• Journal of Korean Academic Society of Home Health Care Nursing
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• v.7 no.1
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• pp.58-72
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• 2000

This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.

• Journal of Nutrition and Health
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• v.43 no.2
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• pp.189-196
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• 2010

Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGSGA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

• Journal of Nutrition and Health
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• v.41 no.2
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• pp.147-155
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• 2008

Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

• Journal of Hospice and Palliative Care
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• v.7 no.2
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• pp.200-213
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• 2004

Purpose: The purpose of this study was to create an electronic nursing record form to build a hospice nursing process database to be used in the u-hospital EMR system. Specific aims of the study were: 1. To generate a complete, accurate, and simple electronic nursing record form. 2. To verify its appropriateness following documentation with the standardized hospice protocol. 3. To verify its validity and finalize the hospice nursing process database through discussion among hospice professionals. Methods: Nursing records from three independent hospice organizations were collected and analyzed by five expert hospice nurses with more than 10 years of experience, and a nursing record database was developed. This database was applied to 81 hospice patients at three hospice organizations to verify its completeness. Results: 1. An electronic nursing record form with completeness, accuracy, and simplicity was developed. 2. The completeness of the standardized home hospice service protocol was 95.86 percent. 3. The hospice nursing process database contains 18 items on health problems, 79 items on related causes and major symptoms, and 229 items on nursing interventions. Conclusion: The new nursing record form and database will reduce documentation time and articulate and streamline the working process among team members. They can also improve the quality of hospice services, and ultimately enable us to estimate hospice service costs.

• Journal of Hospice and Palliative Care
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• v.21 no.1
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• pp.23-32
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• 2018

Purpose: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. Methods: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). Results: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P<0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P<0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P<0.001). Palliative care was associated with decreased hospital cost by 28.71% (P<0.001). Conclusion: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.

• Journal of the Korean Society of Food Culture
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• v.17 no.3
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• pp.240-251
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• 2002

This study is to describe practices of and attitude toward traditional wedding food and the attitude of housewives toward the traditional wedding food in Busan metropolitan and Kyungnam province area. Data were analyzed from the convenient sample of 525 housewives collected from September 20 to September 28, 2001. As for the necessity of traditional wedding food, the most popular food was ebagee food, pebaek food, yedan food in order. Of the various kinds of traditional wedding food, table setting for parent-in-law was chosen as the most popular one. Sociodemographic characteristics such as education level and age were statistically associated with perception of traditional wedding food being necessary as a ritual thing. The respondents preferred rice cakes as wedding food to fishes, fruits, traditional sweets and skewered slices of seasoned meats. More than half of the respondents think current practices of wedding food is prodigal and has to be done in thrifty manner. As a ritual practices of wedding food were to be readjusted to the change of social custom depending on the degree of modernization. More than half (52.1%) of the housewives expected traditional wedding food should fade away. A conclusion was that it is necessary to develop modernized wedding food reflecting traditional wedding customs with economic costs.

• Proceedings of the Korean Institute Of Construction Engineering and Management
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• autumn
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• pp.305-310
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• 2001

The purpose of this study is to calculate delay damages for contractors. The study has been performed by investigation of delay cost occurrence status and the analysis of subway construction cases. The results of this study are as follows: 1. Delay cost( 1day) equivalent to $0.005\%$ of total construction cost by analysis case studies. 2. Including bank interest, dealy cost is analysed as the following; $1.1\~9.2\%$ of total construction cost in part extension period, $3.3\~11.0\%$ of total construction cost in total extension period. 3. In comparison between liquidated damages and delay cost, liquidated damages account for average 20.1 times of delay costs. 4. Acceleration cost will be calculate on the basis of delay cost calculation method. In the result of this method, acceleration cost is equal to delay cost at least or must be large than delay cost

• KDI Journal of Economic Policy
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• v.31 no.1
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• pp.239-276
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• 2009

The paper investigates the possible relationship between earnings prediction by security analysts and special ownership ties that link security companies those analysts belong to and firms under analysis. "Security analysts" are known best for their role as information producers in stock markets where imperfect information is prevalent and transaction costs are high. In such a market, changes in the fundamental value of a company are not spontaneously reflected in the stock price, and the security analysts actively produce and distribute the relevant information crucial for the price mechanism to operate efficiently. Therefore, securing the fairness and accuracy of information they provide is very important for efficiencyof resource allocation as well as protection of investors who are excluded from the special relationship. Evidence of systematic distortion of information by the special tie naturally calls for regulatory intervention, if found. However, one cannot presuppose the existence of distorted information based on the common ownership between the appraiser and the appraisee. Reputation effect is especially cherished by security firms and among analysts as indispensable intangible asset in the industry, and the incentive to maintain good reputation by providing accurate earnings prediction may overweigh the incentive to offer favorable rating or stock recommendation for the firms that are affiliated by common ownership. This study shares the theme of existing literature concerning the effect of conflict of interests on the accuracy of analyst's predictions. This study, however, focuses on the potential conflict of interest situation that may originate from the Korea-specific ownership structure of large conglomerates. Utilizing an extensive database of analysts' reports provided by WiseFn(R) in Korea, we perform empirical analysis of potential relationship between earnings prediction and common ownership. We first analyzed the prediction bias index which tells how optimistic or friendly the analyst's prediction is compared to the realized earnings. It is shown that there exists no statistically significant relationship between the prediction bias and common ownership. This is a rather surprising result since it is observed that the frequency of positive prediction bias is higher with such ownership tie. Next, we analyzed the prediction accuracy index which shows how accurate the analyst's prediction is compared to the realized earnings regardless of its sign. It is also concluded that there is no significant association between the accuracy ofearnings prediction and special relationship. We interpret the results implying that market discipline based on reputation effect is working in Korean stock market in the sense that security companies do not seem to be influenced by an incentive to offer distorted information on affiliated firms. While many of the existing studies confirm the relationship between the ability of the analystand the accuracy of the analyst's prediction, these factors cannot be controlled in the above analysis due to the lack of relevant data. As an indirect way to examine the possibility that such relationship might have distorted the result, we perform an additional but identical analysis based on a sub-sample consisting only of reports by best analysts. The result also confirms the earlier conclusion that the common ownership structure does not affect the accuracy and bias of earnings prediction by the analyst.

• Korean journal of communication and information
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• v.73
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• pp.56-91
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• 2015

This study examined changes in the independent production environment in the perspectives from flexible specialization of labor and media routines since January 2011, when comprehensive programming television channels (JTBC, MBN, Channel A, TV Chosun) emerged in Korea. In-depth interviews were conducted with thirteen individuals, including producers from independent production companies, broadcast writers, and individuals involved with these TV channels. The interview results indicated that a flexible specialization production system had been established by the comprehensive programming channels. This means that they were heavily dependent on independent producers, except in relations to their own news programs. Moreover, it was identified that the production of diverse programs could be difficult due to absurd contract practices such as those related to TV ratings and performance systems. Second, these channels have implemented some positive changes such as the payment of higher production costs and an incentive system, compared to terrestrial TV stations. However, the incentive system also helps to aggravate internal competition in the channel and also instigate contract competitions among independent companies, which can eventually result in the channels for holding exclusive rights to certain content and, hence, unfair business practices. Third, as a result of the newspaper and broadcast cross-owenership system of the comprehensive programming channels, hierarchical independent production practices can be established under the influence of newspaper proprietors and executives or managers who have previously worked for newspapers. Lastly, as a result of interviews with independent producers and individuals involved with the TV channels concerning the awareness of comprehensive programming channels, it could not be ascertained whether it is difficult to produce programs dealing with diverse items and genres, because programming autonomy has been distorted by capital or the advertisement market. In this circumstance, it is not surprising that some comprehensive programming channels mentioned that they prioritize profit and performance in programming. In conclusion, it is absolutely imperative that complementary and legal measures be implemented institutionally in order to redress the existing systematic dysfunctional routines in the independent productions of the comprehensive programming TV channels in Korea.

• Korean journal of communication and information
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• v.40
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• pp.150-191
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• 2007

Defamation lawsuits of public figures against media have been an issue since Roh government set in. Dissension between the government and media has probably acted as the key factor on this problem. Accordingly, arguments on the defamation lawsuits of public figures occurred the political issues such as opposition between the Progressive and the Conservative Parties or between the ins and the outs and showed the limits to suggest an appropriate judgment or solution. This study will analyze how the court makes its judgement on their rights and the limits by understanding the characteristic and the problem of defamation lawsuits made by senior government officials including a politician, the government, the president, and etc. As results, the defamation lawsuits of politicians and senior government officials showed specially noteworthy matters in salvation (damage suits), the amount claimed, court costs, ratio of winning lawsuits, and etc. The result on the tendency of the court decision showed the following matters in confusion: it holds the media responsible for the burden of proof by applying the inappropriate criterion; The applied laws, especially in the inferior court decision, do not show the consistency of the burden of proof between the misconception/ intention (malice)/ accident/ purpose of slander on the legal principles of public figures. Therefore, this study suggests the court to apply an appropriate law, let alone regulating the Anti-SLAPP law, so that it curtails the rights of public figures; limits the salvation of damage suit; and protects the right only in the case of false accusation by applying the existing law of "the Protection of the Deceased's Defamation Law." In order to dissolve the confusion when applying the laws on the public figures, the study insists the court to positively apply the Constitutional Court made criterion on "people" and "content." The study also insists to distinguish "intention(malice)," "accident," and "purpose of slander" and variant sorts of the burden of proof should be applied to each.