• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.19-40
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• 2002

The purpose of this study is to find out if there has been any change in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare program that divides the roles of doctors and pharmacists and the reason for the change if there is any. Two tertiary care hospitals with the largest capacity of 1200 beds and two tertiary care hospitals with the lowest capacity of 600-700 beds were randomly selected. Data of the outpatient visits from March-May 2(xx), before the new healthcare system was adopted, were compared with the data from March-May 2001, after the new policy was adopted. Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. Decrease in re-visits is much higher than the first visits. Female patients decreased more than the male patients. Outpatient visits by economically active patients group aged 25-44 declined much. Tertiary hospitals in Seoul and Kyonggi Province, as well. Outpatient income of tertiary hospitals has dropped up to 14.7% due to the decline in outpatient visits and pharmaceutical income, and resell price system which in turn has caused the hospital financial deficits. While the new program has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs. A full-fledged review of the system should be conducted for the establishment of the new system and I believe this study may be a useful references. Furthermore, more profound and overall studies on the chance in the patients use of hospitals are needed.

• International Journal of Automotive Technology
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• v.8 no.4
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• pp.413-419
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• 2007

Experimental study of additives on the ignition performance of a compression ignition natural gas engine is introduced, followed by results of a simulation of its working mechanism. From the experimental results, it is understood that engine ignition performance can be improved when a certain amount of Di-tertiary-butyl peroxide additive is added. If the mass fraction of Di-tertiary-butyl peroxide additive reaches as high as 14.2%, engine ignition can be realized at ambient temperatures with a glow plug temperature of about $750^{\circ}C$. From the simulation results, we verify that the Di-tertiary-butyl peroxide additive, by cracking its radicals at lower temperature, can accelerate reaction rate. Therefore, the additive is able to improve the ignition performance of natural gas significantly.

• Mass Spectrometry Letters
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• v.5 no.2
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• pp.49-51
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• 2014

The effectiveness of tertiary matrices composed of the combination of three common matrices (dihydrobenzoic acid (DHB), ${\alpha}$-cyano-4-hydroxycinnamic acid (CHCA), and sinapinic acid (SA)) was compared with that of single or binary matrices in the analysis of polyethylene glycol (PEG) polymers ranging from 1400 to 10000 Da using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). A tertiary matrix of 2,5-DHB+CHCA+SA was the most effective in terms of S/N ratios. CHCA and CHCA+SA produced the highest S/N ratios among the single matrices and the binary matrices, respectively. The improvement observed when using a tertiary matrix in analyses of PEG polymers by MALDI-TOF MS is believed to be due to the uniform morphology of the MALDI sample spots and synergistic effects arising from the mixture of the three matrix materials.

• YAKHAK HOEJI
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• v.25 no.4
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• pp.199-204
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• 1981

The methanol extract of Thalictrum uchiyamai Nakai was fractionatedi nto four parts; (1) ether soluble nonphenolic fraction (2) phenolic tertiary bases fraction, (3) chloroform soluble tertiary bases fraction and (4) aqueous quaternary bases fraction. The fractions of this plant showed a total of twenty-four spots on the silica gel TLC. Ether soluble nonphenolic fraction and ether soluble phenolic fraction showed nine alkaloid spots respectively, chloroform soluble fraction showed three alkaloid spots and quaternary bases fraction showed three alkaloid spots. The antimicrobial activity of the four extracts was shown as follows; nonphenolic tertiary bases inhibited the growth of Micrococcus dutica at the concentration of $50\mu$g/ml, in phenolic tertiary bases $500\mu$g/ml concentration was inhibitory to Micrococcus dutica and to Staphyloccus aureus. In aqueous quaternary bases, $500\mu$g/ml concentration was inhibitory to Klebsiella pneumonae. Chloroform soluble tertiary fraction showed slight activity. All of bases showed reproducible activity against tested microorganisms.

• Proceedings of the Korean Institute of Building Construction Conference
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• 2021.11a
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• pp.164-165
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• 2021

To prepare the good-adherent and weather-resistant acrylic resin coatings, acrylic resin was prepared by a radical polymerization. Glass transition temperature(Tg) of the acrylic copolymer was fixed at 30℃ and the contents of tertiary amine monomer(DMAEMA) was varied to be 5, 10, 15, 20 wt% respectively. γ-Glycidoxypropyltrimethoxysilane(GPTMS) containing epoxy group was used for curing agents and di-n-butyltindilaurate(DBTDL) was used for drying accelerator. The equivalent ratio of amine to epoxy was 1:1. The prepared coatings exhibited excellent adhesion to various substrates, and various physical properties of the coatings were satisfactory. The gloss retention and color difference were improved at low tertiary amine concentration. The coatings containing 10wt% tertiary amine concentration have especially good weather resistant properties.

• Proceedings of the Korean Geotechical Society Conference
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• 2002.11b
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• pp.3-17
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• 2002

Tertiary Pohang basin distributed in south weatern part of the korean peninsula, is composed of Chunbuk formation as the basal conglomerate, Hakjon formation, Duho formation and intrusive basalt which is 15 Ma by absolute age data. The basement of the basin is represented by Cretaceous sedimentary rocks, Hakjon welded tuff and Chilpo welded tuff and rhyolite. The fault systems at the basement of the Pohang basin are consist of NNE direction fault, WNW to EW trend fault. NNE fault is not only strike-slip fault but also normal fault. n fault has sinistral strike-slip sene and the EW fault is strike-slip and normal fault. In the Tertiary basin, the fault system is represented by nm strike-slip fault, EW normal fault and NNE thrust fault. By these fault relationships and geometries, it is interpreted that NNE sinistral strike-slip fault and nomal fault have acted at Creceous times. At Tertiary tines, NNE dextralstrike-slip fault and EW normal fault has created. Progressively Tertiary Pohang basin was influenced by the trenspression to make thrust fault and fold, namely as inversion tectonics.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.1
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• pp.63-73
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• 2003

Purpose : The purpose of this study is to analyze the comparison of organizational climate and job satisfaction of nurses between a secondary hospital and a tertiary hospital. Method : The subjects of this study were 50 nurses who were working in a secondary hospital and 50 working in a tertiary hospital. The data was collected by self-reporting questionnaires. The data were analysed using frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson's correlation coefficient, regression analysis. Result : 1) There was no statistical significance of the difference of organizational climate between a secondary hospital and a tertiary hospital. However, there was a statistical significance of the difference of job satisfaction. 2) In the organizational climate, there was a significant difference by income in a secondary hospital, and by position in a tertiary center. 3) In the job satisfaction, there was significant differences by age, marriage, position, and duration of working in a secondary hospital, otherwise. there was no significant difference in a tertiary hospital. 4) There was significant positive correlation between organizational climate and job satisfaction. Organizational climate significantly affected job satisfaction. Conclusion : It is suggested that the nursing organizational effectiveness program should be developed with reflecting on organizational characteristics that the nurses perceived.

• Health Policy and Management
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• v.23 no.1
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• pp.19-34
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• 2013

Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

• Korean Journal of Clinical Pharmacy
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• v.28 no.4
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• pp.300-307
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• 2018

Objective: As the demands of healthcare environment change, it is necessary to advance human health care by improving students' essential competencies including knowledge, skills, abilities, inter-professional collaboration and patient centered care. This study identified long term accomplishment and improvement of the essential competencies in clinical pharmacy practice education (CPPE) at Korean hospitals over time. Methods: This study was conducted for pharmacy students who completed CPPE evaluation related to tertiary hospitals and secondary hospitals located in Seoul and Gyeonggi-do regional area from 2014 to 2018. Results: Over the past 5 years, overall results of student evaluation on the essential competencies in CPPE at both tertiary and secondary hospitals showed a decreasing trend or did not change. Essential competency in CPPE at tertiary hospitals had been identified as superior on 'Learn clinical knowledge in the treatment of diseases' to secondary hospitals [average number of students (%): 210 (72.9%) vs 68 (68.0%)]. On the other hand, essential competencies in CPPE at secondary hospitals had been identified as better at 'inter-professionals collaborative teamwork and direct patient care' than tertiary hospitals [average number of students (%): 64 (64.0%) and 56 (56.0%) vs 121 (42.0%) and 90 (31.3%)]. A total of 176 (61.1%) students in tertiary hospitals and 66 (66.0%) in secondary hospitals evaluated that 'patient-centered care' education was good. Conclusion: In tertiary hospitals, all six essential competency outcomes have not been improved, whereas four essential competency outcomes showed an increasing trend in secondary hospitals. It will be necessary to develop outcome-based CPPE education program to better reflect the essential competencies.

• Journal of Korean Clinical Nursing Research
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• v.28 no.2
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• pp.122-136
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• 2022

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.