• Journal of agricultural medicine and community health
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• v.24 no.1
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• pp.91-101
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• 1999

The home nursing care system is an integral part of the health care delivery system in order to meet the various needs of consummer, in particular, early discharge patient from the hospital, patient with long term care needed and the elderly. To find out the cost of home nursing care services, the home nursing care records of patients registered by home nursing care units established in public hospital with 150beds during the period of 1996 - 1997 were analyzed. The subjects were 102patients, 45 of male patients and 57 of female patients, those who live in a rural area in Kymiggi - Do The results obtained are as follows : 1. The male patients accounted for 44.1% of the total, with 45cases : group aged 60 years and more was the largest group, accounting for 79.5%. 2. The most frequent disease revealed was the osteoporosis which constitute 35.3% of the total registered patients, followed, in order, by malignant tumor, cerebrovascular disease. 3. It revealed that the cost per visit for the male was 47,764won ; the female, 46,078 won per visit. Noteworthy the cost per visit was high in the older patient. It was clearly that the gender, years of age and the cost per visit were statistically significant at 0.01 level and 0.05 level. 4. The cost per visit for the non complicated disease was slightly higher than the complicated disease, but it is not statistically significant, the cost per visit by type of disease varied, the cost per visit for COPD was the highest, followed, in order, by in malignant tumor, cancer, diabetes, osteoporosis etc. 5. It revealed that home nursing care cost for a eligible disease for home nursing care was less than the cost for hospitalization of the same disease, therefore, we expect that the home nursing care is cost efficiency. In conclusion, the home nursing care costs are needed to analyze further in comparison with the hospitalization costs for a certain disease.

• Journal of Venture Innovation
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• v.5 no.1
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• pp.145-154
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• 2022

This study briefly compares the first-cycle certification of nursing hospitals with the second-cycle certification, reviews the changes and achievements of the second-cycle certification and the third-cycle certification, and examples of challenges and solutions in the process of preparing the third-cycle certification. In this study, it is suggested as follows. First, in order to see the practical effect of certification intended by the government, the exhibition is prepared in a short period of time before certification. Second, after the implementation of the nursing hospital certification system, research on the hospital performance of the medical institution certification system is insufficient in terms of quality and quantity. Therefore, in order to see the effect on the certification system, various research support is also required so that research on this can be actively conducted. Third, design certification standard guidelines from a long-term perspective so that the standard guidelines for certification do not change significantly, and certify not only the guidelines but also individual standards and forms that can be used by medical institutions. Fourth, in the four-cycle certification, accurate and realistic guidelines for infection control and quarantine ward operation support should be developed. The importance of managing infectious diseases will be highlighted in the future due to COVID-19. Fifth, medical institutions can improve the quality of medical care in nursing hospitals and have competitiveness if their daily activities, not short-term certification preparation, are carried out in accordance with certification standards, which affects performance. Sixth, when preparing for certification, nursing hospital officials have problems in organizing documents or processing administratively in the short term as in the past. This is also based on the certification criteria for the usual business process.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.18-27
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• 2009

Purpose: This study is to provide effective care to each individual with myocardial ischemia by finding out how the patient's knowledge related to the disease and anxiety level affect his/her compliance of patient role behavior. Methods: The subjects of study were 100 patients diagnosed as ischemic heart disease at a university hospital located in Gyeonggi Province. The data were collected from May 19, 2008 to August 30, 2008. A cross-sectional descriptive survey was done using a structured questionnaires. Results: The average score of knowledge level about myocardial ischemia was $22.24\pm5.07$(out of 31), anxiety level was $54.68\pm9.15$(out of 80), and compliance of patient role behavior was $34.28\pm6.00$(out of 50). A significant correlation between the patient's level of knowledge and his/her compliance of patient role behavior was found(r=0.239 p=0.017). The patients who are females, singles, without occupation, have a long term being diagnosed, under-educated, tend to be excellent in their compliance. Conclusion: The patient with a higher level of knowledge is better in his/her compliance of patient role behavior. Therefore, it is suggested that we need to develop nursing intervention to increase knowledge level as well as consistent educational support.

• Health Policy and Management
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• v.3 no.1
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.3 no.2
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• pp.75-79
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• 2007

Background: Down's syndrome, or trisomy 21, is the commonest congenital chromosome anomaly. With improvement in medical care, these patients increasingly reach adulthood in spite of their physical maldevelopment and mental retardation. And, the number of those who required general anesthesia for dental treatment is increasing. Methods: We reviewed the 26 cases of 22 patients with Down's syndrome who underwent outpatient general anesthesia for dental treatment at the clinic for the disabled in Seoul National University Dental Hospital. Results: The mean age was 22 years. They all had severe mental retardation and some had congenital heart anomaly, epilepsy, hypothyroidism, acute leukemia, autism, cleft palate, and chronic renal failure. For anesthesia induction, 4 cases was needed physical restriction, but others showed good or moderate cooperation. Drugs used for anesthesia induction was thiopental (17 cases) and sevoflurane (9 cases). All patients received nasotracheal intubation and 3 cases needed difficult airway management. Mean total anesthetic time was $166{\pm}60$ min and staying time at PACU was $92{\pm}48$ min. There was no death or long term hospitalization because of severe complications. Conclusion: If general anesthesia is needed, pertinent diagnostic tests and workup about anomaly, and appropriate anesthetic planning are essential for safety.

• Journal of Digital Convergence
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• v.13 no.5
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• pp.89-99
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• 2015

This study aims to develop a LOS(Length of Stay) bench-making system that can provide efficient by comparing the LOS management of other hospital and level evaluation for inducing the LOS to manage their own activities. The convergence LOS bench-making web program has been implemented to compare a variety of beds, regional group, followed reporting with excel files downloads by using the severity-adjusted LOS model of Korean National Hospital Discharge in-depth Injury Survey data. Features that are computed in real-time severity-adjusted LOS was also implemented. Trial operating results, bench-making system was confirmed efficient for management of LOS on the long-term care and group of disease in hospital from the staff or medical department, receive requests comparative statistics by area and disease group. Therefore the policy alternative on extension of severity-adjusted LOS is needed to utilized bench-making system on LOS.

• Journal of Oral Medicine and Pain
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• v.46 no.2
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• pp.41-48
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• 2021

Purpose: To evaluate compliance by analyzing and comparing treatment duration, degree of improvement after treatment and treatment response of oral lichen planus (OLP) patients according to characteristics of them and the severity of the lesion. Methods: According to treatment process, 132 subjects with OLP who first visited the Department of Oral Medicine at the Pusan National University Dental Hospital from January 2017 to December 2020were classified into three groups: Treatment completed (CT) group, Under treatment (UT) group, and Dropped out during follow-up (DT) group. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLP. The degree of improvement after treatment was evaluated in CT group. Results: There were 53 (40.15%) CT, 27 (20.45%) UT and 52 (39.39%) DT. In CT group, according to initial REU score there was a statistical difference in the degree of improvement, but not in the length of time to complete treatment. There was no statistical difference between the days it took for patients to feel symptom relief, and the days of entire treatment among three groups. However, there was a positive correlation between the REU score of gingiva and duration of treatment in DT group. In the CT and DT groups, there was a correlation between the length of time taken to relieve symptoms and the duration of treatment. Conclusions: The severity of the gingival lesion and the initial response to treatment have a large effect on the entire treatment period and prognosis, so it should be considered when explaining the disease prognosis and treatment period to patients, and the clinician needs to focus on initial symptom relief.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.374-386
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• 2023

Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.

• Korea Journal of Hospital Management
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• v.5 no.1
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• pp.40-61
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• 2000

The purpose of this study is to promote the efficiency of the management of the controls organization in the university hospitals and general hospitals by evaluating the factors underlying organizational conflict. The subject population included 351 hospital workers randomly selected from two general hospitals of less than 200 beds and two university hospitals over 500 beds in Seoul area. Data were collected through a survey questionnaire. To define related factors for the level of conflict among departments in each hospitals multivariate regression analysis was conducted. Independent factors were characteristics of subjects, conflicting factors between the departments. The results are as follows: 1. Those in high job position group demonstrated significantly higher level of conflict between departments. Those working in the general hospitals, who were older and had long-term tenure at current working hospital had higher level of conflict between the departments. 2. Concerning the involvement of conflicting factors and the level of conflict in the employees' there was statistically significant positive correlation between reliability and job-related and intradepartmental level of conflict in university hospitals. There was a significant positive correlation between interdepartmental conflicting factors of mutual dependence, difference in goal/orientation and interdepartmental level of conflict. 3. In the university hospitals, among the interdepartmental factors, mutual dependence and difference in goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals, job position was a significant factor which showed that those in high position such as section chief or above, compared to those in general position had higher level of conflict. Among the interdepartmental characteristics, factors of mutual dependence and goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the general hospitals setting efforts to reduce conflict in areas among workers with high position, old age, and long tenure and those in medical care department should be made and prudent management and planning for improved manpower and increased budget or efficient allocation and clear definition of job description are necessary to adequately assess. In the university hospitals setting efforts to reexaminitation of the organizational structure and efficiency conveyance of information and efforts to resolve conflict among young workers with lower level of education is need. This study has its own merit in comparing empirically the conflict among hospital workers in the university hospitals and general hospitals. Future study are needed with respect to the relationship between interdepartmental level of conflict and the effectiveness of the hospital organization for improved resolution of conflict in the organization and hospital management.

• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.768-781
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• 1996

The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.