• 한국보건간호학회지
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• 제6권1호
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• pp.15-24
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• 1992

This study was conducted to follow the patient referral system operated from the primary health care facilities to the hospital in a rural area of Korea. The subject for this study was sampled from a community health development project carried out by the Korea University in Yeoju Kun, Kyonggi Province. The data of referred patients from primary health care facilities were collected during the period from January 1989 to December 1989. The data was sorted out by a computer system using Database package. The results of this study were summarized as follows: 1. Characteristics of the referred patients were: males $32.0\%$. and females $68.0\%$. The more elderly of the patients visited to the hospital after having been referred there by CHPs or public physicians, $25.9\%$ has been to hospital on at least one previous occasion as against $74.1\%$ for whom it was there first visit. 2. The majority of patients who were referred to a hospital where: medicine $44.3\%$ and orthopedics$16.4\%$, major diseases were : diseases of digestive system $(21.3\%)$ ; symptoms and ill defined conditions $(17.3\%)$ ; diseases of the muscular skeletal system and connective tissue$(14.2\%)$. chronic illness was $82.0\%$ and acute illlness was $18.0\%$. 3. From Community health practitioners more patients referred than the public physicians. Categoris of diseases of the referred patients were different between community health practitioners and public physicians. Due to the. respective differences between the medical restrictions put on the nursing staffs at the community health practitioners and public physicians. From this study it was recommended to define the reason of differences between ~he two groups in futher study. Study as to 1) why one group should be referring more for hospital treatment than the other. And 2) why the two agencies should be referring different diseases.

• 대한핵의학회지
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• 제23권2호
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• pp.189-193
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• 1989

To observe the effect of gastric filling on the images of hepatic scintigraphy, we performed hepatic scintigraphy using $^{99m}Tc-tin$ colloid in twenty patients both in the fasting state and after meal, and made the visual comparison of both images. We found that gastric filling could cause some of the following changes in individual patients. 1) In the anterior view, the distance between the liver and the spleen increased and the interlobar notch of the inferior hepatic border was obliterated. The spleen was displaced downwards, its radioactivity in the upper medial part was reduced, and its upper pole was laterally displaced. 2) In the posterior view, the left lobe of the liver was separated from the spleen and the distance between the liver and the spleen increased. 3) In the right lateral view, the notch separating the right and the left lobes of the liver was well demarcated. 4) In the left lateral view, the spleen was separated from the liver and the distance between the liver and the spleen increased. The shape of the spleen was also changed. In case of the follow-up study, above changes should make one consider the possibility of the effect of gastric filling.

• 한국콘텐츠학회:학술대회논문집
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• 한국콘텐츠학회 2008년도 춘계 종합학술대회 논문집
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• pp.352-355
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• 2008

국립대병원은 국가가 설립주체이고 엄연한 공공의료기관임에도 불구하고, 국가가 직접 운영하던 방식에서 특수법인 형태의 독립채산제로 전환되면서 사립대병원과 차이가 없이 수익성에 치중하여 운영되고 있는 실정이다. 국립대병원이 설립법에 명기된 교육, 연구, 진료 외에도 지역내에서 선도병원으로서의 3차진료기관에 합당한 공공성의 책무를 다하여야 한다고 본다. 따라서, 현재 수익성에 치중하고 있는 국립대병원에 어떠한 공공성 기능을 부여하여야 할것이가. 그리고, 지역사회내에서 다른 공공의료기관과는 어떻게 역할분담을 하여야 할것인가. 또한 국립대병원내에서 공공성과 수익성의 조화로운 강화방안은 어떻게 하여야 하는지를 다각도로 분석하여 상관관계를 살펴보고 방안을 제시하고자 한다.

• Journal of Preventive Medicine and Public Health
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• 제29권1호
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• pp.51-65
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• 1996

The purpose of this study was to examine the trends of length of hospital stay (LOS), which is most likely to be a major attribute to hospital performance. From 1984 to 1994, an average LOS of each hospital was analyzed by factors such as medical departments, bed size, occupancy rate, region and ownership. This study was analyzed changing rate of LOS during 11 years. This rate was calculated by simple regression, which was used only with hospital without missing data during 11 years. This study findings are as follows. 1. The results indicated that the average LOS was steadily increased until 1990 but it was slightly decreased after 1990. 2. This trend could be found in all hospital scale and all group of occupancy rate. Specifically this trends of LOS were found in internal medicine, corporate owned hospitals, and hospitals in major city. But LOS of individual owned hospital was continuously increased until 1994. 3. Means of changing rates of LOS were calculated from 1984 to 1994. If we devided it into two parts, before 1990 and after 1990, most changing rates of LOS before 1990 except individual owned hospital were found positive sign. The changing rates after 1990 were negative sign but small hospital(lesser then 200 bed), individual owned hospital, national & public hospital and hospital in small urban have little change of LOS after 1990. Finally from this results we thought that most hospitals in Korea began to be concerned with LOS. Nevertheless LOS of several hospital such as small hospital or individual owned hospital was increased. And this trend may be caused by a few patients, low occupancy rate, or low profit. This trend of LOS is different from that of other countries. Perhaps this phenomenon is resulted from the reimbursement method. Because of fee for service reimbursement system in Korea the hospitals didn't need to shorten LOS in order to save the cost and increase the profit. Therefore reform of hospital cost reimbursement method will be needed to reduce hospital cost in Korea. We thought that the Korean health authority should consider the reimbursement method by unit of bundle of services, for example DRG and prepayment in the United States. This study presents some limitations such as no insight of severity of disease, case-mix measurement of hospital, and other clinical characteristics that can. possibly affect LOS. However, this study reports an important trend in LOS from 1984 to 1994.

• 한국환경보건학회:학술대회논문집
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• 한국환경보건학회 2003년도 Challenges and Achievements in Environmental Health
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• pp.150-151
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• 2003

• 보건행정학회지
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• 제34권2호
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• pp.211-221
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• 2024

연구배경: 코로나바이러스감염증-19로 인한 공중보건 위기는 공공병원의 확충 및 강화의 필요성을 강조하지만, 공공병원에 대한 전반적인 인식은 여전히 부정적인 것으로 나타났다. 공공병원에 대한 부정적 인식은 공공병원의 역할과 기능 수행에 어려움을 초래할 수 있어 이 연구에서는 공공병원에 대한 부정적 인식에 영향을 미치는 요인을 분석하고자 한다. 방법: 이 연구는 충청북도공공보건의료지원단에서 수행한 충청북도 도민의 공공보건의료 인식에 대한 실태조사 자료를 활용하였다. 연구에는 조사에 응답한 만 19세 이상 성인 1,916명이 포함되었으며, 공공병원 이용 경험과 공공의료 및 공공병원 정책 평가가 공공병원의 부정적 인식에 미치는 영향을 분석하기 위해 로지스틱 회귀분석을 활용하였다. 결과: 공공병원 미이용 경험(adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74)과 공공의료 및 공공병원 정책에 대한 부정적인 평가는 공공병원의 부정적 인식에 유의한 영향을 미치는 것으로 나타났다. 구체적으로, 공공의료 정책에서 필수의료 제공이 부족하다고 느낀 경우(aOR, 4.14; 95% CI, 2.59-6.62), 지역 간 격차가 크다고 느낀 경우(aOR, 1.59; 95% CI, 1.02-2.49), 보장성(aOR, 1.99; 95% CI, 1.25-3.16)과 의료의 질(aOR, 2.39; 95% CI, 1.50-3.80)이 낮다고 평가한 경우 공공병원에 대한 부정적 인식이 증가하였으며, 공공병원 정책에서는 시설·장비가 열악하다고 느낀 경우(aOR, 3.74; 95% CI, 2.36-5.94), 진료과목 및 서비스가 부족하다고 느낀 경우(aOR, 1.91; 95% CI, 1.21-3.01), 진료수준이 낮다고 평가한 경우(aOR, 2.71; 95% CI, 1.72-4.25) 공공병원에 대한 부정적 인식이 증가하는 것으로 나타났다. 결론: 이 연구는 공공병원 이용 경험과 공공의료 및 공공병원 정책 평가를 고려한 공공병원 인식 제고의 필요성을 강조한다.

• 한국병원경영학회지
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• 제24권2호
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• pp.67-83
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• 2019

The aim of this study is to analyze the differences in the publicness indices depending on the environmental factors of regional public hospitals to derive the policy implications for improving management for regional public hospitals. The data of the 34 regional public hospitals from 2016 was used for the analysis. Major results of this study are as follows. First, the analysis of the differences in the scores of the medical safety net function showed significantly higher scores for regional public hospitals with a larger location, a larger number of hospitals in a unit area, a larger number of nurses per 100 beds, and the lower management fee ratio. Second, the analysis of the differences in the scores of the unmet healthcare needs showed significantly higher scores for regional public hospitals with a larger number of hospitals in a unit area, and a larger number of beds. Third, the analysis of the differences in the scores of the hospital-specialized services showed significantly higher scores for regional public hospitals with a larger location, a higher financial independence of the local government, a larger number of hospitals in a unit area, a larger number of beds, and a larger number of nurses per 100 beds. Major conclusions of this study are as follows. Consideration should be given to the appropriate number of nurses for each regional public hospital to maximize publicness by providing the appropriate amount of medical services, but not to incur unnecessary labor costs. In addition, efforts should be made to enhance profitability, which can be a means of strengthening publicness, by identifying the minimum administrative expenses required for efficient operation and reducing unnecessary administrative expenses. Finally, it is necessary to identify the appropriate number of beds to meet the needs of the customers and to create maximum profits.

• 문화기술의 융합
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• 제8권5호
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• pp.619-629
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• 2022

본 연구의 목적은 공공병원 간호사의 공공서비스동기, 병원조직문화유형, 직업존중감과 이직의도 간의 관계를 알아보기 위함이다. 본 연구는 경기도의 4개 공공병원(이천, 안성, 수원, 파주) 간호사 124명을 대상으로 횡단적 단면연구를 실시하였다. 자료분석은 기술 통계, t-검정, ANOVA 및 Pearson 상관 계수를 사용하여 분석하였으며, 데이터가 정규분포를 하지 않는 경우에는 Mann-Whitney U 검정 및 Kruskal-Wallis 검정, Bonferroni 사후검정으로 분석하였다. 대상자의 이직의도는 공공봉사동기(r=-.30, p<.001), 친화적 조직문화(r=-.28, p=.002), 진취적 조직문화(r=-.34, p<.001), 과업적 조직문화(r=-.30, p=.001)와 음의 상관관계가 있는 것으로 나타났다. 본 연구결과를 통해 공공병원 간호사의 이직 의도를 줄이기 위해서는 공공봉사동기를 향상시키는 것이 필요함을 시사한다.

• 한국병원경영학회지
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• 제12권2호
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• pp.43-68
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• 2007

The administration of a regional public hospitals are expending from profit preference to publicity preference. The weight rate for a profitability and publicity of performance assessment has changed from 84:16 which was resulted by the assessment executed firstly in 1989 to 39:61 as resulted in 2004, the final assessment execution in 2005. Regional public hospitals are exerting and promoting a magnification in public sector to raise up the public-score. With comparison between publicity scores and profitability scores in original scores basis excluding weight rate, the publicity scores ranked higher than profitability scores although the latter was higher by 2002. However, for the administration performance of the regional public hospitals, the deficits increased 11 times from \92.6billion deficits with \460.3billion cost increased by 457% although income as \367.7billion increased by 394% comparing the last 2004 year to the first 1989 year for profit & loss statement of a regional public hospitals. There was analysis for the relation in yearly basis partitioning publicity and profitability for the assessment scores of the to regional public hospitals confirm the accumulated deficits of the hospitals like this attribute to the extension of public sector. The result showed that there was distinct plus relationship from 1999 although a minus relationship in general until 1997 except 1992 and there is a more plus relationship as approaching 2004. That is, it is hard to tell that the accumulated deficits increase of regional government medical center attributed to extension of public sector. On the contrary, the analysis showed the extension of public sector has a mutual relationship with uplift of profitability Meanwhile, it showed that operation cost rate and labor cost are the factors which influence a revenue & expenditure rate among the profitability index according to the results of relation analysis for the representative index of profitability and that of publicity.

• Asian Pacific Journal of Cancer Prevention
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• 제13권5호
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• pp.1917-1921
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• 2012

Background: Colorectal cancer is one of the leading causes of mortality worldwide. Genome wide analysis studies have identified sequence mutations causing loss-of-function that are associated with disease occurrence and severity. Epigenetic modifications, such DNA methylation, have also been implicated in many cancers but have yet to be examined in the East Asian population of colorectal cancer patients. Methods: Biopsies of tumors and matched non-cancerous tissue types were obtained and genomic DNA was isolated and subjected to the bisulphite conversion method for comparative DNA methylation analysis on the Illumina Infinium HumanMethylation27 BeadChip. Results: Totals of 258 and 74 genes were found to be hyper- and hypo-methylated as compared to the individual's matched control tissue. Interestingly, three genes that exhibited hypermethylation in their promoter regions, CMTM2, ECRG4, and SH3GL3, were shown to be significantly associated with colorectal cancer in previous studies. Using heatmap cluster analysis, eight hypermethylated and 10 hypomethylated genes were identified as significantly differentially methylated genes in the tumour tissues. Conclusions: Genome-wide methylation profiling facilitates rapid and simultaneous analysis of cancerous cells which may help to identify methylation markers with high sensitivity and specificity for diagnosis and prognosis. Our results show the promise of the microarray technology in identification of potential methylation biomarkers for colorectal cancers.