• Title/Summary/Keyword: Over crowding

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Change in the severity of patients visiting emergency medical centers through the 119 ambulance during the COVID-19 pandemic (COVID-19 기간 119구급차를 통해 일개 응급의료센터에 내원한 환자 중증도의 변화)

  • Kim, Yong-Joon;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.2
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    • pp.145-156
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    • 2021
  • Purpose: Despite the fact that emergency medical centers (ED) are used by emergency patients, more than 50% of non-emergency patients have been reported to be admitted in EDs, of which more than 10% of them used the 119 ambulance. Therefore, this study investigated whether there was a change in the severity of patients visiting EDs during the first year of the COVID-19 pandemic. Methods: This was a retrospective study of patients who visited the ED through the 119 ambulance in 2019 (13,735) and 2020 (11,015). Patient data were analyzed using the medical information system. Results: There was an increase in non-emergency patients at the emergency departments (KTAS levels 4-5) in 2020 with a rate of 58.0% (6,393), as compared to the 2019 data with a rate of 44.9% (6,169). However, the 2020 median length of stay in the emergency department was 188 minutes (IQR: 0-5,909minutes) (p=.000), which was decreased as compared to the 2019 median length of stay of 231 minutes (IQR: 5-6,211minutes) (p=.003). Conclusion: Providing emergency ambulance guidelines for selecting proper hospitals and educating patients to refrain from using the ED for non-emergency patients should be taken into consideration to prevent overcrowding and construct a more effective emergency medical system (EMS).

An Analysis of the Contribution of the Elderly to Income Inequality (노인의 소득구조 불평등 기여도 분석)

  • Shin, Gyu-Cheol;Lee, Yong-Jae
    • The Journal of the Korea Contents Association
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    • v.21 no.8
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    • pp.478-488
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    • 2021
  • This study analyzes the change in the contribution of the elderly to income inequality by using the Gini coefficient and the decile distribution ratio from the data of the Korea Welfare Panel Survey from 2007 to 2018 on economic inequality in old age. According to the study, the Gini coefficient of total income gradually decreased from 0.430 in 2007 to 0.383 in 2018. As a result, inequality decreased. Also, the higher the income quintile, the higher the income growth rate. Market income inequality has increased and inequality between public and private transfer income has decreased. Analysis of the contribution of income inequality to total income confirmed that public transfer income has replaced the role of private transfer income in reducing inequality over time. The expansion of public transfer income for the maintenance of basic living of the elderly is an important source of income for the elderly despite the crowding-out effect of private transfer income, market income, public and private transfer income, which are components of the income structure of the elderly, mutually complement total income. Therefore, it is important to identify income sources that contribute to alleviating income inequality among the elderly and reflect them in policy-making process.

Effectiveness of laser-engineered copper-nickel titanium versus superelastic nickel-titanium aligning archwires: A randomized clinical trial

  • Omar Khairullah Ahmed;Ammar Salim Kadhum
    • The korean journal of orthodontics
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    • v.54 no.1
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    • pp.16-25
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    • 2024
  • Objective: To compare the effectiveness of laser-engineered copper-nickel titanium (SmartArch) and superelastic nickel-titanium (SENT) archwires in aligning teeth and inducing root resorption and pain experienced by patients. Methods: Two-arm parallel groups with a 1:1 allocation ratio were used. The participants were patients aged 11.5 years and older with 5-9 mm of mandibular anterior crowding who were indicated for non-extraction treatment. The primary outcome was alignment effectiveness, assessed using Little's irregularity index (LII) over 16 weeks with a single wire (0.016-inch) in the SmartArch group and 2 wires (0.014- and 0.018-inch) in the SENT group (8 weeks each). Secondary outcomes included root resorption evaluated by pre- and post-intervention periapical radiographs and pain levels recorded by the participants during the first week. Results: A total of 40 participants were randomly allocated into 2 groups; 33 completed the study and were analyzed (16 in the SmartArch group and 17 in the SENT group, aged 16.97 ± 4.05 years). The total LII decrease for the SmartArch and SENT groups was 5.63 mm and 5.29 mm, respectively, which was neither statistically nor clinically significant. Root resorption was not significantly different between the groups. The difference in pain levels was not statistically significant for the first 5 days following wire placement; however, there was a significant difference favoring the SENT group in the final 2 days. Conclusions: SmartArch and SENT archwires were similarly effective during the alignment phase of orthodontic treatment. Root resorption should be observed throughout the treatment with either wire. SmartArch wires demonstrated higher pain perception than SENT wires.

Delayed use of Operating Rooms in a University Hospital (한 대학병원의 수술실 이용 지연요인과 개선방안에 관한 연구)

  • Kim, Kyung-Ae;Yu, Seung-Hum;Kim, In-Sook;Sohn, Tae-Yong;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.7 no.3
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    • pp.44-62
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    • 2002
  • Advanced surgical technology demands more precise, meticulous, and time-consuming procedures. In addition, the patient's preference of tertiary health providers makes over crowding of the University Hospitals. Therefore, it has been necessary to maximize utilization of the operating room of such hospitals to accommodate these requirements. This study, targeting 1,302 surgical cases performed in 22 operating rooms at a university hospital in Seoul from October 8 to November 1, 2001, analyzed reasons for delay, and factors that caused delayed use of operating rooms. This study also assessed that the rate of operating room use would increase if the sources for possible reform were improved. 1. Among total of 1,302 cases of surgery, the incidence of surgeries in which there were no time delays and no factors for delay were discovered is 71.4% or 930 cases: the incidence in which surgeries were delayed was 28.6% or 372 cases. 2. As results of logistic regression for delay, procedures involving women were delayed 1.4 times more frequently than those of men. Compared to Department A, Department B was 1.8 times more likely to be delayed, and Department H was 0.4 times less likely to be delayed. Regional anesthesia was 2.4 times more likely to be delayed than general anesthesia, and surgeries that PCA was applied were 0.6 times less likely to be delayed than those when it was not. Surgeries performed on the Thursday were 1.7 times more likely to be delayed than those performed on the Monday. Compared to surgeries performed between 07:00-07:59, those performed between 08:00-08:29 were 4.3 times higher. 3. The reasons for delay were related to surgeon, surgical department, patient, anesthesia, administrative system, sick ward, and support services. Among these, 5,755 minutes for 276 delayed cases could be resolved easily, and resolving delays of 3,320 minutes for 131 cases would be more difficult. Among the causes for delay that could be improved, delays due to patient's transfer and surgeon's factor were the most common, 21.6% and 17.4% respectively. 4. If resolvable delays are improved, pre-anesthesia room is administered, and regional anesthesia and PCA are done ahead of time, use of emergency operating rooms will increase, we can increase overall utilization by 4.09%, we will save 744 minutes a day, we can reduce the time the operation room is used after 4 PM by 35%, and we can resolve the operation cancellations due to insufficient operating rooms. For the increase in the use of operating rooms, we need to maximally decrease the delays that could be improved, by allocating block time based on used totals hours of elective cases, giving accurate information on surgery schedule, voluntary cooperation by staff participating in surgeries in reducing delay time, and the hospital management's will to improve delay.

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The Prevalence of Malocclusion and Related Self-Esteem of Adolescents in Yangsan (양산시 청소년의 부정교합 유병률 및 관련 자존감 조사)

  • Ryu, Hyunjung;Kim, Hyungjun;Jeong, Taesung;Kim, Jiyeon;Kim, Shin
    • Journal of the korean academy of Pediatric Dentistry
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    • v.40 no.4
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    • pp.296-305
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    • 2013
  • For the purpose of evaluating the prevalence of malocclusion and self-esteem in adolescents, 1,380 middle-school students in the Yangsan area were surveyed by oral examination and questionnaires and the obtained results were as follows: The distribution of 1st molar occlusion by Angle's classification was 69.0, 19.4, 10.6% for Class I, II and III respectively. In the horizontal relationship, the prevalence of normal overjet and crossbite was 86.9% and 5.6% respectively whereas larger and extremely larger overjet was found in 6.6% and 0.8%. In the vertical relationship of anterior teeth, normal, deep overbite and openbite was shown in 94.1%, 4.7%, and 1.2%. For the midline discrepancy, the distribution of groups with 0~1 mm, 2~4 mm and over 5 mm was 98.2%, 1.4%, and 0.4%. Crowding only in the maxilla was found in 9.6%, while that only in the mandible and in both arches was 14.1% and 24.1% respectively. Spacing only in the maxilla was seen in 3.0%, while that only in the mandible and in both arches was 2.4% and 1.7% respectively. Significant difference in self-esteem was revealed in female and malocclusion groups of crossbite and openbite(p < 0.05).

Trends in Malocclusion Patients of Yeungnam University Hospital (영남대학교병원 치과에 내원한 부정교합환자의 특성)

  • Chung, Sung-Ho;Lee, Hee-Kyung
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.71-81
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    • 2006
  • Background: This study was done to better understand patterns, trends and local distribution patterns of malocclusion so that we can provide adequate information to patients, to help make the appropriate diagnosis and therapeutic plans, and to assess the future directions of malocclusion treatment. Materials and Methods: Malocclusion patterns, distribution and trends of visiting patients were examined in 993 malocclusion patients who had been evaluated and diagnosed at the Department of Dentistry, Yeungnam University Hospital over a 10-year period from 1995 to 2004. Results: The number of visiting patients per year showed an increasing trend and the visit rate was 1.28 time-higher in females(56.1%) than in males(43.9%). 1) Age distribution showed that the 7-12 year-old group was the largest (36.7%). Geographic distribution showed the majority of patients were from the Dalseo district(28.2%). Angle's malocclusion classification revealed that class III was the largest(38.4%). Crowding was the chief complaint in the highest percentage of patients(33.9%). The therapeutic method used was the fixed appliance in 61% of cases and a combination with extraction in 30.8%. Conclusions: The availability of dental services can accommodate orthodontic needs adequately as well as obtain reliable quantitative information regarding the characteristics of orthodontic patients.

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DENTAL TREATMENT OF A PATIENT WITH LOWE SYNDROME UNDER GENERAL ANESTHESIA: A CASE REPORT (Lowe syndrome 환아의 전신마취 하 치아우식 치료: 증례보고)

  • Kim, Min Jin;Song, Ji-Soo;Shin, Teo Jeon;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taeg;Lee, Sang-Hoon;Hyun, Hong-Keun
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.15 no.1
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    • pp.35-39
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    • 2019
  • Oculo-cerebro-renal syndrome, known as Lowe syndrome, is an X-linked gene disorder characterized by congenital cataracts, brain abnormalities and renal dysfunction. Tooth crowding, taurodontism, delayed eruption in the permanent dentition and over-retained primary teeth with ectopic eruption of the permanent teeth have been reported as dental findings. Because of the high incidence of poor cooperation, patients with Lowe syndrome have difficulties in maintaining good oral hygiene, which may require dental treatment. We present a case of dental treatment for the uncooperative child with Lowe syndrome under general anesthesia. A 4-year-old, 11.2 kg boy with Lowe syndrome visited Seoul National University Dental Hospital for gingival swelling. The patient had multiple caries requiring dental treatment. Because of his past history of malignant hyperthermia during inhalation induction, anesthesia was induced and maintained with total intravenous anesthesia (TIVA) after medical consultation. Dental restorative treatments were successfully performed and no complications were observed during and after the procedure. Safe and effective dental management of the patients with Lowe syndrome could be performed with the help of general anesthesia and careful monitoring.

Current trends in orthodontic patients in Seoul National University Dental Hospital (서울대학교 치과병원 교정과에 내원한 부정교합 환자의 최근 경향)

  • Im, Dong-Hyuk;Kim, Tae-Woo;Nahm, Dong-Seok;Chang, Young-Il
    • The korean journal of orthodontics
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    • v.33 no.1 s.96
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    • pp.63-72
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    • 2003
  • Over the Past decades, the number of Patients seeking orthodontic treatment has increased markedly with socioeconomic development and change of recognition on appearance. The purpose of this study was to provide an epidemiologic data base related to the orthodontic treatment need. We could take an adequate information regarding the characteristics of orthodontic patients, and the changing trends about treatment mordality. Distrubution and treands were Investigated in 676 patients who had been examined and diagnosed at Department of orthodontics, Dental Hospital, Seoul National University from January to June in 1992 and 2002. 1. Sex distribution of patients changed from 1:2.1 to 1:1.5 (male female). 2. In 2002, are distribution had shown $7\~12$ year-old group being the largest$(32.0\%)$ and percentage of $19\~24,\;13\~18,\;over\;25,\;4\~6,\;0\~3$ year-old group were $24.0\%,\;21.6\%,\;14.2\%,\;5.8\%,\;2.4\%$ respctively. Compared with data in 1992, the number of adult patients highly increased. 3. With regard to Angle classification, each percentage of Class I, Class II div 1, Class II div 2, and Class III malocclusion were $25.0\%,\;20.9\%,\;3.4\%,\;and\;48.1\%$ respectively in 2002. 4. Geographic distribution showed that most of the patients visited $(37.0\%)$ lived in northeast of Seoul in 2002. 5. Mandibular prognathism showed the highest percentage in chief complaints. The percentages of crowding and facial asymmetry were $14.2\%\;and\;11.8\%$ in 2002. Patients with facial asymmetry increased significantly. 6. Percentages of patients treated with fixed appliance and orthognathic surgery were $38.0\%\;and\;25.0\%$ in 2002. Patients needed to observe the growth pattern comprised $13.0\%$ with increasing trends. The use of chin cap reduced and the percentage of ortognathic surgery and growth observation increased significantly.

Debating Universal Basic Income in South Korea (기본소득 논쟁 제대로 하기)

  • Back, Seung Ho;Lee, Sophia Seung-yoon
    • 한국사회정책
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    • v.25 no.3
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    • pp.37-71
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    • 2018
  • Since 2016, public and political interest on basic income has been increased beyond academic interest. The recent debate on basic income has expanded on issues regarding to the concrete implementation of basic income moving further than the debate on conception of the basic income in the abstract level. This study examines major critiques of basic income which was raised from social policy area and makes a counter-argument on these critiques. Major points summarized as follows. First, the problem of jobs and social insurance exclusion is not serious enough to call for basic income. Second, existing social security systems will be crowded out by excessive financial burden if basic income is introduced. Third, policies to cultivate citizens' capacities to cope with a technological change should be given priority over basic income. This study disputes these critiques by counter arguing four points. First, it is necessary to reconstruct welfare state based on basic income, given the labor market changes, such as long-term trend of employment change, newly emerging employment of platform companies, and inconsistency of platform labor and social insurance. Second, hypothesis of crowding-out effect on social security system is just a criticism that can be applied to the basic income initiative of the right-wing. Also, it is unable to find a logical basis or evidence of this hypothesis from the historical process of welfare state development or previous studies. Third, it is necessary to discuss how to reconfigure existing social security system and basic income which are complementary to each other and also have consistency with labor market as a configuration, not as a matter of choosing between basic income and social security system. Fourth, de-laborization does not mean a refusal to labor but a free choice, and the basic principle of social security is not needs but right. In conclusion, in order to develop more productive debate on basic income, it requires more sophisticated discussion and criticism from the point of view of the distributive justice; the debate on the sustainability of social insurance-centered welfare states; and debates on the political realization of basic income.

Dual Path Model in Store Loyalty of Discount Store (대형마트 충성도의 이중경로모형)

  • Ji, Seong-Goo;Lee, Ihn-Goo
    • Journal of Distribution Research
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    • v.15 no.1
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    • pp.1-24
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    • 2010
  • I. Introduction The industry of domestic discount store was reorganized with 2 bigs and 1 middle, and then Home Plus took over Home Ever in 2008. In present, Oct, 2008, E-Mart has 118 outlets, Home Plus 112 outlets, and Lotte Mart 60 stores. With total number of 403 outlets, they are getting closer to a saturation point. We know that the industry of discount store has been getting through the mature stage in retail life cycle. There are many efforts to maintain existing customers rather than to get new customers. These competitions in this industry lead firms to acknowledge 'store loyalty' to be the first strategic tool for their sustainable competitiveness. In other words, the strategic goal of discount store is to boost up the repurchase rate of customers throughout increasing store loyalty. If owners of retail shops can figure out main factors for store loyalty, they can easily make more efficient and effective retail strategies which bring about more sales and profits. In this practical sense, there are many papers which are focusing on the antecedents of store loyalty. Many researchers have been inspecting causal relationships between antecedents and store loyalty; store characteristics, store image, atmosphere in store, sales promotion in store, service quality, customer characteristics, crowding, switching cost, trust, satisfaction, commitment, etc., In recent times, many academic researchers and practitioners have been interested in 'dual path model for service loyalty'. There are two paths in store loyalty. First path has an emphasis on symbolic and emotional dimension of service brand, and second path focuses on quality of product and service. We will call the former an extrinsic path and call the latter an intrinsic path. This means that consumers' cognitive path for store loyalty is not single but dual. Existing studies for dual path model are as follows; First, in extrinsic path, some papers in domestic settings show that there is 'store personality-identification-loyalty' path. Second, service quality has an effect on loyalty, which is a behavioral variable, in the mediation of customer satisfaction. But, it's very difficult to find out an empirical paper applied to domestic discount store based on this mediating model. The domestic research for store loyalty concentrates on not only intrinsic path but also extrinsic path. Relatively, an attention for intrinsic path is scarce. And then, we acknowledge that there should be a need for integrating extrinsic and intrinsic path. Also, in terms of retail industry, this study is meaningful because retailers want to achieve their competitiveness by using store loyalty. And so, the purpose of this paper is to integrate and complement two existing paths into one specific model, dual path model. This model includes both intrinsic and extrinsic path for store loyalty. With this research, we would expect to understand the full process of forming customers' store loyalty which had not been clearly explained. In other words, we propose the dual path model for discount store loyalty which has been originated from store personality and service quality. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. II. Research Model Dual path model integrates intrinsic path and extrinsic path into one specific model. Intrinsic path put an emphasis on quality characteristics and extrinsic path focuses on brand characteristics. Intrinsic path is based on information processing perspective, and extrinsic path emphasizes symbolic and emotional dimension of brand. This model is composed of extrinsic path, discount store personality$\rightarrow$store identification$\rightarrow$store loyalty, and intrinsic path, service quality of discount store$\rightarrow$customer satisfaction$\rightarrow$store loyalty. Hypotheses are as follows; Hypothesis 1: Service quality perceived by customers in discount store has an positive effect on customer satisfaction Hypothesis 2: Store personality perceived by customers in discount store has an positive effect on store identification Hypothesis 3: Customer satisfaction in discount store has an positive effect on store loyalty. Hypothesis 4: Store identification has an positive effect on store loyalty. III. Results and Implications We examined consumers who patronize discount stores for samples of this study. With the structural equation model(SEM) analysis, we empirically tested the validity and fitness of the dual path model for store loyalty in discount stores. As results, the fitness indices of this model were well fitted to data obtained. In an intrinsic path, service quality(SQ) is positively related to customer satisfaction(CS), customer satisfaction(CS) has very significantly positive effect on store loyalty(SL). Also, in an extrinsic path, the store personality(SP) is positively related to store identification(SI), it shows significant effect on store loyalty. Table 1 shows the results as follows; There are some theoretical and practical implications. First, Many studies on discount store loyalty have been executed from various perspectives. But there has been no integrative view on this issue. And so, this research was theoretically designed to integrate various and controversial arguments into one systematic model. We empirically tested dual path model forming store loyalty, and brought up a systematic and integrative framework for future studies. We want to expect creative and aggressive research activities. Second, a few established papers are focused on the relationship between antecedents and store loyalty; store characteristics, atmosphere, sales promotion in store, service quality, trust, commitment, etc., There has been some limits in understanding thoroughly the formation process of store loyalty with a singular path, intrinsic or extrinsic. Beyond these limits in single path, we could propose the new path for store loyalty. This is meaningful. Third, discount store firms make and execute marketing strategies for increasing store loyalty. This research provides real practitioners with reference framework needed for actual strategy formation. Because this paper shows integrated and systematic path for store loyalty. A special feature of this study is to represent 6 sub dimensions of service quality in intrinsic path and 4 sub dimensions of store personality in extrinsic path. Marketers can make more analytic marketing planning with concrete sub dimensions of service quality and store personality. When marketers of discount stores make strategic planning like MPR, Ads, campaign, sales promotion, they can use many items which are more competitive than competitors.

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