• Title/Summary/Keyword: Risk management factors

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Factors Related to Admission via Emergency Room in Korean Hospitals with an Emergency Medical Center (응급의료센터를 보유한 의료기관 입원 중 응급실경유입원 관련 요인)

  • Na, Baeg-Ju;Lee, Sun-Kyung;Oh, Kyung-Hee;Kim, Keon-Yeop;Chung, Seol-Hee
    • Health Policy and Management
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    • v.19 no.2
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    • pp.71-84
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    • 2009
  • Objectives : The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods : This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi-square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results : The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300-699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion : We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.

A Study on Selection of Bicycle Road Hazard Detection Elements For Mobile IoT Sensor Device Operation (이동형 IoT 센서 장비 운용을 위한 자전거도로 위험 감지요소 선정 연구)

  • Woochul Choi;Bong-Joo Jang;Sun-Kyum Kim;Intaek Jung
    • The Journal of The Korea Institute of Intelligent Transport Systems
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    • v.23 no.4
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    • pp.37-53
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    • 2024
  • This study selected bicycle road hazard detection factors for mobile IoT sensor device operation and developed service application plans. Twelve bicycle road hazard detection factors were derived through a focused group interview, and a fuzzy AHP-based importance analysis was conducted on 30 road and transportation experts. As a result, 'damage to pavement' (1st overall) and 'environmental obstacle' (2nd) with low visibility but a high risk of accidents were selected the most. The factors in terms of facility management, such as 'disconnected route occurrence' (4th), 'artificial obstacle' (5th), 'effective width' (6th), and 'poor drainage' (7th), were selected as the upper and middle areas. Factors that are not direct accident-inducing factors, such as 'loss of road markings' (11th) and 'free space width' (12th), were selected the least. Based on this, a plan was presented to apply the bicycle road hazard detection service and a service operation strategy according to real-time performance. Nevertheless, follow-up studies, such as human behavioral analysis based on bicycle operators, analysis according to the bicycle road type, service demonstration, and pilot operation, will be needed to develop safe bicycle road management is expected.

Association between Risk of Obstructive Sleep Apnea and Subjective Health and Health-Related Quality of Life of the Korean Middle-Aged and Elderly Population (한국 중고령층의 폐쇄성 수면무호흡증 위험과 주관적 건강 및 건강 관련 삶의 질 간의 연관성)

  • Nu-Ri Jun;Min-Soo Kim;Jeong-Min Yang;Jae-Hyun Kim
    • Health Policy and Management
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    • v.34 no.2
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    • pp.141-155
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    • 2024
  • Background: This study aimed to identified the relationship between the risk of obstructive sleep apnea, subjective health, and health-related quality of life among the middle-aged and elderly population in Korea. Methods: Adults aged 40 or older were extracted from the total 22,559 respondents to the 2019-2020 Korea National Health and Nutrition Examination Survey VIII, and secondary analysis was conducted on a total of 6,659 middle-aged and elderly people with no missing values. Logistic regression analysis and multiple regression analysis were conducted to examine the relationship between obstructive sleep apnea risk factors and subjective health as well as quality of life. Results: The subjective health status decline in the high-risk group compared to the non-risk group for obstructive sleep apnea was statistically significantly higher, with an odds ratio of 1.84 (p<0.001). The health-related quality of life was also statistically significantly lower by 0.02 points (β, -0.02; p<0.001). As a result of subgroup analysis on specific variables, the association between the risk of obstructive sleep apnea and subjective health and health-related quality of life was statistically significant depending on gender, sleep time, presence of depression, household income, and number of household members. Based on the obstructive sleep apnea risk group, women had a higher correlation with low subjective health and lower health-related quality of life scores than men. Sleeping time of more than 8 hours or less than 6 hours was more associated with low subjective health and lower health-related quality of life score than sleeping time of 6-8 hours. Patients with depression were more likely to have low subjective health than those without depression. The lower the household income level and the smaller the number of household members, the higher the association with low subjective health and the lower the health-related quality of life score. Conclusion: It is essential to recognize that the risk of obstructive sleep apnea not only directly affects sleep disorders but also impacts individuals' subjective health and quality of life. Consequently, social support and education should be provided to raise awareness of this issue. Particularly, programs for preventing and managing obstructive sleep apnea should target vulnerable groups such as women, individuals in single-person households, low household income, and those with depression, aiming to improve their subjective health and quality of life.

A Study on Legal and Institutional Improvement Measures for the Effective Implementation of SMS -Focusing on Aircraft Accident Investigation-

  • Yoo, Kyung-In
    • The Korean Journal of Air & Space Law and Policy
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    • v.32 no.2
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    • pp.101-127
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    • 2017
  • Even with the most advanced aviation technology benefits, aircraft accidents are constantly occurring while air passenger transportation volume is expected to double in the next 15 years. Since it is not possible to secure aviation safety only by the post aircraft accident safety action of accident investigations, it has been recognized and consensus has been formed that proactive and predictive prevention measures are necessary. In this sense, the aviation safety management system (SMS) was introduced in 2008 and has been carried out in earnest since 2011. SMS is a proactive and predictive aircraft accident preventive measure, which is a mechanism to eliminate the fundamental risk factors by approaching organizational factors beyond technological factors and human factors related to aviation safety. The methodology is to collect hazards in all the sites required for aircraft operations, to build a database, to analyze the risks, and through managing risks, to keep the risks acceptable or below. Therefore, the improper implementation of SMS indicates that the aircraft accident prevention is insufficient and it is to be directly connected with the aircraft accident. Reports of duty performance related hazards including their own errors are essential and most important in SMS. Under the policy of just culture for voluntary reporting, the guarantee of information providers' anonymity, non-punishment and non-blame should be basically secured, but to this end, under-reporting is stagnant due to lack of trust in their own organizations. It is necessary for the accountable executive(CEO) and senior management to take a leading role to foster the safety culture initiating from just culture with the safety consciousness, balancing between safety and profit for the organization. Though a Ministry of Land, Infrastructure and Transport's order, "Guidance on SMS Implementation" states the training required for the accountable executive(CEO) and senior management, it is not legally binding. Thus it is suggested that the SMS training completion certificates of accountable executive(CEO) and senior management be included in SMS approval application form that is legally required by "Korea Aviation Safety Program" in addition to other required documents such as a copy of SMS manual. Also, SMS related items are missing in the aircraft accident investigation, so that organizational factors in association with safety culture and risk management are not being investigated. This hinders from preventing future accidents, as the root cause cannot be identified. The Aircraft Accident Investigation Manuals issued by ICAO contain the SMS investigation wheres it is not included in the final report form of Annex 13 to the Convention on International Civil Aviation. In addition, the US National Transportation Safety Board(NTSB) that has been a substantial example of the aircraft accident investigation for the other accident investigation agencies worldwide does not appear to expand the scope of investigation activities further to SMS. For these reasons, it is believed that investigation agencies conducting their investigations under Annex 13 do not include SMS in the investigation items, and the aircraft accident investigators are hardly exposed to SMS investigation methods or techniques. In this respect, it is necessary to include the SMS investigation in the organization and management information of the final report format of Annex 13. In Korea as well, in the same manner, SMS item should be added to the final report format of the Operating Regulation of the Aircraft and Railway Accident Investigation Board. If such legal and institutional improvement methods are complemented, SMS will serve the purpose of aircraft accident prevention effectively and contribute to the improvement of aviation safety in the future.

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Development of Nutrition Education Program for Hypertension Based on Health Belief Model, Applying Focus Group Interview (건강신념 모델을 적용한 고혈압 영양교육 프로그램 개발 -포커스그룹 인터뷰에 기초하여-)

  • Park, Seoyun;Kwon, Jong-Sook;Kim, Cho-il;Lee, Yoonna;Kim, Hye-Kyeong
    • Korean Journal of Community Nutrition
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    • v.17 no.5
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    • pp.623-636
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    • 2012
  • Health Belief Model is a socio-psychological theory of decision making to individual health-related behaviors. This study was aimed to develop an effective education program for hypertension based on health belief model. The main factors of health belief model were investigated by focus group interview (FGI) with 23 hypertensive or prehypertensive subjects aged over fifty years. 'Perceived susceptibility' to hypertension was family history, neglect of health care, preference for salty food, broth of soup and stew. Lifelong medication, complications, and medical costs were reported as 'perceived severity' of hypertension. 'Perceived benefits' of hypertension management were decrease of medicinal dose, reduction of medical costs, and healthy eating habits of the family, while 'perceived barriers' were lack of palatability of low salt diet, convenience-oriented dietary habits, and limited choice of foods when eating out. Subjects mentioned TV health programs, public health center programs, and advice from doctors and family as 'cues to action' of hypertension management. These qualitative information provided basis for developing a nutrition education program for hypertension which could be implemented in the public health center. Eight week program was composed of understanding hypertension, risk factor management (eating habits, weight), low salt diet (principles, cooking), advanced management for healthy diet in 2 sessions, and summary. Each session was designed to alert the susceptibility and severity, to emphasize the benefits, and to reduce the barriers by providing dietary monitoring, practical advice, and action tips.

Analysis of Delay Causation by Characteristics of Construction Projects (건설사업 특성에 따른 공기연장사유 분석)

  • Kim, Jong-Han;Kim, Kyung-Rai
    • Korean Journal of Construction Engineering and Management
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    • v.8 no.1 s.35
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    • pp.78-86
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    • 2007
  • Top priority to manage construction projects is given to the planning and scheduling in order to keep the project duration, which is one of the most important factors in construction management. However, recently most of public construction projects especially for civil projects are delays and preventive research, many efforts were made concerning construction delays and preventive management methods. But analysis of delay causation, which is a main key to solve the problems is not done, yet. Therefore, in this research causation delays are analyzed by characteristics of construction projects, which are type of projects, type of contracts, project participants, and general condition. As a result of the analysis, delay causation are proved to be different by characteristics of the projects. The research results will be used for prevention of time extension and dispute resolution.

Development of a 4D Information based Integrated Management System for Geothermal Power Plant Drilling Project (지열발전 시추프로젝트의 4D 정보화기반 통합관리 시스템 개발)

  • Lee, Seung Soo;Kim, Kwang Yeom;Shin, Hyu-Soung
    • Tunnel and Underground Space
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    • v.24 no.3
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    • pp.234-242
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    • 2014
  • Deep drilling project should be managed systematically and efficiently because it is significantly influenced by various related factors having uncertainty and high risk in terms of economy and effective management. In particular, drilling project involves participants from various sectors including necessary service company and it also needs their collaboration by sharing related information occurring at drilling process in order to secure efficient performance management. We developed 4D (3D + time) information based visualization system for progress management by combining 3D design model and predicted optimized control parameters for each section in geothermal well design. We also applied PDM (precedence diagramming method) to the system in order to setup the effective process model and hooked it up to 3D information based on precedence relation and required time for informatized process network.

A Study on Safety Inspection Model for Small Scale Construction Field (중.소규모 건설현장 안전점검 모질 연구)

  • 안병수;양광모;강경식
    • Journal of the Korea Safety Management & Science
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    • v.3 no.3
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    • pp.11-21
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    • 2001
  • Domestic construction industry has considerable level of construction performance and technology thanks to the economic development and as the result of performing diverse oversea construction project. However, construction disasters have been steadily increasing, and do severe disasters at faster pace. Most of such disasters happen at small and small medium-sized construction fields, which contract size is less than 10 billion won. small and medium-sized construction fields are not obliged to designate a safety manager, and have limitations in engaging self-regulating disaster prevention activities due to reduced budget for safety facilities. For the small and medium-sized construction sites with less than 10 billion won, the Ministry of Labor has been carrying out mobile inspections of construction safety. However, the effect so far is insignificant and an improvement plan is required. Therefore, in the present thesis, we derive problems appearing in the current construction safety mobile inspection system, investigate and study systems in foreign countries, and suggest an efficient and effective plan to operate safety technology inspections. First of all, we establish a standard to select sites to be inspected that are high in construction risk and disaster occurrence probability In addition, we suggest a plan to take administrative and judiciary measures based on the total score for disaster factors considering the disaster occurrence probability and the illegal practices. Furthermore, a scheme to maximize the effect of disaster prevention is sought by building an organic cooperative system between the Ministry of Labor, Korea Occupational Safety & Health Agency and other organizations specialized in instruction of construction disaster prevention. Finally, we induce a research conclusion that leads to self-regulating safety management through checking and instructing systematic management on mobile inspections.

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An Efficient Dynamic Workload Balancing Strategy Design of the Wireless Reading/Management System for the Corrosion Monitoring of Underground Structures (지하 구조물 부식 감시를 위한 무선 검침/관리 시스템 설계)

  • Kwan, Yong-Kwang
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.7
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    • pp.95-102
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    • 2014
  • There are a variety of structures below the surface are buried. In particular, if It is experiencing problems in the city gas pipe or electrical wire, our safety would be greatly jeopardized. Therefore, the underground structures which encounter a variety of pollutants are highly sensitive to corrosion. So if you are not identify the degree of corrosion, it can lead to large accidents such as gas leakage. Until now, person visit directly every underground structure to measure and record manually, but This approach requires a lot of human and material resources and the continuity of management. Therefore, the research to find out the risk factors quickly via the continuous management is needed, and in this paper the structures management systems in the vehicle being moved by combining ICT underground structures for state information wirelessly collects and analyzes system is proposed.

Management of Traumatic Pancreas Injury in Korea: Literature Review (한국에서 외상성 췌장 손상의 치료에 대한 문헌 고찰)

  • Lee, Seung Hwan;Jang, Ji Young;Shim, Hongjin;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.26 no.3
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    • pp.207-213
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    • 2013
  • Purpose: Traumatic pancreas injuries are rare conditions that result in high morbidity and mortality. Thus, early diagnosis and intervention are very important to manage pancreatic injuries. The purpose of this study is to review the management and outcomes of the pancreatic injuries in the Korean population. Methods: Original articles published from January 2001 to December 2012 and addressing the Korean population were selected by using indices such as 'pancreas injury', 'traumatic pancreas injury', and 'pancreatic trauma' to search KoreaMed and PubMed. Nine reports were selected to review the management options for surgery or endoscopic retrograde cholangio-pancreatography. We assessed the injury mechanisms, injury severities, associated injuries, types of operation, and outcomes. Results: Two hundred fifty of the 332 patients included in the 9 selected reports were men, and the mean age of all patients was 36.4 years. The main injury mechanism was traffic accidents(65.6%). Most patients had grade II or III injuries(68.9%). The most common extra-pancreatic injury site was the liver, followed by the chest and spleen. Operative management, including distal pancreatectomies(129), drainage procedures(64), pancreaticoduodenectomies(23), and others(60), was used for 276 patients. The reported mortality rate was 10.2%, and the morbidity rate ranged from 38% to 76.9%. The average length of hospital stay was 39.5 days. Risk factors for mortality were amount of transfusion, injury severity, base deficit, age, and presence of shock. Conclusion: In this study, we found neither significant data nor a consensus. If national guidelines are to be developed and established, a national data bank or registry, and nationwide data collection are required.