• Journal of Gastric Cancer
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• v.22 no.1
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• pp.35-46
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• 2022

Background: The correlation between hospital volume and postoperative outcomes has led to the centralization of complex procedures in several countries. However, the results reported in relation to gastric cancer (GC) are contradictory. This study aimed to analyze GC surgical volumes and 30-day postoperative mortality in Italy and to provide a simulation for modeling centralization of GC resections based on district case volumes. Methods: A national registry was used to identify all GC resections, record mortality rates, and track the national in-border GC resection health travel. Hospitals were grouped according to caseload. Centralization of all GC procedures performed within the same district was modeled. The outcome measures were a minimal volume of 25 GC resections/year and the 30-day postoperative mortality. Results: In 2018, 5,873 GC resections were performed in 498 Italian hospitals (mean resections per hospital per year: 11.8); the postoperative mortality rate (5.51%) was tracked from 2016-2018. GC resection health travel ranged from 2% to 50.5%, with a significant (P<0.001) difference between northern and central/southern Italy. The mean mortality rate was 7.7% in hospitals performing one to 3 GC resections per year, compared with 4.7% in those with >17 GC resections/year (P≤0.01). Most Italian districts achieved 25 procedures/year after centralization; however, 66.3% of GC cases in southern Italy vs. 42.2% in central and 52.7% in the northern regions (P<0.001) required reallocation. Conclusion: Postoperative mortality after GC resection correlated with hospital volume. Despite health travel, most Italian districts can reach a high-volume threshold, but discrepancies in mortality rates are alarming.Trial RegistrationResearch Registry Identifierresearchregistry6869

• Journal of Construction Engineering and Project Management
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• v.2 no.4
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• pp.32-41
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• 2012

In recent times, multi-centralization and decentralization as well as large Capital area and suburbanization in the spatial structure of capital area. With rapid growth, urbanization and industrialization are unsystematic, and growth inequality between regions caused negative effects such as discordant centralization and decentralization, fluctuating land value, and gap between living conditions. Accordingly, this study analyzed urban spatial indexes by the self-governed body in the capital area such as Seoul, Incheon, and Gyeonggi province for the analysis of the regional inequality phenomenon. We examined the characteristics of temporal and spatial changes in urban spatial structure in the capital area by utilizing the distribution pattern and density of city indexes such as population, employment, etc, and then drew the commonality of those factors through factor analysis. We evaluated the drawn results through the city standard index by each city, conducted factor score analysis, and identified the interaction between each factor and Housing Purchase Price Composite Indices index, housing rent price index(Housing Jeonse Price Composite Indices), land price fluctuation rate, diffusion ratio of house, and financial independence.

• Health Policy and Management
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• v.3 no.1
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• pp.102-123
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• 1993

This study investigates effcts of HMO internal structural arrangements on performance, specially cost reduction measured by hospitalization rate. This study formulates formalization, centralization measured by decision-making participation, differentiation, and coordination as structural factors, considering coordination as an intermediate factor between the rest of structural factors and hospitalization rate. The commonly used HMO types is assumed not effective in explaining performance differences. For the empirical test, I use bootstrap regression analyses with 48 HMOs. The results of the analyses show that HMO types fail to explain differences in hospitalization rate. However, dicision-making participation and differention effectively reduce hospiatalization rate, while frmalization increases hospitalization rate and coordination has nonessential effect on hospitalization rate. And, formalization and decision-making participation positively contribute to achieve coordination in HMO. These findings suggest that the theoretical framework derived from rational-citingency theory of formal organization better explains performance differences of HMOs than HMO types.

• Korean Institute of Interior Design Journal
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• v.23 no.6
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• pp.195-203
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• 2014

This study selects factors affecting form type of hospital architecture by considering studies and references on hospital architecture type in korea and other countries in general. Also this study classifies general hospitals chronologically and analyzes type change of general hospitals in relation with periodic change of healthcare environment. Through this, this study aims to analyze chronological change of general hospitals' form type and provide the current of hospital architecture's general type. The form type classification of this study is classification according to the form of ward, classification according to the relationship between ward and D.T.D(Diagnostic and Treatment department), classification according to the relationship between O.P.D(Out Patient department) and D.T.D, classification according to the rate of centralization, classification according to the circulation system. The form type of ward changed from plate type to tower type, and the circulation system of ward changed from middle corridor to double corridor, the number of Team Nursing chaged from 1 to 2 in 1990. On the other hand the chage of others classifications took place from 1990' to 2010'. It is judged that this overall change is appeared by a change from an inpatien-oriented system to an outpatient-oriented system followed by an increase in number of outpatients, an increase in amenities in ground floor and adoption of healing environment for patients and visitors.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.311-317
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• 2015

Background: Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods: Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results: Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (p<0.0001) more common in cardiac surgery than in thoracic surgery. A total of 39 surgeons performed robotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion: Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed.

• Proceedings of the KSR Conference
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• 2004.06a
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• pp.1446-1448
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• 2004

Communication line used in the rail-road have different use from subscriber line in the public telecommunication. But, when an existing communication equipment is replaced, by applying new high-speed transfer technology, we can anticipate the increase of transmission rate and decrease of waiting time according to high-speed of communication line. cost reduction of infrastructure construction and maintenance/repair according to centralization of communication line and transmission equipment. In this study, the transmission scheme of several xDSL(Digital Subscriber Line) modems were compared and analyzed. The way of applying xDSL modem to the metal cable which is used in the JR(Japan Railroad) is analyzed. In addition, the result tested in railroad communication line was reviewed.

• Journal of Communications and Networks
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• v.18 no.2
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• pp.162-172
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• 2016

The placement of the complete baseband processing in a centralized pool results in high data rate requirement and inflexibility of the fronthaul network, which challenges the energy and cost effectiveness of the cloud radio access network (C-RAN). Recently, redesign of the C-RAN through functional split in the baseband processing chain has been proposed to overcome these challenges. This paper evaluates, by mathematical and simulation methods, different splits with respect to network level energy and cost efficiency having in the mind the expected quality of service. The proposed mathematical model quantifies the multiplexing gains and the trade-offs between centralization and decentralization concerning the cost of the pool, fronthaul network capacity and resource utilization. The event-based simulation captures the influence of the traffic load dynamics and traffic type variation on designing an efficient fronthaul network. Based on the obtained results, we derive a principle for fronthaul dimensioning based on the traffic profile. This principle allows for efficient radio access network with respect to multiplexing gains while achieving the expected users' quality of service.

• Health Policy and Management
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• v.24 no.3
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• pp.271-282
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• 2014

Background: Although the mortality rate in cancers has been decreased recently, it is still one of the leading causes of death in most of the countries. This study analyzed the relationship between surgery volume and in hospital mortality of cancer patients. The purpose of this study is to investigate the relationship in Korean healthcare environment and to provide information for the policy development in reducing cancer mortality. Methods: The study sample was the 20,517 cancer patients who underwent surgery and discharged during a month period between 2008-2011. The data were collected in Patient Survey by Korean Institute of Social Affairs. Logistic regression was used to analyse a comprehensive analytic model that includes a binary dependent variable indicating death discharge and independent variables such as surgery volume, organizational characteristics of hospitals, socio-economical characteristics of the patients, and severity of disease indicators. Results: In chi-square test, as the surgery volume increases, the in-hospitals mortality showed a downward trends. In regression analysis, the relationship between surgery volume and mortality showed significant negative associations in all types of cancer except for pancreatic cancer. Conclusion: In the absence of other information patients undergoing cancer surgery can reduce their risk of operative death by selecting a high-volume hospital. Therefore, policies to enhance centralization of cancer surgery services should be considered.

• International Journal of Internet, Broadcasting and Communication
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• v.7 no.1
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• pp.42-48
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• 2015

Generally, the current commercial cloud system is hosted by the centralization large datacenter. However, the other clouding forms existed and one of them is the P2P cloud. The P2P Cloud is a distributed systems, is freedom to join and leave and is possible to provide the IaaS. Commonly, P2P Cloud System is based on Pure-P2P System. Since a number of connection paths exist, it has a high reliability and easily scalability of the network. However, there are disadvantages of the slow rate of route because of looking up the all peers in order to search for the peer. In this paper, it proposes the P2P cloud system based on super-peer P2P. Super-peer P2P system has fast routing time, because of searching for cluster unit and it also can has high reliability and high scalability. We designs the super Peer cloud service and proposes the system model and Resource Allocation Algorithm for IaaS in Super peer P2P environment.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.363-385
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• 1998

The purpose of this study is to investigate the relationship between organizational culture types and organizational effectiveness in the hospitals and to identify the cultural and organizational characteristics of the hospitals with high organizational effectiveness. Data were collected from May 12 to June 14. 1997 through questionnaire taken by 1.118 nurses working in 10 hospitals with more than 800 beds and from annual reports published by the hospitals. The instruments were used for collecting the data: Organizational Culture Questionnatire and Organizational Characteristics Questionnatire developed by the researcher. Mowday's Organizational Commitment Questionnaire. Taylor & Bovver's General Satisfaction Scale. The Results were as follows: 1. The meta culture of the hospital organizations was the conservative culture. 2. There were significant differences of the four organizational cultural types - affiliative culture. innovative culture. conservative culture. task culture among the hospitals(p=.00). 3. The hospital organizations were classified in to three cultural patterns. each of which had similar cultural composition. on the basis of the scores indicating the similarity and difference of the foul' organizational cultural types among the hospitals. The organization of each group represents conservative- dominant culture. innovative-dominant culture and competitive culture. 4. Nurses' organizational commitment and job satisfaction were significantly different among the cultural patterns(p=.00). In other words. the hospitals with innovative-dominant culture showed higher organizational commitment and job satisfaction than ones with conservative-dominant culture and competitive culture. And also. the growth rate of outpatients and inpatients were significantly different among the cultural patterns(p<.05). The hospitals with innovative -dominant culture showed higher growth rate of outpatients and inpatients than ones with conservative-dominant culture and competitive culture. 5. The hospitals with conservative-dominant culture and competitive culture showed higher level of centralization than ones with innovative -dominant culture(p=.00) And the hospitals with competitive and innovative-dominant culture showed higher level of communication than those with conservative-dominant culture(p=.00) Finally. the hospitals with innovative-dominant culture showed higher level of managerial strategy than those with conservative-dominant and competitive culture. among which the latter showed higher level of managerial strategy than the former(p=.00).