• Journal of Preventive Medicine and Public Health
• /
• v.25 no.1 s.37
• /
• pp.88-100
• /
• 1992

This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1, 1988 to June 30, 1989 and the post-implementation period was from July 1, 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respectively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased from 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Departments of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments(from 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 2.2 to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased from 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.

• Journal of the Korean Society for information Management
• /
• v.36 no.1
• /
• pp.169-190
• /
• 2019

This study aims to identify the effects of teachers' recognition and application of 2015 revised national curriculum on their educational information needs in high schools. Several in-depth interviews and a questionnaire survey with the teachers, who were in charge of teaching common courses, such as Korean language, mathematics, English, social studies, and science, in general public high schools in Incheon, were executed for the purpose. As a result, the teachers' recognition and application affected their educational information needs in part. Especially, new demands on small sized copies and learning information sources were identified which were related to the application of 2015 revised national curriculum. Based on the results, we proposed several improvements of school library operations, such as small sized local consortium for sharing resources and providing referral services, in order to strengthen the gateway role of school libraries.

• Korea Journal of Hospital Management
• /
• v.26 no.1
• /
• pp.55-70
• /
• 2021

Purpose: The purpose of this study was to examine the influencing factors of the patient leaning phenomenon in tertiary hospitals. Based on the results of this study, we intended to find implications for improving the problems of the delivery system imbalance in tertiary hospitals caused by patient leaning phenomenon. Methodology/Approach: Qualitative studies were conducted, using focus group interviews and in-depth interviews. The focus group interviews were conducted for 12 users of tertiary hospitals by 2 groups. And in-depth interviews were conducted for 6 tertiary hospital managers. This was considered to be the most effective approach to gather diverse and in-depth information about the influencing factor of patient leaning phenomenon in tertiary hospitals. Findings: In focus group interviews, the reason for choosing tertiary hospitals was the reliability of the hospital(physician, reputation, etc.). And the effect of the policy to strengthen coverage of National Health Insurance and private medical insurance was relatively small. In other words, we found that the individual's desire to receive medical services suitable for one's health status and disease condition was the biggest factor, rather than the cost and policy factors. Practical Implications: We suggested that the appropriate medical care provision should be strengthened according to the role and function of medical institutions. In addition, the education system needs to be reorganized to activate the referral program, expand community medical capabilities, and foster quality primary medical care.

• Journal of Korean Academy of Nursing Administration
• /
• v.5 no.2
• /
• pp.197-207
• /
• 1999

The purpose of this research was fourfold: (a) to identify the use rate of the indirect care interventions performed by nurses, (b) to estimate the time to perform each intervention, (c) to identify the indirect care interventions to be delegated to others, and (d) to determine the level of provider preparation needed to delegate indirect care interventions. The sample consisted of 199 nurses working in three hospitals. The Indirect Care Survey developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean and validated by nurse experts. Each of the 26 indirect care interventions were used several times a day. Four interventions (i.e.. Documentation, Shift Report, Specimen Management, and Transport) were performed several times a day by 50% or more of the nurses. The most frequently used intervention was Documentation, followed by the interventions Shift report. Environmental Management, Transport, and Examination Assistance. The least used intervention was Quality Monitoring, followed by the interventions Order Transcription, Referral, Health Care Information Exchange, Multidisciplinary Care Conference, and Product Evaluation. The intervention taking the most time to per-form was Technology Management (155.3 minutes), followed by the interventions Documentation, (122.2 minutes), Delegation (84.4 minutes), Supply management (83.4 minutes), and Preceptor: Student (79.9 minutes), Overall, the nurses reported that they would not delegate to others the majority of the interventions. More than 50% of the nurses would not delegate 21 interventions. Shift Report would not be delegated by 95% of the nurses and Documentation would not be delegated by 92% of the nurses. Caregiver Support would be delegated by 68% of the nurses to family. Three interventions (i.e.. Environmental Management, Examination Assistance, and Transport) would be delegated by more than 50% of the nurses to Nursing Assistant. This study will contributes to determining costs of nursing services and enhancing quality of nursing care. Replication study will be needed with large sample.

• Journal of Hospice and Palliative Care
• /
• v.1 no.1
• /
• pp.56-64
• /
• 1998

Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

• Korean Journal of Social Welfare
• /
• v.52
• /
• pp.5-32
• /
• 2003

This paper examines the labor entry of conditional welfare recipients. This paper focuses on two questions. First, what is the percentage of conditional welfare recipients who have labor entry? Second, what are the predictors in the labor entry and the duration to the entry? Using Data about 917 welfare recipients who participated in the self-sufficiency programs of the Offices for Secure Employment in Seoul, this paper attempts to answer the above questions. Logistic regression analysis and survival analysis are adopted to identify variables predicting labor entry of conditional welfare recipients. This paper also utilizes a multiple imputation method to deal with the limitation of data by the missing values in some variables. The major findings are as follows: about 43.8% of the conditional welfare recipients have successful labor entry; and in the labor entry and the duration to the entry, gender, household, information and referral services for employment, health and willingness for self-sufficiency are the predictors that are statistically significant. Among these variables, health and willingness for self-sufficiency are more noticeable; it is recognized that programs to care for health of welfare recipients who want to have the labor entry and counseling programs to strengthen welfare recipients' willingness for labor entry are very important for them to be successful in the labor entry. This paper provides a basic knowledge about realities of the conditional welfare recipients' labor entry, identifies research areas for further research, and develops policy implications for their self-sufficiency.

• Korean Journal of Social Welfare
• /
• v.57 no.4
• /
• pp.119-146
• /
• 2005

The purpose of this study is to find out the structural and developmental characteristics of inter-organizational community network of the school social work and the characteristics of direct workers and the school social work organizations delivering services to the children in low-income families, and to identify the magnitude of efficient structure for networking for the children living in Kayang-dong. By searching out the central organization and block modeling, this study attempted to show the characteristics of inter-organizational community network for the children. The research sample was 18 organizations, and the data were collected by a survey questionnaire and analyzed by SPSSWIN 12.0 and UCINET 6.29. The main results show that the social welfare organization is the central organization in almost every dimensions(information exchange, client referral, cooperation, resource exchange) and education organizations play an important role in betweenness centrality. Also it can be evaluated that the present developmental stage of the network is collaboration. Based on the research results, implications for the future practice are discussed.

• Journal of Korean Academy of Nursing
• /
• v.11 no.2
• /
• pp.5-8
• /
• 1981

This study concerns itself with the development of a new model of comprehensive health service for rural communities of Korea. The study was conceived to resolve the problems of both underservice in rural communities and underutilization of valuable health manpower, namely the nurses, the disenchanted elite health personnel in Korea. On review of the current situation, the greatest deficiencies in the Korean health care system were found in the availability of primary care at the peripheries of md communities, in the dissemination of knowledge of disease prevention and health care, and in the induction of and guidance for active participation by the clientele in health maintenance at the personal, family and community level Abundant untapped health resources were identified that could be brough to bear upon the national effort to extend health services to every member of the Korean Population. Therefore, it was Postulated that the problem of underservice in rural communities of Korea can be structurcturally resolved by the effective mobilization and organization of untapped health resources, and that. a primary care Nursing Service System offers the best possibility for fulfillment of rural health service goals within the current health man-power situation. In order to identify appropriate strategies to combat the present difficulties in Korean rural health services and to utilize nurses and other health personnel in community-centered health programs, a search was made for examples of innovative service models throughout the world. An extensive literature survey and field visits to project sites both in Korea and in the United States were made. Experts in the field of world health, health service, planners, administrators, and medical and nursing practitioners in Korea, in the United States as well as visitors from other Asian countries were widely consulted. On the basis of information and inputs from these experts a new rural health service model has been constructed within the conceptual framework of community development, especially of the innovation diffusion Model. It is considered especially important that citizens in each community develop capacities for self-care with assistance and supports from available health professionals and participate in health service-related decisions that affect their own well-being. The proposed model is based upon the regionalization of health care planning utilizing a comprehensive Nursing Service System at the immediate delivery level The model features: (1) a health administration unit at each administrative level; (2) mechanisms for community participation; (3) a continuous source of primary health care at the local community level; (4) relative centralization of specialty care and provision of tertiary or super-specialty care only at major national metropolitan centers; and (5) a system for patient referral to the appropriate level of care. This model has been built around professional nurses as the key community health workers because their training is particularly suited and because large numbers of well-trained nurses are currently available and being trained. The special element in this model is a professional nurse-guided, self-care facilitating primary care Community Nursing Service System. This is supported by a Nursing Extension Service as a new training and support structure. (See attached diagrams). A broad spectrum of programs was proposed for the Community Nursing Service System. These were designed to establish a balance of activities between the clinic-centered individual care component and the field activity-centered educational and supportive component of health care services. Examples of possible program alternatives and proposed guidelines for health care in specific situations were presented, as well as the roles and functions of the key health personnel within the Community Nursing Service System. This Rural Health Service Model was proposed as a real alternative to the maldistributed, inequitable, uncoordinated solo-practice, physician-centered fee-for-service health care available to Koreans today.

• Journal of Intelligence and Information Systems
• /
• v.27 no.2
• /
• pp.1-15
• /
• 2021

If it is difficult for us to make decisions, we ask for advice from friends or people around us. When we decide to buy products online, we read anonymous reviews and buy them. With the advent of the Data-driven era, IT technology's development is spilling out many data from individuals to objects. Companies or individuals have accumulated, processed, and analyzed such a large amount of data that they can now make decisions or execute directly using data that used to depend on experts. Nowadays, the recommender system plays a vital role in determining the user's preferences to purchase goods and uses a recommender system to induce clicks on web services (Facebook, Amazon, Netflix, Youtube). For example, Youtube's recommender system, which is used by 1 billion people worldwide every month, includes videos that users like, "like" and videos they watched. Recommended system research is deeply linked to practical business. Therefore, many researchers are interested in building better solutions. Recommender systems use the information obtained from their users to generate recommendations because the development of the provided recommender systems requires information on items that are likely to be preferred by the user. We began to trust patterns and rules derived from data rather than empirical intuition through the recommender systems. The capacity and development of data have led machine learning to develop deep learning. However, such recommender systems are not all solutions. Proceeding with the recommender systems, there should be no scarcity in all data and a sufficient amount. Also, it requires detailed information about the individual. The recommender systems work correctly when these conditions operate. The recommender systems become a complex problem for both consumers and sellers when the interaction log is insufficient. Because the seller's perspective needs to make recommendations at a personal level to the consumer and receive appropriate recommendations with reliable data from the consumer's perspective. In this paper, to improve the accuracy problem for "appropriate recommendation" to consumers, the recommender systems are proposed in combination with context-based deep learning. This research is to combine user-based data to create hybrid Recommender Systems. The hybrid approach developed is not a collaborative type of Recommender Systems, but a collaborative extension that integrates user data with deep learning. Customer review data were used for the data set. Consumers buy products in online shopping malls and then evaluate product reviews. Rating reviews are based on reviews from buyers who have already purchased, giving users confidence before purchasing the product. However, the recommendation system mainly uses scores or ratings rather than reviews to suggest items purchased by many users. In fact, consumer reviews include product opinions and user sentiment that will be spent on evaluation. By incorporating these parts into the study, this paper aims to improve the recommendation system. This study is an algorithm used when individuals have difficulty in selecting an item. Consumer reviews and record patterns made it possible to rely on recommendations appropriately. The algorithm implements a recommendation system through collaborative filtering. This study's predictive accuracy is measured by Root Mean Squared Error (RMSE) and Mean Absolute Error (MAE). Netflix is strategically using the referral system in its programs through competitions that reduce RMSE every year, making fair use of predictive accuracy. Research on hybrid recommender systems combining the NLP approach for personalization recommender systems, deep learning base, etc. has been increasing. Among NLP studies, sentiment analysis began to take shape in the mid-2000s as user review data increased. Sentiment analysis is a text classification task based on machine learning. The machine learning-based sentiment analysis has a disadvantage in that it is difficult to identify the review's information expression because it is challenging to consider the text's characteristics. In this study, we propose a deep learning recommender system that utilizes BERT's sentiment analysis by minimizing the disadvantages of machine learning. This study offers a deep learning recommender system that uses BERT's sentiment analysis by reducing the disadvantages of machine learning. The comparison model was performed through a recommender system based on Naive-CF(collaborative filtering), SVD(singular value decomposition)-CF, MF(matrix factorization)-CF, BPR-MF(Bayesian personalized ranking matrix factorization)-CF, LSTM, CNN-LSTM, GRU(Gated Recurrent Units). As a result of the experiment, the recommender system based on BERT was the best.

• Journal of Hospice and Palliative Care
• /
• v.13 no.3
• /
• pp.181-189
• /
• 2010

Purpose: Recently, health policy making is increasingly based on evidence. Therefore, Korean Terminal Cancer Patient Information System (KTCPIS) was developed to meet such need. We aimed to report its developmental process and statistics from 6 months data. Methods: Items for KTCPIS were developed through the consultation with practitioners. E-Velos web-based clinical trial management system was used as a technical platform. Data were collected for patients who were registered to 34 inpatient palliative care services, designated by Ministry of Health, Welfare, and Family Affairs, from $1^{st}$ of January to $30^{th}$ of June in 2009. Descriptive statistics were used for the analysis. Results: From the nationally representative set of 2,940 patients, we obtained the following results. Mean age was $64.8{\pm}12.9$ years, and 56.6% were male. Lung cancer (18.0%) was most common diagnosis. Only 50.3% of patients received the confirmation of terminal diagnosis by two or more physicians, and 69.7% had an insight of terminal diagnosis at the time of admission. About half of patients were admitted to the units on their own without any formal referral. Average and worst pain scores were significantly reduced after 1 week when compared to those at the time of admission. 73.4% faced death in the units, and home-discharge comprised only 13.3%. Mean length of stay per admission was $20.2{\pm}21.2$ days, with median value of 13. Conclusion: Nationally representative data on the characteristics of patients and their caregiver, and current practice of service delivery in palliative care units were obtained through the operation of KTCPIS.