• Quality Improvement in Health Care
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• v.4 no.2
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• pp.242-259
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• 1997

This study describes associated factors of readmission of 213 inpatients from an university hospital in Seoul. This retrospective study reviewed medical records of patients who discharged from a hospital stay for general diseases between 1 August 1995 and 31 October 1995, Cases were 68 discharge patients with an unplanned readmission within 30 days of discharge from an index stay. And the other cases are 145 patients who had more than two discharges and didn't have an unplanned readmission within 30 days. Logistic regression model was analyzed and the results were as follows; 1. duration of readmission, rate of unpayed, room, path, and risk of disease were more likely to be readmitted unexpectedly than the expected readmission patients. 2. early readmission, low risk condition group, and inadquateness of discharge plann for patients had unplanned radmissions rather than planned readmissions. Therefore, discharge planning education to health care provider is required and assessement of discharge planning should be evaluated. Readmissions are usually for related problems that arose during the original hopitaliztion and caused cost problems. Especially the unplanned readmissions are frequently preventable. Ultimately, models for readmissions can serve as a valuable clinical tool for target high-risk patients and older patients and with this kind of tools we can reduce hospital readmissions and maintain high-quality of inpatient care.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.39C no.11
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• pp.1050-1067
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• 2014

CAS(Close Air Support) is aircraft attack against hostile targets that are in close proximity to friendly forces. Immediate CAS is the mission that attack unplanned targets, and especially the distribution of suitable aircraft assets makes huge effect on the result of immediate CAS mission. But It is hard to find a previous studies on immediate CAS sortie distribution with aircraft suitability. This study suggests a methodology with aircraft suitability for immediate CAS sortie distribution. The methodology consists of 3 steps. Firstly, we analyze target information for situational awareness. Secondly, we calculate each aircraft's suitability value per each target based on the result of previous analysis. Lastly, we suggest immediate CAS sortie distribution based on the aircraft adoptability value to a decision maker. This methodology will provide not only quantitative analysis, but also decision making of immediate CAS sortie distribution more timely and effectively.

• Korean Management Science Review
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• v.34 no.1
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• pp.47-56
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• 2017

We focus on the Real time Fire Scheduling Problem (RFSP), the problem of determining the sequence of targets to be fired at, for the objective of minimizing threatening probability to achieve tactical goals. In this paper, we assume that there are m available weapons to fire at n targets (> m) and the weapons are already allocated to targets. One weapon or multiple weapons can fire at one target and these fire operations should start simultaneously while the finish time of them may be different. We suggest mathematical modeling for RFSP and several heuristic algorithms. Computational experiments are performed on randomly generated test problems and results show that the suggested algorithms outperform the firing method which is generally adopted in the field artillery.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.11 no.4
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• pp.2058-2074
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• 2017

Dense Heterogeneous Cellular Networks(HCNs) offer a promising approach to meet the target of 1000x increase in aggregate data rates in 5G wireless communication systems. However how to best utilize the available radio resources at densely deployed small cells remains an open problem as those small cells are typically unplanned. In this paper we focus on balancing loads across macro cells and small cells by offloading users to small cells, as well as dynamically switching off underutilized small cells. We propose a joint user association and base station(BS) sleep mangement(UA-BSM) scheme that proactively offloads users to a fraction of the densely deployed small cells. We propose a heuristic algorithm that iteratively solves the user association problem and puts BSs with low loads into sleep. An interference relation matrix(IRM) is constructed to help us identify the candidate BSs that can be put into sleep. User associations are then aggregated to selected small cells that remain active. Simulation results show that our proposed approach achieves load balancing across macro and small cells and reduces the number of active BSs. Numerical results show user signal to interference ratio(SINR) can be improved by small cell sleep control.

• Quality Improvement in Health Care
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• v.10 no.2
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• pp.176-189
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• 2003

Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

• Korean Journal of Social Welfare
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• v.52
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• pp.89-115
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• 2003

While many social work studies has focused on the development of practice intervention and demonstration of the efficacy, little attention has been given to the way how the results can be disseminated and utilized in practice area. But attempts to bridge the research-practice gap empathize importance of dissemination and utilization including knowledge utilization, innovation diffusion, information dissemination, program replication, and technology transfer etc. In this recognition, this study that focused on the process after development of program tried to search and analyze the real disseminating process and utilization state with applying Growing-up Skills Program(GUSP) developed and disseminated by this researcher. For the purpose, theories and models for program diffusion were reviewed, and dissemination & utilization of GUSP was analyzed on the 'Herie & Martin's model' with retrospective perspectives. Through this tracer study, these were confirmed or founded as problems of GUSP in disseminating process : lack of specific strategy for the dissemination ; unplanned coping due to little preparation ; and unclear and insufficient understanding of the target system in the beginning stage of dissemination. And followings are suggested for the improvement of social work program dissemination & utilization in the field: to conduct diffusion process on the basis of a proper model; to consider integrative relationship between D&D and dissemination & utilization ; to endeavor for collecting feed back from the field ; and to reinforce social work education and study related to innovation diffusion. These results showed importance of dissemination & utilization in social work and utility of GUSP despite of several limitations. More concerns of dissemination & utilization are needed for the integration of research and practice in Korean social work.