• Quality Improvement in Health Care
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• v.2 no.2
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• pp.56-71
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• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.

• Korean Medical Education Review
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• v.12 no.2
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• pp.13-18
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• 2010

This study is aimed to reflect non-cognitive traits that should be assessed in admissions interviews for medical school applicants, with the goal being to increase the reliability of the admissions interview. The admissions interview is valued for its ability to assess noncognitive and nonteachable attributes of good doctors, especially which cannot be evaluated with other admission assessment tools. Various characteristics of applicants including age, gender, exam scores, and nonverbal communication were found to have influenced the interview results. Bias from interviewers was a significant factor in the results of the interview. A Structured interview in multiple stations such as the Multiple Mini-Interview showed the highest reliability and validity. To make the interview fair, no information about the applicants was provided to the interviewers and interviewers were recruited from different backgrounds. There have been few research papers on admission interviews in Korea. Active research on the qualities of good doctors and effective and reliable admission interview methods should be encouraged. A strategy should be developed to overcome the philosophical obstacles that medical school professors want to admit academically excellent applicants.

• Korea Journal of Hospital Management
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• v.15 no.4
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• pp.125-142
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• 2010

Objective : To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods : A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results : Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient's room, lenth of stay, number of admissions in the prior 12 months. Conclusions : One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

• Women's Health Nursing
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• v.12 no.2
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• pp.132-141
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• 2006

Purpose: The purpose of this study was to supply basic data for a health promoting program and to elevate the level of it by examining whether university students' health promoting behaviors were related to health perception, health concept, self- esteem, perceived benefits of action, perceived barriers of action, perceived self-efficacy, activity-related affect, social support, preference, prior related behavior, and a plan for action. Method: Subjects were 192 university students in K city. Data collection method was a structured questionnaire. Data was analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression. Result: The most powerful predictor was previous related behavior (36%). Altogether previous related behavior, health status, a plan for action, perceived self-efficacy and number of admissions were proven to account for 57% of health promoting behaviors. Conclusion: It suggested that prior related behavior, health status, a plan for action, perceived self-efficacy, and number of admissions should be considered when developing a students' health promoting program.

• Child Health Nursing Research
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• v.26 no.1
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• pp.55-63
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• 2020

Purpose: The purpose of this study was to evaluate the current level of sleep quality among Korean middle-school students using the Pittsburg Sleep Quality Index (PSQI), and to analyze the factors influencing sleep quality. Methods: The study used a descriptive cross-sectional design and a self-report questionnaire. The participants were 744 middle-school students. The questionnaire included the PSQI and health-related questions, such as the types of diseases they had been diagnosed with and the frequency of hospital admissions. The data were analyzed using the independent t-test, analysis of variance, Pearson correlation coefficients, and linear multiple regression. Results: The global PSQI score was 4.21, which indicated good sleep quality. The major factors that were associated with the sleep quality of middle-school students were the number of diseases they had been diagnosed with (β=.54, p=.001) and atopic dermatitis (β=.32, p=.001). In addition, asthma and the frequency of hospital admissions were significant factors influencing each component of the PSQI. Conclusion: The findings from this study suggest that sleep quality was associated with several health-related factors. Thus, nurses, school nurses, and nursing researchers may need to assess the health-related factors associated with adolescents' sleep quality as part of efforts to improve their sleep quality.

• Korea Journal of Hospital Management
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• v.9 no.2
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• pp.102-127
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• 2004

The objective of this study is to analyze a current trend of and relating factors on profitability of the Korean Public Corporation Medical Centers(KPCMCs, hereinafter, hospitals) in Korea. There are 34 hospitals in Korea as of 2004. Among these hospitals some are red ink hospitals, others are black inks in terms of profitability. Data were collected by Korea Health Industry Development Institute(KHIDI) Statistics for Hospital Management 2000-2002 and Ministry of Health and Welfare(MOHW) financial data of public hospitals which was planned to coordinate public health care services roadmap in the long run. The samples are 32 hospitals. Profitability was measured in the aspect of profit rate with normal profit to total assets, and normal profit to gross revenues as dependent variables in respective. Independent variables were classified by general factors, i.e., location, intern/resident training, period of opening, number of beds, and managerial factors(current ratio, fixed ratio, liability to total assets, total assets turnover, personnel costs, materials cost, administrative cost), and finally factors related to patient treatment(average length of stay, bed occupancy rate, admission ratio of outpatients). The methods of analysis are correlation and multiple regression analysis. This study shows firstly, a lot of hospitals are optimal current ratio. Hospitals in upper 100% current ratio are 81.2%. And the personnel cost in total costs are high. Secondly, the trend of normal profit to gross revenues of hospitals are deteriorating gradually. And lastly, as a result of multiple regression analysis, the factors had on significant effect on normal profit to total assets are fixed ratio(+), liability to total assets(-), bed occupancy rate(+), admissions of outpatients(+), etc. And the factors had on significant effect on normal profit to gross revenues are current ration(+), fixed ratio(+), personnel cost(-), administrative expenses(-), admissions of outpatients(+), etc. In conclusion, to improve the profitability of hospitals, the efforts to reduce personnel cost and average length of stay might be needed. And also beds utilization rate need to be increased.

• Journal of the Korean Data and Information Science Society
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• v.21 no.4
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• pp.729-736
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• 2010

In this paper, we study the influence analysis of admission variables including their characteristics on academic achievements of freshmen at K university in Busan. First, multiple regression analysis is used to examine the main effects of admission variables including students' characteristics on the academic achievements. Also, Decision tree analysis is used to examine the interaction effects for the admission variables on the academic achievements. The results of this paper may be helpful to K university in designing effective admissions strategies for recruiting students.

• Journal of Trauma and Injury
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• v.34 no.3
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• pp.155-161
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• 2021

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals' service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea. Methods: We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS. Results: The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4-19 days] vs. 16 days [IQR 8-28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found. Conclusions: The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.

• Health Policy and Management
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• v.3 no.1
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• Journal of The Korean Association For Science Education
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• v.30 no.4
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• pp.452-471
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• 2010

As the Korean College scholastic Ability Test (CSAT) has been implemented for 17 years since 1994, it is becoming more and more difficult to make new items that haven't been previously used to measure students' thinking ability. Therefore, it is necessary to keep conducting research on making new test items that can measure students' scholastic ability reliably. For this reason, multiple choice items on the Japanese university entrance exam, which is a Japanese National Center Test for University Admissions (NCTUA) equivalent of CSAT, were analyzed in order to draw implications for CSAT item development. In this study, we analyzed the Japanese NCTUA administered in January 2009 to investigate the structure of its science test. We also analyzed the NCTUA items by the domains of contents and behaviors, and tried to predict item difficulty from the perspective of Korean applicants. Major findings are as follows: Most NCTUA items measure understanding knowledge or low level thinking ability. Also the alloted time for each item is longer than CSAT. The number of test items, and the number of choice and alloted points for each item are diverse, unlike CSAT. The number of items using real-life materials are much more, but the items are not rigorous in sentence expression compared to CSAT. And the difference of difficulty level among science tests were larger with reference to CSAT. Also science score is required for most applicants regardless whether they are taking liberal arts or going onto the science track.