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Comparison of Inpatient Medical Use between Non-specialty and Specialty Hospitals: A Study Focused on Knee Replacement Arthroplasty (전문병원과 비전문병원 입원환자의 의료이용 비교 분석: 인공관절치환술(슬관절)을 대상으로)

  • Mi-Sung Kim;Hyoung-Sun Jeong;Ki-Bong Yoo;Je-Gu Kang;Han-Sol Jang;Kwang-Soo Lee
    • Health Policy and Management
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    • v.34 no.1
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    • pp.78-86
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    • 2024
  • Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

Optimal Exploration-Exploitation Strategies in Reinforcement Learning for Online Banner Advertising: The Impact of Word-of-Mouth Effects (온라인 배너 광고 강화학습의 최적 탐색-활용 전략: 구전효과의 영향)

  • Bumsoo Kim;Gun Jea Yu;Joonkyum Lee
    • Journal of Service Research and Studies
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    • v.14 no.2
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    • pp.1-17
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    • 2024
  • One of the most important decisions for managers in the online banner advertising industry, is to choose the best banner alternative for exposure to customers. Since it is difficult to know the click probability of each banner alternative in advance, managers must experiment with multiple alternatives, estimate the click probability of each alternative based on customer clicks, and find the optimal alternative. In this reinforcement learning process, the main decision problem is to find the optimal balance between the level of exploitation strategy that utilizes the accumulated estimated click probability information and exploration strategy that tries new alternatives to find potentially better options. In this study we analyze the impact of word-of-mouth effects and the number of alternatives on the optimal exploration-exploitation strategies. More specifically, we focus on the word-of-mouth effect, where the click-through rate of the banner increases as customers promote the related product to those around them after clicking the exposed banner, and add it to the overall reinforcement learning process. We analyze our problem by employing the Multi-Armed Bandit model, and the analysis results show that the larger the word-of-mouth effect and the fewer the number of banner alternatives, the higher the optimal exploration level of advertising reinforcement learning. We find that as the probability of customers clicking on the banner increases due to the word-of-mouth effect, the value of the previously accumulated estimated click-through rate knowledge decreases, and therefore the value of exploring new alternatives increases. Additionally, when the number of advertising alternatives is small, a larger increase in the optimal exploration level was observed as the magnitude of the word-of-mouth effect increased. This study provides meaningful academic and managerial implications at a time when online word-of-mouth and its impact on society and business is becoming more important.

Current and Future Perspectives of Lung Organoid and Lung-on-chip in Biomedical and Pharmaceutical Applications

  • Junhyoung Lee;Jimin Park;Sanghun Kim;Esther Han;Sungho Maeng;Jiyou Han
    • Journal of Life Science
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    • v.34 no.5
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    • pp.339-355
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    • 2024
  • The pulmonary system is a highly complex system that can only be understood by integrating its functional and structural aspects. Hence, in vivo animal models are generally used for pathological studies of pulmonary diseases and the evaluation of inhalation toxicity. However, to reduce the number of animals used in experimentation and with the consideration of animal welfare, alternative methods have been extensively developed. Notably, the Organization for Economic Co-operation and Development (OECD) and the United States Environmental Protection Agency (USEPA) have agreed to prohibit animal testing after 2030. Therefore, the latest advances in biotechnology are revolutionizing the approach to developing in vitro inhalation models. For example, lung organ-on-a-chip (OoC) and organoid models have been intensively studied alongside advancements in three-dimensional (3D) bioprinting and microfluidic systems. These modeling systems can more precisely imitate the complex biological environment compared to traditional in vivo animal experiments. This review paper addresses multiple aspects of the recent in vitro modeling systems of lung OoC and organoids. It includes discussions on the use of endothelial cells, epithelial cells, and fibroblasts composed of lung alveoli generated from pluripotent stem cells or cancer cells. Moreover, it covers lung air-liquid interface (ALI) systems, transwell membrane materials, and in silico models using artificial intelligence (AI) for the establishment and evaluation of in vitro pulmonary systems.

What are the Characteristics and Future Directions of Domestic Angel Investment Research? (국내 엔젤투자 연구의 특징과 향후 방향은 무엇인가?)

  • Min Kim;Byung Chul Choi;Woo Jin Lee
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.18 no.6
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    • pp.57-70
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    • 2023
  • The investigation delved into 457 pieces of scholarly work, encompassing articles, published theses, and dissertations from the National Research Foundation of Korea, spanning the period of the 1997 IMF financial crisis up to 2022. The materials were sourced using terms such as 'angel investment', 'angel investor', and 'angel investment attraction'. The initial phase involved filtering out redundant entries from the preliminary collection of 267 works, leaving aside pieces that didn't pertain directly to angel investment as indicated in their abstracts. The next stage of the analysis involved a more rigorous selection process. Out of 43 papers earmarked in the preceding cut, only 32 were chosen. The criteria for this focused on the exclusion of conference presentations, articles that were either not submitted or inconclusive, and those that duplicated content under different titles. The final selection of 32 papers underwent a thorough systematic literature review. These documents, all pertinent to angel investment in South Korea, were scrutinized under five distinct categories: 1) publication year, 2) themes of research, 3) strategies employed in the studies, 4) participants involved in the research, and 5) methods of research utilized. This meticulous process illuminated the existing landscape of angel investment studies within Korea. Moreover, this study pinpointed gaps in the current body of research, offering guidance on future scholarly directions and proposing social scientific theories to further enrich the field of angel investment studies and analysis also seeks to pinpoint which areas require additional exploration to energize the field of angel investment moving forward. Through a comprehensive review of literature, this research intends to validate the establishment of future research trajectories and pinpoint areas that are currently and relatively underexplored in Korea's angel investment research stream. This study revealed that current research on domestic angel investment is concentrated on several areas: 1) the traits of angel investors, 2) the motivations behind angel investing, 3) startup ventures, 4) relevant institutions and policies, and 5) the various forms of angel investments. It was determined that there is a need to broaden the scope of research to aid in enhancing and stimulating the scale of domestic angel investing. This includes research into performance analysis of angel investments and detailed case studies in the field. Furthermore, the study emphasizes the importance of diversifying research efforts. Instead of solely focusing on specific factors like investment types, startups, accelerators, venture capital, and regulatory frameworks, there is a call for research that explores a variety of associated variables. These include aspects related to crowdfunding and return on investment in the context of angel investing, ensuring a more holistic approach to research in this domain. Specifically, there's a clear need for more detailed studies focusing on the relationships with variables that serve as dependent variables influencing the outcomes of angel investments. Moreover, it's essential to invigorate both qualitative and quantitative research that delves into the theoretical framework from multiple perspectives. This involves analyzing the structure of variables that have an impact on angel investments and the decisions surrounding these investments, thereby enriching the theoretical foundation of this field. Finally, we presented the direction of development for future research by confirming that the effect on the completeness of the business plan is high or low depending on the satisfaction of the entrepreneurs in addition to the components.

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Structural and Resting-State Brain Alterations in Trauma-Exposed Firefighters: Preliminary Results (외상에 노출된 소방관들의 뇌 구조 및 휴식기 뇌기능 변화: 예비 결과)

  • Yae Won Park;Suhnyoung Jun;Juwhan Noh;Seok Jong Chung;Sanghoon Han;Phil Hyu Lee;Changsoo Kim;Seung-Koo Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.3
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    • pp.676-687
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    • 2020
  • Purpose To analyze the altered brain regions and intrinsic brain activity patterns in trauma-exposed firefighters without posttraumatic stress disorder (PTSD). Materials and Methods Resting-state functional MRI (rsfMRI) was performed for all subjects. Thirty-one firefighters over 40 years of age without PTSD (31 men; mean age, 49.8 ± 4.7 years) were included. Twenty-six non-traumatized healthy controls (HCs) (26 men; mean age, 65.3 ± 7.84 years) were also included. Voxel-based morphometry was performed to investigate focal differences in the brain anatomy. Seed-based functional connectivity analysis was performed to investigate differences in spontaneous brain characteristics. Results The mean z-scores of the Seoul Verbal Learning Test for immediate and delayed recall, Controlled Oral Word Association Test (COWAT) score for animals, and COWAT phonemic fluency were significantly lower in the firefighter group than in the HCs, indicating decreased neurocognitive function. Compared to HCs, firefighters showed reduced gray matter volume in the left superior parietal gyrus and left inferior temporal gyrus. Further, in contrast to HCs, firefighters showed alterations in rsfMRI values in multiple regions, including the fusiform gyrus and cerebellum. Conclusion Structural and resting-state functional abnormalities in the brain may be useful imaging biomarkers for identifying alterations in trauma-exposed firefighters without PTSD.

A Study on the Operation Plan of the Gangwon-do Disaster Management Resources Integrated Management Center (강원도 재난관리자원 통합관리센터 운영방안에 관한 연구)

  • Hang-Il Jo;Sang-Beom Park;Kye-Won Jun
    • Journal of Korean Society of Disaster and Security
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    • v.17 no.1
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    • pp.9-16
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    • 2024
  • In Korea, as disasters become larger and more complex, there is a trend of shifting from a focus on response and recovery to a focus on prevention and preparedness. In order to prevent and prepare for disasters, each local government manages disaster management resources by stockpiling them. However, although disaster management resources are stored in individual warehouses, they are managed by department rather than by warehouse, resulting in insufficient management of disaster management resources due to the heavy workload of those in charge. In order to intensively manage these disaster management resources, an integrated disaster management resource management center is established and managed at the metropolitan/provincial level. In the case of Gangwon-do, the subject of this study, a warehouse is rented and operated as an integrated disaster management resource management center. When leasing an integrated management center, there is the inconvenience of having to move the location every 1 to 2 years, so it is deemed necessary to build a dedicated facility in an available site. To select a location candidate, network analysis was used to measure access to and use of facilities along interconnected routes of networks such as roads and railways. During network analysis, the Location-Allocation method, which was widely used in the past to determine the location of multiple facilities, was applied. As a result, Hoengseong-gun in Gangwon-do was identified as a suitable candidate site. In addition, if the integrated management center uses our country's logistics system to stockpile disaster management resources, local governments can mobilize disaster management resources in 3 days, and it is said that it takes 3 days to return to normal life after a disaster occurs. Each city's disaster management resource stockpile is 3 days' worth per week, and the integrated management center stores 3 times the maximum of the city's 4-day stockpile.

Chest CT Findings of COVID-19 Patients with Mild Clinical Symptoms at a Single Hospital in Korea (경증의 임상 소견을 보이는 COVID-19 환자들의 흉부 CT 소견)

  • Woon Young Baek;Young Kyung Lee;Suhyun Kim;Chorom Hahm;Mi Young Ahn;Dong Hyun Oh;Jae-Phil Choi
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.139-151
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    • 2021
  • Purpose To retrospectively evaluate the chest computed tomography (CT) findings of coronavirus disease 2019 (COVID-19) in patients with mild clinical symptoms at a single hospital in South Korea. Materials and Methods CT scans of 87 COVID-19 patients [43 men and 44 women; median age: 41 years (interquartile range: 26.1-51.0 years)] with mild clinical symptoms (fever < 38℃ and no dyspnea) were evaluated. Results CT findings were normal in 39 (44.8%) and abnormal in 48 (55.2%) patients. Among the 48 patients with lung opacities, 17 (35.4%) had unilateral disease and 31 (64.6%) had bilateral disease. One (2.1%) patient showed subpleural distribution, 9 (18.8%) showed peribronchovascular distribution, and 38 (79.2%) showed subpleural and peribronchovascular distributions. Twenty-two (45.8%) patients had pure ground-glass opacities (GGOs) with no consolidation, 17 (35.4%) had mixed opacities dominated by GGOs, and 9 (18.8%) had mixed opacities dominated by consolidation. No patients demonstrated consolidation without GGOs. Conclusion The most common CT finding of COVID-19 in patients with mild clinical symptoms was bilateral multiple GGO-dominant lesions with subpleural and peribronchovascular distribution and lower lung predilection. The initial chest CT of almost half of COVID-19 patients with mild clinical symptoms showed no lung parenchymal lesions. Compared to relatively severe cases, mild cases were more likely to manifest as unilateral disease with pure GGOs or GGO-dominant mixed opacities and less likely to show air bronchogram.

Safety and Efficacy of Ultrasound-Guided Percutaneous Core Needle Biopsy of Pancreatic and Peripancreatic Lesions Adjacent to Critical Vessels (주요 혈관 근처의 췌장 또는 췌장 주위 병변에 대한 초음파 유도하 경피적 중심 바늘 생검의 안전성과 효율성)

  • Sun Hwa Chung;Hyun Ji Kang;Hyo Jeong Lee;Jin Sil Kim;Jeong Kyong Lee
    • Journal of the Korean Society of Radiology
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    • v.82 no.5
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    • pp.1207-1217
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    • 2021
  • Purpose To evaluate the safety and efficacy of ultrasound-guided percutaneous core needle biopsy (USPCB) of pancreatic and peripancreatic lesions adjacent to critical vessels. Materials and Methods Data were collected retrospectively from 162 patients who underwent USPCB of the pancreas (n = 98), the peripancreatic area adjacent to the portal vein, the paraaortic area adjacent to pancreatic uncinate (n = 34), and lesions on the third duodenal portion (n = 30) during a 10-year period. An automated biopsy gun with an 18-gauge needle was used for biopsies under US guidance. The USPCB results were compared with those of the final follow-up imaging performed postoperatively. The diagnostic accuracy and major complication rate of the USPCB were calculated. Multiple factors were evaluated for the prediction of successful biopsies using univariate and multivariate analyses. Results The histopathologic diagnosis from USPCB was correct in 149 (92%) patients. The major complication rate was 3%. Four cases of mesenteric hematomas and one intramural hematoma of the duodenum occurred during the study period. The following factors were significantly associated with successful biopsies: a transmesenteric biopsy route rather than a transgastric or transenteric route; good visualization of targets; and evaluation of the entire US pathway. In addition, the number of biopsies required was less when the biopsy was successful. Conclusion USPCB demonstrated high diagnostic accuracy and a low complication rate for the histopathologic diagnosis of pancreatic and peripancreatic lesions adjacent to critical vessels.

Violations of Information Security Policy in a Financial Firm: The Difference between the Own Employees and Outsourced Contractors (금융회사의 정보보안정책 위반요인에 관한 연구: 내부직원과 외주직원의 차이)

  • Jeong-Ha Lee;Sang-Yong Tom Lee
    • Information Systems Review
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    • v.18 no.4
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    • pp.17-42
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    • 2016
  • Information security incidents caused by authorized insiders are increasing in financial firms, and this increase is particularly increased by outsourced contractors. With the increase in outsourcing in financial firms, outsourced contractors having authorized right has become a threat and could violate an organization's information security policy. This study aims to analyze the differences between own employees and outsourced contractors and to determine the factors affecting the violation of information security policy to mitigate information security incidents. This study examines the factors driving employees to violate information security policy in financial firms based on the theory of planned behavior, general deterrence theory, and information security awareness, and the moderating effects of employee type between own employees and outsourced contractors. We used 363 samples that were collected through both online and offline surveys and conducted partial least square-structural equation modeling and multiple group analysis to determine the differences between own employees (246 samples, 68%) and outsourced contractors (117 samples, 32%). We found that the perceived sanction and information security awareness support the information security policy violation attitude and subjective norm, and the perceived sanction does not support the information security policy behavior control. The moderating effects of employee type in the research model were also supported. According to the t-test result between own employees and outsourced contractors, outsourced contractors' behavior control supported information security violation intention but not subject norms. The academic implications of this study is expected to be the basis for future research on outsourced contractors' violation of information security policy and a guide to develop information security awareness programs for outsourced contractors to control these incidents. Financial firms need to develop an information security awareness program for outsourced contractors to increase the knowledge and understanding of information security policy. Moreover, this program is effective for outsourced contractors.