• 제목/요약/키워드: large hospitals

검색결과 381건 처리시간 0.03초

Current Trend of Robotic Thoracic and Cardiovascular Surgeries in Korea: Analysis of Seven-Year National Data

  • Kang, Chang Hyun;Bok, Jin San;Lee, Na Rae;Kim, Young Tae;Lee, Seon Heui;Lim, Cheong
    • Journal of Chest Surgery
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    • 제48권5호
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    • pp.311-317
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    • 2015
  • Background: Robotic surgery is an alternative to minimally invasive surgery. The aim of this study was to report on current trends in robotic thoracic and cardiovascular surgical techniques in Korea. Methods: Data from the National Evidence-based Healthcare Collaborating Agency (NECA) between January 2006 and June 2012 were used in this study, including a total of 932 cases of robotic surgeries reported to NECA. The annual trends in the case volume, indications for robotic surgery, and distribution by hospitals and surgeons were analyzed in this study. Results: Of the 932 cases, 591 (63%) were thoracic operations and 340 (37%) were cardiac operations. The case number increased explosively in 2007 and 2008. However, the rate of increase regained a steady state after 2011. The main indications for robotic thoracic surgery were pulmonary disease (n=271, 46%), esophageal disease (n=199, 34%), and mediastinal disease (n=117, 20%). The main indications for robotic cardiac surgery were valvular heart disease (n=228, 67%), atrial septal defect (n=79, 23%), and cardiac myxoma (n=27, 8%). Robotic thoracic and cardiovascular surgeries were performed in 19 hospitals. Three large volume hospitals performed 94% of the case volume of robotic cardiac surgery and 74% of robotic thoracic surgery. Centralization of robotic operation was significantly (p<0.0001) more common in cardiac surgery than in thoracic surgery. A total of 39 surgeons performed robotic surgeries. However, only 27% of cardiac surgeons and 23% of thoracic surgeons performed more than 10 cases of robotic surgery. Conclusion: Trend analysis of robotic and cardiovascular operations demonstrated a gradual increase in the surgical volume in Korea. Meanwhile, centralization of surgical cases toward specific surgeons in specific hospitals was observed.

뇌혈관 한의학 기반 연구사업 등록자료를 통한 363명의 급성기 뇌경색 환자의 기초 임상자료 분석 (Analysis of 363 Consecutive Patient with Acute Ischemic Stroke f개m the Hanbang Stroke Registry)

  • 선종주;정재한;문상관;조기호;고성규;전찬용;한창호;정우상
    • 대한한의학회지
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    • 제28권1호통권69호
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    • pp.35-41
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    • 2007
  • Objectives : To gain better insights on the characteristics of stroke patients admitted to oriental medical hospitals, we analyzed the data of 363 consecutive patients with acute ischemic stroke from Hanbang Stroke Registry supported by the Ministry of Science and Technology of Korea. Methods : Subjects' enrollment was in the oriental medical hospitals of 3 universities located in the metropolitan region from October 2005 to October 2006. We assessed the subjects' general characteristics, risk factors, and etiology of stroke. Each patient's TOAST classification type was confirmed by two independent specialists. Those were small vessel occlusion (SVO), large artery atherosclerosis (LAA), cardioembolism (CE), stroke with other determined etiology (SOE), and stroke with undetermined etiology (SUE).Results 'The distribution of the subjects' general characteristics and risk factors for stroke were similar with result storm previous reports. However, in the TOAST classification, SVO was the major type occupying 78.5% in the total subjects, which is the highest share compared with other research with similar methods. These results imply that patients with more severe symptoms rarely visit oriental medical hospitals. Conclusion : Assuming that this research will continue adding patient's data continuously, this work will help us to understand the features of stroke patients at oriental medical hospitals, and contribute to expansion of the Korean Hanbang Stroke Data Bank.

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노인장기요양시설의 현황 및 Web GIS 분석에 의한 농촌지역 요양시설과 보건소·병원간의 접근성 (The Present Condition of Nursing Home & Accessibility to Health Center and Hospital from Nursing Home in Rural Area by Web GIS Analysis)

  • 남윤철;박경옥
    • 한국농촌건축학회논문집
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    • 제12권4호
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    • pp.29-36
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    • 2010
  • The purpose of this study is to have detailed data of the distribution, locations, and the amount of people in the waiting line of the nursing home. Also, we studied the accessibility to the facilities by using Web GIS to analyze the transit time it takes from the nursing home to health center and hospitals. We can provide the basic data that could contribute when future plans for the nursing homes' locations, health and medical policy are made. The results are as follows. 1. The nursing homes are stiffly concentrated in regions of Seoul and Gyeongi-do where large number of the elderly covered by long-term care insurance and the waiting line was very long for the elderlies to enter the nursing homes. In these cities of Ulsan and Jeju where number of the elderly covered by long-term care insurance is relatively small, there were less facilities. 2. The nursing homes located in urban areas had higher occupancy rate and higher number of people in the waiting line. 3. The average time taken by driving from the nursing homes and health center was 10 minutes and there was not a noticeable difference between the cities. Driving from the nursing homes to hospitals in rural areas took 22 minutes which is 2.5 times of the time taken for urban areas. Daegu-si and Incheon-si had relatively short distance from the nursing homes and the hospitals while Jeju-do had the furthest. For rural areas, it is needed for health center to be equipped with a wider medical coverage, have closely connected with hospitals to minimize the differences they have from ones in rural areas. It is also needed to have ambulances equipped for tele-medical examination and treatment system.

의약분업 이후 약국의 운영현황 분석 (An Analysis of the Changes in Community Pharmacy Operation after the Implementation of the Separation Policy of Drug Prescription and Dispensing)

  • 류시원;윤경일;정우진
    • 한국병원경영학회지
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    • 제7권4호
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    • pp.102-122
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    • 2002
  • It has been 2 years since the implementation of the separation policy of drug prescription and dispensing. This study analyzes the changes in community pharmacy operation after the implementation of the policy. The main purposes of the analysis are to determine whether the changes in community pharmacy operation have occurred and to evaluate that the changes are consistent with the intention of the policy, if the changes actually have occurred. For the study a survey on 961 pharmacies chosen by stratified sampling method has been performed. Of the 961 sample pharmacies, 438 pharmacies were responded resulting 45.6% response rate. The sample pharmacies are classified by the location that the pharmacy are operating: the pharmacies around large size hospitals, the pharmacies around clinics or medium to small size hospitals and the pharmacies with no hospitals or clinics around. Based on the classification, the number of pharmacies, number of prescriptions processed, the personnel structure, the changes in facility, and other operational characteristics are compared. The results showed that the pharmacies were tended to concentrate around hospitals and clinic since the implementation of the policy. The number of pharmacists per pharmacy was increased, the size of pharmacy was increased and the facilities were improved to accomodate the requirements of the policy. The work hours a pharmacist spent on dispensing drug have increased almost twice, however, there was no corresponding increase in the time spent on patient education and medication history management, indicating a problem in the provision of quality pharmaceutical services. Based on the results, suggestions to minimize the negative effects of the policy are provided.

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The Effect of Security Information Sharing and Disruptive Technology on Patient Dissatisfaction in Saudi Health Care Services During Covid-19 Pandemic

  • Beyari, Hasan;Hejazi, Mohammed;Alrusaini, Othman
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제16권10호
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    • pp.3313-3332
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    • 2022
  • This study is an investigation into the factors affecting patient dissatisfaction among Saudi hospitals. The selected factors considered for analysis are security of information sharing, operational practices, disruptive technologies, and the ease of use of EHR patient information management systems. From the literature review section, it was clear that hardly any other studies have embraced these concepts in one as was intended by this study. The theories that the study heavily draws from are the service dominant logic and the feature integration theory. The study surveyed 350 respondents from three large major hospitals in three different metropolitan cities in the Kingdom of Saudi Arabia. This sample came from members of the three hospitals that were willing to participate in the study. The number 350 represents those that successfully completed the online questionnaire or the limited physical questionnaires in time. The study employed the structural equation modelling technique to analyze the associations. Findings suggested that security of information sharing had a significant direct effect on patient satisfaction. Operational practice positively mediated the effect of security of information sharing on patient dissatisfaction. However, ease of use failed to significant impact this association. The study concluded that to improve patient satisfaction, Saudi hospitals must work on their systems to reinforce them against the active threats on the privacy of patients' data by leveraging disruptive technology. They should also improve their operational practices by embracing quality management techniques relevant to the healthcare sector.

제왕절개 분만율의 지역간 변이에 영향을 미치는 의료기관 특성요인 분석 -의료보험관리공단 대상자를 중심으로- (Analysis of Institutional Factors Influencing Regional Variations in the Cesarean Section Rate)

  • 안형식;권영대;이영성;김명기;김용익;신영수
    • 보건행정학회지
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    • 제1권1호
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    • pp.27-41
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    • 1991
  • The purpose of this study is to estimate cesarean section rate in Korea and analyze characteristics of health care institution which affect regional variation in the rate. We have searched vaginal and cesarean section deliveries among Diagnosis Related Group dat based upon insurance claim bills which have been submitted to Korean Insurance Corporation for two years since March, 1985. The results are as follows: 1. Out of all delivery cases of 87,500, cesarean section rate was 16.3% (14,299 cases). 2. Cesarean section rate varied according to size and ownership of health care institutions. In above 6- bed sized hospitals, the rate was at about 20% higher than small sized institutions, but rather in hospitals that have more than 500 beds, it was somewhat low. Classified by the hospital ownership, the rate was low at 18.4% in hospitals of religious organization and highest at private or corporate hospitals. 3. This study shows large regional variation in cesarean section rate; there are two times differences between region with the highest and lowest rate. Strongly related factors in that variation was the ownership of health care institution and urbanization variables. Low level of cesarean section rate in a region is explained by high proportion of delivery cases at institutions of religious organization and at insitutions in county level site. This result shows that apart from medical conditions of patients, indications of cesarean section differs from health care providers, and especially ownership of institution strongly affect them. Cesarean section rate in Korea is supposed to be at high level and development of utilization review programs to keep appropriate cesarean section rate is needed.

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Do some patients receive unnecessary parenteral nutrition after pancreatoduodenectomy? Results from an international multicentre study

  • Thomas B. Russell;Peter L. Labib;Paula Murphy;Fabio Ausania;Elizabeth Pando;Keith J. Roberts;Ambareen Kausar;Vasileios K. Mavroeidis;Gabriele Marangoni;Sarah C. Thomasset;Adam E. Frampton;Pavlos Lykoudis;Manuel Maglione;Nassir Alhaboob;Hassaan Bari;Andrew M. Smith;Duncan Spalding;Parthi Srinivasan;Brian R. Davidson;Ricky H. Bhogal;Daniel Croagh;Ismael Dominguez;Rohan Thakkar;Dhanny Gomez;Michael A. Silva;Pierfrancesco Lapolla;Andrea Mingoli;Alberto Porcu;Nehal S. Shah;Zaed Z. R. Hamady;Bilal Al-Sarrieh;Alejandro Serrablo;Somaiah Aroori
    • 한국간담췌외과학회지
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    • 제28권1호
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    • pp.70-79
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    • 2024
  • Backgrounds/Aims: After pancreatoduodenectomy (PD), an early oral diet is recommended; however, the postoperative nutritional management of PD patients is known to be highly variable, with some centers still routinely providing parenteral nutrition (PN). Some patients who receive PN experience clinically significant complications, underscoring its judicious use. Using a large cohort, this study aimed to determine the proportion of PD patients who received postoperative nutritional support (NS), describe the nature of this support, and investigate whether receiving PN correlated with adverse perioperative outcomes. Methods: Data were extracted from the Recurrence After Whipple's study, a retrospective multicenter study of PD outcomes. Results: In total, 1,323 patients (89%) had data on their postoperative NS status available. Of these, 45% received postoperative NS, which was "enteral only," "parenteral only," and "enteral and parenteral" in 44%, 35%, and 21% of cases, respectively. Body mass index < 18.5 kg/m2 (p = 0.03), absence of preoperative biliary stenting (p = 0.009), and serum albumin < 36 g/L (p = 0.009) all correlated with receiving postoperative NS. Among those who did not develop a serious postoperative complication, i.e., those who had a relatively uneventful recovery, 20% received PN. Conclusions: A considerable number of patients who had an uneventful recovery received PN. PN is not without risk, and should be reserved for those who are unable to take an oral diet. PD patients should undergo pre- and postoperative assessment by nutrition professionals to ensure they are managed appropriately, and to optimize perioperative outcomes.

일부 한.양방병원 뇌혈관질환 환자의 진료결과 및 만족도의 비교연구 -한양방협진 진료프로토콜의 적용을 중심으로- (The Clinical Interchange between Western Medicine and Oriental Medicine: with the Stroke Patient Outcomes Research)

  • 박종구;강명근;이성수;김달래;최서영;한창호;유준상;김민기;김춘배
    • 대한한방내과학회지
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    • 제22권4호
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    • pp.691-702
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    • 2001
  • Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.

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암 등록사업의 현황과 추진방향 (Cancer Registration in Korea: The Present and Furtherance)

  • 안윤옥
    • Journal of Preventive Medicine and Public Health
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    • 제40권4호
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    • pp.265-272
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    • 2007
  • It was not until 1975 that cancer registration was initiated in Korea; voluntary registration of cancer patients of training hospitals throughout the country began under the auspices of the Korean Cancer Society(KCS). However, an official cancer registration, the Korea Central Cancer Registry(KCCR), began on July 1st, 1980. Forty-five training and two non-training hospitals throughout the country initiated registration of patients in whom neoplasms had been found. Data related to case information specified are to be sent to the KCCR at the National Medical Center(it moved at National Cancer Center in 2000). The initial cancer registration of KCS was merged to the KCCR in 1980. Although the KCCR covers most all the large training hospitals in Korea, it cannot provide incidence data. It is, however, the only of its kind in the world, being neither hospital nor population based. The first population based cancer registry(PBCR) was launched in a small county, Kangwha(it has around 80,000 inhabitants), by Yonsei University Medical College in 1983. All data were collected by active methods, and incidence statistics for 1986-1992 appeared in Vol VII of the CI5. Another PBCR, Seoul Cancer Registry(SCR), started in 1991. It was supported by a civilian foundation, the Korean Foundation for Cancer Research. The basic idea of case registration of SCR was the incorporation of KCCR data to PBCR, e. g. dual sources of case registration, i.e., from the KCCR and also including cases diagnosed in small hospitals and other medical facilities. Assessing completeness and validity of case registration of SCR, the program and methodology used by the SCR was later extended to other large cities and areas in Korea, and the PBCR in each area was established. Cancer incidence statistics of Seoul for 1993-1997, Busan for 1996-1997, and Daegu for 1997-1998, as well as Kangwha for 1993-1997, appeared eventually in Vol VIII of the CI5. The Korean or 'pillar' model for a PBCR is a new one. The KCCR data file is a reliable basis, as a pillar, for a PBCR in each area. The main framework of the model for such a registry is the incorporation of a KCCR data file with data from additionally surveyed cases; the data related to cancer deaths, medical insurance claims, and visit-and surveillance of non-KCCR medical facilities. Cancer registration has been adopted as a national cancer control program by Korean government in 2004 as the Anti-Cancer Act was enacted. Since then, some officers have tried to launch a nation-wide PBCR covering whole country. In the meantime, however, cancer registration was interrupted and discontinued for years due to the Privacy Protection Law, which was solved by an amendment of the Anti-Cancer Act in 2006. It would be premature to establish the nation-wide PBCR in Korea. Instead, continuous efforts to improve the completeness of registration of the KCCR, to progress existing PBCRs, and to expand PBCRs over other areas are still to be devoted. The nation-wide PBCR in Korea will be established eventually with summation of the PBCRs of the Korean model.

물리치료사의 개인 및 직무특성, 전문직업성, 집단응집성이 조직시민행동에 미치는 영향 (Influence of Individual and Job Characteristics, Professional Job Perception, and Group Cohesiveness on Organizational Citizenship Behavior of Physical Therapists in Hospitals)

  • 임정도;이기효;김원중
    • 한국병원경영학회지
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    • 제8권2호
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    • pp.70-92
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    • 2003
  • The main objective of this paper is to investigate the factors affecting organizational citizenship behavior of hospital employees, and based on the investigation, to suggest some implications for effective human resources management of hospitals. For this purpose, physical therapists were selected as the subject of the research. Using their individual characteristics, job characteristics, professionalism and group cohesiveness as the variables affecting organizational citizenship behavior, an empirical model was constructed and tested. A survey was conducted through structured and self-administered questionnaire for the physical therapists working at hospitals of Busan-Kyongnam area, and data from 240 therapists were utilized in the final analysis. Major results of the empirical analysis are as follows: First, perception on professionalism and the degree of organizational citizenship behavior were higher for male, older, relatively more-educated and higher-grade employees. It is necessary to develope some measures to educate and motivate the employees who are in lower state of professionalism and organizational citizenship behavior. Second, among the individual characteristics, need for growth was found to have significant, positive influence on professionalism and group cohesiveness, but no direct effect on organizational citizenship behavior. On the other hand, extroversion had direct, positive effect on organizational citizenship behavior, as well as on professionalism and group cohesiveness. This result suggests that personnel selection and personality education should be conducted carefully. Third, job characteristics appeared to have very large, positive effect on professionalism, but not directly on organizational citizenship behavior. Fourth, professionalism was found to have very large, positive influence on group cohesiveness and direct, positive effect on organizational citizenship behavior. This implies that enhancing professionalism of physical therapists can strengthen organizational citizenship behavior in hospitals, and hence top management should actively support the programs for job re-design, skill education and quality improvement to enhance professionalism of their employees. Fifth and last, as an intervening factor, group cohesiveness appeared to have the largest, direct, positive effect on organizational citizenship behavior. It is, therefore, important for top management to improve group cohesiveness by exploring ways toward greater harmony and solidarity among the members of physical therapy department.

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