• 제목/요약/키워드: Out-of-Hospital

검색결과 6,255건 처리시간 0.041초

병원근무 간호사의 직장애착도와 관련요인 (Factors Affecting on Organizational Commitment of Hospital Nurses)

  • 제갈봉순;이성희
    • 간호행정학회지
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    • 제13권1호
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    • pp.65-73
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    • 2007
  • Purpose: This study was carried out to find out the factors affecting on organizational commitment of hospital nurses. Method: The questionnaire-based research was done with 989 hospital nurses between January and March, 2004. Results: Variables such as job satisfaction, met expectations, compensation and welfare status of hospital, work involvement, positive affectivity had significant positive direct effect on organizational commitment in order of size, however, vertical conflict and job opportunity had negative direct effect in order of size. It was found that the following variables, listed in order of size, had significant total effects on organizational commitment: job satisfaction, met expectations, vertical conflict, compensation and welfare status of hospital, positive affectivity, work involvement, job opportunity, job autonomy, work definiteness, division justice, stability of employment, expectations before entering a hospital. Conclusion: It is recommended that programs for job satisfaction promotion, met expectations promotion, adequate compensation and welfare of hospital, work definiteness and work autonomy, solving conflict, positive affectivity promotion should be implemented to increase organizational commitment of hospital nurses.

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연부조직(軟部組織) 손상(損傷)으로 인한 경항통(頸項痛) 환자의 봉약침(蜂藥鍼) 치료(治療)에 관한 임상적 고찰 (The Clinical Effects of Korean Bee-Venom Therapy in Neck Pain Due to Soft Tissue Damage)

  • 강영화;김효은;조명제;김태우;윤기붕;김은영
    • Journal of Acupuncture Research
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    • 제19권6호
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    • pp.67-79
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    • 2002
  • Objective : This study was designed to find out the effects of Korean bee-venom therapy on neck pain due to soft tissue damage. Methods : This study was carried out for 34 patients who had neither structral defectiveness of cervical spine nor neural injury but simple soft tissue damage among poeple who visited Hye-dang Oriental Hospital from March 4, 2002 to September 30, 2002. Group A of 17 patients was taken Korean bee-venom therapy Group B of 17 patients was taken common acupuncture therapy. Results : We have found out the good effects of Korean bee-venom therapy on the patients due to soft tissue damage. Conclusions : The Korean bee-venom therapy is useful on the patients of neck pain due to soft tissue damage.

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Delayed Lateral Row Anchor Failure in Suture Bridge Rotator Cuff Repair: A Report of 3 Cases

  • Jeong, Jae-Jung;Ji, Jong-Hun;Park, Seok-Jae
    • Clinics in Shoulder and Elbow
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    • 제21권4호
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    • pp.246-251
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    • 2018
  • Compared to single row repair, use of lateral row anchors in suture bridge rotator cuff repair enhances repair strength and increases footprint contact area. If a lateral knotless anchor (push-in design) is inserted into osteoporotic bone, pull-out of the lateral row anchor can developed. However, failures of lateral row anchors have been reported at several months after surgery. In our cases, even though complete cuff healing occurred, delayed pull-out of the lateral row anchor in the suture bridge repair occurred. In comparison to a conventional medial anchor, further biomechanical evaluation of the pull-out force, design, and insertion angle of the lateral anchor is needed in future studies. We report three cases with delayed pull-out of lateral row anchor in suture bridge rotator cuff repair with a literature review.

병원 밖 심정지 환자의 전문소생술이 자발순환 회복에 미치는 영향 (Effect of advanced life support (ALS) on recovery of spontaneous circulation in out-of-hospital cardiac arrest patients)

  • 박소은;윤병길
    • 한국응급구조학회지
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    • 제28권2호
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    • pp.47-62
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    • 2024
  • Purpose: This retrospective study analyzed the effects of advanced life support on the recovery of spontaneous circulation (SC) in patients with out-of-hospital cardiac arrest. Methods: The subjects of this study were out-of-hospital cardiac arrest patients transferred to the hospital by 119 paramedics in Gyeongsangbuk-do from January 1, 2021, to December 31, 2022, amounting to a total of 2,524 patients. Results: The younger the age, the higher the probability of recovery of spontaneous circulation, and it was higher when cardiac arrest occurred in a public place or was witnessed. If the patient's initial electrocardiogram rhythm is defibrillable, the probability of recovery from spontaneous circulation is high. The recovery of the spontaneous circulation rate decreased with time between the time of report and the time of contact with the patient. Recovery of the spontaneous circulation rate was high when mechanical chest compression devices and advanced airways were not used. Additionally, this study had positive effects on defibrillation, peripheral intravenous catheter insertion, and epinephrine infusion. Conclusion: Paramedics should actively perform peripheral intravenous catheter insertion and epinephrine infusion, and it should be possible to clearly determine whether defibrillation should be applied through electrocardiographic education.

선택진료 및 상급병실제도 개선정책이 건강보험 보장성에 미친 영향: 일개 상급종합병원 입원 진료비를 중심으로 (The Effect of Physician Surcharges and Private Room Charges Improvement Policy on National Health Insurance Coverage: Focusing on Analysis of a Upper Grade General Hospital's Inpatient Medical Costs)

  • 나비;은상준
    • 한국병원경영학회지
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    • 제23권1호
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    • pp.51-64
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    • 2018
  • Purposes : In February 2014, the government said that the National Health Insurance Service (NHIS) will enforce plan for reducing the financial burden from two major non-covered services including physician surcharges and private room charges, the main causes to increase uninsured, by 2017. The purpose of this study is to analyze the policy effect that performed so far by comparing out-of-pocket payment rates of policy process Methodology: This study analyzed admission medical expenses that occurred from January 2013 to March 2016 at a upper grade general hospitals in Daejeon. Number of study subjects were 134,924 and the data were analyzed with SPSS 22.0 program by using frequency, percentage, mean, standard deviation, ANOVA. The effect of two major non-payment improvement plan on out-of-pocket rates was ascertained via generalized estimating equation. Findings: Out-of-pocket payment rates was statistically significantly declined 2.7 percent than enforcement ago. Also, out-of-pocket payment, physician surcharge, the proportion of out-of-pocket payment of hospital room charge to out-of-pocket payment was statistically significantly declined. However, a further analysis of the cause of the decline in total medical costs is needed. Practical Implications: Physician surcharges and private room charges improvement policy had a positive effect on the decline of out-of-pocket payment rate. The policy of physician surcharges was very effective after the first policy enforcement but it was less effective to medical aids and near poor that was a more greater coverage than national health insurance. Since the policy has not been finalized, we have to continue a research for the successful implementation of the policy.

지역사회 응급의료 자원이 병원 밖 심장정지 환자의 생존에 미치는 영향 (Effects of community emergency medical resources on survival in out-of-hospital cardiac arrest)

  • 조윤주;김광기
    • 한국응급구조학회지
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    • 제25권1호
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    • pp.205-221
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    • 2021
  • Purpose: This paper is to determine whether automatic defibrillators (AEDs) deployed across communities make a contribution to prevent death in patients with acute cardiac arrest out-of-hospital. Methods: A total of 30,179 cases of cardiac arrest investigation data from the Korea Centers for Disease Control and Prevention was matched to those on emergency medical statistics drawn from annual report for the 2018 Central Emergency Medical Center, and statistics from the National Statistical Office in 2018. Results: Multiple logistic regression analyses revealed that availability of emergency medical resources across associated with different survival rates at emergency room after taking variability of the patient's personal characteristics and episodic situational characteristics held constant. The survival rate was 1.71 times higher for patients living in communities with more than 105 AEDs avaiable per 100,000 inhabitants than for those living in communities with less than 55 AEDs. Conclusion: The survival-related factors of patients with acute cardiac arrest that occurred out-of-hospital were found to be associated with patients' and episodic situational characteristics. The hospital stage were found to be associated with patients characteristics and episodic situational characteristics, The variability of AED available in a community has an impact on survival rate after emergency room treatment.

의료급여 수급자의 건강관리 및 의료이용에 대한 텔레케어 사례관리의 효과 (Comparison of Case Management between Tele Care Regions and General Care Regions in Korean Medicaid)

  • 이현주;오진주;최정명
    • 간호행정학회지
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    • 제16권4호
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    • pp.381-388
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    • 2010
  • Purpose: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. Method: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. Results: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. Conclusions: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.

An Analytic Case Study on the Management of an Upper-level General Hospital(2010-2012)

  • Park, Hyun-Suk;Lee, Jung-Min;Baek, Hong-Suck;Lee, Jun-Ho;Park, Sang-Sub
    • 한국임상보건과학회지
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    • 제2권1호
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    • pp.1-16
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    • 2014
  • Purpose. For a more efficient hospital management, this study aims to provide basic data so that the hospital management and staff in charge of hospital administration may systematically classify and collect hospital information, by analyzing the ordinary characters of an upper-level general hospital system and its common-type balance sheet, common-type profit and loss statement and financial ratio. Methods. By using information about an upper-level general hospital in C Province, provided by Alio(www.alio.go.kr), a public organization information provision site, Health Insurance Review & Assessment Service(www.hira.or.kr) and Ministry of Health and Welfare(www.mw.go.kr), this study analyzed 3 year's data from 2010 to 2012 and provided basic data by analyzing the ordinary characters of an upper-level general hospital system, and its common-type balance sheet, common-type profit and loss statement and financial ratio. Results. After analyzing the ordinary characters, common-type balance sheet, common-type proft and loss statement and financial ration of this general hospital, based on the 2010 to 2012 data, this study came to the following conclusions. Firstly, out of all the 1,069 hospital staff, there were 272 doctors working for 24 medical departments, out of whom the majority was 33 physicians. Most of the nurses were third-class ones, and about 2,000 outpatients and 600 inpatients on average were treated per day. Secondly, as a result of analyzing the common-type balance sheet, this study discovered that intangible assets out of fixed assets accounted for 41%, the majority, out of which usable and profitable donation asset buildings were of great importance, and the liquid assets increased more in 2012 than 2011. In the financial structure, the ratio of liquid liabilities was over 50% out of all the liabilities in 2012, and the ratio of purchase payables was high as well. The ratio of fixed liabilities reached up to 40%, out of which the retirement benefit appropriation fund was quite high. The capital was over 80%, but the surplus was in a deficit state. Compared to the capital, the ratio of total liabilities was about 90%, which indicates the financial structure of this general hospital was vulnerable. Thirdly, as a result of analyzing the common-type profit and loss statement, this study found out that the medical profits from inpatients were higher than profits from outpatients. The material cost was related to the medical quality of this general hospital, and it was as high as 30% out of the total costs and was about 45% of the labor cost. This general hospital showed 10% in the ratio of non-medical profits, and it seemed because of government subsidies. The ratios of medical profits and current net income were gradually changing for the better in 2012, compared to 2011. Lastly, as a result of analyzing the financial ratio, it was found that the liquidity ratio kept decreasing, from 110.7% in 2010 and 102.0% in 2011 to 77.2% in 2012. Besides, it was analyzed that the liquidity ratio and the net working capital ratio greatly decreased, while the quick ratio and the liquid ratio kept decreasing. Conclusions. 1. It is necessary to take the risk management into more consideration, and particularly, it is needed to differentiate and manage the levels of risk in detail. 2. By considering the fact that investments into hospital infrastructures were mostly based on liabilities, it is needed to deal with the scale of losses when evaluating risks. 3. By reflecting the character that investments into hospital infrastructures were based on liabilities, it is necessary to consider the ratio of ordinary profits as well as the ratio of operating profits to sales, and it is also important to consider sales productivity factors, such as the sales amount per a sickbed, by comparing them with other hospitals. As for limitations of this study, there may be some problems in terms of data interpretation because of the lack of information about the number of inpatients and the number of outpatients per year, which are needed for the break-even point analysis. Besides, to suggest a direction for the improvement of hospital management through analyses, non-financial factors should be reflected, such as the trend of economy, medical policies, and politic backgrounds. However, this study only focused on the common-type balance sheet, common-type profit and loss statement and financial ratio, so this study is actually limited to generalizing all the factors by analyzing public data only.

대기오염으로 인한 건강효과의 경제적 비용 -급성 호흡기 질환 외래환자를 중심으로- (Estimating the Cost of Air Pollution on Morbidity: Focusing on Hospital Visit for Acute Respiratory Diseases)

  • 신영철
    • 자원ㆍ환경경제연구
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    • 제11권4호
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    • pp.659-687
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    • 2002
  • This study used a discrete choice model to investigate an association between air pollution and hospital visits for acute respiratory symptoms with the national health interview survey conducted in 1998 in South Korea. The results showed that $NO_2$ and TSP were significantly related to hospital visits in a single-pollutant model, but when they were simultaneously considered, only $NO_2$ remained significant. It was estimated as $NO_2$ level increased by 10%(0.0027ppm) from 0.027ppm (the mean $NO_2$ level), hospital visits increase by 0.176%. This study also measured respondent's out-of-pocket expense and the time cost for commuting and waiting for the visit. We found that on the average, out-of-pocket expense is 5,600 won per hospital visit, but the total cost per hospital visit is measured at 33,440 won with time cost of commuting and waiting at 27,840 won. Time cost was over 63.6~83.3% of the total cost per hospital visit.

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병원 전 심정지 환자의 자발순환 회복에 관한 병원전 처치 - 하트세이버 수상자를 중심으로 - (Prehospital care after return of spontaneous circulation in out-of-hospital cardiac arrest patients: Based on Heart Saver laureate)

  • 고봉연;홍성기;김진영
    • 한국응급구조학회지
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    • 제18권2호
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    • pp.125-136
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    • 2014
  • Purpose: We aimed to improve the survival rates of out-of-hospital cardiac arrest patients. Methods: We analyzed data regarding cardiopulmonary resuscitation (CPR) outcomes and clinical characteristics of out-of-hospital cardiac arrest patients. The data included prehospital emergency medical service reports of 207 patients, 135 patients of Heart Saver, who survived over 72 hours after return of spontaneous circulation (ROSC) in Gyeonggi-do from January, 2012 to December, 2013. Data were analyzed using SPSS 18.0 descriptive statistics. Results: Among patients who achieved ROSC, 87.6% were men and 73.6% were aged 41-70 years; 86.7% were cases of witnessed cardiac arrest, and cardiopulmonary resuscitation was performed by bystanders in 65.9% of cases. The initial electrocardiogram showed ventricular fibrillation or pulseless ventricular tachycardia in 96.3% of patients. The call time was 1.0 minutes, arrival time was 6.3 minutes, time spent at the scene was 8.0 minutes, hospital arrival time was 10.0 minutes, and total CPR duration was 9.6 minutes. The certificate of them was paramedics in 89.6%. Conclusion: To improve the survival rates of out-of-hospital cardiac arrest patients, standard prehospital care for these patients and educational programs regarding CPR for lay rescues should be developed.