• 대한영양사협회학술지
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• 제6권2호
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• pp.136-147
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• 2000

The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.

• 대한간호학회지
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• 제22권4호
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• pp.589-603
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• 1992

This study investigated a process to estimate the need for nursing staff on the basis of a patient elassification system and the required care needs and activities. The investigation was carried out in the following four steps. Step 1. Patients were classified according to the amount of nursing care need on each shift as class I (mildly ill), class II (mederately ill), class III (acutely ill), and class IV (critically ill). Step 2. Measurement of the direct nursing care hours needed for each patient class, and measurement of indirect nursing care hourse and personal time of the nursing staff. Step 3. Calculation of he total nursing workload in a nursing unit. Step 4. Estimation of the nursing staff needed. The investigation was carried out from July 17th to 30th, during 24hours every other day. The subjects were the patients and the nursing staff on two units of Seoul National University Hospital, Korea. Some of the results from the investigation are as follows : 1) Distribution of patient classification On the neuro surgical (N.S.), the distribution was class I, 22 patient, 3, class II, 27 patients, class III, 26 patients, and class IV, 25 patients, For the orthopedic surgical unit(0.5.), it was class I, 43 patients, class II, 43 patients, class III, patients, and class IV, 3 patients. 2) Direct nursing care hours per day On the N.S. unit, 3.2 hours of direct nursing care were needed for class I, 3.9 hours for class II, 5.1 hours of class III, and 6.2 hours for class IV patients, while 2.0 hours for class I, 2.5 hours for class II, 3.5 hours for class III, 5.0 hours class IV patients were needed on the 0.5. units. 3) Analysis of direct nursing care activities Activities were classified into assessment and observation(47%), medication(38.7%), communiontion(5.1%), exercise(2.4%), elimination and irrigation(1.3%), treatmemt(1.1%), hygiene(0.8%), nutrition(0.8%), and hot and cold compress(0.1%). 4) Average hours of indirect nursing care per day. On the N.S. unit 4.2 hours, and on the O.S. unit, 3.5 hours of RN indirect care was needed. 5) The average personal time used by the of nursing staff was 17 minutes for both RNs and nursing assistants in the N.S. unit, and 32 minutes for both RNs and nursing assistants in the O.S. unit. 6) Estimation of nursing staff needed on two specialized units of a university hospital For the N.S. nursing unit of 43 beds, 31 nursing staff would be indicated. For the 0.5. nursing unit of the same number of beds, 19 nursing staff would be indicated.

• 한국해양학회지:바다
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• 제8권1호
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• pp.1-13
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• 2003

본 연구는 해초지(seagrass bed)와 그 주변 퇴적물에 서식하는 중형저서동물의 군집 특성을 비교하고자 1999년 2월부터 7월까지 매월 남해안 돌산도 율림의 Zostera marina로 구성된 해초지에서 조사를 실시하였고, 1999년 5월에 서해안 백령도 두무진의 Zostera caespitosa 해초지와 어청도 내항의 Zostera marina 해초지를 중심으로 조사를 실시하였다. 모든 조사지역에서 해초지와 해초의 서식이 없는 비해초지(Non-seagrass bed)로 구분하여 채집하였다. 총 13개의 중형 저서동물 분류군이 출현하였고, 모든 정점에서 선충류가 가장 우점하였으며, 그 다음의 주요 우점 동물군은 저서유공충류, 환형동물류 그리고 저서성 요각류로 나타났다. 서식밀도는 6월에 돌산도 율림의 해초지 정점에서 7,244 개체/10 cm2 로 가장 높게 나타났으며, 5월에 백령도의 비해초지 정점에서 438개체/10$\textrm{cm}^2$로 가장 낮은 밀도를 보였다. 중형저서동 물의 퇴적물내 수직분포는 해초지 정점과 비해초지 정점 모두, 표층 2cm이내에서 가장 높은 서식밀도를 나타냈으며. 그 이하에서는 급격한 감소를 보였다. 전체 중형저서동물 크기별 분포는 해초지 정점과 비해초지 정점 모두, 0.125 mm-0.25 mm 크기의 개체가 가장 많았다. 퇴적불의 입도는 S(sand)에서 sM(sandy mud)까지 나타나며 , 평균 입도 조성은 해초지가 비해초지에 비해 더 세립한 경향을 나타냈다. 각 시기별 정점별로 총 개체 서식밀도, 정점별 출현분류군 수 그리고 주요 우점종의 해초지 선호성 등의 항목을 대상으로 ANOVA 검정을 실시한 결과, 해초지는 비해초지와 유의한 차이를 나타내(P<0.05), 해초지가 중형저서동물의 서식지로 중요한 의미를 갖고 있음을 보여주었다.

• 대한간호학회지
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• 제23권1호
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• pp.68-89
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• 1993

This study was conducted to develop a model of a fee schedule for nursing services.'Regardless of the demand for skilled and professional nursing service today, the Korean health insurance system does not furnish a chapter for the nursing service fee schedule. A nation-wide survey of hospital nursing service fee schedules was to provide practical and realistic data about how the variety of nursing services are being charged. From September 1990 to April 1991, data from the fee schedule used by twenty hospitals located in eight large cities which are designated large medical regions in the Korea Health Care and Patient Referral System were collected. Nursing services and the fees charged for them were analyzed. The nursing services were subjected to a secondary analysis with referrence to reports on “nursing services to be charged in Korea”. The total number of nursing services recommended by the literatures was 177 : finally 141 types of nursing services were selected by investigator as chargable nursing services. In addition, data on managerial characteristics of the hospitals were collected to discover influential variables for a nursing fee schedule model. Under the assumption that all the managerial characteristics of the hospitals influenced the fee schedule, the following model was tested : Fee of nursing services (C) = f(A₁, A₂, A₃, A₄, A/sub 5/, A/sub 6/, A/sub 7/, A/sub 8/,) When, A₁ = number of nurses A₂ = the first salary of a nurse educated in a four year A₃ = scale of nursing management division A₄ = location of the hospital A/sub 5/ = the type of hospital management (profit / non-profit) A/sub 6/ = number of hospital beds A/sub 7/ = years of hospital operation A/sub 8/ = number and kinds of clinical divisions The results showed that the model should be built as follows : C = f (A₁, A/sub 4/, A/sub 5/) Each nursing service was applied to the fee schedule with consideration for the professional level and time-taken to provide the services. Detailed fee schedules were presented in the related tables. Of the 141 kinds of nursing services, 24.8% were chargeble to the Korea Health Insurance, 32.6％ of the nursing services were being paid directly by the patienty. The rest of nursing services (42.6％) were not being charged to any source. It was recommened that the Korea Health Insurance Reimbursement system should add a classification system for nursing services that can be used in the national health care program. Further study is needed about how to include 32.6% of the nursing services now being paid for directly by the patients in the health insurance system.

• 보건행정학회지
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• 제30권3호
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• pp.326-334
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• 2020

Background: Korea has gradually expanded the coverage of medical care services in its national health insurance system. On April 1, 2018, it implemented a policy that expanded the coverage for an ultrasonography in the upper abdomen. In this study, we aimed to investigate the effect of the policy on the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals. Methods: Using the dataset of the Health Insurance Review and Assessment Service, we explored changes in the utilization of the ultrasonography in the upper abdomen in tertiary care hospitals from July 1, 2017 to November 30, 2018 through the difference-in-difference (DID) mixed-effects-model method. Facility factor, equipment factor and personnel factors, type of hospital, the total amount of medical care expenses, and geographic region were considered as control variables. Results: On average, the utilization of the ultrasonography in the upper abdomen increased by 228% after the coverage expansion policy. However, the results of DID mixed-effects-model method analysis showed that the utilization increased by 73%. As for the number of beds, the utilization was higher with a group of 844-930, 931-1,217, and 1,218 or greater compared with a group of 843 or fewer, while the utilization of the number of ultrasonic devices was lower with a group of 45-49 compared with a group of 44 or fewer. The utilization decreased with the number of interns and the number of nurse assistants. Besides, relative to Seoul, the utilization was lower in the other metro-cities and provinces. Conclusion: The coverage expansion policy in the national health insurance system increased service utilization among people. Future research needs to investigate the degree to which such coverage expansion policy reduces the unmet medical care needs among the deprived in Korea.

• 한국산림과학회지
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• 제20권1호
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• pp.45-50
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• 1973

싸리류(類)에 대(對)한 선발된 우량개체 및 앞으로 육성(育成)될 신품종(新品種)에 대(對)하여 무성번식의 방법을 구명(究明)코져 조록싸리, 참싸리, 늦싸리, 싸리, 털근록싸리, 풀싸리를 공시재료로 하여 4월(月) 상순(上旬) 삽목직전 1년지(年枝)를 채취하여 삽수길이 15~20cm, 삽수굵기 3~4mm, 삽수상하단을 동일하게 타원형으로 조제하여 1,000배액의 "우수프론"으로 소독한 삽상길이 150cm의 모래상에 삽목하였으며 삽목후 해가림 관수를 하였다. 그 결과 교배에 의한 신품종 및 선발개체(選拔個體)에 대(對)한 무성번식이 가능함을 인정할 수 있었으며 아래와 같은 결과를 얻었다. 1. 싸리류(類)의 삽목발근율은 50.3~69% 로 품종간 차이를 인정할 수 있었으며 털조록싸리, 조록싸리의 발근율이 제일 높고 풀싸리가 제일 낮았다(유의 수준 1%). 2. 생육상황(生育狀況)은 조록싸리, 싸리가 좋았으며 풀싸리가 가장 불량했다. 3. 본당(本當) 뿌리수는 길이 5cm 이상만을 측정하였으며 털조록싸리가 6.4개로 제일 많고 풀싸리가 1.3개로 제일 적었다(유의수준 1%). 4. 본당(本當) 뿌리의 총연장은 털조록싸리 279.8cm, 조록싸리 200.1cm로 가장 길고 풀싸리는 41.1cm로 가장 짧았다(유의 수준 1%). 5. 본당(本當) 근류착생수는 직경 1mm 이상만을 조사하였으며 털조록싸리 34.4개, 조록싸리 27.1개로 제일 많고 풀싸리는 4.6개로 제일 적었다.

• 한국산학기술학회논문지
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• 제16권6호
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• pp.4031-4039
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• 2015

저출산 고령화로 헌혈인구는 감소하고, 노년층의 혈액사용량은 증가할 것으로 예상되어 혈액부족과 수혈의 안정성 문제가 대두되고 있다. 이에 본 연구에서는 만성 퇴행성관절염인 슬관절과 고관절 전치환술 환자의 수혈에 영향을 주는 요인을 분석하고자 하였다. 이를 위해 건강보험심사평가원의 2011년 환자표본자료 중 입원환자 5,370명을 대상으로 하였으며, SPSS 20 프로그램을 이용하여 로지스틱 회귀분석을 실시하였다. 독립변수로 사용된 변수는 병원특성과 환자특성으로 병원특성은 의료기관 종류, 설립구분, 기관소재지와 가동병상수를, 환자특성으로는 성, 연령, 중증도, 전신마취유무, 주 진단, 빈혈유무와 의료보험종류로 구분하였다. 분석결과, 슬관절전치환술 환자의 수혈에 유의한 영향을 미치는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 주 진단, 빈혈유무였으며, 고관절전치환술 환자의 수혈에 유의한 영향을 주는 변수로는 의료기관 종류, 기관소재지, 성, 연령, 중증도, 전신마취유무, 빈혈유무였다. 수혈현황과 영향요인을 분석한 본 연구는 비용 효과적이며, 양질의 의료를 위한 기초자료로 활용될 수 있을 것으로 기대한다.

• 보건행정학회지
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• 제18권4호
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• pp.148-169
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• 2008

As the Korean Government began to perceive healthcare as one of foundational industries for national dynamics, there has been mounting advocacy for the introduction of for-profit hospitals with a view to bringing efficiency in healthcare services industries and improvement of their international competitiveness. The Government is now considering the issue from all angles in favor of permitting for-profit hospitals. However, There have been few precedent studies on this subject to provide helpful data for the discussion and in the health policy making. This study used private hospitals - for-profit and nonprofit - in Florida, USA as study subjects to accumulate basic data that may be utilized for those involved in debates and health policy making relating to the introduction of for-profit hospitals in Korea. Among all the private general hospitals in Florida, those surveyed by AHA(American Hospital Association) for four consecutive years from 2001 and 2004 and others reported about to MCR(Medicare Cost Report) included in the collected data for analysis. In total 139 private general hospitals consisting of 73 for-profit hospitals and 66 nonprofit hospitals were included in the collected analysis data. Results of analysis revealed no significant difference between for-profit hospitals and nonprofit hospitals in the usage aspects of healthcare services including the average length of stay and the ratio of Medicare vs Medicaid patients. However, financial performances indicated by such factors. as the pre-tax return on assets and the pre-tax operating margin showed to be significantly higher in for-profit hospitals compared with nonprofit hospitals. And the ratio of personnel expenses and the turn period of total assets showed to be significantly lower in for-profit hospitals. Based on the hypothesis that arguments about the introduction of for-profit hospitals have considerably different viewpoints depending on the size of hospital represented by the number of bed, these two hospital types were compared again using the number of beds as a controlled factor, but the results were similar. We, therefore, could conclude that the for-profit hospitals in Florida included in this study could, in their for-profit operation, improve their financial performance by pursuing cost reduction and effectively utilizing their assets without limiting the amount and the range of their services or avoiding less medically protected groups such as Medicare and Medicaid patients.

• 한국어류학회지
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• 제29권2호
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• pp.130-138
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• 2017

경남 통영시 한산면 추봉리 봉암에 위치한 잘피밭의 어류의 월별 종조성과 양적 변동을 분석하였다. 자료는 2009년 8월부터 2010년 7월까지 매월 예인망을 이용하여 수집하였다. 총 30종, 3,237개체, 6,850.1 g의 어류가 채집되었다. 우점한 종들은 살망둑, 그물코쥐치, 복섬, 점망둑, 일곱동갈망둑, 실고기로 전체 개체수의 86.7%를 나타내었다. 잘피의 평균 엽장은 8월에 $772.7{\pm}136.0mm$, 건중량 81.6 g, 11월 평균 엽장은 $698.1{\pm}146.4mm$, 건중량 57.2 g, 2월 평균 엽장은 $499.2{\pm}96.4mm$, 건중량 15.41 g, 5월의 평균 엽장은 $642.5{\pm}208.3mm$, 건중량 61.90 g이었다. 봉암 잘피밭 어류 군집은 9월부터 12월까지 종수와 개체수가 감소하다가 그 이후부터 증가하였다. 이러한 결과는 계절변화에 따른 수온 변화가 잘피밭의 어류 종조성에 주요한 영향을 주었기 때문인 것으로 생각된다.

• 대한간호학회지
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• 제42권3호
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• pp.351-360
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• 2012

Purpose: The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. Methods: A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. Results: The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Conclusion: Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.