• 한국의료질향상학회지
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• 제1권1호
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• pp.96-108
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• 1994

Background: An appropriate use of hospital beds can improve productivity of hospital significantly. The authors' previous study revealed that approximately one third of Korean hospital bed days and one sixth of admissions were inappropriately used, when it was measured by Appropriateness Evaluation Protocol(AEP) and Delay Tool modified into Korean situation by the authors. This study aims to evaluate applicability of the instruments in a new hospital. More specifically the study aims to measure appropriateness of the instruments used by newly trained nurse reviewers at a new hospital setting. Methods: In order to evaluate applicability of these instruments, agreement rates of the scores recorded by newly trained nurse reviewers with by skilled nurse reviewer and also compared with the scores recorded by physician's implicit decision were assessed. Agreement rates were derived from concurrent application of AEP and Delay Tool to 52 admissions and 104 patient days from internal medicine, pediatrics, and general surgery of one university hospital. Overall agreement rate, specific nonacute agreement rate, and kappa statistics were used to indicate level of agreement. Results: Overall agreement rates on appropriateness between newly trained nurse reviewers and skilled nurse reviewer were 100% in admission and 98% in bed days. Overall agreement rates on reason for inappropriateness between newly trained nurse reviewers and skilled nurse reviewer were 96% in admission and 91% in bed days. Overall agreement rates between newly trained nurse reviewers and physician reviewer were 86% in admission and 87% in bed days. Conclusion: Results indicated that AEP and Delay Tool were applicable to a new hospital in detecting inappropriate utilization of beds and reasoning of the inappropriateness. These instruments could contribute to enhance efficiency of hospital use, through continuous monitoring of level of inappropriate hospital use at national or individual hospital level.

• 한국실내디자인학회논문집
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• 제36호
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• pp.76-83
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• 2003

The purpose of this study is to know how to improve environment of multi-bed room by investigating and analysing factors influencing to patients. 1 measured stress and satisfaction degrees about patient room for 4ㆍ5ㆍ6ㆍ7 men of domestic general hospital wards. The results of research show that patients of 4 bed room appeared the fewest stress and highest satisfaction degree among patients of other room styles. The patients positioned between two beds can give us more stress and fewer satisfaction than others. These results have proven that 4 bed room patients are offering comfortable environment than any other room types as a healing environment. When patient room area are more than 7.3$M^2$ per 1 person, bed interval space is more than 120cm, there is curtain between bed, transit space such as a toilet were established in patient room, patients' satisfaction appeared high.

• 한국병원경영학회지
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• 제6권3호
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• pp.109-129
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• 2001

The purpose of this study was the acquisition of the optimum scale of the apportionment of standard & high-class bed for the maximum profit representative of the desire of customers in a General Hospital with 1,100 beds located in Seoul. This investigation was proceeded by the analysis of the result of the simulation with the survey of both the patients' needs for bed and the degree of the medical service by the grade of the ward. And finally the consequence was obtained as follows: 1. The result of the investigation of the inpatients' preference for the grade of ward classes shows that a private ward reflected 4.3 percent, a semi-private ward 1.7 percent, a three-bed ward 0.1 percent, and a ward with six beds 93.9 percent each other. 2. A questionnaire poll was paralleled of service terms of a medical doctor and a nurse by ward class, the data were used for the standard of the allotment of labor cost by the ward class. The poll shows that the service tenn of a medical doctor and a nurse based on a ward with six beds by ward class showed 1.7 times in internal medicine and 1.9 times in surgery at a private ward; 1.4 times in internal medicine and 1.7 times in surgery at a semi-private room; and 1.2 times both in internal medicine and in surgery at a three-bed ward 3. The resultant findings revealed the most profit per bed and per patient in a private ward. However, an analysis of profit with a standard of unit area by ward class represented a higher profit in both the internal medicine and the surgery semi-private ward than other ward classes. 4. The result of the analysis through simulation based on the data of the prime cost per the ward class proved the optimum scale of the distribution of beds by class as follows: sixteen beds of the internal medicine and twenty three beds of the surgery in the private ward; two hundreds and two of the internal medicine and one hundred and ninety eight of the surgery in the semi-private room; three of both the internal medicine and the surgery each other in the three-bed ward; one hundred and ninety eight of the internal medicine and two hundred and fifty two of the surgery in the ward with six beds. The result of this research exhibits that the income and expenditure of the hospital could be improved by changing parts of wards into private ones(containing the maximum profit per a unit of width) in case the scale of the number of beds is reset with the consideration of the profit per the unit width. In the near future it's strongly expected that the research for the more scientific standard of the allotment of labour cost by ward class and for definition of the optimum scale of the number of beds that actualize the maximum profit with the change of the three elements of the prime cost: cost of materials; labor costs; management expenses.

• 한국응급구조학회지
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• 제12권3호
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• pp.27-41
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• 2008

Purpose : The purpose of this study was to supply basic data for the impact on the accuracy of basic CPR according to position and foot-board height of basic CPR provider. Methods : Study design was within - group design. Subjects were 25 EMT-P Students in K city. Interventions was basic CPR performed on a resuscitation manikin placed on a hospital bed, kneeling on the bed adjacent to the manikin. Data was analyzed using descriptive statistics and Friedman test. Results : In case of the basic CPR performed on a resuscitation manikin placed on a hospital bed, ventilation accuracy was the highest in less than 160 cm height, foot-board height : $34.2{\pm}1.48cm$, 91.4% and in 161-165 cm height, foot-board height : $26.0{\pm}2.14cm$, 88.4% and in 171-175 cm height, foot-board height : $23.0{\pm}1.41cm$, 91.3% and in the above 176 cm, kneeling on the bed, 95%. Chest compression accuracy was the highest in less than 160 cm height, foot-board height : $30.2{\pm}1.48cm$, 95.6% and in 161-165 cm height, kneeling on the bed, 97.6% and in 171-175 cm height, kneeling on the bed, 98.5% and in the above 176 cm, kneeling on the bed, 98.7% and foot-board height : $20.5{\pm}1.91cm$, 98.7%. Chest compression error was due to too weak : 2.0-35.4 times. There were ststistically significant differences in 191-195 cm group according to chest compression mean depths($x^2=10.824$, p = .013) and chest compression error (p = .040). Conclusion : In contrast to current guidelines, the position and foot-board height of basic CPR provider are very important to the accuracy of the basic CPR. Furthermore, we recommend that a using real time audiovisual feedaback system significantly improve the quality of chest compression and ventilation during resuscitation.

• 대한장애인치과학회지
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• 제7권1호
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• pp.38-43
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• 2011

Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

• Journal of the Korean Statistical Society
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• 제4권1호
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• pp.79-87
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• 1975

However, the mechanism for producing revised estimate is the principal means of varying the resulting precisions of estimate. Therefore, a scheduling system including physician's revision should be checked by a computer simulation to evaluate possible gains to admissions scheduling accruing from the use of these estimates. The ability to accurately predict bed occupancy has long been an objective of hospital management. If the one were able to anticipate bed accupancy, then the one could more accurately plan for bed needs, schedule personnel, allocate service and supply. We may conclude that even though the Markov chain analysis would not lead to ready-made answers for the scheduling system of elective patients, it can provide the more detailed and systematic knowledgy for the solutions on the weekly base as well as the foundations for long run planning in relative sense.

• KIEAE Journal
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• 제12권6호
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• pp.113-121
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• 2012

A hospital is the most important infra-facility of the places which take care of people's body in social environment. There exist several environmental factors in the ways to heal the human body in hospital ward, but this study tried to look into the improvable pleasant sickroom environment with focus on light environment among the factors. In other words, this study aims at the research on proper daylight inflow into sickroom space as basic data for understanding the link between healing environment and natural lighting. In the simulation analysis through this research, this study completed the initial simulation using Autodesk Revit 2011 with focus on two types of individual multi-bed room units of the two general hospitals located in Gwangju City. This study made a simulation analysis of The two multi-bed rooms looking to the west using the weather data on Gwangju district, which is the strong point of ECOTECT2011. Conclusively, looking into the analysis of the simulation model in time of attaching the length of in & outside light shelf, the angle controlling of light shelf, the daylight factor and DA were found to show the tendency to decrease in the numerical value due to the decrease in sunlight inflow as the simulation model moved more toward the room from the window in comparison with the existing analysis of multi-bed rooms. Particularly, this study was able to read that the daylight factor and DA were more decreasing to improve at the light shelf than the existing bedrooms; conclusively, this study judges that the natural lighting simulation analysis could be helpful in improving the healing environment as basic data.

• 보건의료산업학회지
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• 제8권2호
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• pp.1-10
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• 2014

This study examined nonpatient revenues of university hospitals in korea. The data source for this study was 22 university hospitals over the period 2010-2012. In this study, patient revenues, patient expenses, operating profit, nonpatient revenues, total revenues, operating margin, normal profit to gross revenues, ratio of the nonpatient revenues in the total revenues were analysed by the annual and three-year average. The analysis of nonpatient revenue differences by hospital type, bed size, location, management performance was performed by T-test and oneway ANOVA. The results were as follows. First, nonpatient revenues of university hospitals were increased during the period 2010-2012. Second, nonpatient revenues according to hospital type, bed size, location in the university hospitals had significant difference. Third, hospital type was significantly associated with normal profit to gross revenues which was profitability index about nonpatient revenues. Based on these results, this study suggests implications to diversify for management performance in hospitals.

• 대한족부족관절학회지
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• 제2권1호
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• pp.13-18
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• 1998

Subungal exostosis is a rare benign cartilaginous tumor affecting the distal phalanx. From 1995 to 1996, six subungal exostoses of the hallux were treated in the Chonnam national university hospital. The symptoms were subungal pain, mass on the distal phalanx elevating the nail or causing ulceration of the nail bed. The plain radiological examination showed a bony mass occurring on the dorsomedial or medial aspect of the distal phalanx. The diagnosis of the subungal exostosis of the hallux were suspected from clinical presentation and confirmed with radiographic examination. Histological patterns were fibrocartilaginous cap with the mature trabecular bone. Complete excision of the lesion including overlying nail bed was curative without recurrence in all cases.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제6권10호
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• pp.15-21
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• 2000

Most of the existing studies of hospital ward were concentrated on the bed room and there was no study on the day place and corridor space for the inpatient. According to the existing study, 50% inpatients move here and there freely and they want to have a rest in the day place or corridor of the general hospital. So the purpose of this study is to find out the reason why the inpatients prefer to rest in the day place, to survey the inpatients' behavior there and to stress the importance of exterior environment except the bed room in the public space of hospital.