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Studies on Determinant Factors of SCM Performance: From the Supplier Perspective (SCM 성과 결정요인에 관한 통합적 연구: 공급업체 관점으로)

  • Park, Kwang-Oh;Chang, Hwal-Sik
    • Asia pacific journal of information systems
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    • v.21 no.1
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    • pp.1-27
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    • 2011
  • In an attempt to cope with widespread, dynamic, and accelerating changes in both internal and external business environments, companies often utilize information technologies such as SCM(Supply Chain Management). To date, SCM research has mainly focused on the effects of dynamic factors on SCM success and emphasized adoption strategies and critical success factors. Consequently, the effects of more static factors such as interdependency between SCM partners have been largely ignored. The purpose of this study, therefore, is to examine the effects of both dynamic and static factors on SCM performance by controlling for information quality and partnership quality. The five factors examined in this study include innovative ness, mutual dependency, quality of information, partnership quality, and SCM performance. All factors were examined from the perspective of part suppliers, except the mutual dependency which was examined from two aspects: supplier's dependency on customer and customer's dependency on supplier. Data was collected through five hundred survey questionnaires distributed to the part supplier companies that have implemented SCM systems for at least one year. As a result, a total of 170 valid responses were obtained. A structural equation research model was fitted using SAS 9.1.3 and SMART-PLS 2.0. The results of this study can be summarized as follows. First, innovativeness positively affected SCM information quality. SCM partnership quality, and ultimately SCM performance. The path coefficient between innovativeness and information quality was 0.387, with a t-value of 3.528. Innovativeness also had a positively direct effect on partnership quality. The path coefficient was 0.351 with a t-value of 3.366. The total effect of innovativeness on partnership quality was significant, although its indirect effect on partnership quality by altering information quality was negligible. The total indirect effect of innovativeness on SCM performance by affecting information quality and partnership quality was significant with a p-value of 0.014. Innovativeness played an important role in determining SCM performance. Second, mutual dependency showed no significant effect on SCM information quality. This result contradicts the earlier assertion that the more dependent two companies are, the more accurate and timely the information they exchange ought to be. This study showed that this may not be the case; a partner may provide information of poor quality even when it is strongly dependent on the other. Mutual dependency showed significant effect on partnership quality. However, when the mutual dependency perceived by suppliers was divided into two parts, one being a supplier's dependency on its customer company and the other being a customer's dependency on the supplier, the latter showed a significant impact on the perceived SCM partnership quality. This result indicates that a customer company can hardly improve the partnership quality perceived by suppliers by making them more dependent. It improves only when the suppliers perceive that their partners, typically having more bargaining power, are more dependent on them. The overall effect of mutual dependency of any kind on SCM performance, however, was not significant. Although mutual dependency has been mentioned as an important static factor influencing almost every aspect of cooperation on a supply chain, its influences may not be as significant as it was initially perceived to be. Third, the correlation between information quality and partnership quality was 0.448 with a p-value of less than 0.001. Information quality had a path coefficient of 0.256 to partnership quality with a t-value of 2.940. The quality of information exchanged between partners may have an impact on their partnership quality. Fourth, information quality also had a significant impact on SCM performance with a path coefficient of 0.325 with a t-value of 3.611. In this study, SCM performance was divided into four categories: product quality, cost saving, service quality, and order fulfillment. Information quality has Significant impacts on product quality, cost saving and service quality, but not on order fulfillment. Fifth, partnership quality, as expected, had a significant impact on SCM performance. The path coefficient was 0.403 with a t-value of 3.539. Partnership quality, like information quality, had positive impacts on product quality, cost saving and service quality, but showed no impact on order fulfillment. It seemed that order fulfillment is the hardest category of performance that SCM can satisfy. One major limitation of this study is that it surveyed only the suppliers. To better understand the dual aspects of SCM, it is important to survey both suppliers and the assemblers, especially in pairs. This research, to our best knowledge, was the first attempt to study the level of dependency between the two groups by measuring the dual aspects of SCM and studying mutual dependency from the categories of suppliers and assemblers each.. In the future, a more comprehensive and precise measurement of SCM characteristics needs to be achieved by examining from both the supplier's and assembler's perspectives.

N-terminal Pro-B-type Natriuretic Peptide as a Predictive Risk Factor in Fontan Operation (Fontan 수술시 위험 예측인자로서의 N-Terminal Pro-B-type Natriuretic Peptide의 유용성)

  • Jang, Gi Young;Lee, Jae Young;Kim, Soo Jin;Shim, Woo Sup
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1362-1369
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    • 2005
  • Purpose : This study aimed to investigate the correlation between the plasma level of N-terminal pro-B-type natriuretic peptide(pro-BNP) and several known risk factors influencing outcomes after Fontan operations, and to assess whether pro-BNP levels can be used as predictive risk factors in Fontan operations. Methods : Plasma pro-BNP concentrations were measured in 35 patients with complex cardiac anomalies before catheterization. Cardiac catheterization was performed in all subjects. Mean right atrium pressure, mean pulmonary artery pressure(PAP), and ventricular end-diastolic pressure(EDP) were obtained. Cardiac output and pulmonary vascular resistance were calculated by Fick method. Results : Plasma pro-BNP levels exhibited statistically significant positive correlations with mean PAP(r=0.70, P<0.001), pulmonary vascular resistance(r=0.57, P<0.001), RVEDP(r=0.63, P<0.001), LVEDP(r=0.74, P<0.001), and cardiothoracic ratio(r=0.71, P<0.001). The area under the ROC curve using pro-BNP level to differentiate risk groups in Fontan operations was high : 0.868(95 percent CI, 0.712-1.023, P<0.01). The cutoff value of pro-BNP concentrations for the detection of risk groups in Fontan operations was determined to be 332.4 pg/mL(sensitivity 83.3 percent, specificity 82.7 percent). Conclusion : These data suggest that plasma pro-BNP levels may be used as a predictive risk factor in Fontan operations, and as a guide to determine the mode of therapy during follow-up after Fontan operations.

Clinical Characteristics of Neonatal Status Epilepticus (신생아 간질 중첩증의 임상 특성)

  • Jung, Kyeong Hun;Kim, Yun Hee;Kwon, Young Se;Jun, Yong Hoon;Kim, Soon Ki;Son, Byong Kwan
    • Clinical and Experimental Pediatrics
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    • v.48 no.12
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    • pp.1342-1347
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    • 2005
  • Purpose : Among perinatal risk factors, neonatal seizures are one of the strongest independent discriminators of adverse outcome, representing high risks of mortality and neurologic morbidity. This study was undertaken to evaluate the neurologic outcome of neonatal status epilepticus according to underlying etiology, seizure pattern, onset time, and duration. Methods : We reviewed retrospectively 36 neonates(19 males, 17 females) with status epilepticus who were admitted to the neonatal intensive care unit, Inha Hospital between July, 1988 and June, 2003. They were evaluated with neurologic examination, laboratory data, EEG findings, and neuroimaging studies etc. Results : The mean gestational period of the patients was $37.0{\pm}3.6$ weeks and birth weight was $2.70{\pm}0.82$ kilogram. Fifty two point eight percent of the neonates were male and 66.7 percent were born at term. The most common cause of neonatal status epilepticus was hypoxic-ischemic encephalopathy. In preterm babies, intracranial hemorrhages showed an especially high frequency(P=0.034). Gestational age and birth weight did not show a correlation with neurologic complications. The incidence of neurological sequelae were significantly related to prolonged seizures lasting more than 1 hour(P=0.002). Neonates with seizures within the first 72 hours tended to be more frequent among those who developed adverse outcomes(P=0.016). Generalized tonic seizures had the worst prognosis, whereas those children who had subtle seizures had better outcomes than any other type(P<0.05). Generalized tonic seizures were primarily represented on EEG by abnormal background, whereas subtle seizure showed a significantly more normal EEG than any other seizures(P<0.05). Conclusion : Our results indicate that neonatal status epilepticus with early onsets, prolonged durations. And generalized tonic types can predict an increased risk for neurologic sequelae. So, those seizures must be perceived as medical emergencies and treated aggressively with antiepileptic drugs.

Analysis of cytosine adenine repeat polymorphism of the IGF-I promoter gene in children with idiopathic short stature (특발성 저신장증 환자에서 IGF-I 프로모터 cytosine-adenine repeat 유전자 다형성의 분석)

  • Moon, Jae Hoon;Chung, Woo Yeong
    • Clinical and Experimental Pediatrics
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    • v.52 no.3
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    • pp.356-363
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    • 2009
  • Purpose : A polymorphism in the IGF-I gene promoter region is known to be associated with serum IGF-I levels, birth weight, and body length, suggesting that IGF-I gene polymorphism might influence postnatal growth. The present study aimed to investigate the role of this polymorphic cytosine-adenine (CA) repeat of the IGF-I gene in children with idiopathic short stature. Methods : The study involved 131 children (72 boys and 59 girls) diagnosed with idiopathic short stature, aged 715 years. Genomic DNA was extracted from anticoagulated peripheral whole blood. The primers were designed to cover the promoter region containing the polymorphic CA repeat. Data were analyzed using GeneMapper software. The correlations between age and serum IGF-I levels were analyzed using Spearmans correlation coefficient. Results : The CA repeat sequences ranged from 15 to 22, with 19 CA repeats the most common with an allele frequency of 40.6%. Homozygous for 19 CA repeat was 13.0%, heterozygous for 19 CA repeat was 56.5%, and 19 CA non-carrier was 30.5%. The three different genotype groups showed no significant differences in height, body weight and body mass index, and serum IGF-I levels. The serum IGF-I level and age according to the IGF-I genotypes were significantly correlated in the entire group, 19 CA repeat carrier group, and the non-carrier group. The three groups also showed no significant differences in the first year responsiveness to GH treatment. Conclusion : There were no significant different correlations between 19 CA repeat polymorphism and serum IGF-I levels according to genotype. Our results suggest that the IGF-I 19 CA repeat gene polymorphism is not functional in children with idiopathic short stature.

The studies about the weight-changes during pregnancy and the condition of mother and infant (임신 중 체중변화와 임부 및 신생아 상태에 관한 연구)

  • Park, Kwang-Hee
    • Korean Parent-Child Health Journal
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    • v.4 no.1
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    • pp.68-81
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    • 2001
  • This research is to study about the weight-change of a pregnant woman, conditions of the woman and an infant. The weight-change of a mother during pregnancy was observed and that was expressed as the basis on the body mass index of a mother before pregnancy. The effects of weight-changes on both the discomfort, complications of pregnant mother and the condition of an infant were also investigated. Thus we set a purpose that this study would help pregnant woman and an infant to maintain and enhance their health conditions by proper weight control through nursing mediation. This study was performed in a certain hospital of university in seoul from Feb. 1. 2000 to Mar. 31. 2000. We explained the purpose of this study to the hospital institution and obtained consent of investigation. 152 inpatients who were in condition from PA 37 weeks to PA 42 weeks were the subject of this study. The research materials were made through of question paper that inpatients make answer by themselves and investigation paper. The question paper was about general background, weight and height before pregnancy and discomfort of the physical degree. And the investigation paper was about parity, maternal weight(late pregnancy), high pregnancy, delivery method, hemoglobin level, Apgar score, fetal weight. Physical discomfort was measured using the implement made by Kim hae won(1996) (chronbach's ${\alpha}=0.85$). SPSS was used to do statistics for managing and analyzing data. The results of this study were like followings. 1. The mean value of gained weight during pregnancy was about 13.8kg within from 3 kg to 26 kg. Among 152 research candidates, the gained weight of 80(52.6%) candidates remained within an ideal range. But that of 37 candidates(24.3%) became less than the ideal range. Also that of 35 candidates(23.0%) became over than the ideal range. 2. In the investigation of the relation between the weight change of a pregnant woman and her condition, the scores to represent physical discomfort were middle in all candidates. And the physical discomfort of over weight-gained group was more than that of low weight-gained group, but there was no difference in statistics(F=0.234, p=0.791). The weight-changes of pregnant woman didn't have an influence with the high risk of pregnancy(F=0.509, p=0.477). Also, the weight-changes didn't have an influence on delivery method($x^2=3.825$, p=0.148). However, in the investigation of the relation between weight-change and hemoglobin level, the change of hemoglobin level was highest in over weight gained group(F=3.062, p=0.05). 3. In the investigation of the weight-change of pregnant woman and the condition of infant. the weight changes didn't have an influence on both 1 min Apgar score(F=0.157, p=0.855) and 5 min Apgar score(F=0.030, p=0.970) of infant. Also, in the investigation of weight-change of a pregnant woman and weight difference of a infant with Pearson Correlation Coefficient, the weight-change of a pregnant woman affected vastly the weight of a infant. It was also found that the more pregnant woman gained in weight, the more did gain weighty infants. This relation was in net proportion(r=0.256, p=0.001). In conclusion, these results suggest that the weight-changes during pregnancy in Korea women of these days are more increased than that of the past days and individual variation in weight-changes is very high. Also, these results suggest that the changed hemoglobin level of a mother and weight of an infant were meaningfully affected by the weight-changes of a pregnant woman during pregnancy. However, the physical discomfort of a pregnant woman, the high risks of pregnancy, the delivery method and Apgar score of an infant were not affected by the weight-changes during pregnancy. Because the recommendation suggesting the ideal weight-change, used this study, is basis on the subject of American women, therefore, these results also suggest the necessity of such recommendation which is subject to Korean women.

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A Study on the Strategic Use of an IMC Planning Model for the Distribution Industry (유통업 IMC 기획모델의 전략적 활용에 관한 연구)

  • Mo, Sun-Jong;Song, In-Am
    • Journal of Global Scholars of Marketing Science
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    • v.18 no.2
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    • pp.113-145
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    • 2008
  • Marketing for the distribution industry is making an ongoing progress in the changes of customers, the competitive environment, and the internal marketing environment. Integrated marketing communication activities are required for the enhancement of efficiency in the market.oriented activities. In this study, IMC is defined as "a notion that a market oriented business integrated marketing communication means, conducting and evaluating marketing activities with consistent messages in order to communicate with customers based on databases." In this study, an IMC planning model for the improvement of marketing efficiency in the distribution industry was derived from a pilot study. This model may be broken down into the following phases: IMC goals setting, situational analysis (customer analysis, competition analysis and company analysis), customer data analysis, contact management, budgeting, the establishment of an IMC strategy, the IMC mix and execution, an evaluation system, and feedback. In consideration of the characteristics of the distribution industry, this study was accompanied by a vocational study on IMC means employed by, in particular, department stores and other distributors such as: advertising, sales promotion, sales promotion advertising, direct marketing, public relations, personal selling, the Internet, mobile, visual merchandising, words of mouth. In addition, this study also covered the correlation among variables such as IMC activities of distributors, the process of forming customer's brand attitudes, brand loyalty and repurchase intention. This research would enhance the utilization of IMC. The analysis on customer's brand attitudes toward the IMC activities of distributors requires the simultaneous consideration of how they are linked to purchase as well as their attitudes toward both distributors and stores. The formation of brand loyalty and repurchase intention is related to the integration of marketing communication and the maintenance of consistency in contents, which requires integrated brand communication (IBC) strategies. IBC is a concept of using IMC means to manage the brand in a continuing and consistent manner and measuring their effect, which is a process to establish enterprise.level brand identity and maximize brand loyalty and repurchase intention by integrating IMC means. For an empirical analysis in this study, an online questionnaire survey was conducted among those department store customers from 20's to 50's who reside either in the Seoul and Gyeonggi areas and have made purchase at department stores. In this study, the research model consisted of four theoretical variables: IMC activities, IMC attitudes, brand loyalty, and repurchase intention, on which variables a pilot study was conducted. A number of hypotheses were constructed on the relations between IMC activities and IMC attitudes, between IMC attitudes and repurchase intention, and between brand loyalty and repurchase intention. The test of the hypotheses may be summarized as follows: Firstly, the test of the hypothesis concerning the relation between IMC attitudes and IMC activities - advertising, sales promotion, direct marketing, public relations, personal selling, the Web, mobile, visual merchandising, and word of mouth - indicates that advertising, sales promotion, direct marketing, public relations, personal selling, mobile, visual merchandising, and word of mouth have significant impact on IMC activities. In addition to the result similar to those of previous studies that such marketing communication means as word of mouth, advertising, personal selling and sales promotion, in particular, play very important roles, a notable finding of this study is that visual merchandising performed by department stores is shown to have very significant impact on IMC activities. On a separate note, it is also noteworthy that Internet marketing activities engaged by department stores are not shown to have significant impact on IMC attitudes. Secondly, the test of the hypothesis on the relation between IMC attitudes and brand loyalty attests that IMC attitudes for the distribution industry significantly affect brand loyalty. Thirdly, the test of the hypothesis concerning the relation between IMC attitudes and repurchase intention confirms that IMC attitudes for the distribution industry significantly affect repurchase intention. Fourthly, the test of the hypothesis concerning the relation between brand loyalty and repurchase intention indicates that brand loyalty significantly affect repurchase intention. A comprehensive view of these findings points to the conclusion that the IMC activities for the distribution industry do affect IMC attitudes, brand loyalty, and repurchase intention.

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An Application Effect of Rhythmic Movement Program for the Health Promotion in the Elderly (노인의 건강증진을 위한 율동적 운동프로그램의 적용효과)

  • 이숙자
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.776-790
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    • 2000
  • Every year the number of the elderly increases in Korea thanks to the improvemen of social and economical levels and the development of medicine. However, many problems such as insufficent care and the isolation of the elderly have been commonplace. This trend exists not only because of increased lifespan but also the changing social structure of the nuclear family. Accordingly, inspite of the development of medicine, geriatric diseases including circulatory diseases are increasing in proportion of elderly population, as well as the severity. Therefore, it is important to emphasize that health care programs provide the best possible health care and functional capacities in terms of healthy elderly lifestyles. Especially, the phenomena of aging and geriatric diseases taking place with the elderly naturally are affected by lifestyle and the drastic changes in exercise patterns. This study aims to improve geriatric health by introducing a rhythmic movement program for the elderly to estabilish a health-promoting self-care system and by developing quality of life, perceived health status, their physical and physiological functions and emotional state. The theoretical framework used in this dissertation is derived from the Health-Promoting Self-Care System Model (Simmons, 1990), which integrates the Self-Care Deficit Nursing Theory (Orem, 1985), the interaction model of Client Health Behavior (Cox, 1982) and the Health Promotion Model (Pender, 1987). As a quasi-experimental design, the nonequivalent control group pretest-posttest design is utilized for this study. The subjects of this study consist of 64 people, over 65 years old who live in 2 nursing homes for the aged located in S city , Kyong-gi province and volunteered for this study from July, 12, 1999 to September, 17, 1999. They are divided into two groups:33 in the experimental group and 31 in the control group. The experimental group particpated in the Rhythmic Movement Program at the nursing home, which was comprised of 45 minutes a session, 5 sessions a week during 9 weeks. In order to measure the results of the Rhythmic Movement Program, aspects of perceived health status, balance, flexibility, grip strength, leg strength, heart rate, blood pressure, depression, anxiety and the quality of life were measured before and after participating in the Rhythimic Movement Program for the experimental group after 9 weeks, as well as the control group. The collected data were processed by SPSS PC+ and analyzed by the X2 test, t-test, ANCOVA and the Pearson Correlation Coefficient. The results of this study are as follows: 1. The perceived health status conditions in the experimental group show statistically significant improvement when compared to the control group (F=17.51, p=.000). 2. The physical and physiological functions, that is, balance (F=17.51, p=.000), flexibility (F=8.01, p=.006), grip strength (F=3.21, p=.018) and leg strength (F=25.78, p=.000) in the experimental group are higher than the control group. The vital signs, that is, the number of heart rate (F=.022, p=.884), systolic pressure (F=1.73 p=.193), and diastolic pressure (F=2.74, p=.103) in the experimental group compared to the control group decreased, but doesn't show statistically significant differences. Immune responses (F=5.13, p=.003) showed statistically significant increases in the experimental group when compared to the control group. 3. The emotional state are improved, that is, degree of depression (F=11.56, p=.001) and degree of anxiety (F=9.14, p=.004) in the experimental group showed statistically significant decreases. 4. The quality of life in the experimental group (F=3.03, p=.037) showed statistically significant differences compared to the control group. 5. The observations of the relationships among the perceived health status, emotional state , the quality of life, the relationships between the perceived health status, the degree of depression (r=-.653, p=.000) and the degree of anxiety (r=-.786, p=.000) were in contrary propotions, while the relationships between the perceived health status and the quality of life (r=.234, p=.008) were in direct propotion. In conclusion, the Rhythmic Movement Program used in this study for geriatric nursing care is simple and safe for application to the elderly and shows significant effects by implementing 5 sessions a week for 9 weeks. The Rhythmic Movement Program improves the quality of life, maintains as well as improves the physical and physiological fuctions and emotional state, therefore this program is strongly recommended for positive applications for independant geriatric nursing health care.

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A Study on User Behavior and Satisfaction with Neighborhood Parks within Walking Distance with Consideration for Interior and Exterior Environments - Focusing on the Case Study Hwarang and Gwanum Park, Daegu - (도보권 근린공원의 내·외부 환경을 고려한 이용행태 및 만족도에 관한 연구 - 대구광역시 화랑공원과 관음공원을 대상으로 -)

  • Jung, Sung-Gwan;Lee, Seul-Gi;Kang, Dong-Hyun
    • Journal of the Korean Institute of Landscape Architecture
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    • v.42 no.5
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    • pp.110-123
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    • 2014
  • Recently, having neighborhood parks within walking distance has grown in importance. The purpose of this study is to analyze the effect of user satisfaction with neighborhood parks within walking distance considering interior and exterior environments. To do so, a field survey and GIS were conducted to construct data which were then compared with result of the analysed environment. Finally, amultiple regression analysis was conducted to confirm impact on user satisfaction of environment. By summarizing the study results, it was found that users of Hwarang Park exhibited a high level of satisfaction with 'park facilities' and 'safety of park use'. In the case of Gwanum Park, users exhibited a high level of satisfaction with 'green space' and 'amount of shade'. On the contrary, two park users exhibited low levels of satisfaction with 'facilities for children' and 'various attractions' within the parks. The pedestrian environment of Hwarang Park was rated higher than Gwanum Park within the park service area. User satisfaction was also rated higher than for Gwanum Park. However, two park users exhibited low levels of satisfaction with 'various attractions' within the pedestrian environment. From the result regression analysis of the total satisfaction factors, 'environment of access route', 'park facilities' and 'space for walking' positively influenced park use satisfaction. It was found that improvement of the pedestrian environment would be more effective than the improvement of the internal environment on Hwarang Park. This study investigated correlation with the access road environment as well as the interior environment of the parks. The results of this research will be used to improve accessibility and availability for neighborhood parks within walking distance.

The Moderating Effect of Social Capital between Organizational Slack and Managerial Practices for Open Innovation in Venture SMEs (벤처중소기업의 조직여유와 개방형 경영혁신 간의 관계에서 사회적 자본의 조절효과 연구)

  • Bae, Hoyoung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.10 no.5
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    • pp.73-81
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    • 2015
  • This research is designed to analyze the moderating effect of social capital between organizational slack and managerial practices for open innovation. After controlling the firm size, firm age, and environmental uncertainty, we test two hypotheses. First, we test the hypothesis that organizational slack has a positive effect on managerial practices for open innovation. Especially we focus on the managerial innovation and open innovation because recently managerial innovation and open innovation are more and more important. Second, we test the moderating role of social capital between organizational slack and managerial practices for open innovation. Because social capital is a kind of networking activity, we assume that social capital can contribute to managerial practices for open innovation through the networking activity. For this research, we administered the questionnaire surveys, and got the 250 effective data (companies) in Korea. Then we used the validity, reliability, correlation and multiple regression analysis by means of SPSS 18.0. As a result, we can find the two meaningful results. First, organizational slack, especially not absorbed slack but unabsorbed slack, has positive effect on managerial practices for open innovation. It is because absorbed slack such as excessive facilities, machines, or employees is not useful in managerial practices for open innovation. On the other hand, unabsorbed slack is useful in managerial practices for open innovation because unabsorbed slack such as excessive money or securities is very flexible and active. Taken together, the relationship between managerial practices for open innovation and unabsorbed slack is proven in terms of flexibility. Second, social capital has a moderating effect positively between organizational slack, especially not absorbed slack but unabsorbed slack, and managerial practices for open innovation. A prior study related to the relationship between managerial practices for open innovation and social capital doesn't exist yet, so this analysis result is very meaningful in academic respect. But this research has some limitations. First, this research is analyzed by limited region (Korea) and samples (250 companies), so more global regions and samples are recommended in the future. Second, we focus on managerial practices for open innovation in this paper, so the studies about technological practices for open innovation are recommended in the future.

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The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology (병원 밖에서 발생한 심인성 심장정지환자의 생존 관련 요인 7년간 국가심장정지조사사업 자료 활용)

  • Jeong, Su-Yeon;Kim, Chul-Woung;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.2
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    • pp.560-569
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    • 2016
  • Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.