• Quality Improvement in Health Care
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• v.11 no.1
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• pp.16-30
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• 2004

Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.21 no.3
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• pp.196-202
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• 2018

Purpose: Treatment of chronic constipation and fecal impaction is usually outpatient and requires high or frequent doses of laxatives. However, there are children who fail outpatient treatments, sometimes repeatedly, and are ultimately hospitalized. We sought to compare the characteristics of the children who failed outpatient treatment and needed inpatient treatment vs those who achieved success with outpatient treatment, in an effort to identify attributes that might be associated with a higher likelihood towards hospitalization. Methods: In this retrospective cohort study, we reviewed the medical records of all patients aged 0 to 21 years, with chronic functional constipation and fecal impaction seen in the pediatric gastroenterology clinic over a period of 2 years. Results: Total of 188 patients met inclusion criteria. While 69.2% were successfully treated outpatient (referred to as the outpatient group), 30.9% failed outpatient treatment and were hospitalized (referred to as the inpatient group). The characteristics of the inpatient group including age at onset of $3.6{\pm}3.6years$ (p=0.02); black ethnicity (odds ratio [OR] 4.31, 95% confidence interval [95% CI] 2.04-9.09); p<0.001); prematurity (OR 2.39, 95% CI 1.09-5.26; p=0.02]; developmental delay (OR 2.20, 95% CI 1.12-4.33; p=0.02); overflow incontinence (OR 2.26, 95% CI 1.12-4.53, p=0.02); picky eating habits (OR 2.02, 95% CI 1.00-4.08; p=0.04); number of ROME III criteria met: median 4, interquartile range 3-5 (p=0.04) and $13{\pm}13.7$ constipation related prior encounters (p=0.001), were significantly different from the outpatient group. Conclusion: Identification of these characteristics may be helpful in anticipating challenges and potential barriers to effective outpatient treatment.

• 한국사회복지학회:학술대회논문집
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• 2004.10a
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• pp.461-492
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• 2004

This study examined the effects of gender, parental support and treatment type on the treatment outcome of adolescent substance abusers. Outcome variable was the successful graduation (or drop) from an Intensive Adolescent Outpatient Program. Adolescents with their parents' support were treated in one of three treatment models (2-weeks Inpatient plus 6 week Intensive Croup-Oriented Outpatient, 8-weeks Intensive Croup-Oriented Outpatient, and 8-weeks Individual-Family Therapy) within a private hospital-affiliated treatment center by managed care practice allowing their own choice (non-random natural assignments). Several hypotheses were tested for main effects by the Log-Linear Analyses for a multi-dimensional contingency table with 440 adolescents (284 boys and 156 girls treated during 1992-l997) from middle-class families with private health insurances. The following results were found. Odds of graduating versus dropping out of the treatment program among : (1) girls were 1.7 times higher than those among boys; (2) adolescents with two-parent were 2.2 times higher than those among adolescents with one-parent ; (3) adolescents with Inpatient plus Outpatient was 1.7 times higher than that of those with Outpatient; (4) adolescents with Individual-Family Therapy was 2.3 times higher than that of those with Outpatient Model. There was no statistically significant outcome difference between the Individual-Family Therapy and the Inpatient plus Outpatient. Implications from the results were discussed. Suggestions were made to improve the treatment components in the areas of gender sensitivity, securing more parental support, alternatives for separation from peer group and integrating new peer groups, and flexibility for the unique needs of individual family. Also, some research questions for future studies were suggested.

• Korean Institute of Interior Design Journal
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• v.23 no.3
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• pp.64-74
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• 2014

This study attempts to evaluate the interior space of outpatient department of general hospital in aspects of nurses. The subjects are 97 nurses who work in outpatient department of H general hospital, Busan. Evaluating items are ones related to space layout, furniture, interior climate, color and finishes of outpatient department. Also, evaluating spaces are waiting area, doctor's room, treatment room, nurse station, and resting and dressing area for nurses in outpatient department. The results are ; 1) The space layout type of outpatient area in general hospital which each department consists of waiting area, doctors offices, treatment room and etc. was evaluated positively by nurses. 2) The waiting area and doctor's room was evaluated relatively positive, the treatment room was more negatively than these two rooms. But nurse related spaces such as nurse station and resting and dressing room were evaluated relatively negative. 3) In aspects of interior elements, furniture, and color and finishes were rated to be relatively positive. However, air conditions were rated negatively. 4) The finishes and dressing area in treatment room were rated relatively low. This would be a basic data for planning the outpatient area of general hospital.

• Korean Journal of Psychosomatic Medicine
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• v.25 no.1
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• pp.46-55
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• 2017

Objectives : Outpatient treatment orders refer to a mandatory social program in which mentally ill persons are ordered by the court to participate in specified outpatient treatment programs. This study aimed to investigate the factors that affect outpatient treatment orders and adherence to outpatient treatment in mental health patients. Methods : A survey on outpatient treatment orders and adherence to outpatient treatment was conducted on 60 psychiatrists between October and November 2016. The questionnaire items were drafted based on a literature review, and they were then evaluated by 3 psychiatrists and 1 law school professor before being finalized. Answers from the respondents were analyzed using descriptive statistics, and the median, maximum, and minimum values of the effectiveness scores of outpatient treatment orders were calculated. Results : Among the 60 psychiatrists, 45(75.0%) were aware of outpatient treatment orders; however, only 2 out of the 45(4.0%) had actually used the program in the last 12 months. The subjective effectiveness was very low, with only 40 points out of 100. Furthermore, of the readmitted patients, 37.7% had received continued outpatient treatment, whereas 53.1% chose to quit the outpatient treatment programs, meaning that the number of dropouts was higher. Among the discharged patients, approximately two-thirds were receiving continued treatment. With regard to follow-up for dropouts, majority of the responses were either "Not taking any action"(n=27) or "Not following up"(n=15). Only two respondents answered "Contact the community mental health promotion center," meaning that this response was very rare. Meanwhile, when asked about efficient measures to be implemented for dropouts, a vast majority of the respondents(n=30) selected the answer "Work with the community mental health promotion center." Conclusions : The outpatient treatment orders currently being administered were found to be ineffective, and the associated adherence to outpatient treatment was also found to be extremely poor. Hence, the effectiveness of the therapeutic interventions could benefit from institutional as well as administrative improvements. Community mental health promotion centers are expected to have an important role in the future.

• Journal of The Korean Dental Society of Anesthesiology
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• v.13 no.3
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• pp.95-102
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• 2013

Background: Sedation or outpatient general anesthesia is a necessary method for a successful dental treatment for children and the disabled who have a difficulty of cooperation. The aim of this study was to assess the patients who had dental treatment under sedation or outpatient general anesthesia at department of pediatric dentistry, Chonnam national university dental hospital and Gwangju dental clinic for the disabled. Methods: 875 patients who had sedation from January 2009 to September 2013 and 88 patients who had outpatient general anesthesia after May 2011 were assessed for this study. Patient's distribution and treatment patterns were examined. Results: The number of patients has been increasing in both sedation and outpatient general anesthesia. In case of sedation, the proportion of male patients was higher and 4-6 years age group was the highest. Most patients have resided in Gwangju buk-gu and the percentage of restorative treatment was the highest. In case of outpatient general anesthesia, the proportion of male patients was higher than that of sedation. Two groups, 10-19 and 20-29 years age, consisted most of patient. Most patients have resided in Gwangju buk-gu and Jeollanam-do, and the percentage of periodontic and preventive treatment was the highest. Conclusions: Sedation or outpatient general anesthesia for dental treatment has been increasing for children and the disabled who have a difficulty of cooperation. Therefore, it is important to improve treatment environment under sedation and general anesthesia through continuous research and studies.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.15 no.1
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• pp.1-6
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• 2019

There are increasing number of patients having dental treatment under outpatient general anesthesia. There were researches that studied patients treated under outpatient general anesthesia in Chonbuk National University Dental hospital between 2005~2013. However, there has been an absence of research since 2013. Therefore, the aim of this research is to study cases regarding outpatient general anesthesia visiting Chonbuk National University hospital between 2014~2017 and analyze the trends of these patients. The medical records of 409 cases from January, 2014 to December, 2017 were reviewed. From the patients' charts, data on sex, residence, visiting dates, disability status, and types and number of treatments was collected and investigated. The number of cases has increased from 86 in 2014 to 140 in 2017. Among 409 cases, 275 cases(67.2%) had disabilities, with mental disabilities consisting most of the disabilities. 192 cases were aged under 20 years old mostly with no disabilities, 142 cases were 20~39 years old mostly with mental disabilities, and 75 cases were 40 years old or more mostly with physical disabilities. The conservative treatment was performed most frequently in both disabled and non-disabled patient groups. There was an increasing trend in the number of patients treated under outpatient general anesthesia, and more than half were disabled patients. In order to meet this demand, Chonbuk National University Dental Hospital increased the number of general anesthesia pracrice. To follow this trends, the implementation of safe outpatient general anesthesia system and cooperation among teams is needed to improve the quality of treatments.

• Journal of Korean Academy of Nursing
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• v.38 no.3
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• pp.363-371
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• 2008

Purpose: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. Methods: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. Results: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. Conclusion: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.

• Health Policy and Management
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• v.18 no.1
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• pp.21-42
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• 2008

This study investigates economies of scale, cost complementarity and economies of scope for healthcare organizations using econometric approaches. The economies of scale appear to exist in each service provided by a hospital such as inpatient treatment services, outpatient treatment services, and other patient treatment services, respectively. When we test all services in aggregate level, it also indicates that the healthcare industry on average exhibits the economies of scale of 6 percent, which implies that scaling up hospital sizes will bring substantial cost savings to them Evidence shows that cost complementarity exists between outpatient services and other services for patients and, i.e., these other services for patients experience the reduction in marginal costs as the outputs of the outpatient services increase. For the economies of scope, they are present in most service areas; aggregate level services, outpatient services, and other services for patients, respectively. Inpatient treatment services, however, do not show any evidence of the economies of scope. Results show that the economies of scope are achieved by the general hospital type that provides all service areas such as inpatient treatments, outpatient treatments, and other services for patients. The existence of the economies of scope provides the rationale for extending the existing line of business in a hospital into more diverse areas of services where its benefit comes in the form of cost savings. In sum, it overall provides evidence that the M&As in this industry are encouraged to achieve cost reductions from the economies of scale and scope by changing the size and the output mix.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.2
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• pp.7-15
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• 2015

Purpose: The purpose of this study is analyze linkage and spatial and structural characteristics of outpatient department and diagnosis/treatment area of geriatric hospitals based on quantitative analysis, according to function and corridor types. Methods: To examine structural characteristics and correlation of outpatient department and diagnosis/treatment area of six geriatric hospitals according to the corridor type, were systemized according to the function and corridor type and made into a j-graph, and an index was created by using space syntax to understand spatial characteristics. Results: 1) Different functional spaces are connected by a corridor, which, therefore, can be an axis of the connectivity and linkage of functional spaces and an important element in a clear hierarchy. 2) Treatment areas were disconnected from different functional spaces and, therefore, the accessibility was low. Many hospitals had an arrangement plan for treatment and diagnosis areas, and recent hospitals have segmented treatment areas within the rehabilitation space, which resulted in deeper space. 3) In terms of the level of integration, more integrated reception area meant shallower spatial depth, and deeper space for treatment and diagnosis areas. Implications: Spatial relation of outpatient department of geriatric hospitals was analyzed based on characteristics of the elderly.