• Title/Summary/Keyword: Public Hospital

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Ethnic Variation in Consumption of Traditional Tobacco Products and Lung Cancer Risk in Nepal

  • Raspanti, Greg A;Hashibe, Mia;Siwakoti, Bhola;Wei, Mei;Thakur, Binay Kumar;Pun, Chin Bahadur;Milrod, Charles;Adhikari, Subodh;Lee, Yuan-Chin Amy;Sapkota, Amir
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5721-5726
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    • 2015
  • Lung cancer is the leading contributor to cancer deaths in the developing world. Within countries, significant variability exists in the prevalence of lung cancer risk, yet limited information is available whether some of the observed variability is associated with differences in the consumption pattern of local tobacco products with differing potency. We recruited 606 lung cancer cases and 606 controls from the B.P. Koirala Memorial Cancer Hospital in Nepal from 2009-2012. We estimated odds ratios (ORs) and 95% confidence intervals (CI) for lung cancer risk associated with different tobacco products, using unconditional logistic regression. Unfiltered cigarettes tended to be the most frequently used products across ethnic subgroup with about 53.7% of Brahmins, 60.1% of Chettris, and 52.3% of Rai/Limbu/Magar/others. In contrast, about 39.9% of Madishe/Tharu smokers reported using bidi compared with only 27.7% who smoked unfiltered cigarettes. Among those who only smoked one type of product, choor/kankat smokers had the highest lung cancer risk (OR 10.2; 95% CI 6.2-16.6), followed by bidi smokers (OR 5.6; 95% CI 3.6-8.7), unfiltered cigarettes (OR 4.9; 95% CI 3.4-7.2), and filtered cigarettes (OR 3.4; 95% CI 2.2-5.3). A clear dose-response relationship was observed between increased frequency of smoking and lung cancer risk across all ethnic subgroups. These results highlight the important role of traditional tobacco products on lung cancer risk in the low income countries.

Current Status of Home-Based Cancer Patients Management in Jeju (제주지역에서의 호스피스.완화의료기관과 보건소의 재가암 관리 현황)

  • Huh, Jung-Sik;Kim, Hyeon-Ju
    • Journal of Hospice and Palliative Care
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    • v.13 no.2
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    • pp.76-80
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    • 2010
  • Purpose: As a part of analysis of home-based cancer patients management of public health centers, regional cancer center, and hospice institution in Jeju, this study was undertaken to establish their role. Methods: We investigated current status of hospice palliative care, especially home-based cancer patients management and summary demand of public health centers. Results: Services provided through the home-based cancer patients management project included physical, emotional, spiritual and education/informative services, even though there was little difference between them. The result showed that in the view of patients there was little relationship between public health centers, regional cancer center and hospice palliative institution. Conclusion: The relationship between home-based cancer patients management and institutions should be reinforced. Patients in acute state and difficulty care of patients should be referred to regional cancer center whereas maintenance state of patients should be referred to public health center.

Analysis on the Relating Factors of Profitability of Korean Public Corporation Medical Centers(KPCMCs) (지방공사 의료원의 수익성 관련요인 분석)

  • Moon, Jae-Woo;Park, Jae-San
    • Korea Journal of Hospital Management
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    • v.9 no.2
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    • pp.102-127
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    • 2004
  • The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

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Dimensions of Consumer Ratings of a Hospital Outpatient Service Quality (의료소비자가 인지하는 의료서비스 질의 구성 차원)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Kim, Dong-Kee;Lee, Yun-Whan;Moon, Ki-Tae
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.495-504
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    • 2000
  • Objectives : To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. Methods : A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer's ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. Results : The 5 dimensions were as follows, 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. Conclusions : The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.

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Presence of Thrombectomy-capable Stroke Centers Within Hospital Service Areas Explains Regional Variation in the Case Fatality Rate of Acute Ischemic Stroke in Korea

  • Park, Eun Hye;Gil, Yong Jin;Kim, Chanki;Kim, Beom Joon;Hwang, Seung-sik
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.6
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    • pp.385-394
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    • 2021
  • Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs). Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression. Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS. Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

A Survey of Medical Environments in Regional Public Hospitals Respond to Disasters (지역거점공공병원의 재난 대비 안전한 의료환경 실태조사 연구)

  • Lee, Hyunjin;Song, Sanghoon;Kim, Taeyun;Kim, Youngaee
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.30 no.2
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    • pp.35-46
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    • 2024
  • Purpose: It is the responsibility of public healthcare to respond quickly to infectious disease outbreaks and disasters such as MERS, COVID-19, the Syrian earthquake, and the Miryang Sejong Hospital fire accident. It is very important to secure safe medical facilities and protect lives through emergency medical support and disaster response systems. The purpose of this study is to investigate the safety status of regional medical facilities that play a central role in the event of a disaster. Methods: The target was 41 local public hospitals, including 35 regional medical centers and 6 Red Cross hospitals nationwide. We delivered a questionnaire to 41 medical facilities and collected data from 32 regional public hospitals that received responses. Results: In order to respond to safety accidents, a survey was conducted on infections, falls, patient identification, and incorrect connections for medical accidents, and for in-hospital accidents, a survey was conducted on entrapment, collision, water leaks, falling objects, and crime prevention. For natural disasters, we investigated the response environment for typhoons, floods, and snow damage, and for social disasters, we investigated the response environment for fire, power outages, and radiation damage. Implications: We hope that it will be used as basic data for developing standards and creating hospital facilities and environments that are safe for everyone to respond to various disasters and prevent patient safety accidents in the future.

Efficiency of Public Hospitals and Their Social Role (공공병원의 效率性과 사회적 역할)

  • 정형선;이기호
    • Health Policy and Management
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    • v.6 no.2
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    • pp.1-13
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    • 1996
  • To evalate the efficiency of public and private hospitals, the author used Data Envelopment Analysis(DEA), a mathematical linear programming method calculating the of ficiency of a unity(DMU: Decision Making Unit) in relation to the other units in analysis. DEA was applied to thirty three (10 public and 23 private) general hospitals wiwith 160 to 299 beds. In respect to productivity, public hospitals appeared to be a little more efficient than private ones, even though it's statisticansignificant. However, the efficiency score for profitability conversed that these contrary results were due to the caring of more medical protection patients in public hospitals, who brought less revenlue to te hospital than other patients. Public hospitals' superiority to private counterparts in productivity, which are aguged mainly based on cared patients, suggests that the former contributes so much positively to social utility. In particular, the fact that public hospitals are caring more medical protection patients, namely the poverty group whom the society should bear a burden of by all means, seems to be desirable in respect of role of publi hospitals.

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Life-Sustaining Treatment Choices and Related Factors Involving Hospital Nurses (간호사 자신과 간호사 가족의 연명의료 결정과 관련요인)

  • Choi, Yoo Nam;Song, Yeoungsuk
    • Journal of Korean Public Health Nursing
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    • v.32 no.2
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    • pp.167-180
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    • 2018
  • Purpose: The aim of this study was to identify the life-sustaining treatment choices and related factors among general hospital nurses. Data were collected from June 16 to June 29, 2015. The participants were 244 nurses from five general hospitals in D city. Methods: The data were analyzed using the SPSS 18.0 program, descriptive statistics, paired t-test and one-way ANOVA. Results: Significant differences were observed in the level of life-sustaining treatment choices for nurses to themselves and to their families except for pain control. More nurses declined life-sustaining treatment choices, but suggested their families receive it. The related factors of special life-sustaining treatment choices for nurses themselves and their families according to their general characteristics were age, marital status, education and religion. Conclusion: This study suggests that the related factors need to be considered in the education of nurses' or public health providers' Life-sustaining treatment choices.

Impact of District Medical Insurance Plan on Number of Hospital Patients: Using Box-Jenkins Time Series Analysis (Box-Jenkins 시계열 분석을 이용한 지역의료보험 실시가 병원 환자 수에 미친 영향)

  • Kim, Yong-Jun;Chun, Ki-Hong
    • Journal of Preventive Medicine and Public Health
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    • v.22 no.2 s.26
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    • pp.189-196
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    • 1989
  • In January 1988, district medical insurance plan was executed on a national scale in Korea. We conducted an evaluation of the impact of execution of district medical insurance plan on number of hospital patients: number of outpatients; and occupancy rate. This study was carried out by Box-Jenkins time series analysis. We tested the statistical significance with intervention component added to ARIMA model. Results of our time series analysis showed that district medical insurance plan had a significant effect on the number of outpatients and occupancy rate. Due to this plan the number of outpatients had increased by 925 patients every month which is equivalent to 8.3 percents of average monthly insurance outpatients in 1987, and occupancy rate had also increased by 0.12 which is equivalent to 16 percents of that in 1987.

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A Simulation Model of a Outpatient Scheduling System (외래환자의 예약제도 개선을 위한 시뮬레이션 모형)

  • Chun, Ki-Hong;Chae, Young-Moon
    • Journal of Preventive Medicine and Public Health
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    • v.19 no.1 s.19
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    • pp.56-64
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    • 1986
  • This paper describes a GPSS-based, multi-server queueing model that was developed to simulate the patient flow, and to analyze the effectiveness of the patient scheduling system under various conditions. Unpredictable and unacceptably long waits to receive the service at the outpatient department of a general hospital necessitated the study. Arrival and service time distribution needed for the simulation model were generated from actual arrival and service patterns observed during the peak hours. The simulation results show that a change in patient scheduling system (i.e. time interval between appointments, starting time. and the number of physicians) from a current system would significantly reduce the patient wait time. This study provides the hospital administrator with an analysis of patient scheduling system under several conditions, and will be used to plan future scheduling system and staffing. Studies such as this can demonstrate the value of simulation in providing information for use in future planning.

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