Purpose: The purpose of the study is to suggest the main functions and implications of public hospitals to effectively respond to the future epidemic crisis based on analyzing the accessibility to designated Coronavirus Disease 2019 (COVID-19) medical institutions of Seoul and examining the main features of the quarantine of Seoul municipal hospitals. Method: To analyze the response and function of Seoul municipal hospitals, we reviewed the Infectious Disease Control and Prevention ACT, 258 articles of Seoul Metropolitan Government press releases from January to the end of April, 48 articles of Seoul Metropolitan Government's daily newsletters, 2019 Health Bureau Budget report. We also referred to internal data of Seoul Children's Hospital, Seoul Seobuk Hospital, and Seoul Eunpyeong Hospital during the same period. Besides, the accessibility to medical institutions was analyzed by using the COVID-19 data which was announced daily basis. Results: The accessibility of COVID-19 patients living in the Southeastern part of Seoul to a medical institutions was 16.2km on a distance basis, and it was the lowest accessibility among four regions of Seoul since it took about 40 minutes by car. On the other hand, patients living in the Northeast part had the highest accessibility, as the access to medical institutions was 10.7km and 27 minutes by car. Also, the main functions of the municipal hospital of Seoul against COVID-19 were to shift the public hospital function to COVID-19 patients only hospitals, to perform the epidemiological investigation by medical doctors, and to support the operation of self-isolation facilities, community treatment centers and triage rooms of community health centers. Conclusion: Through the experience of COVID-19, we suggested that the functions of public hospitals will be reorganized as the reinforcement of infectious disease treatment and mental health for quarantined patients, cooperation with private hospitals, supporting for strengthening community health capacity and preparation for another epidemic.
Purpose: Since hospitals have a big impact on the natural and social environment, hospitals' sustainability must be considered in various aspects including environmental, social, and economical aspects. So far, research on sustainable hospitals has mainly been conducted on indoor environment, but outdoor space of hospital is as important as well. The purpose of this research is to study the sustainability of hospital outdoor space and to make proposals for improving sustainable regional public hospitals. Methods: Through preceding research analysis and literature review, the concept of sustainable outdoor space of hospital was defined. Also, the evaluation contents of outdoor space were extracted from domestic and foreign green building certification criteria. With this analytic frame, we visited 4 regional public hospitals in Korea, interviewed the facility managers, and analyzed sustainability of hospital outdoor space. Results: Analysis of 4 regional public hospitals reveals that there is a lack of consideration for sustainability in all 4 categories; urban and network, natural environment, community, and user. In terms of community, sustainability has rarely been applied to all four hospitals. The site selection and terrain of the site were essential to sustainability. Implications: Establishing a master plan considering future expansion is critical. Also more attempt to show regional characteristics is needed. It is necessary to design a comprehensive outdoor space that considers sustainability and also healing environment. Level difference in the site can be used as a design element.
Purpose: The number of severely ill patients requiring post-acute care has been increasing. Careful discharge planning minimizes unplanned emergency room visits and readmissions. This study aimed to survey the knowledge, experience, confidence, and obstacles faced by medical residents and fellows regarding the discharge process of severely ill patients. Methods: A survey consisting of 27 questions was sent electronically to residents and fellows who had experience in discharging severely ill patients from a tertiary hospital in Korea. The survey was conducted over a two-week period from September 29, 2022. Results: A total of 98 residents and fellows responded to the survey. Of these, 94% experienced difficulties related to the discharge process. The main obstacle was changes in the patient's condition during discharge planning (92.3%). Although 95% of the respondents acknowledged the need for providing discharge information, only 53.1% of the residents and fellows practiced this. Only 42.9% of the respondents and 20.4% of residents and fellows explained local community healthcare and welfare resources to patients because of a lack of relevant knowledge (69.7%) and feeling no responsibility to explain (40.4%). Conclusion: This study revealed that residents and fellows experienced difficulties in devising discharge plans and providing post-acute care related information, despite recognizing the importance of these. These gaps result from the lack of a discharge planning curriculum regarding critically ill patients and appropriate training in the discharge process. This suggests that an integrated discharge planning curriculum should be developed and adopted in residents' training programs for the differentiated treatment of critically ill patients.
Purpose: The purpose of this study is to seek in-depth perspectives of stakeholders on the necessity and specific criteria for designating a specialized hospital for urologic diseases. Methods: Eight participants experts in urology medicine and specialized hospital system were divided into four groups. Following the semi-structured guidelines, an in-depth interview was conducted twice and a focus group discussion was conducted three times. All the interviews were transcribed verbatim and analyzed. Results: The majority of participants predicted that there would be demand for specialized hospitals for urologic diseases. The criteria of designating a specialized hospital, such as the number of hospital beds and quality of health care, have to be modified in consideration of the specificity of urology. The introduction of a specialized hospital would improve the healthcare delivery system, positively affecting hospitals and patients. Furthermore, government support is essential for the maintenance of specialized hospital systems as urology hospitals experience difficulties in generating profits. Conclusion: This study is expected to be used as base data for introducing and operating a specialized hospital for urologic diseases. In addition, it is expected that the methodology and results of this study would encourage follow-up studies on specialized hospitals and provide guidelines to evaluate the effectiveness of such hospitals in other medical fields.
Purpose: The purpose of this study was to compare the costs and benefits of home nursing care services between public health centers (PHC) and private hospitals. Method: Participants were 105 patients who had received home nursing care services from a private hospital or public health center. From a societal perspective, the researcher identified the costs and benefits of the services using performance data and calculated the net benefit and benefit/cost ratio. Result: The net benefit of the home nursing care service based in the PHC was 165.9 million won and benefit/cost ratio was 2.0, while the net benefit of the home nursing care services by the private hospital was 141.1 million won and benefit/cost ratio was 1.7. Both types of programs were economically validated. Conclusion: Home nursing care services were basically efficient as the results showed a positive net benefit. A cost-benefit analysis indicated that the PHC-based home nursing care services were more efficient than that of the private hospital. With limited human resources and management standards in public health centers, results suggest the need for a more systematic management of the home nursing care service to improve the health of this vulnerable community population.
The purpose of this study is identify the status of the ward of public hospital for integrated nursing care service. Integrated nursing care service has been expanding on a national scale from 2016 but most of public hospitals are currently unable to operate due to nursing shortage. In this study 8 wards of public hospital have been chosen and analyzed. The measure of space program and area distribution(patient area percentage, staff area percentage, circulation area percentage), nurses's walking distance(distance from ns to patient room, distance from ns to core) were calculated by depthmapX and autocad programs. The result of this study is as follows. Nurse's walking distance is more than 24m so the efficiency of nurse's patient care is reduced. The percentage of patient area in double-corridor is higher and the patient feels more comfortable but the Nurse's walking distance is longer and the accessibility is lowered. NS should be located in the center of the ward and close to the core but some wards are not composed of proper space-separation and flow of human trrafic is overlapped. This study may serve as basic research for the architectural plan for future integrated nursing care ward.
Purpose: The characteristics of site plan and space configuration of public dentistry through examining the public dental healthcare centers for the disabled in Korea and comparison between them are necessary for the development of planning of the dental healthcare system. This study has been started to provide basic informations such as nationwide distribution, site relationship, and space configuration for the planning of public dental hospital architecture. Methods: Literature review of publicness and public dental healthcare and investigation on current status of public dental healthcare center for the disabled in Korea have been conducted. The site plan and space configuration of eight public healthcare centers for the disabled have been analyzed. Results: The result of this study can be summarized in three points. The first one is that public dentistry in Korea are distributed public dental hospital for the disabled in Seoul and public dental healthcare centers for the disabled in eight provinces. The second one is that the types of the dental healthcare center for the disabled are divided with remodeling type which is diverted from existed dental or medical out patient clinic space or independent building type which is planned with a new and exclusive usage for the disabled. The third one is that the space configuration of dental healthcare center for the disabled is needed more required programs, larger treatment unit space, and more private clinic space than typical dental treatment plan. Implications: This study is the starting point for the research of public dentistry and it is necessary to analyze the dental prevention and dental public policy to develop the public dental healthcare system.
The mandible plays a crucial role in the vital human functions of breathing, eating, and speaking. No other bone in the body has such a distinctive shape and function. Because of its prominence in the facial structure, the mandible is highly prone to fracture. A clinical study on 122 patients with mandibular fracture who visited Kangnam General Hospital during 4 year(1992-1995) was done by analysing sex, age, cause, fracture site, teeth involvement, treatment method, complication and involvement of other body part. The results obtained were as follows : 1. The occurrence was more frequent in male than in female with the ratio of 5.4 : 1 and most frequently in twenties. 2. Violence was the most common cause of facial mandibular fracture. 3. In mandibular fracure, fracture site was average 1.5 sites, most frequently in symphysis and simple fracture was 86.1%. 4. As treatment methods, open reduction(78.6%) was used more frequently than closed reduction(21.4%). 5. Post-operational complication occurred in 27.0% of the cases. 6. Other injuries that were related to maxillofacial fracture occurred in 25.4%.
This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).
In recent years, many of medical institution have reinforced educations for their employees aiming to secure competitiveness and to achieve higher performances. In an effort to actively response to the fast changing environment in the medical industry, the Ministry of Health and Welfare has implemented "Innovation and Service promotion" educations for employees of 34 regional medical institutions and 6 Red Cross hospitals. In this regards, the effect of the educations to change employees' mind for innovation and services and its results need to be evaluated. This study conducted surveys asking participants of the 2006 Education for Innovation of Regional Public Hospital Employees and Service Promotion and synthetically analyzes the effect of the education on their mind for services compare to their mind before the education. As a result, more them 92% of participants say that they are satisfied with the education, and many more participants agreed the effect of the education to change their mind for services. Under this circumstance, after the educations participants change more positively on "their mind for innovative services" and "their service skills in practice".
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