• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.21-40
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• 1999

One Diagnosis Related Group(DRG) pilot study participating hospital was measured and analyzed to see if there were any changes after the DRG program. It was implemented in consideration of medical service utilization, hospital charges, and non-covered medical service charges by insurance in all Cesarean section cases by reviewing medical records for 3 years, including 1 year before pilot study as well as 1 and 2 years after, respectively. The results were as follows: First, the use of intramuscular antibiotics decreased statistically significantly, whereas intravenous use did not. Second, the administration period and charges of antianemic medication decreased significantly, where the prescription was appropriate. Third, the length of hospital stay decreased statistically significantly. Fourth, there were significant statistical differences in cost sharing between the insured and the insurer: cost sharing of the insured was reduced, whereas the share of the insurer increased. However, there was no change in the quality of care. Fifth, there were no statistically significant changes in the Cesarean section rate. As a result, if the fee schedule is reasonably high, hospitals can provide quality care. This DRG pilot study resulted expected outcomes: by paying a higher fee schedule than fee-for-service, then hospitals can provide quality care to their patients and increase hospital profits.

• Journal of Korean Neurosurgical Society
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• v.65 no.6
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• pp.853-860
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• 2022

Objective : This prospective, randomized, double-blinded trial aimed to evaluate the efficacy and safety of prophylactic ramosetron administration against postoperative nausea and vomiting (PONV) in patients undergoing microvascular decompression (MVD). Methods : In this study, 100 patients undergoing MVD were randomly allocated to the control (normal saline, 2 mL) or ramosetron (ramosetron, 0.3 mg) groups at the end of surgery. The incidence and severity of PONV, need for rescue antiemetics, patient satisfaction score, duration of hospital stay, and the occurrence of adverse events were evaluated 48 hours post-surgery. Results : Data obtained from 97 patients were included in the final analysis. The incidence of PONV was significantly lower in the ramosetron group than in the control group throughout the 48-hour postoperative period (29.2% vs. 51.0%, p=0.028). A similar trend was observed with regard to PONV severity (p=0.041). The need for rescue antiemetics, satisfaction score, duration of hospital stays, and the occurrence of adverse events did not significantly differ between the groups. Conclusion : Prophylactic ramosetron administration reduced the incidence and severity of PONV in patients undergoing MVD without causing serious adverse events. Thus, ramosetron use may improve patient recovery following MVD.

• 대한예방의학회:학술대회논문집
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• 1995.10a
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• pp.191-192
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• 1995

• Journal of Korean Academy of Nursing Administration
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• v.21 no.5
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• pp.587-587
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• 2015

• Tuberculosis and Respiratory Diseases
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• v.83 no.3
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• pp.248-254
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• 2020

Background: Although few studies have reported improved clinical outcomes with the administration of vitamin B1 and C in critically ill patients with septic shock or severe pneumonia, its clinical impact on patients with sepsis-related acute respiratory distress syndrome (ARDS) remains unclear. The purpose of this study was to evaluate the association with vitamin B and C supplementation and clinical outcomes in patients with ARDS. Methods: Patients with ARDS requiring invasive mechanical ventilation, admitted to the medical intensive care unit (ICU) were included in this study. Clinical outcomes were compared between patients administered with vitamin B1 (200 mg/day) and C (2 g/day) June 2018-May 2019 (the supplementation group) and those who did not receive vitamin B1 and C administration June 2017-May 2018 (the control group). Results: Seventy-nine patients were included. Thirty-three patients received vitamin B1 and C whereas 46 patients did not. Steroid administration was more frequent in patients receiving vitamin B1 and C supplementation than in those without it. There were no significant differences in the mortality between the patients who received vitamin B1 and C and those who did not. There were not significant differences in ventilator and ICU-free days between each of the 21 matched patients. Conclusion: Vitamin B1 and C supplementation was not associated with reduced mortality rates, and ventilator and ICU-free days in patients with sepsis-related ARDS requiring invasive mechanical ventilation.

• Journal of Korean Society of Health-System Pharmacists
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• v.35 no.4
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• pp.400-408
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• 2018

Background : Palivizumab is an intravenous monoclonal antibody which is used in the prevention of respiratory syncytial virus (RSV) infection. It is currently recommended for infants who are at high-risk for RSV infections due to preterm birth or other medical conditions such as congenital heart disease. Palivizumab is a humanized monoclonal antibody directed against an epitope in the antigenic site A of the protein F of RSV particles. Palivizumab is given once a month via intramuscular (IM) injection throughout the duration of the RSV season. Since palivizumab is known to have preventive effects against RSV infection for children with older siblings, the insurance coverage for palivizumab was expanded in October 2016. Methods : The electronic medical records of children under 2 years old who have older siblings who visited or were admitted to the Severance Hospital from October 2015 to May 2016 and from October 2016 to May 2017 were reviewed retrospectively. The data were then divided into two groups depending on the pilivizumab administration. Results : A total of 67 patients were enrolled in this study. The effectiveness in the reduction of hospitalization was statistically significant (p=0.009). Palivizumab decreased respiratory symptoms such as cough, rhinorrhea, and fever in patients with older siblings (p 0.05). Conclusions : In this study, palivizumab administration was effective in preventing RSV infection in infants with older siblings. Expanding palivizumab-prophylaxis administration to infants with older siblings may be effective in the prevention of upper respiratory infections.

• Korea Journal of Hospital Management
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• v.28 no.1
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• pp.1-13
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• 2023

Purpose: This study purposed to analyze the economic feasibility of introducing a third party logistics system as a strategic alternative to hospital management. Methods: Economic analysis was performed by measuring changes in costs and benefits before and after implement the third party logistics system and estimating the size of net benefits for the next five years for the target hospital. A questionnaire survey and in-depth interview with stake-holders were conducted to find out the satisfaction and effectiveness of the system. Findings: According to results, the cost-benefit ratio for the implementation of the system was 1.18. For the next five years, the cost-benefit ratio was 1.48, the net present value was about 1.7 billion won, and the internal rate of return was 64%. The satisfaction of internal stake-holders was relatively high, in terms of improving the concentration of unique tasks and increasing the efficiency of inventory management. Practical Implications: It was found that the increase in benefits had a greater effect on the change in the cost-benefit ratio than the increase in costs resulting from the expansion of logistics, and the increase in the present value of net benefits gradually decreased as the cost increased. In addition, overall job satisfaction and satisfaction with outsourcing companies were relatively low, which means that stabilization of the new system is important. Further study is needed for more accurate economic analysis.

• Korea Journal of Hospital Management
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• v.26 no.2
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• pp.43-55
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• 2021

Purposes: In this study, we examined the factors which silenced the organizing members and how the factors affects deprivation of employment about the organization culture, the organizational silence, and the turnover intention. Methodology: In order to research, we carry out a survey on 400 employees of small and medium hospitals. Among them, 321 questionnaires were used for actual analysis, excluding insincere respondents, non-responders or duplicate respondents. In order to verify the hypotheses in this study, we conduct the covariance Structural Equation Model(SEM). Finding: We obtained results using following hypotheses. First, ''The organization culture has an effect on the turnover intention.'' Second, ''The organization culture has an effect on the organizational silence'' Third, ''The organizational silence has a influence on the turnover intention.'' Finally, ''When the organization culture mediates the organizational silence, the adaptation relationship of the ornization effectiveness is different.'', as the key hypothesis, showed that the agreement culture, rational culture, and hierarchical culture of the organization culture type were statistically significant. The organizational silence as a parameter has the partial mediating effects(-) because it has direct and indirect effects. Practical Implications: The results of this study showed that the reason for the organizational silence of the organizing members is that the organization culture by a grade of rank is the largest and these the organizational silence affects the turnover intention.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.4
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• pp.445-454
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• 2007

Purpose: This study was to explore the empowerment experienced by hospital nurses. Methods: Focus group was used to gather data and open coding method suggested by Strauss and Corbin was used to analyze the data. Thirty-four nurses who have clinical experience of more than three years at three university hospitals were participated in this study. Results: Five categories were identified: Getting chances of opportunities to show personal capabilities and motivations, acknowledgement, support, recognition and delightfulness. The major sources of empowerment were the acknowledgement of patients and family, colleagues, supervisors. doctors, and other personnels in hospital. Conclusion: Focus groups could be an useful tool for empowerment research in nursing. Further research will be needed to clarify the relationship among individual, group and organization.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.2
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• pp.265-276
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• 2004

Purpose: This study was to define structural subjectivity pattern of whistle-blowing of hospital nurses. Method: This study was conducted using Q-methodology in order to classify the types of perception to an whistle-blowing from the inside of the incumbent hospital nurses. Nineteen members, including hospital nurses, professors and students majoring in the nursing department made 47 statements about the insider's accusation after an in-depth interview about the statements. Forty incumbent hospital nurses were the participants for the Q-Methodology. The statement data was analyzed with QUANL PC Program and five different types were classified according to how the nurse had replied to the statements. Result: The first one is a Propeller type. The second one is a Denial type. The third type is a Patient Advocate type. The fourth one is a Anonymous type. The fifth is a Netizen type. Conclusion: this study as a momentum, a reasonable and constitutional legislation in the nurses organization should be established as soon as possible.