• Title/Summary/Keyword: Hospital Accounting

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A Case of Sarcoidosis with Cavitation (폐 공동을 형성한 유육종증 1예)

  • Lee, Bo Han;Kim, Jin Myong;Kim, Dong Woo;Kim, Jung Hyuk;Bang, Ki Tae;Lee, Kye Young;Jee, Young Koo;Kim, Jae Seuk;Lee, In Sun;Kwon, Mi Seon;Kim, Youn Seup
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.5
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    • pp.546-550
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    • 2005
  • Sarcoidosis is a rare systemic disorder with unknown cause that is characterized pathologically by non-caseating granuloma. The lung and mediastinal lymph nodes are almost always involved, and most patients experience acute or insidious respiratory symptom. Because sarcoidosis is an interstitial lung disorder involving the alveoli and bronchioles, the most common radiological finding is a reticularnodular lesion with lymphatic distribution. However, cavitation is quite rare. Sarcoidosis is also a major cause of hepatic granuloma in Western countries, accounting for 12% to 30% of cases. In most patients, the course of hepatic sarcoidosis is benign. However, chronic intrahepatic cholestasis or portal hypertension may develop in some patients. We report a case of sarcoidosis with cavitation and hepatic involvement.

Impact of Hospital Specialization on Hospital Charge, Length of Stay and Mortality for Lumbar Spine Disease Inpatients

  • Kim, Jae-Hyun;Park, Eun-Cheol;Kim, Young Hoon;Kim, Tae Hyun;Lee, Kwang Soo;Lee, Sang Gyu
    • Health Policy and Management
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    • v.28 no.1
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    • pp.53-69
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    • 2018
  • Background: This study investigates association modified category medical specialization (CMS) and hospital charge, length of stay (LOS), and mortality among lumbar spine disease inpatients. Methods: This study used National Health Insurance Service-cohort sample database from 2002 to 2013, using stratified representative sampling released by the National Health Insurance Service. A total of 56,622 samples were analyzed. The primary analysis was based on generalized estimating equation model accounting for correlation among individuals within each hospital. Results: Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a shorter LOS (estimate, -1.700; 95% confidence interval [CI], -1.886 to -1.514; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had a lower mortality rate (odds ratio, 0.635; 95% CI, 0.521 to 0.775; p<0.0001). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per case (estimate, 192,658 Korean won; 95% CI, 125,701 to 259,614; p<0.0001). However, inpatients admitted with lumbar spine surgery patients at hospitals with higher modified CMS had lower hospital cost per case (estimate, -152,060 Korean won; 95% CI, -287,236 to -16,884; p=0.028). Inpatients admitted with lumbar spine disease at hospitals with higher modified CMS had higher hospital cost per diem (estimate, 55,694 Korean won; 95% CI, 46,205 to 65,183; p<0.0001). Conclusion: Our results showed that increase in hospital specialization had a substantial effect on decrease in hospital cost per case, LOS, and mortality, and on increase in hospital cost per diem among lumbar spine disease surgery patients.

Traumatic Posterior Fossa Epidural Hematomas in Children : Experience with 48 Cases and a Review of the Literature

  • You, Chaoguo;Long, Xiu;Hu, Liuxun;Sheng, Hansong;Zhang, Nu
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.225-231
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    • 2019
  • Objective : Epidural haematoma (EDH) most commonly occurs in the supratentorial area, particularly in the temporal region, of the brain. Posterior fossa epidural haematoma (PFEDH) is less frequently observed, accounting for only 1.2% to 12.9% of all EDH cases. Because of the non-specific symptoms and the potential for rapid and fatal deterioration in children, an early computed tomography (CT) scanning is necessary for all suspicious cases. The aim of the present study was to share the experience of 48 cases and review the literature concerning PFEDH. Methods : A retrospective analysis was conducted for 48 paediatric cases diagnosed with PFEDH and admitted to Yuying Children's Hospital of Wenzhou Medical University from January 2010 to August 2015. The clinical features and outcomes were analyzed and compared with previous literature. Results : Seventeen patients were surgically treated in this series and 31 patients received non-operative treatment. The outcomes were good in 46 patients, evaluated using the Glasgow outcome score (GOS), while mild disability was observed in one patient, and only one case showed severe disability. There were no cases of mortality in this series. Conclusion : Posterior fossa epidural haematoma is relatively rare compared with supratentorial epidural haematoma. Early and serial CT scans should be performed for all suspicious cases. The criteria for the surgical treatment of paediatric patients with PFEDH were concluded. The overall prognosis was excellent in paediatric patients.

A Case of Verrucous Carcinoma of Larynx (후두에 발생한 우상암 1예)

  • Kim, Kyoung Hun;Kang, Ju Yong;Lee, Myung Chul;Choi, Ik Joon
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.29-33
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    • 2017
  • Verrucous carcinoma was first described by Ackerman who reported a case of verrucous carcinoma of the oral cavity. While it is primarily occurred in oral cavity, larynx is the second most affected site, accounting for nearly 35% of cases. It is a rare variant of well-differentiated squamous cell carcinoma and comprises 1% to 4% of all laryngeal carcinomas. It is characterized by locally invasive, slow growth and the surface shows papillary fronds with prominent hyperkeratosis. Because of the benign appearance and difficulty of the tissue diagnosis, it is often undiagnosed or misdiagnosed. The primary treatment modality is surgery and the extent of surgical resection may be guided by T stage. We experienced a case of verrucous carcinoma of larynx in a patient with hoarseness lasted for about 2 years and had difficult to diagnosis and treatment. Therefore we report this case with a brief review of literature.

Two Cases of Cavernous Hemangioma in the Salivary Gland in Old Ages (노인에서 발생한 타액선의 해면상 혈관종 2예)

  • Yeo, Jang-Ok;Lee, Chang-Hee;Lee, Seon-Uk;Lee, Sang-Hyuk
    • Korean Journal of Head & Neck Oncology
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    • v.26 no.1
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    • pp.33-36
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    • 2010
  • Non-lymphoid mesenchymal neoplasms of salivary gland origin are rare, accounting for 1.4% of major salivary gland tumors. Of this group 30% were hemangiomas. Hemangiomas are the most common benign tumors in children, but are rare in old ages. 90% of hemangiomas arise in the first three decades of life. Hemangiomas are classified as capillary(including juvenile type), cavernous, or mixed in type. Salivary gland hemangioma is more common in the parotid(90%) and extremely rare in submandibular gland. We present two adult patients, 69 and 60 years of age, who were referred for palpable mass in the parotid area and submandibular area, respectively. After surgical removal of the lesion, histopathologic examination showed characteristic feature of cavernous hemangioma. The rarity of such a lesion in these locations in old ages have prompted this case report.

Subglottic Adenoid Cystic Carcinoma with Lung Metastasis: A Case Report (폐전이를 동반한 성문 하에서 발생한 선양낭성암종 1예)

  • Park, Hyung-Soon;Choi, Hong-Shik;Hong, Soon-Won;Jeung, Hei-Cheul
    • Korean Journal of Bronchoesophagology
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    • v.16 no.1
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    • pp.68-72
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    • 2010
  • Adenoid cystic carcinoma (ACC) of larynx is a rare disease, accounting for less than 1% of laryngeal malignancies, These tumors arise almost exclusively in the subglottic and supraglottic regions, while the proportion of glottic ACCs is small. We describe a case of a young man with a subglottis adenoid cystic carcinoma, The patient underwent laryngeal microscopic surgery and radiotherapy, Five years after radiotherapy, local recurrence and distant metastasis Clung and kidney) was detected and he underwent palliative chemotherapy and local treatment. He is still alive for seven years after the initial diagnosis. The treatment strategies for laryngeal ACC are still controversial due to the rarity of the condition. We suggest that multimodality approach may be helpful in deciding a treatment option, and thorough and consistent follow-up for recurrence is mandatory for these patients.

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Mediastinal Neurofibroma in a the Patient with Type 4 Neurofibromatosis -A case report- (피부 신경섬유종증을 동반한 환자에서의 종격동 신경섬유종 -1예 보고-)

  • Lee, Jong-Ho;Kwon, Jong-Bum;Moon, Mi-Hyoung;Park, Kuhn
    • Journal of Chest Surgery
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    • v.40 no.4 s.273
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    • pp.317-320
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    • 2007
  • Neurogenic tumors are the most common posterior mediastinal tumors and accounting for $19{\sim}39%$ of all mediastinal tumors and 75% of all posterior mediastinal tumors. Neurofibromatosis is an autosomal dominant disorder with variable expression of tumors, including neurologic tumors of the peripheral nerves, nrve roots, and plexi. A posterior mediastinal neufibroma in neurofibromatosis patients is rare. We report here a case of posterior mediastinal neurofibroma in a patient with type 1 neurofibromatosis.

Intra-Articular Synovial Lipoma of the Knee Joint - A Case Report - (슬관절내에 발생한 윤활막 지방종 - 증례 보고 -)

  • Kim, Kwang-Yeol;Hwang, Yeon-Su;Lee, Ji-Hoon;Yoon, Seung-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.16 no.1
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    • pp.47-51
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    • 2012
  • Although lipoma is the most common soft-tissue tumor, accounting for up to one half of all soft-tissue tumors, intra-articular synovial lipomas are rarely seen. Occasional cases of intra-articular lipoma arborescens have been reported. However, true intra-articular synovial lipomas should be differentiated from other similar lipomatoid conditions such as lipoma arborescens, which are different pathologic entities and show different clinical presentations. This article presents the case of a patient who had an intra-articular synovial lipoma of the knee joint.

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Evaluation on Bankruptcy Prediction Model of Hospital using the comparative Analysis of Financial Index (재무지표 비교 분석에 의한 병원도산예측모형 평가)

  • Kim, Jae-Myeong;Ahn, Young-Chang
    • Health Policy and Management
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    • v.15 no.4
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    • pp.81-109
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    • 2005
  • According to many recent studies suggesting that cash flow analysis method tends to be more effective than traditional financial index analysis method to predict corporate bankruptcy, this study applies the cash flow analysis method to hospital business to identify the significant variables which can distinguish between superior hospitals and bankruptcy hospitals. The author analyzed recent 3 years, i.e. from the year of 2000 to the year of 2002, financial statements of 31 bankrupt hospitals In 2003, and the same number of superior hospitals through using Multiple Discriminant Analysis and Logit Analysis. The results are belows; First, the study releases that Logit Analysis is more likely to be effective than Multiple Discriminant Analysis. Second, this research also shows that traditional financial index analysis method is more superior compare to cash flow analysis method for hospital bankruptcy predict model. Finally, this study suggest that the significant variables, which can distinguish superior hospitals from bankrupt hospitals, are Operating/Current Liabilities$(Y_2)$, CFO/Equity$(Y_5)$ for cash flow analysis method and Net Worth to Total Assets Ratio$(X_1)$, Quick Ratio $(X_3)$, Return on Assets$(X_6)$, Growth Rate of Patient Revenues$(X_{16})$ for traditional financial index analysis method.

The Surgical Treatment of Three Young Chronic Subdural Hematoma Patients with Different Causes

  • Hou, Kun;Li, Chen G.;Zhang, Yang;Zhu, Bo X.
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.218-221
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    • 2014
  • Chronic subdural hematoma (CSDH), which rarely happens in the young, is thought to be a disease of the elderly. Whereas unspecific symptoms and insidious onset in juveniles and young adults, as a result of its relative low morbidity, CSDH is usually neglected even undertreated in the young. Through the three cases and review of the current literature on this subject, we tried to illustrate the clinical and etiopathological characteristics of this entity and find out the most appropriate treatment strategy. We report three young CSDH patients with different but similar symptoms. The present histories, tests and examinations revealed different predisposing factors accounting for the genesis of CSDH. Their preoperative symptoms were all resolved with burr hole and drainage operation. Juveniles and young adults suffering from CSDH differ from that of their elderly counterparts in their clinical and etiopathological characteristics. Although trauma is the most important risk factor in young and old CSDH patients, some other predisposing factors may exist. Burr hole and drainage surgery could resolve the problem most of the time. But further tests and examinations even specific management should be made in some cases.