Purposes: This study aims to analyze the correlation with the current status of the medical resident application rate, physician's income, and non-benefit rates of majors in each specialty subject and to suggest implications. Methodology: First, it analyzes the correlation between the medical resident application rate by specialty subject and the income of physicians. Second, it analyzes the correlation between the income of specialists and the non-benefit rate for each specialty subject at the clinic level. Findings: First, a significant positive correlation was found between the medical resident application rate and the average physician's income for each specialty subject (r=.718, p<.01). Second, a significant positive correlation was observed between physician income at the practitioner level by medical specialty and the non-benefit rate (r=.726, p<.01). Practical Implications: In this study, the correlation between medical resident application rate by specialty subject and physician's income, non-payment and physician's income was confirmed. Choosing a department that is less risky and can earn higher income is a natural phenomenon, but it is necessary to adjust the physicians crowding phenomenon to a specific specialty subject at the government level to maintain the medical system.
The present study was conducted to assess relative importance of hospital attributes considered by patients with spinal diseases in choosing specialty or general hospitals. A total of 230 patients hospitalized with spinal diseases in sampled study sites, including 2 specialty and 2 general hospitals, participated in a self-administered questionnaire survey from April 26 through May 8 2007. Patients were asked to rate the degree of agreement on each of the 15 attributes on a 5-point Likert-type scale (1 : strongly disagree, 5 : strongly agree) for which they chose the hospital because of that specific attribute. Based on a Factor analysis, the attributes were grouped into 4 : facility and environment, accessibility, interpersonal factor, and credibility. Both patient groups from specialty (mean scale score ; 3.75) and general hospitals (3.62) commonly considered 'credibility' to be the most important attribute, followed by 'facility and environment (3.05 and 3.21).' Logistic regression analysis showed that men(Odds ratio(OR)=0.333) and those with monthly income of $\geq$ 4 million won (OR=0.298) were less likely to choose specialty hospitals. Age groups of 30 to 39 years old (OR=5.140) and $\geq$ 60 years old(OR=4.761), and professionals (OR=5.207) tended to choose specialty hospitals. Patients expressing more importance on 'facility and environment' attribute were less likely to use specialty hospitals (OR=0.571), whereas those emphasizing 'accessibility' were more likely to use specialty hospitals(OR=1.487). The findings of significant difference in patient's demographic characteristics and consideration in hospital attributes would contribute to have a better understanding on patient's choice behaviour and to develop strategy to improve patient's satisfaction.
Purposes: As super-aging population and low fertility rates are threatening the sustainability of the National Health Insurance funds, enhancing the efficiency of hospital management is paramount. In the past, studies analyzing the efficiencies of hospitals primarily made inter-hospital comparisons, but it is important to assess hospitals' internal efficiency and develop improvement measures in order to attain practical improvements in hospital efficiencies. The purpose of this study is to analyze the efficiencies of specialists by medical specialty in a hospital in order to provide foundational data for efficient hospital management. Methodology/Approach: We used the activity-based costing (ABC) data and hospital statistical data from one tertiary hospital in Seoul to analyze the efficiency of specialists by medical specialty. Efficiency was analyzed and compared among specialists using the data envelopment analysis developed by Charnes, Cooper, and Rhodes (DEA-CCR) model and the slacks-based measure (SBM) models. The input variables were labor cost, material cost, and operational expenses, and the output variables were the number of outpatients, number of inpatients, outpatient revenue, and inpatient revenue. Findings: First, there was a marked deviation in efficiency across specialists. Second, there was a marked deviation in efficiency across medical specialties. Third, there was little difference in efficiency according to the specialist's sex, age, and job position. Fourth, the SBM model produced more conservative results and better explained efficiency parameters than the CCR model. Practical Implications: The efficiency of a specialist was more influenced by their medical specialty than their personal characteristics, namely sex, age, and job position. Therefore, Further research is needed to analyze the efficiencies of each subspecialty and identify factors that contribute to the variations in efficiencies across medical specialties, such as clinical practices and fee structures.
Choi, Jin Bong;Han, Kyung-Do;Ha, U-Syn;Hong, Sung-Hoo
International Neurourology Journal
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제22권4호
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pp.305-312
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2018
Purpose: The aim of this study was to analyze the efficacy and to estimate the complication rate of incontinence surgery according to the surgeon's specialty and whether a preoperative urodynamic study (UDS) was performed, using a nationally representative dataset. Methods: We enrolled 356,155 women over 20 years old who had undergone surgery for stress urinary incontinence between 2006 and 2015. Patients were followed for up to 3 years to analyze the reoperation and complication rates. Data were obtained from the National Health Claims Database of the National Health Insurance Service (NHIS) of Korea. Multiple Cox regression analysis was conducted to examine the efficacy and safety of incontinence surgery according to the surgeon's specialty and whether a preoperative UDS was performed. Results: The hazard ratio (HR) for reoperation was significantly higher for procedures performed by nonurologists than for procedures performed by urologists (HR, 1.174; 95% confidence interval [CI], 1.103-1.249). Acute urinary retention, postoperative infections, procedure-associated pain, and other complications were also more common in procedures performed by nonurologists than in those performed by urologists. When stratified by whether a preoperative UDS was performed, the HR for reoperation according to the surgeon's specialty varied by performance of a preoperative UDS. While the reoperation rate was significantly higher in procedures performed by non-urologists when a preoperative UDS was performed (HR, 1.208; 95% CI, 1.122-1.3), there was no significant difference in the HRs for reoperation according to specialty when a preoperative UDS was not performed. Conclusions: This population-based study showed that the postoperative outcomes of incontinence surgery were dependent upon the surgeon's specialty and that the reoperation rate according to the surgeon's specialty varied based on whether a preoperative UDS was performed.
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.
Objectives In the previous studies, it has been suggested that temperament and character may affect specialty choice in medical students. The aim of this study is to investigate the effects of temperament and character on specialty interests in medical students. Methods A total 132 third-year medical students initially participated in this study. Among these participants, 128 students had filled out both demographic and Temperament and Character Inventory (TCI) questionnaires. Socio-demographic data, specialty interests and Cloninger's TCI scores were obtained. The specialty interests were categorized into surgical, medical and other departments. Results Among 128 students, 88 (68.7%), 29 (22.7%) and 22 (8.6%) students chose medical, surgical and other departments, respectively. Students choosing surgery departments showed lower Harm Avoidance scores (F = 4.39, df = 1, p = 0.04) and higher Self-Directedness scores (F = 4.30, df = 1, p = 0.04) than those who chose medical departments. There was no significant differences in Novelty Seeking, Reward dependence, Persistence, Cooperativeness, Self-Transcendence scores between groups. Conclusions To the best of our knowledge, this is the first study that has demonstrated the relationship between TCI scores and specialty interests of medical students in Korea. The current study suggests that temperament and character influence specialty interests in medical students. These findings could have implications for medical education research and career counseling.
Background Citation analysis is a recognized scientometric method of classifying cited articles according to the frequency of which they have been referenced. The total number of citations an article receives is considered to reflect it's significance among it's peers. Methods Until now, a bibliometric analysis has never been performed in the specialty of craniofacial anomalies and craniofacial surgery. This citation analysis generates an extensive list of the 50 most influential papers in this developing field. Journals specializing in craniofacial surgery, maxillofacial surgery, plastic surgery, neurosurgery, genetics and pediatrics were searched to demonstrate which articles have cultivated the specialty within the past 55 years. Results The results show an intriguing compilation of papers which outline the fundamental knowledge of craniofacial anomalies and the developments of surgical techniques to manage these patients. Conclusions This citation analysis provides a summation of the current most popular trends in craniofacial literature. These esteemed papers aid to direct our decision making today within this specialty.
The purpose of this study explains how service characteristics such as service competence, service customization, interpersonal communication and image affect service trust and affective commitments and how service trust, affective commitment play a role in affecting risk-taking and service loyalty in specialty hospital. and then confirm the mediating role of relationship quality components such as service trust and affective commitment in the above path relation. For this purpose, the research hypothesis was verified by structural equation model analysis(SEM) using SPSS 21.0 and AMOS 20.0 statistical package. The results of the study are as follows. First, interpersonal communication influenced service trust, image influenced affective commitment, service ability influenced service trust and emotional commitment, while service customization did not affect any factor. Second, service trust and affective commitment did not effect each other. Third, service trust and affective commitment were more powerful in risk-taking than the influence on service loyalty. Fourth, Risk takings affected service loyalty. Therefore, marketers of special hospitals not only medical services by providing medical service with superior service ability, but also by always strengthening interpersonal communication at the time of providing services. This will enable consumers to overcome the avoidance in the service decision process and implement a specific service marketing strategy that can continuously use the hospital service.
As one designs a building, one should have to consider its characters and functions according to its own use. Recently many professional buildings used to be designed by specialized design firms with their own experience and specialty to vitalize the functions of the buildings. Especially the design of the hospital is really needed more concern from the beginning of design ordering because it is pursuing the most specialty in architectural designs and therefore it can not be managed with general architects. The purpose of this study is to present the references for resonable promotions of hospital design in the future with the analysis of the suitability in hospital design ordering and the process after design competition in Korea.
Rosales, Azucena Moreno;Molina, Miguel Corres;Moo, Jacqueline Gongora;Morelos, Pablo Romero;Bandala, Cindy
Asian Pacific Journal of Cancer Prevention
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제17권11호
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pp.5019-5023
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2016
Background: In Mexico, breast cancer (BCa) is in first place regarding cancer mortality and has been established as a priority health issue. The incidence of metastasis from BCa is very high and presents as the principal mortality factor among women younger than 40 years of age. OBJECTIVE. To determine any associations between clinicopathological characteristics and metastasis in Mexican women under 40 years of age. Methods: During the 2010-2015 period, a total of 180 female BCa cases seen at the Navy General High Specialty Hospital, SEMAR, in Mexico City; we collected information on 20 patients with BCa younger than 40 years of age. Statistical analyses were conducted using the Kolmogorov-Smirnov, Students t, Fisher, Chi square, and Mantel-Haenszel tests. Results: The prevalence of women with BCa younger than the age of 40 years during the 2010-2015 period was 13.3%. We found a high frequency of obesity in of these cases (>75%); 100% of obese patients with a history of smoking presented with metastasis (p <0.05). In addition, the hormone phenotype was important; HER2-positive cases were 12 times more likely tto exhibit metastasis (p <0.05), while expression of estrogen and progesterone receptors appeared to be protective. Diabetes mellitus in combination with smoking was also a risk factor for development of metastasis (p <0.05). Conclusion: In this study, we obtained essential data regarding risk of metastasis in young breast cancer cases which could be useful for predicting disease evolution and treatment response.
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