• Title/Summary/Keyword: Hospital costs

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The Location of Medical Facilities and Its Inhabitants' Efficient Utilization in Kwangju City (광주시(光州市) 의료시설(醫療施設)의 입지(立地)와 주민(住民)의 효율적(效率的) 이용(利用))

  • Jeon, Kyung-Sook
    • Journal of the Korean association of regional geographers
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    • v.3 no.2
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    • pp.163-193
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    • 1997
  • Medical services are a fundamental and essential service in all urban areas. The location and accessibility of medical service facilities and institutions are critical to the diagnosis, control and prevention of illness and disease. The purpose of this paper is to present the results of a study on the location of medical facilities in Kwangju and the utilization of these facilities by the inhabitants. The following information is a summary of the findings: (1) Korea, like many countries, is now witnessing an increase in the age of its population as a result of higher living standards and better medical services. Korea is also experiencing a rapid increase in health care costs. To ensure easy access to medical consultation, diagnosis and treatment by individuals, the hierarchical efficient location of medical facilities, low medical costs, equalized medical services, preventive medical care is important. (2) In Korea, the quality of medical services has improved significantly as evident by the increased number of medical facilities and medical personnel. However, there is still a need for not only quantitative improvements but also for a more equitable distribution of and location of medical services. (3) There are 503 medical facilities in Kwangju each with a need to service 2,556 people. This is below the national average of 1,498 inhabitants per facility. The higher locational quotient and satisfactory population per medical facility showed at the civic center. On the other hand, problem regions such as the traditional residential area in Buk-Gu, Moo-deung mountain area and the outer areas of west Kwangju still maintain rural characteristics. (4) In the study area there are 86 general medicine clinics which provide basic medical services. i. e. one clinic per every 14,949 residents. As a basic service, its higher locational quotient showed in the residential area. The lower population concentration per clinic was found in the civic center and in the former town center, Songjeong-dong. In recently build residential areas and in the civic center, the lack of general medicine clinics is not a serious medical services issue because of the surplus of medical specialists in Korea. People are inclined to seek a consultation with a specialist in specific fields rather than consult a general practitioner. As a result of this phenomenon, there are 81 internal medicine facilities. Of these, 32.1% provide services to people who are not referred by a primary care physician but who self-diagnose then choose a medical facility specializing in what they believe to be their health problem. Areas in the city, called dongs, without any internal facilities make up 50% of the total 101 dongs. (5) There are 78 surgical facilities within the area, and there is little difference at the locational appearance from internal medicine facilities. There are also 71 pediatric health clinics for people under 15 years of age in this area, represents one clinic per 5,063 people. On the quantitative aspect, this is a positive situation. Accessibility is the most important facility choice factor, so it should be evenly located in proportion to demander distribution. However, 61% of 102 dongs have no pediatric clinics because of the uneven location. (6) There are 43 obstetrical and gynecological clinics in Kwangju, and the number of residents being served per clinic is 15,063. These services need to be given regularly so it should increase the numbers. There are 37 ENT clinics in the study area with the lower concentration in Dong-gu (32.4%) making no locational differences by dong. There are 23 dermatology clinics with the largest concentration in Dong-Gu. There are 17 ophthalmic clinics concentrated in the residential area because of the primary function of this type of specialization. (7) The use of general medicine clinics, internal medicine clinics, pediatric clinics, ENT clinics by the inhabitants indicate a trend toward primary or routine medical services. Obstetrics and gynecology clinics are used on a regular basis. In choosing a general medicine clinic, internal medicine clinic, pediatric clinic, and a ENT clinic, accessibility is the key factor while choice of a general hospital, surgery clinic, or an obstetrics and gynecology clinic, thes faith and trust in the medical practitioner is the priority consideration. (8) I considered the efficient use of medical facilities in the aspect of locational and management and suggest the following: First, primary care facilities should be evenly distributed in every area. In Kwangju, the number of medical facilities is the lowest among the six largest cities in Korea. Moreover, they are concentrated in Dong-gu and in newly developed areas. The desired number of medical facilities should be within 30 minutes of each person's home. For regional development there is a need to develop a plan to balance, for example, taxes and funds supporting personnel, equipment and facilities. Secondly, medical services should be co-ordinated to ensure consistent, appropriate, quality services. Primary medical facilities should take charge of out-patient activities, and every effort should be made to standardize and equalize equipment and facility resources and to ensure ongoing development and training in the primary services field. A few specialty medical facilities and general hospitals should establish a priority service for incurable and terminally ill patients. (9) The management scheme for the inhabitants' efficient use of medical service is as follows: The first task is to efficiently manage medical facilities and related services. Higher quality of medical services can be accomplished within the rapidly changing medical environment. A network of social, administrative and medical organizations within an area should be established to promote information gathering and sharing strategies to better assist the community. Statistics and trends on the rate or occurrence of diseases, births, deaths, medical and environment conditions of the poor or estranged people should be maintained and monitored. The second task is to increase resources in the area of disease prevention and health promotion. Currently the focus is on the treatment and care of individuals with illness or disease. A strong emphasis should also be placed on promoting prevention of illness and injury within the community through not only public health offices but also via medical service facilities. Home medical care should be established and medical testing centers should be located as an ordinary service level. Also, reduced medical costs for the physically handicapped, cardiac patients, and mentally ill or handicapped patients should be considered.

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Making Aids of Magnetic Resonacnce Image Susing 3D Printing Technology (3D 프린트를 활용한 자기공명영상검사 보조기구 제작)

  • Choi, Woo jeon;Ye, Soo young;Kim, Dong hyun
    • Journal of the Korean Society of Radiology
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    • v.10 no.6
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    • pp.403-409
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    • 2016
  • MRI scan is a useful method in the diagnosis of musculoskeletal excellent contrast of the organization. Depending on the patient's musculoskeletal examinations state the type of aids provided the aid is used there is also challenging as well as the costs do not vary. This study was produced by the use of 3D printing technology, an MRI aids. Aids in the production process, then through 3D modeling and then convert stl files using (3D MAX.2014, Fusion360) slicing programs (Cubicreater 2.1ver., Cura 15.4ver) converted to G-code printed on the FDM scheme (Cubicon Style, output was MICRO MAKE). Output is, but in the FDM to evaluate the SNR on the MRI images were compared to the test is the case before use, and then to produce a Water Phantom case of a PLA, ABS, a TPU thickness 3mm, using aids before, It was evaluated in a clinical image after qualitatively. Obtaining an image of SNR Warter Phantom appeared to have been evaluated as T1 NON $123.778{\pm}28.492$, PLA $123.522{\pm}28.373$, ABS $124.461{\pm}25.716$, TPU $124.843{\pm}27.272$. T2 NON $127.421{\pm}26.949$, was rated as PLA $124.501{\pm}27.768$, ABS $128.663{\pm}26.549$, TPU $130.171{\pm}25.998$. The results did not show statistically significant differences. The use of assistive devices before and after images Clinical evaluation method palliative $3.20{\pm}0.88$, $3.95{\pm}0.76$ after using the aids used to aid improved the quality of the image. Production of the auxiliary mechanism using a future 3D printing is expected are thought to be used clinically, it can be an aid making safe and comfortable than the inspection of the patient is an alternative to improve the problems of the aids used in the conventional do.

The Clinical and Cost Effectiveness of Medical Nutrition Therapy for Patients with Type 2 Diabetes Mellitus (제2형 당뇨병환자에서 임상영앙치료의 임상적 효과와 비용효과 연구)

  • Cho, Youn-Yun;Lee, Moon-Kyu;Jang, Hak-Chul;Rha, Mi-Yong;Kim, Ji-Young;Park, Young-Mi;Sohn, Cheong-Min
    • Journal of Nutrition and Health
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    • v.41 no.2
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    • pp.147-155
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    • 2008
  • Medical nutrition therapy (MNT) is considered a keystone of medical treatment of chronic diseases. However, only few studies have evaluated medical and economical outcome of MNT. The study was performed on the patient with type 2 diabetes mellitus to evaluate the effect of clinical and cost-effective outcomes of MNT. Subjects from two general hospitals were randomly assigned to two different groups; One receiving basic nutritional education (BE) (n = 35), and the other receiving intensive nutritional education (IE) (n = 32) for a 6-month clinical trial. The group which received BE had a single visit with a dietitian, while the other group which received IE had an initial visit with a dietitian addition to two visits during the first 4 weeks of the study periods. Anthropometric parameters, blood components, and dietary intake were measures at the beginning of study period and after 6 month. Cost-effective analysis included direct labor costs, educational materials and medication cost difference during 6 months. After 6 month, subjects from IE group showed significant reduction of body weight (p <0.05) and systolic blood pressure (p <0.05), whereas BE group did not show any significant changes. Result from biochemical indices showed glycated hemoglobin concentration was significantly reduced by 0.7% (p <0.05) only in the IE group. The ratio of energy intake to prescribed energy intake decreased significantly in both groups (p <0.05). Mean time taken for a dietitian to educate the subject was 67.9 ${\pm}$ 9.3 min/person for BE group, while 96.4 ${\pm}$ 12.2 min/person for IE group. Mean number of educational materials was 1.9 ${\pm}$ 0.7/person for BE group and 2.5 ${\pm}$ 0.7/person for IE group. Change in glycated hemoglobin level along the 6 month period of study can be achieved with an investment of \88,510/% by implementing BE and \53,691/% by implementing IE. Considering the net cost-effect of blood glucose control and HbA Ic, IE which provides MNT by dietitian had a cost efficiency advantage than that of BE. According to this study, MNT provided by dietitian had a significant improvements in medical and clinical outcomes compared to that of BE intervention. Therefore, MNT protocol should be performed by systemic intensive nutrition care by dietitian in clinical setting to achieve good therapeutic results of DM with lower cost.

Outline History of Corporation Yudohoi(儒道會) via 『Cheongeumrok(晴陰錄)』 by Hong Chan-Yu: "Volume of Materials" (『청음록(晴陰錄)』으로 본 (사(社))유도회(儒道會) 약사(略史))

  • Chaung, hoo soo
    • (The)Study of the Eastern Classic
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    • no.55
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    • pp.265-291
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    • 2014
  • Cheongeumrok is the journal of Gwonwoo(卷宇) Hong Chan-yu(1915-2005) during the period of January 9, 1969~January 14, 1982. He was personally involved in the foundation of a corporation called Yudohoi and also all of its operation, which makes him the most knowledgeable person about its history. His Cheongeumrok thus seems worthy enough as a proper material to arrange its history. Cheongeumrok consists of total 19 books, amounting to approximately 3,300 pieces of squared manuscript paper containing 200 letters per piece. He wrote it in Chinese and sometimes followed the Hangul-style word order while writing in Chinese. Many parts of the manuscript were written in a cursive hand with many Chinese poems embedded throughout it. The manuscript offers major information related to the corporation Yudohoi extracted from his journal. 1. There was a meeting of promoters to commemorate the foundation of the corporation in November, 1968, and it was in January, 1969 that it was established after getting a permit from the Ministry of Culture and Communication in January, 1969(Permit No. of Ministry of Culture and Communication: Da(다)-2-3(Jongmu(宗務)1732.5)). 2. Its office was moved from the original location of the 3rd floor of Wonnam Building, 133-1 Wonnam-dong, Jongro-gu, Seoul(currently Daekhak Pharmacy in front of Seoul National University Hospital) to Room 388 of Gwangjang Company, 4 Yeji-dong, Jongro-gu(office of Heungsan Social Gathering) and to second floor of KyungBo building, 21 Kyansu-dong, and to 3rd floor of Geongguk Building in Gyeongwoon-dong. 3. Its operational costs were covered by the supports of Seong Sang-yeong, the eldest son of Seong Jong-ho, the chairman of the board, later Kim Won-tae and Gwon Tae-hun, next chairmen of the board, and Hong Chan-yun, a director, since 1979. 4. His Confucian activities include participating in Seonggyungwan Seokjeonje (成均館 釋奠), joining in the erection of the Parijangseo(巴里長書) Monument and the publication of its commemorative poetry book, compiling the biographies(not completed) of Confucian patriotic martyrs for independence, and participating in the establishment of family rituals and regulations as a practice member. 5. His Yudohoi had a dispute with Seonggyungwan and lost a suit at the High Court in July, 1975 and Supreme Court in February, 1976. 6. There were discussions about its unification with Seonggyungwan Yudohoi, but there was hardly any progress. 7. Yudohoi started to provide full-scale courses on Confucian and Chinese classics under the leadership of Director Hong Chan-yu in 1979, and they have continued on today. Its courses for scholarship students including those for common citizens boast a history of 29 years and 220 graduates.