄과정에서의 갈등, 병원 관리자와의 돌봄과정에서의 갈등의 결과를 사례 중심으로 나열하였다. 보다 구체적으로 치매노인 문제행동을 이해하고 이를 바탕으로 하여 실제적인 관리 방법을 고안하고 검증하고자 하는 연구자들의 노력과 열정이 절실히 필요하며, 치매 노인의 문제행동과 그 실태에 대해 심도 있게 파악하기 위해 질적 연구방법을 통한 임상에서의 다양한 사례 연구의 데이터를 확보할 필요가 있을 것이다.

• 한국임상수의학회지
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• 제40권3호
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• pp.197-202
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• 2023

Canine lymphoma (cL) is the most common hematopoietic cancer in dogs. Various determinants have been evaluated to find the predisposing factors in both human and canine lymphoma. Due to common risk factors and similar pathways, cL is considered a potential model for non-Hodgkin lymphoma (NHL) in humans. In this case-series study, major hospitals in Tehran consented to take part in this study and between the years of 2020-2022, provided us with 52 cL cases which were approved by the attended pathologist. We designed a questionnaire and collected information about the dogs and their owners. Most of the owners were women, young (younger than 50 years old), had at least diplomas and interestingly were housewives or househusbands. Male dogs with middle to old age (more than 6 years) were mostly referred. The most common characteristics were neutered, normal BCS, purebred, urban but not industrial residence, previous tobacco smoke exposure but no history of previous fungicide or pesticide exposure. Also, most of them did not have any previous autoimmune or immunosuppressive diseases. Presented characteristics should be considered risk determinants but to approve their validity, they should be further evaluated in epidemiological studies.

• 품질경영학회지
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• 제22권3호
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• pp.142-151
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• 1994

In a hospital, there are many clinical departments. In general, the hospital management often uses the index of cure rate (i.e. the rate of patients recovered by the cure of this hospital) to evaluate the medical quality of each clinical department. But, since the cure rate varies significantly with the rate of patient with severe disease, the evaluation by cure rate is unreasonable and incomplete. This paper proposes a new evaluation method called the cause-selecting evaluation method proposed by Prof. Gongxu Zhang (1990). Besides, this method can also be used to diagnose the abnormality of cure rate. The practical case studies check with the theory very well.