• Title/Summary/Keyword: Quality Program

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Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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A Study on the Image Quality According to the Change of Flip Angle in Flow-Related Enhancement Magnetic Resonance Angiography (유속증강 자기공명혈관조영술에서 숙임각 변화에 따른 영상의 질 연구)

  • Goo, Eun-Hoe
    • Journal of the Korean Society of Radiology
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    • v.12 no.2
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    • pp.201-208
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    • 2018
  • The purpose of this study was to investigate the optimal flip angle by measuring the SNR and CNR according to the angle of changes of the MRI technique using the Image J program. A total of 30 normal volunteers were assessed by using a 1.5T magnetic resonance imaging system (Philips, Medical System, Achieva). For the MRI angiography, we set the region of interest in four regions and evaluated the SNR and CNR. The statistical significance of SNR and CNR was calculated by one-way ANOVA using quantitative analysis at five different positions. The Bonferroni method was used for post-hoc analyzes. Statistical significance was determined by using ANOVA analysis at p<0.05 and Bonferroni method was used as a post-hoc analysis. The results of this study, the measurement values of ACA(SNR:$876.59{\pm}14.22$, CNR:$1999.7{\pm}12.5$), PCA(SNR:$863.48{\pm}13.29$, CNR:$1870.18{\pm}12.56$), ICA(SNR:$1116.87{\pm}08.34$, CNR:$2979.37{\pm}14.69$) and MCA(SNR:$848.66{\pm}15.25$, CNR:$2199.25{\pm}13.48$) were obtained with the high signal intensity at $25^{\circ}$(p<0.05). The values of a1, a2, a3, p1, p2, p3, m1, m2 and m3 were also the same (p<0.05). Post-hoc analysis results, There was a statistically significant difference (p=0.000) between $10^{\circ}$, $15^{\circ}$, $20^{\circ}$ on the $25^{\circ}$ reference for the flip angle, but no significant results were obtained with $30^{\circ}$(p<0.05). In concision, because the signal intensity decreased at $30^{\circ}$, this study revealed that the optimal flip angles were $25^{\circ}$ in cerebrovascular MR angiography.

Hospice Education among Hospice Professionals and Its Regional Variations in Korea -Outcomes from a 2008 Hospice Palliative Care Institutions Support Project- (한국 호스피스.완화의료 전문인력 교육의 지역적 변이 -2008년 말기 암환자 전문기관 활성화 지원사업 신청기관 인력을 중심으로-)

  • Kang, Jin-A;Shin, Dong-Wook;Hwang, Eun-Joo;Kim, Hyo-Young;Ahn, Seong-Hoo;Yoo, Yang-Sook
    • Journal of Hospice and Palliative Care
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    • v.12 no.3
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    • pp.132-138
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    • 2009
  • Proper education of hospice professionals is essential for ensuring quality of end-of-life care. In 2005, 'End-of-life Care Task Force Team' by Ministry of Health and Welfare established '60 hours of hospice education' as basic requirement for hospice professionals. This study is aimed to determine how many of the hospice professionals meet with the criteria and whether there are significant regional variations. Methods: We analyzed the data from 46 hospice organizations, which submitted the application to the 2008 designation program of Ministry of Health, Welfare, and Family Affairs. Data included details of the educational records of each hospice professionals. Results: Total 673 hospice professionals were included in the analysis. Overall, only 41.5% (279/673) met the requirement. Nurses (46.8%; 177/378) were more likely to meet the requirement than doctors (35.8%; 38/106), social workers (32.0%; 24/75) and clergies (35.1%; 40/114). Hospice professionals of the organizations in metropolitan area received more education than those in small cities or rural area (52.4% vs. 25.0% for doctors, 50.6% vs. 43.9% for nurses, 42.9% vs. 25.5% for social workers). By geographic areas, hospice professionals in southeast regions received less education than other part of Korea (28.1% vs. 43.0${\sim}$48.8%, respectively). Conclusion: Less than half of the Korean hospice professionals has received proper amount of hospice education, and significant regional variations existed. National programs to promote the education of hospice professionals and eliminate its disparities are greatly warranted. Implementation of the 60-hour currirulum for hospice professionals, based on the train-the-trainer model, would be regarded as one potential solution.

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Development of RAPD-SCAR Molecular Marker Related to Seed-hair Characteristic in Carrot (당근(Daucus carota var. sativa) 종자모 형질 관련 RAPD-SCAR 분자표지 개발)

  • Shim, Eun-Jo;Park, Sung-Kwan;Oh, Gyu-Dong;Jun, Sang-Jin;Park, Young-Doo
    • Horticultural Science & Technology
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    • v.31 no.6
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    • pp.756-763
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    • 2013
  • Mechanical hair removal of carrot seed causes seed injuries and suppresses the germination in carrot cultivation. This study was performed to develop molecular markers for breeding high quality cultivars with short-hair seed. To meet this objective, random amplified polymorphic DNA (RAPD)-sequence characterized amplified region (SCAR) markers specifically linked to seed-hair characteristic were identified using CT-SMR 616 OP 389-1 line with short-haired seed and CT-SMR 616 OP 616-33 line with long-haired seed, bred by self-pollination for 6 years from 2008 to 2013, as parents. After seed hair lengths of these lines were analyzed using microscope, next generations were advanced and compared with the molecular markers polymorphism. From RAPD analysis using fixed lines in 2011, twelve RAPD primers showing polymorphic bands specific between the two lines were identified from 80 random primers. To develop RAPD-SACR marker, SCAR primers were designed based on sequence analysis of these specific RAPD bands and more than three combinations of primers were tested. As a result, it was found that the $SCA2_{1.2}$ amplified single polymorphic band from short-haired seed line. To confirm this result, $SCA2_{1.2}$ marker was retested by applying to the 2012 and 2013 progenies. Finally, it was concluded that the developed $SCA2_{1.2}$ marker distinguished short-haired line from long-haired seed line. Therefore, SCAR marker, $SCA2_{1.2}$ is expected to be utilized for breeding of the short-haired seed cultivars.

A Study on the Realities of Custom-made Clothing Production in Middle-aged Women's Clothing Firms (중년여성복업체(中年女性服業體)의 맞춤복(服) 생산실태(生産實態) 연구(硏究))

  • Park, Yu-Jeong;Sohn, Hee-Soon
    • Journal of Fashion Business
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    • v.6 no.2
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    • pp.1-16
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    • 2002
  • The need for ready-to-wear clothing increases as the problem comes to arise from the fit of custommade clothing due to the characteristics of middle-aged women's somatotype. At this point of time, a study on the realities of production of custom-made clothing in middle-aged women's clothing business firms is of very greatly significance. Therefore, this study was intended to identify the problem and improvements through the survey research of production of custom-made clothing in middle-aged women's clothing business firms and further present the plan for development of custom-made clothing business. The questionnaire was framed based on the contents extracted from the preliminary questionnaire research for the pattern section chief of each business firm. Collected data were statistically processed using the SPSS 10.0 Windows program. As a result, the following findings were obtained: 1. The target age of the middle-aged women's clothing business firms ranged from more than 45 years to less than 50 years of age. Clothing business firms much made inroads into the ready-to-wear clothing market largely in the 1980s and the 1990s. Their active entry into the custom-made clothing market occurred in the 1970s and the 1980s. 2. In terms of the clothing production method of middle-aged women's clothing firms, some private boutique and designer brand clothing firms entered the clothing market with a focus on custom-made clothing in the beginning of its organization and introduced the production method of ready-to-wear clothing in accordance with changes in production methods and consumers' needs and wants. National brand clothing firms manufactured clothing with a focus on ready-to-wear clothing from the beginning of its organization, but at last they manufactured both partial custom-made and whole custom-made as the problem arose from ready-to-wear clothing. Seeing that their clothing production showed the ratio readyto-wear to custom-made clothing of 2.58:1. And it was found that the manufacture of ready-to-wear and custom-made clothing took into consideration the great difference in the pattern, size and design plan. The research of the clothing production process showed that whole custom-made and partial custommade were distinguished according to whether or not the sample was presented. 3. The ready-to-wear pattern of middle-aged women's clothing firms were used with a focus on the 'patternmaker-developed pattern' and company-developed pattern'. Most clothing businesses produced clothing in 4 to 5 basic sizes, which is found to be insufficient to complement the physical characteristics of middle-aged women with many specific somatotypes. In the pattern of custom-made clothing, the 'pattern of ready-to-wear were applied' or the 'customized pattern was developed'. Actual measurements were most used as the size of custom-made, and accordingly it is predicted that the level of satisfaction is higher with the fit of custom-made clothing than that of ready-to-wear. The selling place and the head office showed the similar percent as the place for measuring the size of custom-made clothing. Size measurers were mostly the shop master. And it was found that most clothing business firms had a problem when the measured size was applied to the pattern. Accordingly, it is necessary to provide education on size measurement for shop masters. 4. It was found that in the middle-aged women's clothing firms, the pattern correction of the length of sleeve, jacket and slacks occupied the highest percent. Accordingly, it is necessary to provide for the size system to complement the accurate somatotype characteristics of middle-aged women. 5. In custom-made clothing customer management, most firms engaged in customer somatotype management through size management. They provided customers with commodity information by informing them of the sales and event period and practiced human management for customers by maintaining the get-together and friendly relationship. 6. Middle-aged women's clothing businesses responded that it would be necessary to improve the fit of custom-made clothing and complement their pursuit for individuality as the plan to improve its quality. In consequence, it suggests that middle-aged women's clothing businesses should provide middle-aged women with the clothing of better-suited size and refined design. Middle-aged women's clothing businesses responded that it was the most urgent task to form the custom-made clothing manufacturing team as the plan to expand the custom-made clothing market, which is identified as their emphasis on the systematized production of custom-made clothing.

Location Analysis of A Collective Consumption Facility with GIS: The Location of Gu-Office and Its Administrative District in Ulsan, South Korea (GIS기법을 이용한 도시공공서비스 시설의 입지분석 -울산시 구 관할구역과 구청입지를 중심으로-)

  • Cho, Sung-Ho;Park, Soon-Ho
    • Journal of the Korean association of regional geographers
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    • v.2 no.1
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    • pp.69-85
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    • 1996
  • This research adoptes a spatial analysis function of the Geographic Information System[GIS] to analyze the location and the service district of a collective consumption facility, to discover the optimal location, and to redefine the service district. The location and spatial district of a collective consumption facility strongly influences the quality of life of residents. This research studies administrative offices and districts, especially Gu-offices in Ulsan. Ulsan would be raised to the status of Kwangyokshi in 1997; so that, the status of four Gus would be changed from a general administration into a self-governing administration. The summary of this research focuses on five significant points. First, the districts of four Gus were strongly required to be redefined to obtain the maximization of the degree of potential development as well as of the efficiency and equity of administring services. The spatial range of residents in a Gu was not in accord with its administrative district. The administrative districts of four Gus in Ulsan were not balanced in terms of area and population, and the high degree of disparity among Gus existed the efficiency and equality of a collective consumption service. Second, the current gu-offices were located based on security of land and accessibility of a main route; so, there was difficult to find the creteria and the principles of selections of the location of Gu offices. The social disparity of an administrative service existed in the accessibility into Gu-offices. Third, the administrative districts of Gus were redefined with spatial analysis tool of ARC/INFO. It was recommended that Ulsan maintain four Gus under the condition of five Kwangyokshi in South Korea. The redefined districts of administration reduced the disparity among four Gus in terms of area and population. improved the degree of harmony between the spatial range of residents of Gus and the administrative district of Gus, and increased the efficiency and equity of administrative service. Fourth, within the redefined adminis trative district of a Gu, the centroid reduced the maximum distance and mean distance; so, the efficiency and equity of public service provided by the Gu-office were improved. Last, the spatial analysis function of GIS helped to select the optimal location and to delineate the district of public service with more speedly and objectively. The function of spatial analysis of GIS was very useful to minimize the conflict in the determination of the location of a collective consumption facility and of the service district. To improve location analysis with GIS. non-spatial data base such as budget, thought of residents, and development policy and program, should be constructed.

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Attitudes and Problems of Urban Parks, in Taegu City, Korea (도시공원(都市公園)의 속성(屬性)과 문제점(問題點))

  • Choi, Seok-Joo
    • Journal of the Korean association of regional geographers
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    • v.2 no.2
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    • pp.205-217
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    • 1996
  • Today in the industrial society, the urban park is the place for citizens' health, recreation, exercise, and education. This is a very important place as a fine sight and maintenance of public security. As the results of rapid economic growth during the last thirty years, citizens are in the age of material civilization and are challenged with many serious urban problems such as pollution, noise, traffic congestion, human alienation, etc. Rapid material civilization brought to citizens' mental and physical diseases. To some of the problems, it is necessary that we should have proper leisure and recreation facilities, and that we should have the active, positive posture to them. Especially we need the out door recreational spaces and facilities. But nowadays the urban parks are given little thought in spites of the necessity of parks which should be used as a recreational spaces in the urban areas. So, This study attempt to comprehend the function, quantity and quality of the urban park system in Taegu. It is clear that the quantity is inappropriate. Because of inappropriate disposition and management, its coefficiency of utilization is low. In view of the population and park ratio, Dong Gu, Nam Gu, Suseong Gu and Dalseong Gun have comparative good, environments. However, Dalseo Qu, Seo Gu and Jung Gu have less geographical features. There are some methods to provide expansion of the aggregate of urban parks. We can use the school-grounds and their facilities. which were moved from C.B.D. to the outskirts of Daegu, or some parts of urban redevelopment, or the riverside of Sincheon river. In the urban park-program, users' satisfaction-factors are analyzed. We must reconsider the efficiency. The above problems are improved. Active administration and inhabitants' Positive participation are demanded so that the sound development of cities and daily life-surroundings are promoted.

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A Suvey on Satisfaction Measurement of Automatic Milking System in Domestic Dairy Farm (자동착유시스템 설치농가의 설치 후 만족도에 관한 실태조사)

  • Ki, Kwang-Seok;Kim, Jong-Hyeong;Jeong, Young-Hun;Kim, Yun-Ho;Park, Sung-Jai;Kim, Sang-Bum;Lee, Wang-Shik;Lee, Hyun-June;Cho, Won-Mo;Baek, Kwang-Soo;Kim, Hyeon-Shup;Kwon, Eung-Gi;Kim, Wan-Young;Jeo, Joon-Mo
    • Journal of Animal Environmental Science
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    • v.17 no.1
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    • pp.39-48
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    • 2011
  • The present survey was conducted to provide basic information on automatic milking system (AMS) in relation to purchase motive, milk yield and quality, customer satisfaction, difficulties of operation and customer suggestions, etc. Purchase motives of AMS were insufficient labor (44%), planning of dairy experience farm (25%), better performance of high yield cows (19%) and others (6%), respectively. Average cow performance after using AMS was 30.9l/d for milk yield, 3.9% for milk fat, 9,100/ml for bacterial counts. Sixty-eight percentage of respondents were very positive in response to AMS use for their successors but 18% were negative. The AMS operators were owner (44%), successor (44%), wife (6%) and company worker (6%), respectively. The most difficulty (31%) in using AMS was operating the system and complicated program manual. The rate of response to system error and breakdown was 25%. The reasons for culling cow after using AMS were mastitis (28%), reproduction failure (19%), incorrect teat placement (12%), metabolic disease (7%) and others (14%), respectively. Fifty-six percentages of the respondents made AMS maintenance contract and 44% did not. Average annual cost of the maintenance contract was 6,580,000 won. Average score for AMS satisfaction measurement (1 to 5 range) was 3.2 with decrease of labor cost 3.7, company A/S 3.6, increase of milk yield 3.2 and decrease of somatic cell count 2.8, respectively. Suggestions for the higher efficiency in using AMS were selecting cows with correct udder shape and teat placement, proper environment, capital and land, and attitude for continuous observation. Systematic consulting was highly required for AMS companies followed by low cost for AMS setup and systematization of A/S.

Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.

A Study of Reportable Range Setting through Concentrated Control Sample (약물검사에서 관리시료의 농축을 이용한 보고 가능 범위의 설정에 대한 연구)

  • Chang, Sang Wu;Kim, Nam Yong;Choi, Ho Sung;Park, Yong Won;Yun, Keun Young
    • Korean Journal of Clinical Laboratory Science
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    • v.36 no.1
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    • pp.13-18
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    • 2004
  • This study was designed to establish working range for reoportable range in own laboratory in order to cover the upper and lower limits of the range in test method. We experimented ten times during 10 days for setting of reportable range with between run for method evaluation. It is generally assumed that the analytical method produces a linear response and that the test results between those upper and lower limits are then reportable. CLIA recommends that laboratories verify the reportable range of all moderate and high complexity tests. The Clinical Laboratory Improvement Amendments(CLIA) and Laboratory Accreditation Program of the Korean Society for Laboratory Medicine states reportable range is only required for "modified" moderately complex tests. Linearity requirements have been eliminated from the CLIA regulations and from others accreditation agencies, many inspectors continue to feel that linearity studies are a part of good lab practice and should be encouraged. It is important to assess the useful reportable range of a laboratory method, i.e., the lowest and highest test results that are reliable and can be reported. Manufacturers make claims for the reportable range of their methods by stating the upper and lower limits of the range. Instrument manufacturers state an operating range and a reportable range. The commercial linearity material can be used to verify this range, if it adequately covers the stated linear interval. CLIA requirements for quality control, must demonstrate that, prior to reporting patient test results, it can obtain the performance specifications for accuracy, precision, and reportable range of patient test results, comparable to those established by the manufacturer. If applicable, the laboratory must also verify the reportable range of patient test results. The reportable range of patient test results is the range of test result values over which the laboratory can establish or verify the accuracy of the instrument, kit or test system measurement response. We need to define the usable reportable range of the method so that the experiments can be properly planned and valid data can be collected. The reportable range is usually defined as the range where the analytical response of the method is linear with respect to the concentration of the analyte being measured. In conclusion, experimental results on reportable range using concentrated control sample and zero calibrators covering from highest to lowest range were salicylate $8.8{\mu}g/dL$, phenytoin $0.67{\mu}g/dL$, phenobarbital $1.53{\mu}g/dL$, primidone $0.16{\mu}g/dL$, theophylline $0.2{\mu}g/dL$, vancomycine $1.3{\mu}g/dL$, valproic acid $3.2{\mu}g/dL$, digitoxin 0.17ng/dL, carbamazepine $0.36{\mu}g/dL$ and acetaminophen $0.7{\mu}g/dL$ at minimum level and salicylate $969.9{\mu}g/dL$, phenytoin $38.1{\mu}g/dL$, phenobarbital $60.4{\mu}g/dL$, primidone $24.57{\mu}g/dL$, theophylline $39.2{\mu}g/dL$, vancomycine $83.65{\mu}g/dL$, valproic acid $147.96{\mu}g/dL$, digitoxin 5.04ng/dL, carbamazepine $19.76{\mu}g/dL$, acetaminophen $300.92{\mu}g/dL$ at maximum level.

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