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An Analysis of the Management of a Tertiary General Hospital (2011 to 2013)

  • Park, Hyun-Suk
    • Journal of Korean Clinical Health Science
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    • v.3 no.1
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    • pp.276-289
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    • 2015
  • Purpose. To efficiently manage hospitals, this study aims to analyze the general characteristics, common-type balance sheet, common-type profit and loss statement and financial ratio of a tertiary general hospital and use the results as basic data for future hospital development by comprehending causes for problems and analyzing hospital management. Methods. By using information about a tertiary general hospital, located in A Metropolitan City, provided through Alio (www.alio.go.kr), a public organization information provider, Health Insurance Review & Assessment Service, and Ministry of Health and Welfare, this study used data during 3 years(2011 to 2013) by analyzing the general characteristics, common-type balance sheet, common-type profit and loss statement, industrial mean ratio and financial ratio of hospitals. Results. This study came to the following conclusions through the general characteristics, common-type balance sheet, common-type profit and loss statement, industrial mean ratio, financial ratio, circular chart and ROI by analyzing the data from 2011 to 2013. Conclusions. Overall, A Tertiary General Hospital showed an increase in fixed cost due to the construction of J Hospital and even in the size of capital and assets. It also showed an increase in medical profit, but the increase of its medical cost was higher, resulting in a financial loss. Especially, this hospital showed a slight decrease in net profit, featuring a reduction in inventory turnover. When the management of A Tertiary General Hospital was predicted based on such features, this hospital is expected to improve its profit structure through the opening of J Hospital, and it is necessary for this hospital to increase and sustain the turnover rate of inventories accumulated by managing them better.

Actual Situation of the Intern Physical Therapist at Hospitals in the Seoul Metropolitan Region (수도권 소재 일부 의료기관의 인턴물리치료사 관련 실태)

  • Lee, Byung-Joon;Yun, Mi-Jung;Lee, Kyoung-Suk;Lee, Hwang-Jae;Lee, Wan-Hee
    • The Journal of Korean Physical Therapy
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    • v.25 no.2
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    • pp.64-70
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    • 2013
  • Purpose: The purpose of this study was to provide information and suggestions for improvement of the intern physical therapist. Methods: I used 'intern physical therapist' as a keyword, and searched using the Google Search Appliance. Hospitals in the Seoul metropolitan region were selected. Twenty six hospitals that operate the intern physical therapist system were selected. A survey was conducted using questionnaires from August 20, 2012 to August 30, 2012. Among the 26 submitted questionnaires, 24 responded, and the results were analyzed using IBM SPSS Statistics 19.0. Results: 1. Education: (1) Sexual harassment prevention training, infection control training was lower at the rehabilitation hospital and semi hospital than at the university hospital and general hospital. (2) The rehabilitation hospital provided more education for intern physical therapists than the university hospital. (3) University hospital practice location was more diverse than that of the rehabilitation hospital. (4) In the rehabilitation hospital, education of practical skill was somewhat higher. 2. The employment rate of people who have completed an internship was higher in the rehabilitation hospital than the university hospital. Conclusion: Trial employment is more reasonable than intern physical therapist at the semi general hospital and rehabilitation hospital. Council is needed for decisions regarding internship training curriculum.

Association between Weekend Admission and In-hospital Mortality among Cardiovascular Patients in Korea

  • Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
    • Health Policy and Management
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    • v.29 no.2
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    • pp.237-244
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    • 2019
  • Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.

2020 Imaging Guidelines for Thyroid Nodules and Differentiated Thyroid Cancer: Korean Society of Thyroid Radiology

  • Ji Ye Lee;Jung Hwan Baek;Eun Ju Ha;Jin Yong Sung;Jung Hee Shin;Ji-hoon Kim;Min Kyoung Lee;So Lyung Jung;Young Hen Lee;Hye Shin Ahn;Jung Hyun Yoon;Yoon Jung Choi;Jeong Seon Park;Yoo Jin Lee;Miyoung Choi;Dong Gyu Na;Korean Society of Thyroid Radiology (KSThR) and Korean Society of Radiology
    • Korean Journal of Radiology
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    • v.22 no.5
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    • pp.840-860
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    • 2021
  • Imaging plays a key role in the diagnosis and characterization of thyroid diseases, and the information provided by imaging studies is essential for management planning. A referral guideline for imaging studies may help physicians make reasonable decisions and minimize the number of unnecessary examinations. The Korean Society of Thyroid Radiology (KSThR) developed imaging guidelines for thyroid nodules and differentiated thyroid cancer using an adaptation process through a collaboration between the National Evidence-based Healthcare Collaborating Agency and the working group of KSThR, which is composed of radiologists specializing in thyroid imaging. When evidence is either insufficient or equivocal, expert opinion may supplement the available evidence for recommending imaging. Therefore, we suggest rating the appropriateness of imaging for specific clinical situations in this guideline.

Telephone follow-up care for disabled patients discharged after receiving dental treatment under outpatient general anesthesia

  • Chi, Seong In;Lee, Soo Eon;Seo, Kwang-Suk;Choi, Yoon-Ji;Kim, Hyun-Jeong;Kim, Hye-Jung;Han, Jin-Hee;Han, Hee-Jeong;Lee, Eun-Hee;Oh, Aram;Kwon, Suk Jin
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.1
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    • pp.5-10
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    • 2015
  • Background: Patients were subjected to post-discharge follow-up (by telephone) in order to investigate the potential complications of outpatient general anesthesia or deep sedation that could develop in disabled dental patients discharged from the hospital. The ultimate aim of this study was to establish an appropriate response measure for such complications. Methods: The caregivers of 79 disabled patients who underwent dental procedures under general anesthesia at our outpatient clinic were interviewed over telephone. Necessary care instructions were provided during the phone calls when required. The patient satisfaction level regarding the telephonic follow-up care was surveyed by additional telephone calls. Results: Most of the patients did not suffer any serious complications; however, some reported fever and bleeding. The data obtained in this study can be utilized towards the development of caregiver education pertaining to the ambulatory general anesthesia of dental patients with disabilities. Conclusions: Additionally, we hope that the findings of this study will help minimize the effects of complications experienced by disabled dental patients undergoing ambulatory general anesthesia, as well as increase the overall patient satisfaction level.

Effects of a Standardized Critical Pathway for Gastrectomy Patients in a General Hospital (일개 종합병원의 위 절제 환자에 적용한 Critical Pathway의 효과)

  • Kim, Eun-Ok;Kwon, Soon-Man
    • Korea Journal of Hospital Management
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    • v.9 no.3
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    • pp.128-142
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    • 2004
  • To evaluate the effects of critical pathway on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a tertiary care academic medical center. The basic research design is a retrospective case-control comparative study. 470 patients of gastrectomy were included in the study; 180 before pathway development (control), 163 right after pathway implementation (path group I) and 127 one year after pathway implementation (path groupII). 476 patients of modified radical mastectomy were also analyzed to examine whether the reduction of the length of hospital stay is from the hospital-wide trend or due to the critical pathway. Death after operation, ICU stay, unplanned re-operation, readmission after discharge, the length of hospital stay and cost were analyzed. 2-test, one-way ANOVA, Bonferroni and Turkey's test were used for statistical analysis. (1) There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. (2) The length of hospital stay was 13.0 days in control group, 12.2 days in path group I and 10.0 days (p<0.01) in path groupII. (3) The total costs during the hospital stay were reduced. However the cost per day was significantly increased from reduction of hospital stay (358,488won in control, 366,017won in path group I and 413,220won (p<0.01) in path groupII). Critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care.

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Nutritional Assessment of ICU Inpatients with Tube Feeding (경관급식을 공급한 중환자실 환자의 영양상태 평가)

  • Kim, Yu-Jin;Seo, Jung-Sook
    • Journal of the Korean Dietetic Association
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    • v.21 no.1
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    • pp.11-24
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    • 2015
  • This study investigated the general status of tube feeding for intensive care unit (ICU) inpatients and evaluated the consequent nutritional status of patients. This study was approved by the Institutional Review Board (IRB) of a general hospital located in Daegu metropolitan city. The subjects of this study were 80 adult patients who had been admitted to the ICU of a hospital, received fed tube feeding, and then been discharged. The differences in nutrition screening indicators, including percentage ideal body weight (PIBW), serum albumin, hemoglobin, total lymphocyte count, and total cholesterol, before and after tube feeding according to body mass index (BMI) or nutrient feeding levels were investigated. The ratios of actually provided amounts to calorie and protein requirements of patients were $72.8{\pm}15.8%$ and $72.6{\pm}19.8%$, respectively. The change in PIBW before and after tube feeding was significantly different among the BMI groups (P<0.01). The change in hemoglobin concentration before and after tube feeding was also significantly different among the BMI groups (P<0.01). When subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided calories to required calories, there was no significant difference in nutrition screening indicators before and after tube feeding. When the subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided protein to required protein, serum albumin concentration showed a significant difference among the groups before and after tube feeding (P<0.05). Therefore, an intensive nutrition intervention program would be needed for the nutritional improvement of ICU inpatients receiving tube feeding.

Dilemmas Within the Korean Health Insurance System

  • Park, Donghwi;Chang, Min Cheol
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.4
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    • pp.285-288
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    • 2020
  • The health insurance system in Korea is well-established and provides benefits for the entire national population. In Korea, when patients are treated at a hospital, the hospital receives a partial payment for the treatment from the patient, and the remaining amount is provided by the health insurance service. The Health Insurance Review and Assessment Service (HIRA) assesses whether the treatment was appropriate. If HIRA deems the treatment appropriate, the doctor can receive payment from the health insurance service. However, this system has several drawbacks. In this study, we aimed to provide examples of the problems that can occur in relation to HIRA assessments in Korea through actual clinical cases.

A rare case of dilated invaginated odontome with talon cusp in a permanent maxillary central incisor diagnosed by cone beam computed tomography

  • Jaya, Ranganathan;Kumar, Rangarajan Sundaresan Mohan;Srinivasan, Ramasamy
    • Imaging Science in Dentistry
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    • v.43 no.3
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    • pp.209-213
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    • 2013
  • It has been a challenge to establish the accurate diagnosis of developmental tooth anomalies based on periapical radiographs. Recently, three-dimensional imaging by cone beam computed tomography has provided useful information to investigate the complex anatomy of and establish the proper management for tooth anomalies. The most severe variant of dens invaginatus, known as dilated odontome, is a rare occurrence, and the cone beam computed tomographic findings of this anomaly have never been reported for an erupted permanent maxillary central incisor. The occurrence of talon cusp occurring along with dens invaginatus is also unusual. The aim of this report was to show the importance of cone beam computed tomography in contributing to the accurate diagnosis and evaluation of the complex anatomy of this rare anomaly.

Serratus Anterior Plane (SAP) Block Used for Thoracotomy Analgesia: A Case Report

  • Okmen, Korgun;Okmen, Burcu Metin;Uysal, Serkan
    • The Korean Journal of Pain
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    • v.29 no.3
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    • pp.189-192
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    • 2016
  • Thoracotomy is a surgical technique used to reach the thoracic cavity. Management of pain due to thoracotomy is important in order to protect the operative respiratory reserves and decrease complications. For thoracotomy pain, blocks (such as thoracic epidural, paravertebral, etc.) and pleural catheterization and intravenous drugs (such as nonsteroidal anti-inflammatory drugs [NSAIDs], and opioids, etc., can be used. We performed a serratus anterior plane (SAP) block followed by catheterization for thoracotomy pain. We used 20 ml 0.25% bupivacaine for analgesia in a patient who underwent wedge resection for a lung malignancy. We provided analgesia for a period of close to seven hours for the patient, whose postoperative VAS (visual analog scale) scores were recorded. We believe that an SAP block is effective and efficient for the management of pain after thoracotomy.