The purpose of this study is to analyze the efficiency in management of general hospitals and investigate the major factors on efficiency. Specifically, the management of each general hospital is evaluated by using Data Envelopment Analysis(DEA) technique which is a nonparametric statistical method for measurement of efficiency. Then, the influencing factors are investigated through analyses of Decision-Tree Model and Tobit Regression. The target hospitals were general hospitals in which bed sizes are between 200 and 500 among a total of 276 general hospitals. The main data of financial indicators were collected from 48 hospitals, and it was analyzed by using two statistical models. For Model I, three input and two output variables were used for efficiency evaluation. In particular, three input variables were the number of medical doctors, the number of paramedical personnel, and the bed size. And, two output variables were the numbers of inpatients and outpatients per year, adjusted by bed-size. The results of DEA analysis showed that only seven out of 48 hospitals(15%) turned out to be efficient. The decision-tree analysis also showed that there were six significant influencing factors for Model I. Six factors for Model I were Bed Occupancy Rate, Cost per Adjusted Inpatient, New Visit Ratio of Outpatients, Retired Ratio, Net Profit to Gross Revenues, Net Profit to Total Assets. In addition, the management efficiency of hospital is proved to increase as profit and patient-induced indicators increase and cost-related indicators decrease, by the Tobit regression model of independent variables derived from the decision-tree analysis. This study may be contributable to the development of analytic methodology regarding the efficiency of hospital management in that it suggests the synthetic measures by utilizing DEA model instead of suggesting simple ratio-analyzing results.
This study was carried out to investigate the effect of nutrition education program for diabetic patients on the glycemic control at the public health center. The study subjects, aged 61.7 $\pm$ 9.4 years, were 93 sex-and age-matched patients with type 2 diabetes mellitus. They were divided into three groups: nutrition education & diet practice group (EDG), nutrition education-only group (EG), and the control group (CG). Height, weight, and the postprandial 2 hour blood glucose (PP2) were measured at baseline, and 4, 6 and 8 week after the diabetic nutrition education program. At baseline there were no differences in height, weight, and blood glucose levels among the three groups. Nutrition education programs, especially that with group lunch practice sessions were found to be effective in lowering the blood glucose levels in patients with NIDDM patients. At 4 week blood glucose levels were decreased by 40.6% and 19.6% in EDG and EG, respectively, which was further dropped by 50.2% and 35.1% at 8 week, as compared to the CG group. For the EDG group, the total energy intake, which was 162.3% of the prescription before the diet counselling session, was decreased to 113.6% of the prescription after the lunch visit, with most decrease coming from the reduction in carbohydrate and fat intake. Multiple stepwise regression analysis revealed that the total energy intake explained 47.9% and 57% of blood glucose changes for men and women, respectively, and that percent energy intake from protein explained 15.8% for women. These results demonstrate that the public health center nutrition education programs for diabetic patients, especially that with group lunch practice sessions are very effective for the glycemic control in patients with diabetes mellitus.
Objectives: The aim of the study is to investigate the health belief model affecting the oral health behavior in middle and high school students. Methods: The subjects were 296 middle and high school students in Seoul, Gyeonggi and Incheon from February 15 to March 21, 2014. The students filled out the self-reported questionnaires after receiving informed consents. The instrument was adopted and revised from those of Kim & Hwang, and Choi & Joo. The questionnaire consisted of 4 questions of general characteristics, 9 questions of oral health status including subjective oral health status, frequency of tooth brushing, duration of tooth brushing, method of tooth brushing, use of oral health devices, dental clinic visit, scaling services, snack intake, and smoking. The oral health belief consisted of 25 questions including susceptibility, seriousness, barriers, benefit, and self-efficacy using Likert 5 scale. The reliability of Cronbach's alpha in the study was 0.725. Data were analyzed using SPSS ver 18.0 for frequency analysis, t-test, ANOVA, ${\chi}^2$-test, and Pearson's correlation coefficient, simple regression, and binary logistic regression. Results: Oral health beliefs of middle and high school students affected the oral health behaviors. Susceptibility, barriers and self-efficacy also influenced on the oral health behaviors. In order to provide the best oral health education, susceptibility and self-efficacy are the primary factors to increase motivation because the motivation endows the students with correction of oral health behaviors that improve the knowledge, attitudes, and decrease barriers in oral hygiene. Conclusions: It is important to correct oral health behaviors in the middle and high school students by providing the continuing and systematic oral health education.
Objectives: This study aimed to identify whether herbal medicine improves the clinical symptoms and abnormal blood tests of a patient with fatty liver accompanied by hypertriglyceridemia. Methods: A 44-year-old man with fatty liver and hypertriglyceridemia was prescribed Saenggangunbi-tang from July 20, 2020, to November 11, 2020, to reduce fatigue and to improve laboratory findings, such as liver enzymes and the lipid profile. We observed changes in symptoms, serum levels of liver enzymes, and the lipid profile during about 4-month treatment. We also recorded changes in the bioelectrical impedance analyzer findings during that time. Results: In this case study, an approximately 4-month treatment with Saenggangunbi-tang led to considerable improvement in laboratory findings and visceral fat area. In particular, the patient experienced a noticeable decrease in triglyceride levels compared with the baseline parameters of the first visit. In addition, no side effects-including weight gain and liver enzyme increases-were observed during treatment. Conclusion: This study suggests that appropriately prescribed herbal medicine is a therapeutic option to manage fatty liver combined with hypertriglyceridemia.
In the Health Insurance System of South Korea, patients must pay high out-of-pocket expenditures for the medical service by uninsured medical benefits. So, the government implemented a policy to relieve the burdens of patients by lowering the uninsured selective-medical treatment costs in August, 2014. This study investigate the policy effects of selective-medical treatment(SMT) on the medical service's usage and cost with severe lung cancer patients. The patients are selected in one university hospital(with 1,000 beds), between one year before and after policy implementation. The study find that the usages of outpatient(visit number) and inpatient (length of stay) are not changed by statistically significant. It means that there are no effect in medical service behavior between before and after the policy. In medical expenses, outpatients decreased in their out-of-pocket payments by policy, but total medical expenses and insured medical benefits is not changed, because of the increased another medical insurance fees. For inpatient, although the SMT costs are statistically significant decrease, the total out-of-pocket payments and insured medical expenses are not changed statistically significant. Those findings show that the political decision making about SMT made lowing the selective-medical expenses, but total insured cost and patient's out-of pocket money were not changed by the new increased medical insurance fees. It means that the policy about SMT gave no particular benefit for patients. So, it need another benefit plans to lower the medical expenses of severe lung cancer patients with a high medical service usage and much total medical expense.
Journal of Korean Society of Industrial and Systems Engineering
/
v.46
no.4
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pp.32-38
/
2023
This study investigates the influence of particulate matter concentrations on the incidence of asthma, focusing on the delayed onset of symptoms and subsequent medical consultations. Analysis incorporates a four-day lag from the initiation of fine dust exposure and compares asthma patterns before and after the World Health Organization's (WHO) classification of fine dust as a Group 1 carcinogen in November 2013. Utilizing daily PM10 data and asthma-related medical visit counts in Seoul from 2008 to 2016, the study additionally incorporates Google search frequencies and newspaper article counts on fine dust to assess public awareness. Results reveal a surge in search frequencies and article publications after WHO announcement, indicating heightened public interest. To standardize the long-term asthma occurrence trend, the daily asthma patient numbers are ratio-adjusted based on annual averages. The analysis uncovers an increase in asthma medical visits 2 to 3 days after fine dust events. Additionally, greater public awareness of fine dust hazards correlates with a significant reduction in asthma occurrence after such events, even within 'normal' fine dust concentrations. Notably, behavioral changes, like limiting outdoor activities, contribute to this decrease. This study highlights the importance of analyzing accumulated medical data over an extended period to identify general public behavioral patterns, deviating from conventional survey methods in social sciences. Future research aims to extend data collection beyond 2016, exploring recent trends and considering the potential impact of decreased fine dust awareness amid the COVID-19 pandemic.
The purpose of this study, as a project for health management at small workplace by Korean association of occupational health nurse, was to evaluate the program for correction of eating habits to prevent digestive disorders of workers. The study cases were twenty nine workers who voluntarily participated in the above program and they were from small(under fifty employees) workplace at Youngdeungpo-gu, Seoul. The study was done between January, 2000 and May, 2000. This program was concerned with daily menu for correction of eating habits and was composed of individual health education and distributing guide books and video. Nurses visited the workplace for the program once a week or two weeks. The result of this program was evaluated by paired t-test of digestive symptoms, eating habits, and self-efficacy before and after the fulfillment of the program. The result could be summarized as below. 1) There were decrease in digestive symptoms and improvement in eating habits and self-efficacy from study cases after fulfillment of the program. 2) The most common digestive symptoms were heartburn, upper abdominal pain, indigestion. The symptom which had been improved through the program were indigestion, heartburn and anorexia in the order. 3) The most improved eating habit was to eat flat foods instead of salty and spicy foods. The most improved self-efficacy was 'I can follow any helpful guides for my health'. The result indicated the program was successful for workers at small workplace. The continual management by nurses' regular visit once a week or two weeks was the most important thing for the successful program.
Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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v.15
no.2
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pp.141-148
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1997
Continuous development of Personal Computer(PC) combined with the decrease of price and the expansion of operating system in PC like Windows 95, and Windows N/T makes it possible for the user to consider PC-bas-ed Automated Happing/Facilities Management (AM/FM) system. Therefore, the purpose of this study is to establish a PC-based data automation system of pipe infrastructures-water, sewer, and drainage-and road in Korea Land Corporation. In order to achieve this goal, relevant literature survey was done first. Secondly, the study site was determined by discussion with Korea Land Institute. Thirdly, PC-based CAD software for AM/FM in the world market were surveyed, and AutoCAD Map was selected because KLC had been using hundreds of AutoCAD copies already. After that user needs assessment was done to visit on-site office, local branch office, and the corresponding city office for the system design and database design. After the graphic data were digitized and the attribute data were entered into the batabase, the data automation system was established, and tested for application. Finally, the guidelines and problems for PC-based data automation in AM/FM was discussed.
Background : The introduction of policies expanding the coverage of uninsured Korean Medicine (KM) services have requires an understanding of the following components of the service : current financial expenses, degree of financial burden on the patient, and financial effect of the coverage expansion. Objectives : This study aims to determine the annual trend of outpatients' characteristics and the category of out-of-pocket spending in KM. Methods : This study uses data from the Korea Health Panel to analyze use of KM in the Korean population. Using the user characteristics and behavior drawn from the Korea Health Panel data, out-of-pocket spending trends of KM were analyzed by year. The diagnosis and prescription of out-of-pocket spending were also analyzed. Results : The proportion of patients receiving uninsured medical treatment and the number of uninsured medical treatment in outpatient clinics have increased. However, the average out-of-pocket spending per person and out-of-pocket spending per visit are consistent or have decreased. Meaningful trends are the increase of R00-R99 (unclassified symptoms) and the decrease of K00-K93 (digestive system disease) and J00-J99 (respiratory system disease). Conclusions : Expansion of KM medical service and insurance is influenced by uninsured medical treatment of KM. Hence, research to increase medical treatment categories for out-of-pocket spending or explore diseases where KM diagnosis has been proven effective should be further developed.
As the complexity of society increases, the demand for the forest-based recreational site is also increased. This, in turn. makes congestion an ubiquitous type of externality in forest-based recreational site. Efficient resource allocation requires this congestion effect to be accounted and considered in the decision making process. In this content, this study was conducted to suggest a process which can be used to measure the congestion and determine the optimal number of users. Willigness to pay(WTP) function obtained from Book Han San National Park users suggested that every 20.000 users increased decrease the satisfaction of users obtained from the site visit be 27.3%. For the purpose of demonstration this WTP function is applied tit determine the optimal number of users which is estimated as about 73,000 persons per day.
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