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Specialization of Small and Medium-Size Hospitals and Managerial Performance (중소병원의 전문화와 경영성과 - 수익성 분석을 중심으로 -)

  • Kim, Won-Joong;Lee, Yong-Chul;Kang, Sung-Hong
    • Korea Journal of Hospital Management
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    • v.4 no.2
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    • pp.85-105
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    • 1999
  • The main purpose of this article is to analyze the managerial performance of small and medium-size hospitals that are specialized in certain areas of medical services. Data of 189 hospitals were obtained from the data file of Korea Institute of Health Services Management The items include general characteristics of the hospitals, fianancial reports, and utilization records. Degree of specialization is measured by concentration(Herfindahl) index, and the sample hospitals are accordingly classified into specialized and unspecialized groups, by means of cluster analysis. These groups are compared in terms of various measures of managerial performance, which include several profitability indices such as operating margin, return on assets(ROA), and return on equity(ROE). To examine the relationship between specialization and managerial performance, we estimate the regression model, where the profitability indices are used as the dependent variables and the concentration index as the independent variable, controlling for the hospital characteristics such as size, type and location. Also, we perform 'Du Pont' analysis, to investigate the basic elements that can explain the differences in profitability between specialized and unspecialized hospitals. Major findings are as follows: 1. Managerial performance is better for the specilized hospitals than the unspecilized, in all aspects of profitability(operating margin, ROA, ROE). 2. Regression analysis suggests that there is a positive, statistically significant relationship beween the degree of specialization(i.e. concentration) and hospital profitability. 3. Main reason for the higher profitability of specialized hospitals lies in lower expenses rather than higher revenue. 4. In particular, personnel and material expenses are significantly smaller for the specialized hospitals, and this result seems to stem from the efficiency of operating fewer lines of business.(some kind of 'economies of scale') 5. Specialized hospitals also have fewer employees compared with the unspecialized, especially in administrative departments, which implies their efficient personnel management.

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Analysis and Realistic Estimation of Maintenance Cost of Construction Equipment Expenses (건설기계 경비의 관리비 구성 분석 및 현실화)

  • Kim, Kyung-A;Huh, Young-Ki
    • Proceedings of the Korean Institute Of Construction Engineering and Management
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    • 2007.11a
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    • pp.503-508
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    • 2007
  • The Equipment Expenses section of the Poom-Saem, that is used for Construction Cost Estimation on public sectors in Korea, has been rarely revised, and so does not reflect changes of construction equipment technology and construction methods, since it was established based on data from Japan and the U.S in the early 1960s. In order to make reasonable estimation of maintenance costs(Interest, Storage, Insurance, Tax), the equipment expenses section of the Poom-Saem and the domestic and overseas documentary records were investigated. Further, 16 construction sites were visited, and 20 Construction Equipment leasing services were surveyed. Based on results from analysing figures related with the estimation of maintenance costs, the maintenance cost is redefined. Then, construction equipment was classified into 6 exclusive construction equipment and general one, and realistic figures of the maintenance cost, which consists of interest, storage, insurance, tax, are suggested respectively. The optimum level of each item which consists of equipment costs was revealed based on the result of the analysis on the figures of equipment costs calculation from the Poom-Saem and the collected data. The research will be the foundation that helps to estimate appropriate construction costs and the ground work of related studies.

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The Creation of Outdoor Environmental Education Space at an Elementary School (초등학교 옥외 환경학습공간 조성)

  • 방광자;김기현;박성은
    • Journal of the Korean Institute of Landscape Architecture
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    • v.29 no.6
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    • pp.50-61
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    • 2002
  • As recognition and polices for plans to preserve natural resources and to develop environment-friendly space in school education is developed, not only organization of curriculums related to these is required but also facilities for the education are indispensable. Therefore, this study tries to suggest several standards on matters including kinds and scale of facilities and the introduction of species by facilities required for outdoor teaming spaces for environmental education in the elementary school system. The methods of this study include researching various records related to environmental education in elementary school, researching the present condition of outdoor learning space installed and operating in the existing schools by making an on-the-spot survey, and analyzing appearance frequencies of plants and animals displayed in the text. In addition, the actual conditions of the facility use and management were investigate through a questionnaire, We chose and diagrammed a model of the installed facilities by putting the results together. For analyses the investigated eight schools, were categorized as ‘facilities-arranged type’or ‘connection type with ecological park’. The first type distributed and arranged facilities, including meteorological observatory, rocky park, experience-learning area, ecological pond, animal-breeding farm and field-leaning area into appropriate locations according to the site conditions of the school while the second type created a natural learning place by integrating several facilities and arranging areas such as an animal-breeding farm and experience-learning area into appropriate sites. In this study, essential facilities for outdoor learning are classified into ecological park, experience-loaming area, field loaming area, and for natural learning, meteorological observatory, animal-breeding farm, and greenhouse.

Nutritional Status, Quality of Diet and Quality of Life in Postmenopausal Women with Mild Climacteric Symptoms Based on Food Group Intake Patterns (중등도 갱년기 증상을 가진 폐경 후 여성에서 식품군별 섭취패턴에 따른 영양소 섭취상태, 식사의 질 및 삶의 질에 관한 연구)

  • Lee, Ok-Hwa;Kim, Jin-Kyung;Lee, Han-Song-Yi;Choue, Ryo-Won
    • Korean Journal of Community Nutrition
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    • v.17 no.1
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    • pp.69-80
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    • 2012
  • This study was conducted to examine the nutritional status, quality of diet and quality of life in postmenopausal women with mild climacteric symptoms based on their food group intake patterns. The data for nutritional status were obtained using 3-day records. Quality of diet was assessed by INQ, NAR, MAR, DDS, DVS, DQI-I. Climacteric symptoms were analyzed by the questionnaire of Kupperman's index and MENoL. The subjects were classified into the five groups, GMVDF, GMVdF, GMVDf, GMVdf, GmVDF according to their food group intake patterns. Analysis of nutrient intakes showed that the GMVDF group took significantly higher levels of kcal, carbohydrate, protein, fat, vitamin A, thiamin, riboflavin, folate, vitamin C, vitamin E, calcium, phosphorous, sodium, iron, zinc and fiber than GMVdf group did (p < 0.05). INQ of Ca and Fe appeared to be higher in GMVDF than in GMVdf groups (p < 0.05). Analysis of NARs showed that missing milk groups took lower riboflavin, Ca and P than other groups did as the same result with MAR (p < 0.05). Analysis of DDS and DQI showed that GMVdf group had the lowest quality of diet (p < 0.05); however, no difference was found on DVS. The GMVdf group showed the worst climacteric symptoms compared with those of the other groups (p < 0.05). However, we couldn't observe any differences in menopause-specific quality of life among the groups. In conclusion, it would be beneficial to meet all five food groups to increase the quality of diet and to reduce the climacteric symptoms in postmenopausal women.

A Compatibility Assessment and Verification of Suitable to DICOM of PACS DATA CD : Current Situation Investigation of Korea (PACS DATA CD의 호환성 평가 및 DICOM 적합성에 대한 검증을 통한 기준 제시)

  • Jeong, Jae-Ho;Sung, Dong-Wook;Park, Bum-Jin;Son, Gi-Gyeong;Kang, Hui-Doo
    • Korean Journal of Digital Imaging in Medicine
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    • v.10 no.1
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    • pp.29-34
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    • 2008
  • Purpose To analyze the input and output error of data CD which records the image information and the problems of the server of the compatibility. And to report a compatibility assessment and verification of suitable to DICOM of PACS data CD with investigation of current situation of Korea METHOD AND MATERIALS Date CD of each 8 vendors in 30 hospitals was analyzed. We grasped a main verification element existence of a generation compatibility of data CD. The items of element are media identification, DICOM compression, DICOM viewer send, specified object information modify, auto-run, DICOM content type, etc, and give 1 point for each item. We divided the assessment about an each item into 5 levels. Verification about. DICOM conformance by using DICOM validation tool kit is shown to be classified pass or fail according to error occurrence of tag valus. Classify the prequency of tag occurrence as the item. RESULTS The average point of date CD compatibility is 8 point (very good), lowest is 5 point (6.6%), and highest is 10 point (23%_. Most high occurrence frequency's distribution is 7 point (36.6%). As a result of verification about DICOM conformance, PASS in 8 occurrence frequency's distribution is 7 point (36.6%). As a result of verification about DICOM maximum length numbers (14 items), DICOM error of modality (10 items), discord of pixel data length (6 items). etc.

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Are Head Impacts Safe during Youth Soccer Game Practice? (유소년 축구 경기에서 발생하는 머리 충격은 안전할까?)

  • O'Sullivan, David;Kwak, Myung-Hoo;Kim, Yun-Sik;Jeong, Hee Seong
    • Korean Journal of Applied Biomechanics
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    • v.30 no.2
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    • pp.155-163
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    • 2020
  • Objective: This study to identify the mechanism of head impact that occurs during youth soccer game with regard to head injuries in sports. Method: Ten male subjects (age: 10.0±2.0 yrs.) were participated during 10 soccer practices spread out over a time period of 10 weeks. During each soccer game, the participants agreed and wore the X-Patch (wireless accelerometer, gyroscopes). The X-Patch records the head impact mechanics, such as peak linear acceleration (PLA), peak rotational acceleration (PRA), peak rotational velocity (PRV), Head Injury Criterion (HIC), and the location of impact. Results: A total of 501 impacts to the head were measured over the 10 soccer games, PLA 17.8±10.4 g, PRA 3168±2442 rad/s2; PRV 16.1±10.6 rad/s; HIC 11.7±34.2. The severity of impact was classified into 3 ranges; low 10~39 g (482 impacts); medium 40~69 g (17 impacts); and high >69 g (2 impacts). There are no significant differences in PLA and HIC (p=0.08, p=0.15), however PRA and PRV show the differences (p<.05) between each of the participants. For the analysis comparing between the soccer games, there are no significant differences in PLA, PRA, PRV and HIC (p=0.11, p=0.13, p=0.14, p=0.05). Conclusion: Our results indicated that there were significant differences between athletes, especially in terms of rotational acceleration, whereas there were significant differences in linear and rotational based variable between each of the soccer games. Although the vast majority of impacts were below 39 g there were 2 potentially dangerous impacts above 69 g. It is important that future research continuous to measure head impact mechanics during soccer to help understand head injury mechanisms to ensure the safety of athletes.

Adequacy of sentinel lymph node biopsy in malignant melanoma of the trunk and extremities: Clinical observations regarding prognosis

  • Bae, Yong Chan;Jeong, Dae Kyun;Kim, Kyoung Hoon;Nam, Kyung Wook;Kim, Geon Woo;Kim, Hoon Soo;Nam, Su Bong;Bae, Seong Hwan
    • Archives of Plastic Surgery
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    • v.47 no.1
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    • pp.42-48
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    • 2020
  • Background Methods for identifying local lymph node metastasis in malignant melanoma include sentinel lymph node biopsy (SLNB) and lymph node dissection (LND). In particular, SLNB has been widely used in recent years. This study aimed to retrospectively confirm the adequacy of the current indication criteria for SLNB by applying those criteria to a mixed group of patients who previously received SLNB and LND. Methods This study included 77 patients with malignant melanoma of the extremities and trunk who were monitored for >24 months. The patients were classified according to whether the current indication criteria for SLNB were applicable. The sentinel lymph nodes were evaluated for each group. Patients for whom the indication criteria for SLNB and LND were applicable were analyzed according to whether SLNB or LND was performed. Finally, the outpatient records of these patients were reviewed to evaluate recurrence, metastasis, and prognosis. Results Of the 77 patients, SLNB was indicated according to the current criteria in 60 cases. Among the 60 patients for whom SLNB was indicated, 35 survived the follow-up period disease-free, 21 died during the follow-up period, and four experienced metastasis. The 17 patients for whom SLNB was not indicated had no recurrence or metastasis. Conclusions Patients for whom SLNB was not indicated had no recurrence or metastasis. In cases where SLNB is indicated, the possibility of metastasis and recurrence may be high even if SLNB is negative or LND is performed, so more aggressive treatment and careful follow-up are crucial.

Association between obesity and local control of advanced rectal cancer after combined surgery and radiotherapy

  • Choi, Yunseon;Lee, Yun-Han;Park, Sung Kwang;Cho, Heunglae;Ahn, Ki Jung
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.113-120
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    • 2016
  • Purpose: The association between metabolism and cancer has been recently emphasized. This study aimed to find the prognostic significance of obesity in advanced stage rectal cancer patients treated with surgery and radiotherapy (RT). Materials and Methods: We retrospectively reviewed the medical records of 111 patients who were treated with combined surgery and RT for clinical stage 2-3 (T3 or N+) rectal cancer between 2008 and 2014. The prognostic significance of obesity (body mass index [BMI] ${\geq}25kg/m^2$) in local control was evaluated. Results: The median follow-up was 31.2 months (range, 4.1 to 85.7 months). Twenty-five patients (22.5%) were classified as obese. Treatment failure occurred in 33 patients (29.7%), including local failures in 13 patients (11.7%), regional lymph node failures in 5, and distant metastases in 24. The 3-year local control, recurrence-free survival, and overall survival rates were 88.7%, 73.6%, and 87.7%, respectively. Obesity (n = 25) significantly reduced the local control rate (p = 0.045; 3-year local control, 76.2%), especially in women (n = 37, p = 0.021). Segregation of local control was best achieved by BMI of $25.6kg/m^2$ as a cutoff value. Conclusion: Obese rectal cancer patients showed poor local control after combined surgery and RT. More effective local treatment strategies for obese patients are warranted.

Retrospective Evaluation of Alfaxalone as an Induction Agent of Inhalation Anesthesia: 150 Cases (호흡마취 유도제로서 alfaxalone의 후향적 평가: 150례)

  • Jang, Min;Son, Won-gyun;Jo, Sang-min;Lee, Inhyung
    • Journal of Veterinary Clinics
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    • v.34 no.2
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    • pp.135-139
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    • 2017
  • This study was performed to evaluate the clinical efficacy of alfaxalone for induction of inhalation anesthesia in small animal practice. Patient data were collected according to anesthetic records (136 dogs and 14 cats) presented to the Veterinary Medical Teaching Hospital of Seoul National University for surgeries and diagnostic imaging from July 2013 to March 2014. Anesthetic results included signalment, American Society of Anesthesiologists (ASA) grade, premedicated drugs, procedures, induction quality, and recovery after anesthesia. One hundred fifty anesthetic events were classified according to the ASA grade. Three patients were ASA grade I, 52 patients grade II, 86 patients grade III, and 9 patients grade IV, respectively. The most common premedication was midazolam and hydromorphone combination (n = 59, 39.3%) follow by acepromazine and hydromorphone combination (n = 22, 14.7%). The majority of anesthesia procedures were diagnostic imaging (n = 33, 22.0%) and ophthalmic surgeries (n = 31, 20.7%), followed by soft tissue surgeries (n = 27, 18.0%), and orthopedic surgeries (n = 20, 13.3%). Intravenous alfaxalone provided smooth induction for inhalation anesthesia in almost cases, but transient apnea and twitching/paddling were observed after induction and during recovery, respectively. In addition, alfaxalone did not show pain response during intravenous administration. Alfaxalone showed smooth induction of inhalation anesthesia in dogs and cats with mild to severe systemic disease (ASA 2-4). Alfaxalone was considered as an acceptable induction agent for patients with higher risk in small animal practice.

The Study on Frequently Consumed Food Items from 1993 Korean National Nutrition Survey(II) -Amounts and Frequency of Dishes Intakes- (국민영양조사를 이용한 우리나라 다소비 식품의 섭취량에 관한 연구(II) -음식의 섭취량 조사 분석-)

  • Kye, Seung-Hee;Lee, Haeng-Shin;Park, Mee-Ah;Moon, Hyun-Kyung
    • Journal of the Korean Society of Food Culture
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    • v.11 no.5
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    • pp.581-592
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    • 1996
  • The purpose of the present study is to collect information in terms of the frequency and amounts in frequently consumed dishes. We conducted the secondary analysis from '93 Korean National Survey. Mainly informations about 2-day food records were used to investigate dish intakes and to compare different food patterns by area. Amounts of total daily intakes of dishes per capita are 1,741.46g in nationwide, 1,722.03g in large city, 1,712.46g in small city, 1,808.73g in rural. The dish consumed in largest quantities per capita per day is the rice which amounts is 481.67g, 27.66% of total intake. Fruits and cabbage were consumed in large quantities too. Kimchi made of cabbage have the highest number of frequencies. Number of frequencies in rice, fruits, and milk showed high, too. Dish groups are classified by the cooking method. Some dishes in several dish groups have small number of frequencies and small amount of quantities. Some dishes in the top list are not included in the 30 dishes list. There should be some studies about validity and reliability of the dish list, using individual dietary assessment methods.

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