• Journal of The Korea Institute of Healthcare Architecture
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• v.6 no.10
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• pp.41-49
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• 2000

Today, medical system faces to two major flows of change. The first one changes to small-to-middle size special hospital from large size general hospital. The another one changes to the patient-focused hospital. In these two flows of change, women's hospital is a typical small-to-middle size special hospital. In Korea, several studies on the architectural planning of delivery-part designed with recent trends in large size general hospital have done with focusing on LDR type or LDR/P type, but few studies on the architectural planning of the recent trends in women's hospitals. Therefore, this study aims to propose improve way after analysis the developing circumstances and problems on the Architectural planning on women's hospital by case studies on Women's hospital builded recently in Korea.

• Journal of Preventive Medicine and Public Health
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• v.29 no.4 s.55
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• pp.831-842
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• 1996

Demand for high quality medical care has recently been increasing in step with high level of income and education. Patients prefer the use of large general hospitals to small community hospitals. Large hospitals, usually located at urban area, expand their capacities to cope with the increasing demand, therefore, they easily secure revenue necessary for growth and development of hospitals. However, small community hospitals are facing with serious financial difficulties caused from the reduction of patients in one hand and the inflation of cost in another. If small rural hospitals were closed, the closure would have negative impacts on local economies in addition to the decrease in access to medical care. Community leaders should have an insight on the contribution of community hospitals to local economies. They could make a rational decision on the hospital closure only with the understanding of hospital's contribution to the community. This study is designed to develop an economic model to estimate the contribution of rural hospital to local economies, and also to apply this model with a specific hospital. The contribution of a hospital to local economies consists of two elements, direct effect and multiplier effects. The direct impacts include hospital's local purchasing power, employee's local purchasing power, and the consumption of patients coming from outside the community. The direct impact induces multiplication effect in the local economy. The seed money invested to other industries grows through economic activities in the region. This study estimated the direct effect with the data of expenditure of the case hospital. The total effect was calculated by multiplied the direct effect with a multiplier. The multiplier was drown from the ratio of marginal propensity of income and expenditure. Beside the estimation of the total impacts, the economic effect from the external resources was also analyzed by the use of the ratio of patients coming outside the region. The results are as follows. 1. The direct economic contribution of the hospital to the local economy is 1,104 million won. 2. The value of multiplier in the region is 2.976. 3. The total economic effect is 3,286 million won, and the multiplication effect is 2,182 million won. 4. The economic contribution from the external resources is 245 million won which is 7.5% of the total economic effect.

• Journal of The Korea Institute of Healthcare Architecture
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• v.19 no.2
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• pp.31-40
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• 2013

Purpose: It seems obvious that the hospital structures become more large-sized and tall-risen in Korea today. Nothing is more influential than the vertical core plan on the movements of various people in such large-tall hospitals. The present paper, therefore, aims to study on the efficient hospital core space paying first attention to patients by analysing the data on relations between/among department layouts of vertical and horizontal movements. Methods: This study sampled representative 14 hospitals and drew their degrees of data importance on the basis of precedented relative studies. This study also analysed their placements on the blueprint and made confirmations of their arrangements through their homepage on line. Actual visits were made to make sure of the spacial connections between/among departments in the hospitals as well. Results: Even in emergency case in need for vertical movements, the central main core spaces are usually used, which is because special vertical transportation systems are not provided. In these cases, the main core spaces are very important for those who have to move vertically and/or horizontally according to the locations and types of main cores. While special lifts or dumbwaiters are prepared to install for the important articles, such as samples of pathology department, most patients should share with regular visitors the elevators not separated visually and spatially from them. Implications: Vertical core plans are greatly dependent on the ward types and hospital styles. This study is hopefully expected to contribute itself to the standard setting-up of comfortable and quick vertical core system operations for patients.

• Health Policy and Management
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• v.20 no.4
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• pp.1-18
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• 2010

Much policy attention has been directed to the concentration of patients in large hospitals, especially in tertiary care hospitals. In order to address the problem, the government has enforced referral requirement for accessing care in tertiary care hospitals by denying insurance benefits to the patients who do not observe the requirement. This approach somehow has failed to produce expected effects although it still exists in theory. The concentration of patients in a certain type of providers results in the distortion of functional differentiation among various types of providers and vice versa. Thus the approaches for the alleviation of the problem should be directed to both patients and providers. However, policy approaches has so far focused on ways of directly affecting patients' choice of a provider neglecting the effects of providers. Based upon the observation, this paper has reviewed selected issues that should be considered in agenda setting for policies concerned with the concentration of patients in large hospitals or the distortion of functional differentiation among health care providers. A brief discussion of each of the issues suggests three general guidelines for the formulation and implementation of policies intended to address the problem. First, attention should be directed to both patients and providers. Secondly, it is necessary to employ diverse measures including regulation, incentives and administrative supports. Thirdly, some of the approaches should be planned from a long range perspective, for it often takes a long time to change some aspects of health care utilization and provision.

• Clinical Endoscopy
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• v.56 no.1
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• pp.65-74
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• 2023

Background/Aims: Gastric varices (GV) are present in 25% of cirrhotic patients with high rates of rebleeding and mortality. Data on endoscopic ultrasound (EUS)-guided treatment in severe liver disease (model for end stage liver disease sodium [MELD-Na] >18 and Child-Turcotte-Pugh [CTP] C with GV) are scarce. Thus, we performed a retrospective comparison of endoscopic glue injection with EUS-guided therapy in cirrhotic patients with large GV. Methods: A retrospective study was performed in the tertiary hospitals of India. A total of 80 patients were recruited. The inclusion criteria were gastroesophageal varices type 2, isolated gastric varices type 1, bleeding within 6 weeks, size of GV >10 mm, and a MELD-Na >18. Treatment outcomes and complications of endoscopic glue injection and EUS-guided GV therapy were compared. Results: In this study, the patients' age, sex, liver disease severity (CTP, MELD-Na) and clinical parameters were comparable. The median number of procedures, injected glue volume, complications, and GV obturation were better in the EUS group, respectively. On subgroup analysis of the EUS method (e.g., direct gastric fundus vs. paragastric collateral [PGC] coil placement), PGC coil placement showed decreased coil requirement, less injected glue volume, decreased luminal coil extrusion, and increased successful GV obturation. Conclusions: EUS-guided treatment is more efficient and safer, and requires a smaller number of treatment sessions, as compared to endoscopic treatment in severe liver disease patients with large GV. Furthermore, PGC coil placement increases the complete obliteration of GV.

• Journal of Chest Surgery
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• v.49 no.sup1
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• pp.44-52
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• 2016

Background: This study investigates the perception of the general public regarding the concentration to metropolitan, hospitals of cardiac and cerebrovascular surgeries, and the perceived public need for government policies to resolve this issue. Methods: A total of 800 participants were recruited for our telephone interview survey. Quota sampling was performed, adjusting for age and sex, to select by various geographic regions. Sampling with random digit dialing was performed; we called the randomly generated telephone numbers and made three attempts for non-responders before moving on to a different telephone number. Results: Our sample population was 818 participants, 401 men (49.0%) and 417 women (51.0%). Our data showed that 85.5% of participants thought that cardiac surgery and neurosurgery patients are concentrated in large hospitals in Seoul. The principle reason for regional patients to want to receive surgery at major hospitals in Seoul was because of poor medical standards associated with regional hospitals (87.7%). We found that a vast majority of participants (97.5%) felt that government policies are needed to even out the clustering of cardiac surgery and neurosurgery patients, and that this clustering may be alleviated if policies that can specifically enhance the quality and the capacity of regional hospitals to carry out surgeries are adopted (98.3%). Conclusion: Government policy making must reflect public desiderata, and we suggest that these public health needs may be partially resolved through government-designated cardiac and neurosurgery specialist hospitals in regional areas.

• Health Policy and Management
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• v.19 no.1
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• pp.81-96
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• 2009

The expansion of long-term care hospitals (LTCHs) is expected to contribute to meeting the long-term care needs of the elderly with chronic diseases in a rapidly aging society. It is also expected to increase efficiency of health resource use and decrease elderly health expenditures by transferring patients from acute care hospitals (ACHs) to LTCHs. This study aimed to empirically examine how the expansion of LTCHs had influences on the length of hospitalization of the elderly in ACHs. Panel regression analysis was employed as an analytic tool using data of the National Health Insurance and the National Statistical Office from 2002 to 2006. The expansion of LTCHs was measured as location quotient (LQ) of LTCHs, denoting the share of LTCHs in a large city or province relative to the share of LTCHs at the national level. In addition, per capita GRDP (gross regional domestic product) and the proportion of population over 65 were included as control variables. The main findings are as follows. First, it was observed that LQ of LTCHs showed a statistically significant negative association with the length of hospitalization of the elderly in ACHs. Second, the negative correlation was evident among general hospitals with over 100 beds while it was not among hospitals with less than 100 beds. Third, LQ of LTCHs had more influences among the elderly over 85. In conclusion, the expansion of LTCHs seems to contribute to decrease in the inpatient cost of the elderly in ACHs and to increase efficiency in the utilization of health resources.

• Journal of Korean Living Environment System
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• v.25 no.1
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• pp.90-97
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• 2018

The purpose of this study is to compare and analyze the air infections in middle and small hospitals with the facilities of large national hospitals that have air-borne infection isolation (AII) wards through actual condition investigation and airflow analysis simulation (CFD) and to provide basic data for prevention. The method and scope of the study are as follows. First, through literature review, data related to prevention of infection spread in domestic medical institutions were investigated. Second, we conducted a survey on the status of isolation facilities to prevent the spread of infectious diseases in large hospitals and small and medium - sized clinics in Korea. Third, airflow analysis simulation (CFD) was carried out using the isolation ward of the nationally designated inpatient ward and the data of the plane and facility system of the small clinic. As a result of the study, it is found that regulations applicable to small and medium-sized clinics are insufficient. In addition, the simulation results show that the infectious disease virus is likely to spread to other patients in the hospital.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.5
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• pp.89-97
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• 2018

In the past, hospitals were planned with a minimum of public space for the sole purpose of treatment. On the other hand, modern hospitals have more public space as the importance of the healing environment increases and are planned taking into consideration the patients, guardians, and medical staff. In addition, the lobby shape is developed from a HALL type and planned as a STREET type or CONCOURSE type, increasing the public area. Unlike past hospitals, which were used as reception, waiting, and procedure spaces, modern hospitals are used as commercial, hobby, and cultural space. The purpose of the study was to evaluate the healing environment of the hospital lobby based on the shape of the plane surface by deducting the elements of general hospitals' healing environment from preceding studies as a framework. The hospital lobby is an important place where many actions occur. Therefore, 3 types of cases were evaluated based on the plane form. As a result of the study, the STREET type showed a better healing environment than the HALL type, but the accessibility, roof garden, and resting place showed similar results. Because the case was based on a large general hospital, which had sufficient planned space, the factor has little to do with the style of the lobby. Among the STREET types, the linear atrium showed a better result in terms of the sense of space and inflow effect of natural lighting than the four-sided atrium because the linear atrium has large open volume ratio. When the lobby plane is the HALL type, a cross section of the courtyard had a large open volume ratio. Therefore, the shape of the cross section is as important as the plane form of the lobby.

• Journal of The Korea Institute of Healthcare Architecture
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• v.1 no.2
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• pp.39-51
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• 1996

Design scheme drawings of the two major corporate hospitals - Asan Medical Center and Samsung Medical Center - are analysed in the aspect of floor area distributions and their proportions for various users and user-functions. Primary users of hospitals are categorized into three ; patients, employees and others. Then, patient spaces are subdivided into patient private, patient/medical, patient/support staff, patient/nursing, patient/guardian, patient common ; employee spaces into doctors, trainees, doctors common, nurses, support staffs, non-medical staffs, employee common ; others spaces into subcontractors, general publics, non-living, and internal circulation. The purpose of this research is to develop a user-focused insight into hospital spaces and a new method of hospital programming and design.