• Health Policy and Management
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• v.19 no.3
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• pp.1-26
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• 2009

Objectives : To identify target areas and set priorities among those areas identified for national quality evaluation. Methods : Target areas were identified from: i) analysis of the national health insurance claims data, mortality and prevalence data ii) various group surveys, including representatives from 22 medical specialty associations, 19 physician associations, QI staffs in hospital, civil organizations, and commissioners of Health Insurance Review and Assessment Service(HIRA) ⅲ) literature reviews and RAM(RAND/UCLA appropriateness method). The priority areas for national quality evaluation represented the full spectrum of health care and the entire life span. The criteria for selecting the priority areas were impact, improvability, and measurability. The priority areas were divided into three categories : short-term, mid-term, long-term. Results: Based on the group surveys and the data analysis, 46 candidates were selected as quality evaluation priority areas. 13 areas were selected as having a short-term priority areas: tuberculosis, community acquired pneumonia, stroke, ischaemic heart disease, diabetes, hypertension, chronic lower respiratory disease(asthma, chronic obstructive pulmonary disease), intensive care unit, emergency room, nosocomial infection, use of antibiotics, multiple medication and renal failure. This results suggested that we need to enlarge the target priority areas to the chronic diseases in short-term. Conclusions: The priority areas identified from the study will assist healthcare quality associated institutions as well as HIRA in selecting quality evaluation areas. It is required to develope and implement strategies for improving the quality of care within the next 5 years.

• Neonatal Medicine
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• v.25 no.3
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• pp.96-101
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• 2018

Purpose: We aimed to evaluate the respiratory illness-related hospital visits (out-patient clinics, emergency room, and re-admission) of preterm infants, and compare them according to corrected age and prematurity. Methods: We reviewed the medical records of preterm infants born at <37 weeks of gestation admitted to the neonatal intensive care unit (NICU) at Inha University Hospital between January 2012 and June 2015. Infant follow-up appointments in both neonatology and pulmonology out-patient clinics occurred for at least 2 years after NICU discharge. Results: The proportion of infants who visited the hospital due to any respiratory illness was as high as 50% until 12 months of corrected age, and subsequently decreased over time. Hospital admission was significantly higher in early preterm infants (<34 weeks of gestation) compared to late preterm infants (${\geq}34$ and <37 weeks of gestation). The proportion of infants who were re-admitted due to lower respiratory tract illness was significantly higher until 6 months of corrected age compared to the later, and did not differ between early and late preterm infants. Conclusion: The proportion of hospital visits of preterm infants due to respiratory disease was high until 12 months of corrected age. Most notably, the re-admission proportion from lower respiratory tract illness was high under 6 months in both early and late preterm infants. Preterm infants within this age that are visiting the hospital with respiratory symptoms should be carefully observed and followed up.

• Health Policy and Management
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• v.23 no.2
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• pp.103-111
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• 2013

Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

• Journal of the Korean Society for Precision Engineering
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• v.19 no.2
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• pp.95-105
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• 2002

In order to reduce the lead-time and cost, the technology of rapid prototyping (RP) has been widely used. However, RP technologies have disadvantageous characteristics according to their working principle: low building speed, high cost for introduction and maintenance of RP apparatus, stair-stepped surface and additional post processing. A new rapid prototyping process, as a transfer type of Variable Lamination Manufacturing by using expandable polystyrene room (VLM-ST), has been developed to reduce building lime. apparatus cost including the introduction and the maintenance and additional post-processing. The objective of this study is to propose a VLM-ST process and to develop an apparatus for implementation of the process. Design criteria of the apparatus are defined and the techniques arc proposed to satisfy the design criterion. In order to examine the efficiency and applicability of the developed process, various three-dimensional shapes, such as a world-cup logo. a knob shape, an extruded cross, a twisted shape, a character, Son-o-kong. a helical gear shaped and a scissor shape are fabricated on the apparatus in which unit shape layer (USL) was generated to build up each layer.

• Journal of Korean Public Health Nursing
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• v.28 no.1
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• pp.114-126
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• 2014

Purpose: The purpose of this study was to determine the accuracy and satisfaction with IVIC300 (Intravenous infusion controller). Method: The subjects consisted of 90 nurses and 100 patients. Data collected during July 2013 were analyzed using descriptive statistics, t-test, ANOVA, and $X^2$-test (Chi-Square). Result: The error value of IVIC300 was less than that of Dosi-flow. Differences of error values according to variable of fluid infusion (needle's gauge, patient's moving, patient's calls, and nurse's arabitary calls) were not significant. The mean scores for satisfaction with IVIC300 of nurses ($3.67{\pm}.76$), patients ($3.75{\pm}.63$) were above average. Satisfaction with IVIC300 of nurses differed significantly according to age, work unit, and clinical career. Satisfaction with IVIC300 of patients was not significantly different according to general characteristics. Conclusion: These findings indicate that it is proven the accuracy of IVIC300, and is considered individual characteristics in use IVIC300.

• Korean Institute of Interior Design Journal
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• v.24 no.3
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• pp.87-94
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• 2015

To analyze the space features of small-sized detached houses, this study has compared the floor plan types of detached houses and apartments. Currently small-sized detached houses are popular in Korea. The comparative analysis was focused on common residential patterns and the apartment plan. The results of space syntax were summarized as follows: four types of apartments and twelve types of small-sized detached houses were deduced by the relative spatial depth analysis. Among the sixty-seven house samples, only two of them showed the same pattern as those of apartments, which showed that each room of detached houses had distinct difference with those of apartments. According to the integration and control analysis, each space of apartments showed difference within narrow range, while the space of detached housed showed difference within wide range. In addition, the detached houses showed distinct relations between the center of space and the surroundings, and there are distinct differences between the easier layouts for access rooms and difficult ones. Moreover, the living rooms of detached houses somewhat exist under the low integration condition, and they cannot be standardized in the center of house, which are different with those of apartments. The master bedrooms of detached houses exit at the surrounding space same as those of apartments. Nevertheless the toilet is in the master bedroom which made its control lower than those of apartments.

• Clinical and Experimental Pediatrics
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• v.61 no.8
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• pp.239-244
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• 2018

Purpose: Hypothermia at admission is associated with increased mortality and morbidity in preterm infants. We performed a quality improvement (QI) effort to determine the impact of a decrease in admission hypothermia in preterm infants. Methods: The study enrolled very low birth weight (VLBW) infants born at Gangnam Severance Hospital between January 2013 and December 2016. This multidisciplinary QI effort included the use of occlusive wraps, warm blankets, and caps; the delivery room temperature was maintained above $23.0^{\circ}C$, and a check-list was used for feedback. Results: Among 259 preterm infants, the incidence of hypothermia (defined as body temperature <$36.0^{\circ}C$) decreased significantly from 68% to 41%, and the mean body temperature on neonatal intensive care unit admission increased significantly from $35.5^{\circ}C$ to $36.0^{\circ}C$. In subgroup analysis of VLBW infants, admission hypothermia and neonatal outcomes were compared between the pre-QI (n=55) and post-QI groups (n=75). Body temperature on admission increased significantly from $35.4^{\circ}C$ to $35.9^{\circ}C$ and the number of infants with hypothermia decreased significantly from 71% to 45%. There were no cases of neonatal hyperthermia. The incidence of pulmonary hemorrhage was significantly decreased (P=0.017). Interaction analysis showed that birth weight and gestational age were not correlated with hypothermia following implementation of the protocol. Conclusion: Our study demonstrated a significant reduction in admission hypothermia following the introduction of a standardized protocol in our QI effort. This resulted in an effective reduction in the incidence of massive pulmonary hemorrhage.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.761-764
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• 2011

Purpose: Pediatric facial laceration takes a huge part of patients visiting emergency room and generates social attention for its proper emergency care. So much more attention should be paid to the proper treatment at emergency care unit, and furthermore, thorough survey of background information of the pediatric facial laceration may offer more proper prevention. Methods: According to annual reports of 2009 and 2010, out of 5149 facial laceration patients who were given primary medical care at our clinic, 1452 patients were aged under 15 years old. Retrospective analysis of each pediatric facial lacerations were evaluated according to gender, age, periodic table, cause of injury, place of injury, sites of injury and so on. Results: Pediatric facial laceration was found to occur mostly at 1 year old as they learn to walk and explore their environment. Evaluated analysis revealed that pediatric facial accidents occurred mostly on forehead region (75%), on Sundays, from 5 p.m. to 8 p.m., at home (61.5%). Most common cause of injury was collision (54.5%). Conclusion: In large group of pediatric facial laceration cases provided us with an surprising fact that accidents most commonly occur under parental supervision. This fact gives an actual understanding regarding pediatric facial laceration and more realistic approach in its prevention strategy.

• Proceedings of the Korean Society of Tribologists and Lubrication Engineers Conference
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• 2004.11a
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• pp.350-354
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• 2004

In this study, the wear characteristics of five different dental composite resins cured by conventional halogen light and LED light sources were investigated. Five different dental composite resins of Surefil, Z100, Dyract AP, Fuji II LC and Compoglass were worn against a zirconia ceramic ball using a pin-on-disk type wear tester with 15 N contact force in a reciprocal sliding motion of sliding distance of 10 mm/cycle at 1Hz under the room temperature dry condition. The wear variations of dental composite resins were linearly increased as the number of cycles increased. It was observed that the wear resistances of these specimens were in the order of Dyract AP > Surefil > Compoglass > Z100 > Fuji II LC. On the morphological observations by SEM, the large crack formation on the sliding track of Fuji ?LC specimen was the greatest among all resin composites. Dyract AP showed less wear with few surface damage. There is no significant difference in wear performance between conventional halogen light curing and light emitting diodes curing sources. It indicates that a light emitting diodes (LED) source can replace a halogen light source as curing unit for composite resin restorations.

• Journal of the Korea Furniture Society
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• v.27 no.4
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• pp.383-391
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• 2016

Recently, the hospital infection has emerged as a major concern in the media. In everyday life, but not good if the infection refers to infection with the population living in the hospital. The case with which the equipment is used in a hospital if the person mediating and mediated, patients sometimes with the pathogen causing the disease to their patients. disease in our country for some time, and Mers is finished, large hospitals are taking place is a change in hygiene and operating systems. The Mers is spreading visits and influenced the patient or patient care. And the hygiene to limit the visiting hours for hospital infection prevention and stabilization of the patient. The infection, especially infection among patients and patients but a number of factors, from the emergency room or intensive care unit of frequent hospital contacts between patients with infection and of course, furniture for storing multiple people to use in the ward also become a source of infection. Hospital, another patient is a Cabinet that used to accept the next patient will cause a secondary infection and the role of infectious agents. Therefore, the general public will have a nervousness in the hospital, also medical care needed to avoid the problem occurred. This study examines such issues for the Cabinet of the hospital with a secondary infection is concerned, eco-friendly and hygienic storage furniture and one-off development that will help to improve the hospital environment for research purposes.