• Health Policy and Management
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• v.30 no.1
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• pp.82-91
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• 2020

Background: This study investigates the influence factors of medical service variations using medical charge and the length of stay (LOS) for urinary incontinence surgery and uterine polypectomy. Methods: The National Health Insurance claims data and Medical Resource Report by the Health Insurance Review & Assessment Service in 2016 were used. Frequency analysis, one-way analysis of variance, and Bonferroni post-hoc tests were executed for each surgery. A multilevel analysis was executed to assess the factors to the medical charge and LOS for each surgery in patient, doctor, and hospital level. Results: Fifty-two point eight percent of urinary incontinence surgery and 87.1% of uterine polypectomy were distributed in general and tertiary hospitals. Among three levels, the patient level variation was 61.5% or 77.2% in medical charge and 93.9% or 96.3% in LOS, respectively. The doctor level variation was 29.6% or 22.6% in medical charge and 0.6% or 0.0% in LOS, respectively. The institution level variation was 8.9% or 0.2% in medical charge and 5.5% or 3.7% in LOS, respectively. Number of other disease and organizational type were main factors that affected the charge and LOS for urinary incontinence surgery and uterine polypectomy. Conclusion: Medical service variations of the urinary incontinence surgery and uterine polypectomy were the largest for the patient level, followed by doctor level for the medical charge, and the institution level for the LOS.

• Journal of Chest Surgery
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• v.47 no.3
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• pp.249-254
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• 2014

Background: Delirium after cardiac surgery is associated with serious long-term negative outcomes and high costs. The aim of this study is to evaluate neurobehavioral, hemodynamic, and sedative characteristics of dexmedetomidine, compared with the current postoperative sedative protocol (remifentanil) in patients undergoing open heart surgery with cardiopulmonary bypass (CPB). Methods: One hundred and forty two eligible patients who underwent cardiac surgery on CPB between April 2012 and March 2013 were randomly divided into two groups. Patients received either dexmedetomidine (range, 0.2 to $0.8\;{\mu}g/kg/hr$; n=67) or remifentanil (range, 1,000 to $2,500\;{\mu}g/hr$, n=75). The primary end point was the prevalence of delirium estimated daily via the confusion assessment method for intensive care. Results: When the delirium incidence was compared with the dexmedetomidine group (6 of 67 patients, 8.96%) and the remifentanil group (17 of 75 patients, 22.67%) it was found to be significantly less in the dexmedetomidine group (p<0.05). There were no statistically significant differences between two groups in the extubation time, ICU stay, total hospital stay, and other postoperative complications including hemodynamic side effects. Conclusion: This preliminary study suggests that dexmedetomidine as a postoperative sedative agent is associated with significantly lower rates of delirium after cardiac surgery.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.398-406
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• 2018

Background: Hypoalbuminemia (serum albumin < 3.5 g/dL) is associated with increased morbidity and mortality in patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, costs associated with hypoalbuminemia remain unknown. This study investigated the effect of serum albumin on direct treatment costs, length of stay (LOS), and readmissions for primary and revision THA and TKA patients. Methods: All adult patients at a single institution undergoing primary or revision THA or TKA between January 2014 and December 2016 were retrospectively reviewed. Patients were stratified by preoperative serum albumin level. The primary outcome was total direct costs at index hospitalization. Secondary outcomes included LOS and readmission within 30 days. Multivariable regressions were utilized to adjust for demographics and comorbidities. Results: Of 3,785 patients, 114 (3.0%) had hypoalbuminemia. After adjustment, hypoalbuminemia was associated with a 16.2% increase in costs (${\beta}=0.162$; 95% confidence interval [CI], 0.112 to 0.213; p < 0.001), representing an average cost increase of $3,383 (95% CI, $2,281 to $4,485) relative to costs for serum albumin > 4.5 g/dL. The increased total costs were significantly higher in revision ($4,322, p = 0.034) than in primary ($3,446, p < 0.001) procedures. In adjusted regression, each 1.0 g/dL increase in serum albumin yielded a 6.6% reduction in costs (${\beta}=-0.066$; 95% CI, -0.090 to -0.042]; p < 0.001), for average savings of $1,282 (95% CI, $759 to $1,806) per unit albumin. Adjusted regressions demonstrated that a 1-point increase in serum albumin reduced readmissions by 53% (odds ratio, 0.47; 95% CI, 0.31-0.73; p = 0.001) and LOS by 0.6 days (${\beta}=-0.60$; 95% CI, -0.76 to -0.44; p < 0.001). Conclusions: Hypoalbuminemia is associated with increased total direct costs, LOS, and readmissions following primary and revision THA and TKA. Future efforts to predict and address total costs should take into consideration the patient's preoperative serum albumin levels.

• Journal of the Korean housing association
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• v.17 no.4
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• pp.155-163
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• 2006

To investigate the actual management condition of group homes for the elderly and their living environment, four group homes and 26 elderly people living in the group home were surveyed. As the results, the relationships between the administrator and the elderly were acceptable, but the group homes seem suffer from insufficient administrative supports. The most required service in the group homes was a conversational partner service. Moreover, the most satisfactory point for the elderly living in group homes was the settlement of food, clothing, and housing. The unsatisfactory things were the service related to medical, leisure, and house work and an invasion of their private life. The resident elderly in group homes were fully satisfied with their living environment including the relationship with the manager and the people in the facility. They, however, do not have much chance to make an exchange with their neighbor. Overall, the elderly want to stay continuously in the group homes where they are living current.

• 제어로봇시스템학회:학술대회논문집
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• 2002.10a
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• pp.54.2-54
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• 2002

Robots are widely used for welding automation in the shipbuilding industry. Because of the distinguishing mark of the shipbuilding, many robots conduct each other welding jobs at a point of time. The manager/operator stay in a place apart from working site for safety reason, but need to observe the progress of work and the status of robots. On this account, the monitoring system for welding robots has become essential. We developed a monitoring system by which, many people can monitor robot's status simultaneously at separated locations through the web. The monitoring system consists of Server and Client, where the server keep connection to robots and deliver client's request to robots and cli...

• Journal of Engineering Education Research
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• v.14 no.4
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• pp.62-68
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• 2011

Many engineering schools in Korea implement ABEEK programs. One of the core parts of ABEEK is accreditation criterion 2, the program outcomes and their appraisal. This paper tries to discuss the program outcomes and to study the impact of applying the program outcomes to one of the graduation requirements. We show simple survey results for implementing ABEEK programs concerning the program outcomes and their relation to graduation requirements. If the program outcomes are used as one of the graduation requirements, some graduates may satisfy the average grade point for graduation requirements but can not meet the program outcome criteria satisfied by other than regular classes. In this case, the graduate may have trouble to try to meet the program outcome criteria, since he may not be able to stay in school without taking classes. The problems of setting the levels of program outcomes as graduation requirements, non classwork related program outcomes, and work burden to professors should be also prudently reviewed for successful ABEEK implementation.

• Proceeding of Spring/Autumn Annual Conference of KHA
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• 2005.11a
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• pp.93-96
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• 2005

To investigate the actual management condition of group homes for the elderly and their living environment, four group homes and 26 elderly people living in the group home were surveyed. As the results, the relationships between the administrator and the elderly were acceptable, but the group homes seem suffer from insufficient administrative supports. The most required in the group homes was a conversational partner service. Moreover, the most satisfactory point for the elderly living in group homes was the settlement of food, clothing, and housing. The unsatisfactory things were the service related to medical, leisure, and house work and an invasion of their private life. The resident elderly in group homes were fully satisfied with their living environment including the relationship with the manager and the people in the facility. They, however, do not have much chance to make an exchange with their neighbor. Overall, the elderly want to stay continuously in the group homes where they are living current.

• Proceedings of the SAREK Conference
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• 2006.06a
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• pp.838-846
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• 2006

The purpose of this study to develop the air-conditioning system that adopts adaptive model as an indoor climate control logic for energy saving. The adaptive model using the ability of human thermal adaptation could be expected to alleviate the indoor set-point temperature compared with the past heat-balance model. Especially, in case of hybrid air-conditioning system coupled with natural ventilation and heating/cooling system, the adaptive model can be describe the thermal comfort of inhabitant who stay at hybrid system controlled buildings with accuracy. In this paper, the concept of adaptive model will be described and the results of a continuous measurement on the actual thermal experiences and behaviors of thermal adaptation for office worker will be reported.

• Journal of Korean Academy of Nursing
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• v.46 no.4
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• pp.610-617
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• 2016

Purpose: Smoking cessation is strongly recommended for every smoker after ischemic stroke, but many patients fail to quit smoking. An improved smoking cessation rate has been reported with intensive behavioral therapy during hospitalization and supportive contact after discharge. The aim of this study was to demonstrate the usefulness of the timely interventions for smoking cessation in men with acute ischemic stroke. Methods: Patients who participated in the timely interventions strategy (TI group) were compared with those who received conventional counseling (CC group). In the TI group, a certified nurse provided comprehensive education during admission and additional counseling after discharge. Outcome was measured by point smoking success rate and sustained smoking cessation rate for 12 months. Results: Participants, 157 men (86 of the TI group and 71 of the CC group), were enrolled. Mean age was $58.25{\pm}11.23$ years and mean initial National Institutes of Health Stroke Scale score was $4.68{\pm}5.46$. The TI group showed a higher point smoking success rate compared with the CC group (p=.003). Multiple logistic regression analysis showed that the TI group was 2.96-fold (95% CI, 1.43~6.13) more likely to sustain smoking cessation for 12 months than the CC group. Conclusion: Findings indicate that multiple interventions initiated during hospital stay and regular follow-up after discharge are more effective than conventional smoking cessation counseling in men with acute ischemic stroke.

• Journal of Korean Society of Transportation
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• v.24 no.3 s.89
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• pp.51-61
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• 2006

Interchanges are passages for vehicle and pedestrians and a gateway to nearby facilities, and a place to stay of vehicle and Pedestrians. Interchange traffic must be able to navigate well for safety and convenience. Traffic safety and efficiency are influenced by the interchange. In this study, relative delays of vehicles are compared by changing traffic interchanges. the volume of traffic, the number of lanes, the rate of left turns vehicle on the interchanges of urban arterial roads. The object of this study is to compare Grade crossing interchange, Diamond interchange. Roundabout interchange. SPUI(Single Point Urban Interchange), Echelon interchange). Echelon interchange. By VISSIM Simulation, this study drew the relative delay value of every scenario and compared the delay value of each vehicle considering construction expenses. Through this comparison study, ideal interchange is dependent on the volume of traffic, the number of lanes, and the rate of left turns.