• 한국의료질향상학회지
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• 제11권1호
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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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• 제21권3호
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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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• 한국사회복지학회 2004년도 추계공동학술대회 자료집
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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.

• 한국실내디자인학회논문집
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• 제23권3호
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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.

• 정신신체의학
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• 제25권1호
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• pp.46-55
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• 2017

연구목적 외래치료명령제는 정신질환을 앓고 있는 사람이 특정한 외래치료 프로그램에 참여하도록 법에 의해 명령을 내리는 사회적 강제 제도이다. 본 연구에서는 외래치료명령제 및 정신질환자들의 치료 순응도에 영향을 미치는 요인들에 관해 알아보고자 하였다 방법 정신건강의학과 전문의 60명을 대상으로 2016년 10월에서 11월까지 외래치료명령제 및 치료 순응도에 관한 설문조사를 실시하였다. 설문지 각 문항은 문헌조사를 통하여 초안을 작성하고 3명의 정신건강의학과 전문의 및 1명의 법학전문대학원 교수의 의견 조회 과정을 거쳐서 최종적으로 확정하였다. 설문에 응답한 대상자들의 답변을 기술 통계를 이용하여 분석하였으며, 외래치료명령제의 실효성 점수에 대해서는 중앙값과 최고치, 최저치를 알아보았다. 결과 60명의 정신건강의학과 전문의 중에서 45명(75.0%)이 외래치료명령제를 알고 있었지만, 지난 12개월 중에 이를 이용한 전문의는 2명(4.0%)이었고, 주관적 실효성 점수는 40점/100점으로 그 실효성은 매우 낮게 나타났다. 또한 재입원 환자 중 외래 치료를 지속적으로 받았던 환자의 비율은 37.7%, 외래치료를 임의 중단한 환자 비율은 53.1%로 임의 중단 환자가 차지하는 비율이 더 높았다. 퇴원 환자 중에서는 약 2/3가량이 지속적인 치료를 받고 있었다. 임의로 치료를 중단한 환자의 관리방법으로 '아무런 조치를 취하지 않는다'(n=27)와 '파악하지 않음'(n=15)가 대부분이었지만 '정신건강증진센터 연락한다'는 의견은 2명으로 매우 저조하였다. 또한 임의 중단 환자에 대한 효율적인 조치로서는 '정신건강증진센터에 연계해야한다'는 의견이 가장 많았다(n=30). 결론 현재 시행되는 외래치료명령제는 실효성이 낮고, 외래치료 환자의 치료순응도 또한 매우 저조하였다. 따라서 이에 대한 효과적인 개입을 위해 제도적, 행정적 개선이 필요하며, 향후 정신건강증진센터의 역할이 중요할 것으로 판단된다.

• 대한치과마취과학회지
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• 제13권3호
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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.

• 대한장애인치과학회지
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• 제15권1호
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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.

• 대한간호학회지
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• 제38권3호
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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.

• 보건행정학회지
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• 제18권1호
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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.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권2호
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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.