• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.1
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• pp.21-27
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• 2019

Purpose: Mortality rate in the health services research field is frequently considered as a proxy for measuring healthcare quality. We compared the mortality rate and hospitalization levels among patients with poisoning. Methods: A population-based study of hospital size and level based on the Korean health insurance and assessment service was conducted to identify the impact of hospital level on patient mortality. Results: We analyzed a total of 16,416 patients, of which 7,607 were from tertiary hospitals, 8,490 were from general hospitals, and 319 were from hospitals. The highest mortality rate of diagnosis regarding poisoning was T60.31 (other herbicides and fungicides, 16%), followed by T60.0 (organophosphate and carbamate insecticides, 12.7%). There was no statistical difference in mortality among hospital levels for gender. Among age groups, tertiary hospitals had lower mortality than general hospitals and hospitals for patients aged more than 70 years (11.9% mortality at tertiary vs 14.2% at general and 23% at hospital; p=0.003, adjusted z score=-6.9), general hospitals had lower mortality than tertiary hospitals and hospitals for patients aged 18 to 29 (0.6% at general vs 2.4% at tertiary and 3.7% at hospital; p=0.01, adjusted z score=-4.3), and hospitals had lower mortality than tertiary hospitals and general hospitals for patients between 50 and 59 years of age (0% at hospital vs 6.4% at general and 8.3% at tertiary; p=0.004). Conclusion: Overall, there was no significant difference between mortality and hospital level among poisoned patients. However, to establish an efficient treatment system for patients with poisoning, further studies will be needed to identify the role of each facility according to hospital level.

• Health Policy and Management
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• v.27 no.2
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• pp.128-138
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• 2017

Background: The purpose of this study is to analyze the effects of differential coinsurance policy on prescription drug coverage of outpatients by types of medical institutions. Methods: In this study, we used a sample cohort database of the National Health Insurance Service and frequency analysis and marginal logistic regression model using generalized estimating equation were used for statistical analysis. Results: The summary on the major research is followed. First, about 16% of patients who used only tertiary or general hospital due to 52 ambulatory care sensitive conditions before policy implementation moved to hospitals and clinics. However, about 57% of them still use tertiary or general hospital. Second, the factors influencing the utilization of hospitals and clinics after the implementation of the policy were gender, age, and income level. As a result, the policy is effective to reduce the medical use of outpatient mental patients in tertiary or general hospital, but the effect is not significant. Conclusion: Therefore, in order to achieve the purpose of the policy for establishing the health care delivery system, it is necessary to adjust the co-payment so as to feel the burden on the co-payment when the outpatient for 52 ambulatory care sensitive conditions is used at the tertiary or general hospital.

• Economic and Environmental Geology
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• v.28 no.1
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• pp.69-77
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• 1995

Tertiary Pohang basin distributed in south western part of the Korean peninsula, is composed of Chunbuk formation as the basal conglomerate, Hakjon formation, Duho formation and intrusive basalt having 15 Ma by absolute age data. The basement of the basin is represented to Cretaceous sedimentary rocks, Hakjon welded tuff and Chilpo welded tuff and rhyolite. The fault systems in the basement of Tertiary Pohang basin are consist of $N20^{\circ}E$ fault, $N60^{\circ}W$ and E-W trend. NNE fault is not only strike-slip but also normal dip-slip. WNW fault has sinistral strike-slip sense and the geometry of E-W fault is strike-slip and normal faults. In the basin, the fault system is represented to $N20^{\circ}E$ strike-slip, E-W normal and NNE thrust faults. By these fault relationship and geometry, it is interpreted that NNE sinistral strike-slip fault and N-S normal faults have acted at the Cretaceous basement. After Miocene NNE dextral strike-slip fault has acted and created E-W normal fault. Progressively Tertiary basin was influenced by the transpression to make thrust and fold, namely inversion tectonics.

• Proceedings of the Korean Society for Bioinformatics Conference
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• 2004.11a
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• pp.250-261
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• 2004

A novel method for ab initio prediction of protein tertiary structures, PROFESY (PROFile Enumerating SYstem), is introduced. This method utilizes secondary structure prediction information and fragment assembly. The secondary structure prediction of proteins is performed with the PREDICT method which uses PSI-BLAST to generate profiles and a distance measure in the pattern space. In order to predict the tertiary structure of a protein sequence, we assemble fragments in the fragment library constructed as a byproduct of PREDICT. The tertiary structure is obtained by minimizing the potential energy using the conformational space annealing method which enables one to sample diverse low lying minima of the energy function. We apply PROFESY for prediction of some proteins with known structures, which shows good performances. We also participated in CASP5 and applied PROFESY to new fold targets for blind predictions. The results were quite promising, despite the fact that PROFESY was in its early stage of development. In particular, the PROFESY result is the best for the hardest target T0161.

• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.175-186
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• 2018

Pneumonia is an important cause of morbidity and mortality. Since 2014, the Health Insurance Review and Assessment Service (HIRA) has assessed the overall quality of care among hospitalized adult patients with community-acquired pneumonia (CAP) provided by all medical institutions in Korea. A committee of the Korea Academy of Tuberculosis and Respiratory Diseases developed the hospital inpatient quality measures set for CAP consisting of eight core measures and five monitoring measures. The composite measure score was calculated. The medical records of hospitalized adult patients ages 18 years or more with CAP from October to December 2014 were evaluated. The data of 523 hospitals (42 tertiary hospitals [8.0%], 256 general hospitals [49%], and 225 hospitals [43.0%]) and 15,432 cases (tertiary hospitals, 1,673 cases [10.8%]; general hospitals, 8,803 cases [57.1%]; hospitals, 4,956 cases [32.1%]) were analyzed. We found large variations among institutions in terms of performance of care measures for CAP. For the composite measure score, the mean value was 66.7 (tertiary hospitals, 98.5; general hospitals, 79.2; hospitals, 43.8). Despite significant differences in measure scores between tertiary, general hospitals and hospitals, no significant differences were found in mortality between hospitals. Further studies are needed to determine the care measures appropriate for CAP.

• Journal of Korean Clinical Health Science
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• v.4 no.2
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• pp.582-592
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• 2016

Purpose. For more effective hospital management, it analyzes the trend through general characteristics, balance sheet, income statement, and financial ratio analysis, grasps the causes of the problems, and analyzes management of the hospital in order to use the result as baseline data for development of the hospital in the future. Methods. The collected data of 3 years from 2011 to 2013 about 3 tertiary hospitals in metropolitan cities from Alio (provider of public institution information; www.alio.go.kr), Health Insurance Review & Assessment Service (www.hira.or.kr), and the website of the Ministry of Health and Welfare (www.mw.go.kr) were analyzed and general characteristics, balance sheet, income statement, and financial ratio, analysis are used as data. Results & Conclusions. From the result of data analysis from 2011 to 2013, general characteristics, balance sheet, income statement, financial ratio analysis, and pie charts could lead to conclusions as follows. In the result of comprehensive analysis, the 3 tertiary hospitals showed increase of fixed expense due to extension of the buildings and so did the scale of fund and asset. Although medical revenue increased, the margin of increase for medical expense was greater than that of medical revenue, which consequently led to loss. In prediction for the 3 tertiary hospitals based on characteristics so far, it is expected to see improved revenue structure after building extension is completed, but it is necessary to exert management effort to maintain its optimal level by enhancement in stability of management and inventory turnover through management of inventories.

• 한국지구물리탐사학회:학술대회논문집
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• 2007.06a
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• pp.337-342
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• 2007

The representative Cretaceous-Tertiary paleomagnetic poles of the Korean Peninsula have been obtained from primary remanences of unremagnetized rocks: $59.6^{\circ}N$, $194.7^{\circ}E$ for $K_{1M}$; $67.6^{\circ}N$, $207.7^{\circ}E$ for $K_{1L}$; $71.1^{\circ}N$, $215.2^{\circ}E$ for $K_2$; and $84.9^{\circ}N$, $292.6^{\circ}E$ for the Miocene. Chemical remanences of remagnetized rocks also yield Early Tertiary paleomagnetic pole ($83.9^{\circ}N$, $88.3^{\circ}E$). These paleopoles provide the tentative APWP of the Korean Peninsula since the Cretaceous, and suggest some tectonic interpretations as follows. The Korean Peninsula was located at similar latitude to the present position, and rotated clockwise with respect to the adjacent blocks during the Cretaceous. The Korean Peninsula experienced latitudinal movement during the Early Tertiary, which was possibly associated with the continental collision between India and Asia. The Korean Peninsula and Southwest Japan might be independent terrains during the Cretaceous based on the temporal discrepancies of the southward movements and the clockwise rotations of the two blocks with respect to Eurasia.

• Journal of Plant Biology
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• v.37 no.3
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• pp.301-308
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• 1994

The individual and combined effects of acidic rain, Mg deficiency (-Mg) and Al surplus (＋Al) on the growth of shoots and roots of pitch pine seedlings and the effect of humic substances (Lit) on Al toxicity were investigated. The growth of height and dry matter were not significantly less for pitch pine seedlings sprayed with simulated acid rain (SAR) of pH 3.5 than for those sprayed with SAR of pH 5.6. But treatments of Al and ＋Al-Mg in soil solution reduced the growth of seedlings in terms of height of shoots, and dry matter of shoots or roots. Effect of Mg deficiency on the growth of seedlings was apparent only when Al was treated simutaneously. The growth of seedlings, regardless of rain pH, decreased in the following order: control=-Mg>Lit＋Al>＋Al>＋Al-Mg. Treatments of Al and ＋Al-Mg in soil solution reduced the total length of secondary and teritary roots of seedlings regardless of rain pH, and decreased in the following order: the primary root

• Journal of Korean Clinical Nursing Research
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• v.23 no.1
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• Journal of Korean Clinical Nursing Research
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• v.19 no.3
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• pp.321-332
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• 2013

Purpose: Korean health insurance extended application of the Diagnosis Related Groups (DRG) payment system to tertiary and general hospitals from July, 2013. This study was done to develop a DRG fee adjustment mechanism applied to levels of nurse staffing to assure quality nursing service. Methods: Nurse stafffing grades among hospitals in Korea were analyzed. Differences and ratio of inpatient costs by nurse staffing grades in DRG fees and differences of DRG fee between tertiary and general hospitals were compared. Results: In 2013, nurse staffing grades in tertiary and general hospitals had improved, but other hospital nurse staffing grades remained at the 2001 level. Gaps of inpatient costs between first and seventh nurse staffing grades were over 10% in 4 out of 7 DRG diagnosis; However differences of DRG fee between tertiary and general hospitals were only 4.51% and 4.72% respectively. A DRG fee adjustment mechanism was developed that included nurse staffing grades and hospitalization days as factors of the formula. Conclusion: Current DRG fees motivate hospitals to decrease nurse staffing grades because cost reduction is bigger than compensation. This DRG fee adjustment mechanism reflects nurse staffing supply to motivate hospitals to hire more nurses as a reasonable compensation system.