• Health Policy and Management
• /
• v.14 no.2
• /
• pp.1-16
• /
• 2004

The study purpose was to find which factors affect selection of hospital network types. This study used the 1998 American Hospital Association Annual Survey Database from Health Forum. Among these U.S. hospitals, the researcher selected hospitals located in Metropolitan Statistical Areas. Therefore the final observation cases for analysis are 1,971 Metropolitan Statistical Area hospitals in the United States. To identify significant variables influencing hospital network types, the study used proportional odds logistics regression model on population size, Health Maintenance Organization penetration rate, and market competition rate of area including a hospital, types of hospital ownership, hospital bed size, proportion of Medicare patients and Medicaid patients in total hospital patients, and occupancy rate. Contrary to conventional wisdom, selection of hospital network types was influenced by population size of area which a hospital located, types of ownership, hospital bed size, and proportion of medicare patients rather than Health Maintenance Organization penetration. Population size 1,000,000-2,499,999 had the highest probability of selecting type IV (clinical-vertical integration) from an independent hospital, and a religious group owned hospitals and for-profit owned hospitals had the highest probability of selecting Type IV (clinical-vertical integration) from an independent hospital. A bed size had positive relation on selecting Type IV (clinical-vertical integration) from an independent hospital. Unlikely general belief that the selecting types of hospital network was determined by the change of health insurance policy such as Health Maintenance Organizations and Preferred Provider Organizations, the types of hospital network were influenced by community characteristics such as population size, and hospital characteristics.

• Journal of Biomedical Engineering Research
• /
• v.35 no.5
• /
• pp.169-176
• /
• 2014

As body postures on bed affects various sleep related diseases, it is considered as important information when monitoring sleeping in daily life. Though there have already been a few approaches to monitor body postures on bed conventionally, the development for simple and unconstrained methods is still needed to realize the long-term daily monitoring. Focusing on the fact that ballistocardiogram changes depending on the body postures on bed, we developed a novel method to estimate body posturesusing extremely simple, film-type ballistocardiogram sensor which is based on polyvinylidene fluoride(PVDF) film. With 10 subjects, we performed two experiments. One was for an estimation test to show that body postures on bed can be estimated by ballistocardiogram, and the other was for a reproducibility test to present the feasibility of ballistocardiogram based body postures monitoring. To estimate body postures on bed, we made an individual template set of body postures by designating one ballistocardiogram (BCG) sample as a template in each postures. Then, we calculated Pearson's correlation coefficients between a sample and each templates and estimated the body posture of the sample by choosing a posture which corresponds to the most significant correlation coefficients. As a result, we estimated body postures on bed with 99.2% accuracy in average and found that the estimation using ballistocardiogram is reproducible.

• Korea Journal of Hospital Management
• /
• v.21 no.1
• /
• pp.43-50
• /
• 2016

The public medical centers are required to make efficient and profitable operation. The efficiency is usually measured by DEA(data envelopment analysis), and profitability is measured by medical income rate. But DEA is measured by relative, not absolute value. So, profitability rate is used alternatively for DEA. This study want to analyze the interchangeability between DEA ranking and medical income rate ranking among public medical centers. The return on total assets is same ranking with DEA on bed number, employee number and total asset, but 60-70% relationship with DEA on bed number and employee number, as input resources. The operating margin is similar ranking with DEA on bed number and employee number, but 50-60% relationship with DEA on bed number, employee number and total asset, as input resources.

• Quality Improvement in Health Care
• /
• v.12 no.1
• /
• pp.62-76
• /
• 2006

Background : There were so many patients who are waiting for admission in Emergency room in spite of more than one hundred empty beds everyday. This study was conducted to evaluate admission-discharge module system by OCS which reduce empty beds. Methods : The data of bed utilization in general beds from 2004 were reviewed. For evaluation of performance at admission-discharge module system by OCS, the change of Occupancy of bed were calculated. Results : The percentage of Average Bed Emptiness was changed from 13.8% to 9.2%. The residents in surgery(100%) and in internal medicine(75.5%) approved this system. Conclusion : The personnel in hospital recognized that it was very important to manage bed. The management of beds by OCS was helpful to reduce empty beds and was important.

• Journal of radiological science and technology
• /
• v.40 no.3
• /
• pp.407-413
• /
• 2017

Medical radiation offers significant benefits in diagnosing and treating patients, but it also generates unnecessary radiation exposure to those nearby. Accordingly, the objective of the present study was to analyze spatial dose rate according to types of radiation source term in multi-bed hospital rooms occupied by patients and general public. MCNPX was used for geometric simulation of multi-bed hospital rooms and radiation source terms, while the radiation source terms were established as whole body bone scan patients and imaging using a portable X-ray generator. The results of simulation on whole body bone scan patients showed $3.46{\mu}Sv/hr$ to another patient position, while experimental results on imaging using a portable X-ray generator showed $1.47{\times}10^{-8}{\mu}Sv/irradiation$ to another patient position in chest imaging and $2.97{\times}10^{-8}{\mu}Sv/irradiation$ to another patient position in abdomen imaging. Multi-bed hospital room, unnecessary radiation generated in the surrounding patients, while legal regulations and systematic measures are needed for radiation exposure in multi-bed hospital rooms that are currently lacking in Korea.

• Korea Journal of Hospital Management
• /
• v.16 no.3
• /
• pp.1-18
• /
• 2011

In this study, population census(2005 & 2008) from Statistics Korea and the statistical data of the number of hospital beds by healthcare facilities classification from Ministry of Health and Welfare were used. For analyzing distribution of hospital beds, hospital beds were classified as acute care beds, long-term care beds and all hospital beds, which is including acute and long-term care beds. Regional areas, which are city(si), county(goon) for the study and district(gu) were reclassified as metropolitan city, city(si) and county(goon). Because there were 165 regional areas in 2005 and 2008, 84 and 81 areas were classified as metropolitan city and/or city and county, respectively. Gini index were calculated for hospital beds from each year, and Lorenz curves were drawn. The following summary presents the findings of this study. Compared to the year 2005 and 2008, the Gini index was 0.24472, and hospital bed numbers increased slightly by 0.80% than in 2005. In case of acute care beds, the Gini index was 0.23797(0.13%), and there was no big difference; however, the Gini index for long-term care beds was 0.41091, and there was a 30.25% decrease, which shows improvement to reduce disparities. It might result from an increase in long-term care beds up to 476.2%. For geographical equality of hospital beds, the Gini index and Lorenz curve, which can be compared the degree of inequality in the distribution of hospital beds reasonably and possibly show statistical data, should be used. Through this study, the distribution policy of hospital beds should be established.

• Radiation Oncology Journal
• /
• v.35 no.1
• /
• pp.71-77
• /
• 2017

Purpose: Although the technical developments of radiotherapy have been remarkable, there are currently few reports on the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as initial treatment in this three-dimensional conformal radiotherapy era. Thus, we retrospectively evaluated the treatment results of radiotherapy for local recurrence of rectal cancer treated with surgery alone as the initial treatment. Materials and Methods: Thirty-two patients who underwent radiotherapy were enrolled in this study. The dose per fraction was 2.0-3.5 Gy. Because the treatment schedule was variable, the biological effective dose (BED) was calculated. Results: Local control (LC) and overall survival (OS) rates from the completion of radiotherapy were calculated. The 1-, 2-, 3-, 4-, and 5-year LC rates were 51.5%, 24.5%, 19.6%, 19.6%, and 13.1%, respectively. LC rates were significantly higher for the high BED group (${\geq}75Gy_{10}$) than for the lower BED group (<$75Gy_{10}$). All patients who reported pain achieved pain relief. The duration of pain relief was significantly higher for the high BED group than for the lower BED group. The 1-, 2-, 3-, 4-, and 5-year OS rates were 82.6%, 56.5%, 45.2%, 38.7%, and 23.2%, respectively. There was a trend toward higher OS rates in with higher BED group compared to lower BED group. Conclusion: For patients with unresectable locally recurrent rectal cancer treated with surgery alone, radiotherapy is effective treatment. The prescribed BED should be more than $75Gy_{10}$, if the dose to the organ at risk is within acceptable levels.

• Korea Journal of Hospital Management
• /
• v.10 no.1
• /
• pp.71-92
• /
• 2005

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.

• Quality Improvement in Health Care
• /
• v.3 no.1
• /
• pp.78-93
• /
• 1996

Background : The goal of this study was to establish the QA items and guidelines for preventing and improving of safety management. Therefore we investigated the nurses' recognition and knowledge of the safety and risk procedures and policies, and the agreement between the nurses beliefs on the degree of importance of those procedures and policies, with actual implementation in hospitals. Method : The subjects of this study were 201 nurses who participated in a program called continuing education for nurses, which held in December, 1993. Result: The results of this study were as follows: 1. Among 18 types of hospital risks, the items that scored highest or the need of closer attention in safety management was the needle stick, medication errors, falling, and bed sores. 2. In most questions of the 18 incidences, the nurses showed that the estimated result would have positive signs except for hospital infections, burns, and bed sores. 3. Even though the survey shows that incidences and types of occurences varies according to the person's age and the time of incident, they mostly occur between midnight to 6AM. Falls and bed sores can be seen more in the elderly. Medications errors, hospital infections and burns are frequently found between the ages of one through twenty. 4. There was a higher mean score for recognizing the importance of those items than the importance of implementing them. Conclusion : In summary, nurses did perceive the need of safety management but the hospital policy for proper safety management was not established. So we recommended that the hospital administration would undertake an early detection and proper management system for hospital precautions, based on QA items & guidelines presented in this study.

• Journal of East-West Nursing Research
• /
• v.14 no.1
• /
• pp.36-43
• /
• 2008

Purpose: This study was conducted for an evidence-based nursing intervention on bed rest period after puncture, by confirming whether there was a difference in scores of headache and back pain between the 1-hour bed rest group and the 6-hour bed rest group following lumbar puncture in patients with leukemia. Method: The subjects were 45 inpatients of the department of hematology at a general hospital in Seoul, from January 1 to March 31, 2005. There were 21 patients in the 1-hour bed rest group and 24 patients in the 6-hour bed rest group. A graphic rating scale was used to measure headaches and back pains. Collected data were analyzed with SPSS 12.0. Non- parametric statistics were used to analyze the data. Results: There was no significant difference between the 1-hour bed rest group and the 6-hour bed rest group in the headache level and back pain level. Conclusion: Therefore, it is considered that a long period of bed rest over 6 hours after lumbar puncture is not a necessary nursing intervention, and repeated studies are required to confirm the result.