• Journal of Trauma and Injury
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• v.24 no.2
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• pp.143-150
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• 2011

Purpose: The object of this study is to compare the patient satisfaction in the view of scarring, cost, and hospital stay between the conventional suture method and a method using Histoacryl$^{(R)}$ (2-N-butylcyanoacrylate) adhesive for treating facial lacerations in the emergency department. Method: This study is a randomized prospective trial, which was conducted from December 2009 to January 2010. The participants include 109 patients who visited the emergency room in Deajon Eulji Medical Center. The ages ranged from 1 to 59 (mean age of 18.7), and all had facial lacerations of less than 3 cm. In order to treat the facial lacerations, an emergency medicine doctor used tissue adhesive (2-N-butylcyanoacrylate, Histoacryl$^{(R)}$) for 41 patients in the experimental group, and a plastic surgeon performed conventional suturing for 68 patients in the control group. The ER-stay and the primary treatment fee were compared in the two groups, and the scarring was evaluated 10 to 11 months from suturing by using the Modified Hollander Method and the 10-cm scaled VAS (visual analogue scale: score 0=no scar, score 10=very severe scar) Result: The ER stay was 76 minutes for the experimental group and 107 minutes for the control group, showing that statistically significantly less time of 31 minutes was taken in the experimental group. The cost of the experimental group was 40000 won (50.1%) more expensive than the control group, with an average cost of 121900 won for the experimental group and 81200 won for the control group. As for scar evaluation, 10.56 months after suturing, the experimental group showed a better result with a score of 2.6 compared to a score of 3.4 in the control group; however, this difference was not statistically significant ($p$ <0.05). As to a detailed evaluation of scar characteristics, the experimental group had a statistically significantly better result in scar elevation, with a score of 0.6 compared to a score of 1.65 for the control group. Conclusion: If appropriate patients are selected, the method using tissue adhesive directly applied by an EM doctor not only decreases ER stay but also creates similar patients satisfaction, with statistically better result in scar elevation, compared to the conventional suture method; thus, ultimately general patient satisfaction is increased.

• Journal of Korean Academy of Nursing
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• v.44 no.1
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• pp.86-96
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• 2014

Purpose: This study was conducted to examine and compare satisfaction with Korean health care services for Americans, Chinese and Russians who resided in Korea. Methods: A questionnaire was distributed to 252 participants (81 Americans, 89 Chinese, 82 Russians). Three focus group interviews were subsequently conducted in order to obtain a greater understanding of participants' experience and perspectives. Results: The average satisfaction score was 3.09, with Americans and Russians showing significantly higher scores than Chinese. Overall, participants reported higher satisfaction in 'Facility', 'Quality of care' and 'Nursing services' as opposed to 'Information/education'. 'Care with cultural respect' as well as communication related services. Data from the focus group interviews were categorized into 12 sub-categories, 7 categories and 2 themes. The two themes were common experience and contrasting experience. Common experience included 4 categories, 'Quality of care', 'Hospital facility and health care system', 'Language barrier' and 'Information and education'. Contrasting experience included 3 categories, 'Medical cost', 'Health care personnel' and 'Accessibility'. Conclusion: Results of this study provide basic knowledge on foreign residents' satisfaction and experience with Korean health care services. Further research is needed with foreigners from different cultural backgrounds. Administrative and educational efforts are required to improve communication skills and cultural competency.

• Korean Journal of Community Nutrition
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• v.6 no.3
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• pp.297-305
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• 2001

The aim of this study was to investigate the effects of food behavior and life-style behavior on the health-status of male industrial workers in the Masan region. The average age of the 173 male subjects was 42.9 years and 59% of the subjects were labor workers, 25% office workers, and 70% of them earned 1 - 1.5 million won monthly. The subjects were categorized into one of three groups : normal group, health-concerned group, and disease-suspected group classified by the criteria of the data (blood pressure, blood glucose, blood hemoglobin, serum total cholesterol, and serum triglyceride) obtained from a health examination. Forty seven belonged to the normal group, 71 to the health-concerned group, and 55 to the disease-suspected group. The health-concerned group, and disease-suspected group had significantly higher systolic and diastolic blood pressure, blood glucose, and serum total cholesterol than the normal group, and the disease-suspected group showed a significantly higher serum triglyceride level than the normal and health-concerned groups. The disease-suspected group consumed carbohydrate foods, such as cereals more frequently and protein foods such as beans and eggs less frequently than the normal group and health-concerned group. However, there was no difference in nutrient intakes among the three groups. The disease-suspected group and health-concerned group smoked more cigarettes and drank more frequently than the normal group, and the disease-suspected group exercised less as compared to the normal group. The kinds of diseases diagnosed in the disease-suspected group were hypertension, hyperlipidemia, liver disease, and neurological disease. The results of this study indicate that nutrition education and monitoring should be implemented for industrial workers to prevent chronic diseases and to reduce medical cost for the treatment of disease.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.631-639
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• 2020

Objective : Traditionally, staged surgery has been preferred in the treatment of compound comminuted depressed fracture (FCCD) after traumatic brain injury (TBI) and involves the removal of primarily damaged bone and subsequent cranioplasty. The main reason for delayed cranioplasty was to reduce the risk of infection-related complications. Here, the author performed immediate reconstruction using a titanium mesh in consecutive patients with FCCD after TBI, reported the surgical results, and reviewed previous studies. Methods : Nineteen consecutive patients who underwent single-stage reconstruction with titanium mesh for FCCD of the skull from April 2014 to June 2018 were retrospectively analyzed. The demographic and radiological characteristics of the patients with FCCD were investigated. The characteristics associated with surgery and outcome were also evaluated. Results : The frequency of TBI in men (94.7%) was significantly higher than that in women. Most FCCDs (73.7%) occurred during work, the rest were caused by traffic accidents. The mean interval between TBI and surgery was 7.0±3.9 hours. The median Glasgow coma scale score was 15 (range, 8-15) at admission and 15 (range, 10-15) at discharge. FCCD was frequently located in the frontal (57.9%) and parietal (31.6%) bones than in other regions. Of the patients with FCCDs in the frontal bone, 62.5% had paranasal sinus injury. There were five patients with fractures of orbital bone, and they were easily reconstructed using titanium mesh. These patients were cosmetically satisfied. Postoperatively, antibiotics were used for an average of 12.6 days. The mean hospital stay was 17.6±7.5 days (range, 8-33). There was no postoperative seizure or complications, such as infection. Conclusion : Immediate bony fragments replacement and reconstruction with reconstruction titanium mesh for FCCD did not increase infectious sequelae, even though FCCD involved sinus. This suggests that immediate single-stage reconstruction with titanium mesh for FCCD is a suitable surgical option with potential benefits in terms of cost-effectiveness, safety, and cosmetic and psychological outcomes.

• Journal of the Korean housing association
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• v.17 no.1
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• pp.117-126
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• 2006

This study was conducted as a survey to find out middle-aged persons's housing preferences for a future elderly housing and to grasp background characteristics of persons influencing the preferences and the effect of elderly's aging situations on the changes of their preferences. A sample of 300 middle-aged people was selected purposely from parents of university students living in Gwang-ju city. Questionnaires were administered to parents by students and analysed with SPSS Windows 10 program. Middle-aged persons's housing preferences were differed according to elderly's aging situations, in the case of healthy situation, they tended to prefer to stay present house without their children in irrespective to couple or single, whereas in the case of unhealthy situation, they tended to prefer to live with their children. and couples showed preferences for planned housing for the elderly and singles showed preferences for elderly housing facilities with care services. The most important characteristics of elderly housing among middle-aged people was a places where they can enjoy leisure and provide home-help services, located in the suburbs. Also middle-aged persons were likely to prefer to a green spaces such as garden, path for walking, and madang for the elderly housing. Needs for community care services (NCCS) were required above the average. Among the items of NCCS, a visiting medical examination was the most demanding, and a visiting nursing services, a emergency calling bell, and home repairs were sequently followed in the level of needs. The characteristics of the elderly housing which preferred to and needs for community care services were influenced by middle-aged persons's age, gender, subjective evaluation of economic abilities, tenure status, the cost of living, and the size of housing. This findings suggests that it must to be considered to develop various types of the elderly housing depending on socioeconomic status.

• Korean Journal of Biological Psychiatry
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• v.22 no.4
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• pp.195-204
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• 2015

Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.6067-6072
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• 2012

Background: Breast cancer in developing countries is on the rise. There are currently no guidelines to screen women at risk in India. Since mammography in the western world is a well-accepted screening tool to prevent late presentation of breast cancer and improve mortality, it is intuitive to adopt mammography as a screening tool of choice. However, it is expensive and fraught with logistical issues in developing countries like India. Materials and Methods: Our breast cancer screening camp was done at a local district hospital in India after approval from the director and administrators. After initial training of local health care workers, a one-day camp was held. Clinical breast examination, mammograms, as well as diagnostic evaluation with ultrasound and fine needle aspiration biopsy were utilized. Results: Out of total 68 women screened only 2 women with previous history of breast cancer were diagnosed with breast cancer recurrence. None of the women in other groups were diagnosed with breast cancer despite suspicious lesions either on clinical exam, mammogram or ultrasound. Most suspicious lesions were fibroadenomas. The average cost of screening women who underwent mammography, ultrasound and fine needle aspiration was $30 dollars, whereas it was $16 in women who had simple clinical breast examination. Conclusions: Local camps act as catalysts for women to seek medical attention or discuss with local health care workers concerns of discovering new lumps or developing breast symptoms. Our camp did diagnose recurrence of breast cancer in two previously treated breast cancer patients, who were promptly referred to a regional cancer hospital. Further studies are needed in countries like India to identify the best screening tool to decrease the presentation of breast cancer in advanced stages and to reduce mortality.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.9015-9019
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• 2014

The study aimed to compare the 2 main types of insurance used by colorectal cancer (CRC) patients in a university hospital in Thailand: universal coverage (UC) and 'Civil Servant Medical Benefit Scheme' (CSMBS) in terms of hospital expenditure and survival outcomes. CRC cases in stages I-IV who were operated on and had completed their adjuvant therapy in Songklanagarind Hospital from 2004 through 2013 were retrospectively reviewed regarding their hospital expenditure, focusing on surgical and chemotherapy costs. Of 1,013 cases analyzed, 524 (51.7%) were in the UC group while 489 (48.3%) belonged to the CSMBS group. Cases with stage IV disease were significantly more frequent in the UC group. Average total treatment expenditure (TTE) was 143,780 Thai Baht (THB) (1 US$ =~ 30 THB). The TTE increased with tumor stage and the chemotherapy cost contributed the most to the TTE increment. TTE in the CSMBS group was significantly higher than in the UC group for stage II-III CRCs. The majority of cases in the UC group (65.5%) used deGramont or Mayo as their first line regimen, and the proportion of cases who started with a capecitabine-based regimen (XELOX or $Xeloda^{(R)}$) was significantly higher in the CSMBS group (61.0% compared to 24.5% in the UC group, p-value < 0.01). On survival analysis, overall survival (OS) and progress free survival in the CSMBS group were significantly better than in the UC group. The 5-year OS in the CSMBS and UC groups were 84.3% and 74.6%, respectively (p-value < 0.01). In conclusion, the study indicates that in Thailand, the type of insurance influences resource utilization, especially the choice of chemotherapy, in CRC cases. This disparity in treatment, in turn, results in a gap in treatment outcomes.

• Health Policy and Management
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• v.5 no.1
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• pp.132-160
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• 1995

This study purported to acquire information necessary to improve the management of general hospitals. It tried to determine major indices which represent managerial performance of general hospitals and to identify the managerial characteristics of general hospitals which affect the major financial indices. Eighty-eight hospitals were chosen from 188 hospitals which were subject to standardization audit by the Korean Hospital Association. The results of a discriminant analysis are summarized as followings. First, when a single index was used to measure managerial performance of the sample hospitals, the ration of net profit to total capital was the best index and its discriminant power was 58.14%. The ratio of the number of boardmen((M. D.) and average daily medical cost were highly related to this index. Second, when two indices were used, income growth rte and the ration of net profit to total capital had the highest discriminant distinction ability. Their discriminant power was 61.9%. In this case, the ratio of the number of boardmen(M. D.) was significantly and highly related to the indices. Third, when all three indices-income growth rate, the ration of net profit to total capital and quick ratio - were used together, a discriminant function was statistically insignificant. Therefore, using all three indices was not useful in measuring managerial performance of the sample hospitals. In conclusion, using two indices-income growth rate and the ration of net profit to total capital-was better in measuring manegerial performance of general hospitals than using a single index. The independent variable which affected these indices was the ration of the number of boardmen. The discriminant function was : $D_{GI}=2.77+4.832\times(the ratio of the number of boardmen)$ *G=growth index(income growth rate) *I=profit index(the ration of net profit to total capital)

• The Journal of Korean Institute of Communications and Information Sciences
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• v.38B no.9
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• pp.728-735
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• 2013

In this paper, we present a method of transmitting ECG signals in real-time mobile environment to be possible to implement the ubiquitous healthcare system. Because of the excessive amount of data transmission of ECG signals, it is necessary to propose a limitation to the real-time transmission. We propose a real-time electrocardiographic monitoring system based on the proposal of unusual waveform detection algorithm which detects the R-wave distortions from the arrhythmia ECG signals having unusual waveform of about 10% on average. It is very effective in terms of time and cost for medical staffs to monitor and analyze ECG signals for a long period of time. Monitoring unusual waveform by gradually adjusting the threshold values of potential and kurtosis makes the amount of data transmitted decrease and significance level of waveform to be enhanced. The unusual waveform detection algorithm is implemented with ubiquitous environment inter-working device client. It is applicable to ubiquitous healthcare system capable of real-time monitoring the ECG signal. While ensuring the mobility, it allows for real-time continuous monitoring of ECG signals.