• Asian Pacific Journal of Cancer Prevention
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• 제16권18호
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• pp.8079-8083
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• 2016

Metformin is an oral anti-hyperglycemic agent, which is the most commonly prescribed medication in the treatment of type-2 diabetes mellitus. It is purportedly associated with a reduced risk for various cancers, mainly exerting anti-proliferation effects on various human cancer cell types, such as pancreas, prostate, breast, stomach and liver. This mini-review highlights the risk and benefit of metformin used for cholangiocarcinoma (CCA) prevention and therapy. The results indicated metformin might be a quite promising strategy CCA prevention and treatment, one mechanism being inhibition of CCA tumor growth by cell cycle arrest in both in vitro and in vivo. The AMPK/mTORC1 pathway in intrahepatic CCA cells is targeted by metformin. Furthermore, metformin inhibited CCA tumor growth via the regulation of Drosha-mediated expression of multiple carcinogenic miRNAs. The use of metformin seems to be safe in patients with cirrhosis, and provides a survival benefit. Once hepatic malignancies are already established, metformin does not offer any therapeutic potential. Clinical trials and epidemiological studies of the benefit of metformin use for CCA should be conducted. To date, whether metformin as a prospective chemotherapeutic for CCA is still questionable and waits further atttention.

• 한국병원경영학회지
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• 제1권1호
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• pp.136-153
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• 1996

The purpose of this study is to identify the factors hindering hospital reengineering project in one university hospital. The data was collected by the self-administered Questionnaire to 288 members of the hospital in Pusan on April 5-18, 1996. This study took some statistical methodologies, such as descriptive analysis, factor analysis and logit model analysis. The results were as follows; First, in the descriptive analysis for whether the hospital reengineering named RUSH94 was a success or not, the subjects judged that it was not successful and regarded their fable mutual communication as the main factor. Second, in the reason of failure at the reengineering project, the group who thought that the failure factor was the lack of mutual consensus checked the scores of the first factor produced from the factor analysis.

• 보건행정학회지
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• 제22권3호
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• pp.365-382
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• 2012

Background : Public hospitals suffer worsening shortage of physicians and face great pressure of recruiting doctors. This study is aim to identify the factors associated with retention of physicians who are working in public hospitals. Methods : We conducted a cross-sectional and self-administered questionnaire survey in July, 2011. A total of 333 physicians responded from the 31 public hospitals. We analyzed the difference of job retention across the variables among doctors stratified as salaried and public health doctors. We used chi-square test and multiple logistic regression analysis. Results : To the salaried doctor, longer work period(OR=2.04 in 3rd quartile), professional autonomy(OR=2.69), and positive attitude toward public health(OR=2.39) affect to the higher job retention whereas complain of low income(OR=0.33) and complain of poor clinical environment(OR=0.26) affects to the lower job retention. To the public health doctors, community connections such as hometown(OR=6.27), spouse factors(OR=3.49), and positive attitude toward public health(OR=3.19) affect to the higher job retention. But longer work period(OR=0.17 in 3rd quartile) affects to the lower job retention. Conclusions : Associated factors of job retention vary across physician's status. Professional autonomy has major impact on the job retention to the salaried doctor. And familial factors as well as community relationship have greatest impact to the public health doctor. Positive attitude toward public health is associated with the higher job retention to the both of salaried and public health doctors.

• Industrial Engineering and Management Systems
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• 제11권2호
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• pp.202-214
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• 2012

This paper discusses the problem of determining locations for public health-care facilities and allocating patients to the public facilities with the objective of minimizing the total construction cost. The public health-care facilities have two types of facilities: public hospitals and health centers. The public hospital provides both hospital services and homecare services, while the health center provides only homecare service. We present an integer programming formulation for the problem, and develop two types of heuristics, based on priority rules and approximate mathematical formulation. Results of a series of computational experiments on a number of problem instances show that the algorithms give good solutions in a reasonable computation time.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.399-407
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• 2001

Objectives : To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. Methods : We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. Results : 100 of 125 hospitals responding (84.8%) had mere than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. Conclusion . Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.

• 대한이식학회지
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• 제31권4호
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• pp.193-199
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• 2017

Background: Although there more than 1,000 liver transplantations (LTs) are performed in Korea annually, their immense cost remains a great hurdle. Hence, in an attempt to reduce the medical costs of LT, a program was initiated at a public hospital affiliated with the Seoul National University Hospital. Methods: A total of 11 LTs have been successfully executed since the first LT performed at Seoul Metropolitan Government Seoul National University Boramae Medical Center in July 2011 through December 2014. Results: Nine patients (81.8%) were male and two (18.2%) were female. The mean age of patients was 53.4±11.4 years. Hepatitis B virus-related liver disease (n=6, 54.5%) was the most common causative disease, followed by alcoholic liver disease (ALD) (n=4, 36.4%). The actuarial 3-year survival rate was 90.9%. The median total medical cost of LTs was US $41,583 (calculated from operation to discharge), but only $11,860 was actually charged for patients with health insurance coverage. One female patient who had undergone deceased donor LT for alcoholic liver cirrhosis died during follow-up. This patient was non-compliant with the medical instructions after discharge, and finally expired due to septic shock at 10 months post-LT. Conclusions: In the public hospital, LT was successfully performed at a much lower cost. However, LT guidelines and peritransplant management protocols for patients with ALD must be established before escalating LT at public hospitals since ALD with poor compliance is one of the most common causes of complications at public hospitals.

• 동서간호학연구지
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• 제30권1호
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• pp.42-50
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• 2024

Purpose: This study aimed to investigate the influence of public hospital nurses' psychological capital and nursing work environment on job embeddedness. Methods: A descriptive cross-sectional survey was conducted from October 21 to 31, 2022. A total of 200 participants working at a public hospital in Gyeonggi-do were recruited. Data collection was conducted using questionnaires. Data were analyzed using t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical regression analysis. Results: The mean scores of psychological capital and nursing work environment were 3.32±0.60 out of 5 and 2.43±0.48 out of 4, respectively. The mean score for Job embeddedness was 3.14±0.72 out of 5. Psychological capital showed a significant positive correlation with nursing work environment and job embeddeness, and nursing work environment also showed a significant positive correlation with job embeddedness. The factors affecting job embeddeness of public hospital nurses were positive psychological capital, nursing work environment, and age. Conclusions: The results of this study suggest that in order to increase job embeddedness, it is necessary to develop education and programs that can strengthen positive psychological capital of public hospital nurses. In addition, the nursing work environment must be improved by providing appropriate manpower and resources.

• Journal of Preventive Medicine and Public Health
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• 제22권2호
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• pp.259-267
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• 1989

The objective of this study was to analyze the influence of the hospital and insurer in causing delayed reimbursement of medical insurance benefits. We analyzed major variables at three different sized hospitals to examine the effect of the hospital and insurer using the two-way ANOVA method. The results were as follows: 1. The time interval between claim by hospitals and payment of the benefit was statistically different according to hospital in both admission and outpatient care. 2. The time needed by the insurer for investigating the claims was statistically different according to hospital and insurer in both admission and outpatient care. There was interaction between the hospital and insurer factors in outpatient care. 3. Although there was interaction between the hospital and insurer factors in admission care, the time interval between claim and payment was statistically different. In outpatient care, the payment interval between claim and payment was also statistically different according to the hospital and insurer.

• Journal of Preventive Medicine and Public Health
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• 제29권4호
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• pp.815-829
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• 1996

A physician survey was done by mailing for the purpose of performing hospital services evaluation and ranking. A slightly over one thousand samples were drawn from the list of professional societies, and 324 physicians(about 32 percent) replied. This study has focused on developing easy and simple method to evaluate hospital services, and providing patients with useful information. Hospital service structure and process were evaluated without outcome evaluation, because it is difficult to obtain reliable data regarding health services outcome indicators. Clinical specialty was targeted to evaluate, and three specialties were chosen, that is obstetrics & gynecology, cardiology, and proctology. Among 16 structural indicators, four indicators were finally chosen in each specialty by respondent specialists. And then using these indicators, structural score was calculated for study hospitals. For process evaluation, physicians were requested to nominate five most famous hospitals. The nomination score and structural score were summed up to produce final score and hospital ranking. This method is very easy to conduct rather than other hospital services evaluation methods prevailing in Korea. And it is more useful for patients to choose hospitals, according to his/her own purpose, because it gives high ranking hospitals with specific clinical specialty.

• 한국보건간호학회지
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• 제15권2호
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• pp.376-386
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• 2001

I. Background The problem of discharging patients from hospital have been well documented in the literature over the last 20 years. They included poor communication between hospital and community, inadequate notice of discharge, over-reliance on informal support and lack of statutory support, inattention to patients needs before leaving hospital, and wasted or duplicated visits by community nurses. Most patients discharged from hospital are able to return home with little or no support, while others will require a 'package of care' to support them back to good health. Patient with complex care needs, including the frail elderly and those with mental health problems, may require continuing care in special housing, residential, or nursing homes. With this population,effective discharge arrangement is needed and the study on this problem is urgent in Korea because the Medical Reform Project is on suspension of success. II. Results of the Study: 1. Discharge service needs assessed on 360 elderly patients who were hospitalized during the survey period at four university hospitals. Patients want to know the information on disease management after discharge. Follow-up telephone service is the most frequently checked service. 2. Multidisciplinary Discharge Planning is recommended at the hospital level to reduce the readmission and decrease the length of stay. 3. Further research is needed to validate and test the assumption of the solution which is developed in this research.