• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.37-45
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• 1984

This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

• Korean Journal of Digital Imaging in Medicine
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• v.10 no.2
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• pp.11-16
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• 2008

Images of medical treatment on PACS environment are digitized and they make saving and transmission of patient's information easy with CD format causing increase of patients transfer rate between hospital and data transmission as well. Figuring out the configuration of confining status of copied images of medical treatment with CD format and present the appropriate way of identification for personal information. 20 general hospital over 500 beds which are utilizing PACS currently. Questionnaire investigation focusing on PACS operation center and it's management people. In accordance with the law of securing personal information of public organizations, it says "Anyone who wants to see his or her information via representative he or she needs to make a letter of attorney and turn in this to the president of it's possessing facility" in the article 16. Based on the investigation of general hospital for CD copy issue status near metropolitan area, 8 out of 20, were issuing CD copy through personal identification process(the person oneself and representative) and 10 general hospital were doing by getting signature of receiptor only without identification of the person oneself and 2 general hospital confirmation process is not at all. By the law of securing personal information of public organization, article 16, confirmation process is supposed to mandate lawfully with a letter of attorney when there is any request of reading and/or copies of one's information. But in reality, there were no consistent rules on reading, the process and coverage of copy issue, rejection coverage of copy issue of CD copy in each general hospital PACS operation center. Therefore there is a big need for consolidated format which is applicable by law when the representative requests to issue of CD copy that is storing medical treatment images. By issue through this consolidated format, securing medical information of individual and systemic operation and management will be valid and effective.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.229-232
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• 2014

A 55 year-old man hit a vehicle while riding a bicycle. He was diagnosed as left hemopneumothorax, multiple rib fracture, cerebral hemorrhage, and skull fracture. Initially he suffered from hypoxia requiring 100% oxygen with a mechanical ventilator. Finally he became hypotensive. Venovenous extracorporeal membrane oxygenation (ECMO) was initiated to support patient's gas exchange. Because hypotension and left ventricular dysfuction persisted, we converted the mode of support to veno-arterio-venous ECMO. Over four days of intensive care, we could wean off ECMO. The patient went to rehabilitation facility after 45 days of hospitalization. Although trauma and bleeding are considered as relative contraindication of ECMO, careful decision making and management may enable us to use ECMO for trauma-related refractory heart and/or lung failure.

• Korea Journal of Hospital Management
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• v.23 no.4
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• pp.40-52
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• 2018

The purpose of this study is to identify medical consumers' hospital selection factors in response to the rapidly changing environment of medical industry. For that purpose this study classified consumers' hospital selection factors into three categories such that human factors including expertise, reliability, empathy; system factor including, convenience, differentiation, efficiency; and facility factor including tangibility, accessibility, and location, based on the previous studies and the results of a preliminary survey of the patients of a small private hospital. The nine factors were further divided into 23 more specific attributes. Then, an online survey was conducted to measure the perceptions of the 23 attributes by the medical consumers over the age of 20. The analysis of the survey data using Kano model and Timko model indicated that 14 of the 23 attributes were classified as attractive factors, eight attributes were or classified as, one-dimensional factors, and one attribute, doctors' educational background, was classified as indifference factor. Of the 14 attractive factors, "unique and differentiated services related to medical treatment" and "distance from home to hospital" had the highest customer satisfaction coefficients. Of the eight one-dimensional factors, "kind treatment," "providing adequate explanations," "accuracy of diagnosis," and "cleanness of facilities" had the highest customer satisfaction coefficients as well as the highest dissatisfaction coefficients. The findings indicate that these six attributes are the most basic and most impactful attributes that hospitals must manage strategically to improve their service quality and attract more medical consumers to their hospitals.

• Journal of the Korea Convergence Society
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• v.10 no.10
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• pp.259-266
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• 2019

The purpose of this study was to examine the need for changes in the administration strategies of hospitals which would be vital for building up competitiveness of hospitals amid the changes in medical market. For that, 20 experts with doctoral degree in public administration and business administration related to the field of hospital administration were selected as the sampling group in the survey. Regarding the method of AHP survey as in this survey. The results showed that the factors were important in the order of medical staff factor(ranked first), overall facility factor(ranked second), staff service factor(ranked third), and access factor(ranked fourth). Second, the relative importance was in the order of medical staff specialization(ranked first), medical staff diversity(ranked second), and medical equipment level(ranked third), regarding the relative importance for general hospital development strategy and the complex weighted value for relative importance.

• Research in Community and Public Health Nursing
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• v.19 no.2
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• pp.260-269
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• 2008

Purpose: The purpose of this study was to identify differences in health status and the utilization of long-term care service between urban and rural aged residents in Korea. Methods: Through convenience sampling, 1,405 elders (829 from urban areas and 576 from rural areas) were selected during March 1 to May 31 in 2004. All the subjects agreed to participate and filled out the survey questionnaire after signing the consent form. The instruments utilized in this study were the impairment of physio-sensory function, ADL IADL, cognitive function, and psycho-social function scale. This instrument was developed by modifying the scab developed by Gurland & Wilder (1984). Data was analyzed using the SPSS Win program. Results: There were significant differences in economic status, duration of living and type of medical insurance between rural and urban elderly(p<.05). Physio-sensory functions (t=4.53. p<.001), ADL (t=3.61. p<.001), IADL (t=2.45, p=.014), cognitive functions (t=-2.63. p=.024) and psycho-social functions (t=3.69. p<.001) were significantly different between the two groups. The utilization of long-term care facility in the urban elderly was significantly higher than that in the rural elderly ($x^2=10.14$, p<.001). Conclusion: Considering these findings. the need for long-term care should be assessed by residence characteristics. Because of different utilization of long term care facility according to the elderly's needs, long-term care services should be considered the residence characteristics.

• Journal of Families and Better Life
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• v.22 no.4
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• pp.1-14
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• 2004

Although the proportion of frail elderly among the elderly population has been rapidly increasing, there is little preparation to provide housing alternatives for them in Korean society. Long-term care facility a housing alternative for frail elderly that enables them to receive social and medical care services that enhance the quality of their life. This research was conducted to study the opinions of middle-aged Koreans about long-term care facilities for the frail elderly. This study provides useful suggestions for the development of user-paid long-term care facilities in the near future. A survey questionnaire was administered to 600 adults in their 50s to collect data. The sample was stratified according to region, gender, and housing structure type. The results showed that most of the respondents were aware of long-term care facilities for the frail elderly; but they were relatively unwilling to live in these facilities, as compared to other housing alternatives. However, a larger number of respondents said that as they became very frail, they would be willing to live in these facilities. The respondents expressed a high level of need for user-paid long-term care facilities as an alternative to hospitalization. Also, they wanted to have a variety of long-term care facilities that are designed for different levels of disability. The education level of respondents and their spouses, average monthly income, subjective economic level, and religion were major variables that differentiated significantly the opinions about long-term care facilities for the frail elderly.

• Journal of The Korean Digital Architecture Interior Association
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• v.11 no.4
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• pp.5-11
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• 2011

The present study investigated the actual conditions of physical therapy rooms at long-term hospitals in Korea and conducted a comparative analysis to develop an efficient floor plan and facility improvement measures. 1. At hospitals surveyed, physical therapy services were used at a high frequency but they did not have enough space for rehab treatment and long paths of patient flow were found to make patient management inconvenient. Therefore, physical therapy units should be conveniently located both in terms of distance and direction so as to be accessible from patient rooms or wards. The space should be organized in a concentrated layout for efficiency of physical therapy, and floor planning for therapy units should ensure the best possible viewing angle to therapists. 2. With regard to the disease characteristics of patients, many physical therapy rooms were in difficult circumstances because of poor facilities, so they need to secure skilled personnel, supplement apparatuses and equipment and have rooms for functional recovery, hydrotherapy and operation treatment. In addition, each of the curtained or partitioned areas for treatment should be set up with consideration for the amount of space taken up by medical equipment. The area under each bed should be designed for patient convenience so that it can be used as storage space for patient's belongings and shoes. 3. Patients complained about the lack of physical therapy space, resting places or exercise areas and demanded the expansion of rehab programs and facilities. Physical therapy facilities need to be improved for patient privacy and effective natural ventilation. 4. At most of the long-term hospitals surveyed, physical therapy units were found to have small areas and treatment equipment and devices were insufficient compared to the number of patients. Therefore, it is required to secure more space (at least 138.24 sq. meters per 100 beds) and improve facilities for better physical therapy services.

• Nuclear Engineering and Technology
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• v.48 no.3
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• pp.785-794
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• 2016

The Argonne National Laboratory of the United States and the Kharkov Institute of Physics and Technology of the Ukraine have been collaborating on the design, development and construction of a neutron source facility at Kharkov Institute of Physics and Technology utilizing an electron-accelerator-driven subcritical assembly. The electron beam power is 100 kW using 100-MeV electrons. The facility was designed to perform basic and applied nuclear research, produce medical isotopes, and train nuclear specialists. The biological shield of the accelerator building was designed to reduce the biological dose to less than 5.0e-03 mSv/h during operation. The main source of the biological dose for the accelerator building is the photons and neutrons generated from different interactions of leaked electrons from the electron gun and the accelerator sections with the surrounding components and materials. The Monte Carlo N-particle extended code (MCNPX) was used for the shielding calculations because of its capability to perform electron-, photon-, and neutron-coupled transport simulations. The photon dose was tallied using the MCNPX calculation, starting with the leaked electrons. However, it is difficult to accurately tally the neutron dose directly from the leaked electrons. The neutron yield per electron from the interactions with the surrounding components is very small, ~0.01 neutron for 100-MeV electron and even smaller for lower-energy electrons. This causes difficulties for the Monte Carlo analyses and consumes tremendous computation resources for tallying the neutron dose outside the shield boundary with an acceptable accuracy. To avoid these difficulties, the SOURCE and TALLYX user subroutines of MCNPX were utilized for this study. The generated neutrons were banked, together with all related parameters, for a subsequent MCNPX calculation to obtain the neutron dose. The weight windows variance reduction technique was also utilized for both neutron and photon dose calculations. Two shielding materials, heavy concrete and ordinary concrete, were considered for the shield design. The main goal is to maintain the total dose outside the shield boundary less than 5.0e-03 mSv/h during operation. The shield configuration and parameters of the accelerator building were determined and are presented in this paper.

• Fire Science and Engineering
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• v.30 no.5
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• pp.108-115
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• 2016

Fire detectors play an important role in alerting the related people to the initial stages of fire to protect assets and life. Therefore, the performance in detecting fires in the early stages without the risk of false alarms is important. Owing to a recent revision of the national fire safety standards to install smoke detectors in living rooms used for sleeping, staying, hospitalizing in apartment house/efficiency apartment/lodging facility/medical facility/facility for elderly and young, the application of smoke detectors is increasing. On the other hand, there is lack of research in preventing false alarms. This study improved algorithms to prevent false alarms in analog photoelectric smoke detector's due to sudden dust and better classify pollution and fire signals through a self-compensatory function. Through this study, alternatives are suggested to reduce the number of false alarms of Analog Photoelectric smoke detectors, and prevent financial losses due to false alarms.