This study purported to evaluate the performance of the appointment system for outpatients in primary care dental clinic. The data of patients' time flow for 1,245 patients in Y Dental Clinic were collected for one month in 2002 and then analyzed. Specifically, the time periods of treatment and patients' waiting as well as rates of appointment and it's failure are estimated. The accuracy of expected treatment time period was also evaluated. The results showed that 72% of patients visited the clinic with appointments, and only 56% kept their appointments. The patient's waiting time period turned out to be 11 minutes in Y clinic. The expected treatment time period is turned out to be very important because they influence significantly on patient's waiting time period. Practically, the expected treatment time period should be overestimated about 9 minutes in general, and the characteristics of dentist, each patient's diagnosis and age need to be especially considered. Hospitals and clinics also need to make the systematic and detailed critical pathways for a variety of patient cases by analyzing the patients' treatment pattern. With the improved appointment systems, healthcare institutions will approach the goal of effective and efficient management of the institution and also satisfy their customers.
Dobran, Mauro;Marini, Alessandra;Nasi, Davide;Liverotti, Valentina;Benigni, Roberta;Costanza, Martina Della;Mancini, Fabrizio;Scerrati, Massimo
Journal of Korean Neurosurgical Society
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v.65
no.1
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pp.123-129
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2022
Objective : Chronic subdural hematoma (CSDH) is one of the most common pathology in daily neurosurgical practice and incidence increases with age. The aim of this study was to evaluate the prognostic factors and surgical outcome of CSDH in patients aging over 90 years compared with a control group of patients aging under 90 years. Methods : This study reviewed 25 patients with CSDH aged over 90 years of age treated in our department. This group was compared with a younger group of 25 patients aged below their eighties. At admission past medical history was recorded concerning comorbidities (hypertension, dementia, ictus cerebri, diabetes, and heart failure or attack). History of alcohol abuse, anticoagulant and antiplatelet therapy, head trauma and seizures were analyzed. Standard neurological examination and Markwalder score at admission, 48 hours after surgery and 1-6 months follow-up, radiologic data including location and CSDH maximum thickness were also evaluated. Results : Their mean age was 92.8 years and the median was 92.4 years (range, 90-100 years). In older group, the Markwalder evaluation at one month documented the complete recovery of 24 patients out of 25 without statistical difference with the younger group. This data was confirmed at 6-month follow-up. One patient died from cardiovascular failure 20 days after surgery. The presence of comorbidities, risk factors (antiplatelet therapy, anticoagulant therapy, history of alcohol abuse, and head trauma), preoperative symptoms, mono or bilateral CSDH, maximum thickness of hematoma, surgical time and recurrence were similar and statistically not significant in both groups. Conclusion : In this study, we demonstrate that surgery for very old patients above 90 years of age affected by CSDH is safe and allows complete recovery. Comparing two groups of patients above and under 90 years old we found that complication rate and recovery were similar in both groups.
In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using 'patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other people's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessive-compulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptoms Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.
This study was carried out to focus on the user-oriented design of patients' room in general hospital. The purpose of the study was to examine the users' evaluation on their patients' rooms in H General Hospital and to suggest how to improve the patients' room design. The users were inpatients, care givers, and nurses, 300 subjects of each 100 users in H hospital. They evaluated 26 items related to the patients' room design using by 5-points Likert scale. Also, they answered three elements which bothered them, what needed improvement, and what they feel ill at ease. The results were as followings; 1) The users evaluated positively the location and size of window. This implies that the current one is relatively ideal and deserve to be maintained. 2) The users responded negatively to the thermostat system and the space for care-givers. 3) The lack of space for care-givers and visitors, common use of refrigerator and bathroom, and the lack of space bothered the users. 4) Most users mentioned the lack of space in patients' room. This implies that it needs to consider the change of the person number per patient's room, from 5 persons to 4 ones. 5) The lacks of sleeping space, dining space, and bathroom space bothered the care-givers. This implies that the space for care-givers such as sleeping, dinging, and bathing should be considered in patients' room.
The purpose of study carried out to determine the effect of informativeness influeucing the state-Anxiety of Hysterectomy patient, the relationship between Hysterectomy patient's general characteristics on State-Anxiety. and to investigation the cause of hysterectomy patient's Anxiety, the relationship between the cause of Anxiety and State-Anxiety. This stuad carried out between April 14. to May 24. 1983. This study sample consisted of 104 Hysterectomy patient who admitted to department of obstetrics of Seoul National University Hospital, Korea University Hospital, Han Yang University Hospital and Seung Nam Hospital. The Sample were divided into two groups; fifty two of experimental and fifty two of control group. The method used for the collection of data were set of information prepared by reseacher and state-Anxiety Inventory, The Questionnaire of state-Anxiety Inventory was made up 20 items. The data was analyzed by computer program. The results of the study were as follows. 1. There was shown state Anxiety to be alleviated by experimental group and control group. 2. There was significant relation between experimental group and control group. (p<0.01) 3. There was relation of state-Anxiety by education Level: Experimental group (p<0.05) control group (p<0.05) religion : only control group (p<0.05)economic state : only control group (p<0.05) The people who encouraged hysterectomy: Experimental group (p<0.05) control group (p<0.0001) 4. The cause of preoperative anxiety about hysterectomy were as follows: 1) destruction of body image(=loss of uterus) 2) husband's attitude 3) Expactation that hysterectomy will adversely affect sexual relation 5. Among the cause of Anxiety, R²for state-Anxiety were as follows: 1) economic state 17.3% 2) deatch 21.6% 3) Expactation that hysterectomy will adversely affect sexual relation 24.5%.
Journal of The Korea Institute of Healthcare Architecture
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v.18
no.3
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pp.41-49
/
2012
Most large-sized and tall-risen general hospitals of today fairly depend on in-patient wards in designing hospital styles. The core planning for the efficient movements of various people in the words should take into account the sustainable connections between/among the floors, as well as hospital structures and mechanical functions. This study sampled for the study 19 hospital in-patient wards and investigated their flat-core styles. It was found out that hospital structures are changing from symmetrical styles of triangles, quadrangles and rectangles through bending, configuring, transforming to efficient new styles. Symmetrically quadrangled flat-styles are made of multi-cores spread with main an sub-cores. In contrast, symmetrically triangled flat-styles place the open place in the middle in order to prevent from its deepening, and widened the depth line through changing the outdoor top point. Non-symmetrical rectangles minimized the depth value to maintain the recent styles used in the wards, and tended to prefer the transformed styles of quadrangles. The double-corridors easily transshaped from mono corridors reveals the triangled, W-shaped, or Y-shaped figures. The site area ratio of the cores is 11.95% in average. The number of beds which one elevator covers is 66.51 beds in average, and the size of site area which one elevator covers 216.68m. Most cores on the base floor clustered around the average value, with more than 1000 beds shoes 12.83%, does 12.93%, does 14.64%, does 14.58%, which says that the core ratio increases according to hospital beds.
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.
Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from $1^{st}$ to $30^{th}$ April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.
The purpose of this study is to find out the present conditions of the facilities in terms of their quality and quantity and to suggest a better way to improve the system. The main results of this study can be summarized as follows ; 1. A few subjects knew there were how many kind of facilities in the hospital. 2. Convenience facilities should be available to the patient and their aids whenever they want to use. 3. There were statistically significant difference between the recognition and utilization on convenience facilities of subjects. 4. Some managers of administration considered that the recognition on convenience facilities of subjects be increased.
Pyo, Seung Bum;Song, Jin Kyung;Ju, Hong Sil;Lim, Seong Yoon
Archives of Craniofacial Surgery
/
v.18
no.3
/
pp.197-201
/
2017
Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately $2.5{\times}3.3cm$. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.
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