The objective of this study is to analyze the utilization patterns of other region inpatients in general hospitals located in Seoul area. For the analysis, the study utilize the nationwide data on '2008 Survey of Patients' of Ministry of Health & Welfare. The statistical methodology used in the study is the logistic regression model. This study has three major findings. First, the significant affecting sociodemographic factors in selecting general hospitals located in Seoul area was sex, age, type of payment and inpatients residence region. Second, compared to other disease groups, the inpatients on both 'congenital malformation, deformity and chromosomal abnormalities' and 'neoplasm' groups are more likely to utilize general hospitals in Seoul area. Furthermore, in 'neoplasm' disease group, inpatients with 'bones and articular cartilage malignant neoplasm' are more likely to utilize general hospitals in Seoul area. Finally, hospitals with more than 1,000 beds was chief factor in selecting Seoul-based hospitals by other region inpatients. In conclusion, the study showed that other region inpatients are more likely to utilize general hospitals located in Seoul area in case of severe disease, rare case and surgical case. Therefore, central and local authority is required to monitor local hospitals on quality of the medical service as well as support them to establish specialized medical centers by providing human and physical resources.
Objectives: The primary objective of the study is to analyze the utilization patterns of provincial patients discharged from hospitals located in Seoul area. Methods: For the analysis, the study employed the nationwide data on 'Survey of Injured Patients Discharged from Hospitals' conducted by KCDC (Korea Centers for Disease Control and Prevention). The statistical methodology used in the measurement model is a logistic regression model. Results: The study has three major findings. First, compared to other disease groups, the discharged on both 'neoplasm(cancer)' and 'congenital malformation, deformity and chromosomal abnormalities' disease groups are more likely to utilize hospitals in Seoul area. Second, as for 'neoplasm(cancer)' disease group, patients with 'bones and articular cartilage' areas are more likely to utilize hospitals in Seoul area. Finally, Hospitals with more than 1,000 beds was primary factor in selecting Seoul-based hospitals by the discharged in provincial areas. Conclusion: In sum, the study showed that patients in provincial areas are more likely to utilize hospitals located in Seoul area regardless of the severity of their cases. Local authority, therefore, is required to monitor local hospitals on regular basis, as well as support them to establish specialized medical centers by providing human and physical resources.
Choo, HyeRan;Kim, Seong-Hun;Ahn, Hyo-Won;Poets, Christian F.;Chung, Kyu-Rhim
The korean journal of orthodontics
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v.52
no.4
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pp.308-312
/
2022
Since the emergence of neonatal infant orthodontics for treatments of cleft lip and palate with or without Robin sequence (RS) in Europe in the 1950s, advancements in design and scope of its application have been remarkable. As the first institution to adopt orthodontic airway plate (OAP) treatment in the United States in 2019, we saw a need for innovation of the original design to streamline the most labor-intensive and time-consuming aspects of OAP utilization. A solution is introduced using a systematic split expansion mechanism to re-size the OAP periodically to accommodate the neonate's maxillary growth. To date, seven RS patients have received this modified treatment protocol at our institution. Each patient completed full treatment using only one OAP. This innovative utilization method is aptly named the split orthodontic airway plate (S-OAP). Details of the S-OAP and its modifications from conventional OAP are reported.
Arnold, Michael T.;Dolezal, Brett A.;Cooper, Christopher B.
Tuberculosis and Respiratory Diseases
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v.83
no.4
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pp.257-267
/
2020
Patients with chronic obstructive pulmonary disease receive a range of treatments including but not limited to inhaled bronchodilators, inhaled and systemic corticosteroids, supplemental oxygen, and pulmonary rehabilitation. Pulmonary rehabilitation is a multidisciplinary intervention that seeks to combine patient education, exercise, and lifestyle changes into a comprehensive program. Programs 6 to 8 weeks in length have been shown to improve health, reduce dyspnea, increase exercise capacity, improve psychological well-being, and reduce healthcare utilization and hospitalization. Although the use of pulmonary rehabilitation is widely supported by the literature, controversy still exists regarding what should be included in the programs. The goal of this review was to summarize the evidence for pulmonary rehabilitation and identify the areas that hold promise in improving its utilization and effectiveness.
The problem of care of patients and families with Alzheimer's disease has become a conscious raising social policy issue in Korea. The government of the Republic of Korea has become cognizant of the situation and has begun searching for ways to remedy it. Thus, there is a need for a comprehensive under-standing of the situation in which patients and their families are struggling and the enormous problems of care. With a realization of the urgent need, this study was done to investigate the situation and the care needs of families with patients with Alzheimer's Disease, and to compare the effectiveness of services utilized by the families in terms of cost and effects on patient's conditions and on family live. The Subjects for the study were 29 families with hospitalized patients, 25 families utilizing hospital outpatient clinics, 14 families utilizing day care facilities, and 16 families with homebound patients. A total of 84 families were interviewed by four trained interviewers using structured and semistructured questionnaires. The data produced from these interviews included : the patient's stage of Alzheimer's disease, patient's bizarre behavior, hours spent on patient care per day, family burden and quality of life, direct and indirect costs encountered in the care of patients, and the families' evaluation of the effectiveness of the services received. The data were analyzed to determine the relationships between family charactersistics, patient's conditions and services utilization. The effectiveness of each of the service entities was assessed through families evaluation and hoped for service and comparisons were made between services in terms of the cost-effectiveness ratios. After initial comparison of cost-effectiveness ratios, further analysis was done to compare between groups for incremental effectiveness for each incremental unit of cost to determine the most cost-effective service entities. The findings of the study are as fellows : 1. The choice of living arrangement and the types of services are a function of the stage of Alzheimer's condition and the economic status of the family. 2. Comparision of the cost of care showed that most expenses were encountered in by families with hospitalization, families using outpatient services, and families using day care services in that order. The least expense was involved in the care of homebound patients. The economic burden felt by families was in the same order as expenses. 3. The average number of hours spent on daily patient care was 9.9 hours for the outpatient clinic users, 9.7 hours for homebound patients, and 5.4 hours for day care users. 4. There were significant differences in the patient's conditions (CDRL), bizarre behaviors and the families's burden by living arrangement and /or types of service. However, no significant difference was found between groups in the family's quality of life. 5. The families rated the services of day care center as most effective for the care of the patients and families, except for a few families who had experienced some improvement in the patient's conditions. The outpatient clinic users expressed psychological comforts mainly in that the patient was being taken care of. For those hospitalized patients, families expressed the comfort of being relieved of the burden of care and that the patient is being professionally cared for. Form the analysis of the costs, hours of patient care, patient's bizarre behaviors, family's quality of life and burdens, and family's evaluation of services, it is concluded that up to the mid stage of Alzheimer's condition, the utilization of day care center services is found to be the most cost-effective, and toward the end stage of the Alzheimer's disease, it is hoped that there will be a establishment of long term or short term in-patient facilities for the protection of patients and preservation of the integrity of families for less cost. Thus. it was concluded that the family centered system of care is the most effective for Korea with systematic support systems developed for the care of patients and their families according to the needs of families as the patient's condition deteriorates.
There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.
Purpose: The purpose of this study was to revise the KPCS-1 and to standardize the three patient classification systems for general ward, ICU and NICU. The actual utilization of the KPCS-1 score and each nursing activity was evaluated and the relationships between KPCS-1 score and nursing related variables were reviewed. Methods: The 47,711 KPCS-1 scores of 6,931 patients who discharged from $1^{st}$ to $30^{th}$ April 2017 were analyzed and the statistical significance between KPCS-1 score and nursing related variables was reviewed by Generalized Estimating Equation. The revision of the KPCS-1 was carried out by Partial Least Square model. The 3 patient classification systems (KPCS-1,KPCSC and KPCSN) were standardized by professional reviews. Results: KPCS-1 was a valid instrument to express nursing condition adequately and was revised as a new version which has 34 nursing activity items. The names and terminologies of pre-existing 3 patient classification systems developed by KHNA were standardized as KPCS-GW, KPCS-ICU, KPCS-NICU. Conclusion: KPCS-1 was a valid instrument to represent diverse nursing conditions precisely and was revised as a 34-item KPCS-GW. The terminologies of the other patient classification systems by KHNA were standardized as KPCS-ICU and KPCS-NICU.
Objectives: In Korea, there are many kinds of evaluations for medical institutions. However, evaluations are increasingly burdensome for medical institutions because evaluation agencies, evaluation timing, and evaluation methods are different. The purpose of this study is to improve the efficiency of evaluation for medical institutions and ultimately to provide quality medical services to patients. Methods: In this study, 2,310 indicators of 19 kinds of evaluation for medical institutions were analyzed. Results: 1,424 indicators were available for on-site surveys and 886 indicators were not available for on-site surveys. There were 4 kinds of evaluation that can be integrated in total, 12 kinds of evaluation that can be integrated partially, and 3 kinds of evaluation that need to maintain the current evaluation system. Conclusion: In order to provide patient-centered quality medical services through reduction of burden due to the evaluation for medical institutions, it is necessary to deeply discuss the efficiency of evaluation integration and result utilization.
Journal of The Korea Institute of Healthcare Architecture
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v.14
no.1
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pp.49-58
/
2008
Considering the rapid growth of elderly population and the increase of medical demand for aged, many of geriatric hospitals are needed in Korea. On the other hand, supplies of hospitals for acute care are considered to be excessive. So many of small and medium hospitals facing management problems have been converged to geriatric hospitals. These attempts are considered resonable for efficient utilization of health care resources in Korea. This paper aims to identify the concept of geriatric hospital and to analyze the problems and then to seek the alternatives for architectural planning on the basis of surveying the geriatric hospitals converged from hospitals for acute care.
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