• Journal of radiological science and technology
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• v.37 no.4
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• pp.315-322
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• 2014

This study demonstrates holding condition of CT by medical institution classification and by season, and examination fee in Korea currently to quantitatively understand frequency of examination region by change of CT equipment, domestic growing trend and change of distribution and using rate. Recent 10 years of CT holding condition by medical institution classification (Tertiary hospital, General hospital, Hospital, Clinic, Dental hospital, Dental clinic, Hospitalized health center) and by year (2003-2012), and CT examination fee of distribution of medical institution by year is surveyed. The holding ratio of Tertiary hospital level and General hospital level is 32.7% in 2003 and 33.0% in 2012. Whereas, Hospital and Clinic level is 74.2% in 2003 and 66.8% in 2012, which takes approximately 70%. Based on data in 2012, it is 82.2% of total examination fee in Tertiary hospital and General hospital, while 17.5% in hospital and clinic. CT holding rate of Hospital level is increasing, while Clinic level is decreasing. Approximately 80% of CT examination fee is claimed by Tertiary hospital and General hospital. Therefore, there is a significant correlation between CT holding condition of medical institution classification and examination fee. Particularly, correlation between CT holding number of Tertiary hospital and examination fee is significant (p<.001). The more CT holding number, the higher the amount claimed examination fee.

• Health Policy and Management
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• v.9 no.4
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• pp.41-64
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• 1999

The major concern for this research is to discuss and to offer some solutions to bring the effectiveness of existing notifiable diseases reporting system over the physicians' attitudes of reporting, the actual condition of performance and the reasons of inertia in notifiable diseases reporting through examining the physicians of medical institutions in nationwide such as pediatrics, internal medicine and family medicine. The actual conditions of notifiable communicable diseases(NCD) reporting was surveyed by mail objectifying an internal medicine, pediatrics and family medicine in nationwide on the basis of stratified random sampling method divided into the classification of medical institutions and areas. As a result of survey. the rate of respondents showed 145 persons from physicians, 105 persons from hospitals. 120 persons from general hospitals, and 51 persons from tertiary hospitals. The total number of respondents were 421 and was rated 59.0 %. The analysis of collected survey went through a descriptive analysis primarily to grasp physicians' attitudes on the notifiable communicable diseases reporting, and then upon the dependent variables. Following are major findings obtained form the data analysis. 1. The results of a descriptive analysis on physicians' attitudes towards reporting NCD were as follows: First, the respondents who didn't know that yellow fever is reporting NCD were 11.0% of clinic, 10.5% of hospital. 5.0% of general hospital. 11.8% of tertiary hospital. and in case of hepatitis B, were 26.9% of clinic, 35.2% of hospital. 35.0% of general hospital. 23.5% of tertiary hospital. Second, The rate of physicians' knowledge on penalties of not reporting the NCD by their medical institution were 35.2% of clinic, 45.7% of hospital. 36.7% of general hospital. 62.7% of tertiary hospital. Third, among the no-reporting physicians in whole, the major reason of not reporting NCD were uncertainty of diagnosis(78.9%), no need to report(46.4%), no adequate actions from PHC(29.1%), no knowledge of the cases being notifiable ones in the order of their frequencies(30.4%), meddling from PHC(29.1%), concerning of patient's privacy(26.3%). 2. To analyze the characteristics related to the physicians' behaviors to report NCD, univariate and multiple logistic regression analyses were applied to the variables related to physician, 4 medical facility, PHC, and reporting system. The result were as follows: First, the result of the univariate analysis on physicians' attitude to report NCD and characteristics related to reporting in odds ratio was in the case of hospital. 3.4 times higher positive responses on physicians' attitude to report NCD came up as compared to the clinic. Second, the result of the univariate analysis on physicians' action of reporting NCD and characteristics related to reporting by the classification of medical institutions showed that the odds ratio of hospital was 2.3 times, the odds ratio of general hospital was 2.0 times, the odds ratio of tertiary was 6.8 times significantly higher than clinic. And the medical institution with significantly higher positive attitudes rate by multiple logistic regression analysis was hospital that rated 2.5 times significantly higher than clinic. Also in the PHC related characteristics of reporting, the rate of action in reporting NCD was significantly higher in medical institution that were endowed with the good condition of reporting. In multiple logistic regression analysis, the medical institution that has a good conditions of reporting showed a significantly higher positive rate on the action of reporting than the others.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.161-172
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• 2008

Purpose: This study was to classify patient severity score for hemodialysis patients. Method: The subject of this study was 1,575 patients. To study the severity of the patients, we used t-test and ANOVA. The congruity was measured by Kappa coefficient and the severity in each medical facility was analyzed by ANOVA. Result: The results showed that there was a significant difference according to the levels of medical center (F=171.187, p<.0001). Categorizing the severity of the patients in each medical facility, group II and III of the secondary medical institution had higher ratio than the primary medical institution. There was not a single patient coming under group IV in both of the primary or secondary medical institutions. However, the tertiary medical institutions had more subjects in group II and III than the primary and secondary medical institutions. The group IV with the highest severity had 11 patients(1.5%), demonstrating that the tertiary medical institution had higher severity patients than the primary or secondary medical institutions. Conclusion: The results of this study appropriately reflects the repayment system of medical expenses by the government. Also, it provides the fundamental information to develop nursing fee system taken into account of the systemic differences among the primary, secondary and tertiary medical institutions.

• Korea Journal of Hospital Management
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• v.4 no.1
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• pp.147-170
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• 1999

This study was performed to assess the financial performance of medical institutions and examine the affecting factors in Taegu metropolitan and Kyungpook province. The major results are as follows ; The liability to total assets was significantly different according to the ownership type of medical institution. It was the highest in the case of juridical person having a special status. The total assets turnover and value added to total assets were significantly different according to the type of medical institution, period of establishment, and ownership type of medical institution. They were higher in the tertiary medical institution, in private hospital and university hospital, and they were increased with establishment period of medical institution. The growth rate of patient revenues were significantly different according to the type of medical institution, period of establishment, and the growth rate of adjusted inpatient days were significantly different by period of establishment. The return on assets and net profit to gross revenues were the highest in private hospital. Private hospital went into the black, but other hospitals went into the red figures. According to the multiple regression analysis for the net profit to gross revenues, ownership type, period of establishment, and management strategy of medical institution were significant It was higher in private hospital and medical institution with prospector management strategy, and it was increased with establishment period of medical institution. In multiple logistic regression analysis for the status of financial performance in medical institution, period of establishment, management strategy of medical institution were significant It was better in medical institution with prospector management strategy and longer period of establishment.

• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.184-185
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• 2002

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4445-4452
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• 2012

Background: Prognosis of breast cancer depends on classic pathological factors and also tumor angiogenesis. This study aimed to evaluate the clinicopathological factors of breast cancer in a tertiary centre with a focus on the relationship between tumor angiogenesis and clinicopathological factors. Methods: Clinicopathological data were retrieved from the archived formal pathology reports for surgical specimens diagnosed as invasive ductal carcinoma, NOS. Microvessels were immunohistochemically stained with anti-CD34 antibody and quantified as microvessel density. Results: At least 50% of 94 cases of invasive breast ductal carcinoma in the study were advanced stage. The majority had poor prognosis factors such as tumor size larger than 50mm (48.9%), positive lymph node metastasis (60.6%), and tumor grade III (52.1%). Higher percentages of estrogen and progesterone receptor negative cases were recorded (46.8% and 46.8% respectively). Her-2 overexpression cases and triple negative breast cancers constituted 24.5% and 22.3% respectively. Significantly higher microvessel density was observed in the younger patient age group (p=0.012). There were no significant associations between microvessel density and other clinicopathological factors (p>0.05). Conclusions: Majority of the breast cancer patients of this institution had advanced stage disease with poorer prognostic factors as compared to other local and western studies. Breast cancer in younger patients might be more proangiogenic.

• Korean Journal of Clinical Laboratory Science
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• v.36 no.2
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• pp.89-97
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• 2004

Many strains of Staphylococcus aureus were isolated from pus samples from primary, secondary, and tertiary medical institutions and were subjected to an antibiotic sensitivity test. Ciprofloxacin, clindamycin, erythromycin, gentamicin, oxacillin penicillin, tetracycline, trimethoprim/sulfamethoxazole, vancomycin and teicoplanin were used for the antibiotic sensitivity test. The strains showed hightest resistance to penicillin(91%), but all of strains tested were susceptible to vancomycin and teicoplanin. The isolated multi-drug(penicillin-tetracycline-ciprofloxacin-clindamycin-erythromycin- oxacillin-gentamicin) resistant S. aureus were analyzed genotypically using an AP-PCR(Arbitrarily Primed polymerase chain reaction) with an arbitrary 3 primers. Based on the result for genotype analysis, the genotypes identified by S1 primer did not coincide with those of S2 or E2 primers. Genotypes identified by S2 primer did not coincide with those of S1 or E2 primers. Also genotypes identified by the E2 primer did not coincide with those of S1 or S2 primers. Therefore, an analysis of AP-PCR test with multiple primers will provide more sensitive identification. A strain from a secondary medical institution and a strain from a tertiary medical institution which showed the same genotype for S1, S2, and E2 primers are required for further epidemiological study.

• Journal of Korean Clinical Health Science
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• v.4 no.2
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• pp.582-592
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• 2016

Purpose. For more effective hospital management, it analyzes the trend through general characteristics, balance sheet, income statement, and financial ratio analysis, grasps the causes of the problems, and analyzes management of the hospital in order to use the result as baseline data for development of the hospital in the future. Methods. The collected data of 3 years from 2011 to 2013 about 3 tertiary hospitals in metropolitan cities from Alio (provider of public institution information; www.alio.go.kr), Health Insurance Review & Assessment Service (www.hira.or.kr), and the website of the Ministry of Health and Welfare (www.mw.go.kr) were analyzed and general characteristics, balance sheet, income statement, and financial ratio, analysis are used as data. Results & Conclusions. From the result of data analysis from 2011 to 2013, general characteristics, balance sheet, income statement, financial ratio analysis, and pie charts could lead to conclusions as follows. In the result of comprehensive analysis, the 3 tertiary hospitals showed increase of fixed expense due to extension of the buildings and so did the scale of fund and asset. Although medical revenue increased, the margin of increase for medical expense was greater than that of medical revenue, which consequently led to loss. In prediction for the 3 tertiary hospitals based on characteristics so far, it is expected to see improved revenue structure after building extension is completed, but it is necessary to exert management effort to maintain its optimal level by enhancement in stability of management and inventory turnover through management of inventories.

• Journal of Korean Academy of Nursing
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• v.35 no.8
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• pp.1493-1499
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• 2005

Background. Adequate staffing is necessary to meet patient care needs and provide safe, quality nursing care. In November 1999, the Korean government implemented a new staffing policy that differentiates nursing fees for inpatients based on nurse-to-bed ratios. The purpose was to prevent hospitals from delegating nursing care to family members of patients or paid caregivers, and ultimately deteriorating the quality of nursing care services. Purpose. To examine nurse staffing levels and related factors including hospital, nursing and medical staff, and financial characteristics. Methods. A cross-sectional design was employed using two administrative databases, Medical Care Institution Database and Medical Claims Data for May 1-31, 2002. Nurse staffing was graded from 1 to 6, based on grading criteria of nurse-to-bed ratios provided by the policy. The study sample consisted of 42 tertiary and 186 general acute care hospitals. Results. None of tertiary or general hospitals gained the highest nurse staffing of Grade 1 (i.e., less than 2 beds per nurse in tertiary hospitals; less than 2.5 beds per nurse in general hospitals). Two thirds of the general hospitals had the lowest staffing of Grade 6 (i.e., 4 or more beds per nurse in tertiary hospitals; 4.5 or more beds per nurse in general hospitals). Tertiary hospitals were better staffed than general hospitals, and private hospitals had higher staffing levels compared to public hospitals. Large-sized general hospitals located in metropolitan areas had higher staffing than other general hospitals. Occupancy rate was positively related to nurse staffing. A negative relationship between nursing assistant and nurse staffing was found in general hospitals. A greater number of physician specialists were associated with better nurse staffing. Conclusions. The staffing policy needs to be evaluated and modified to make it more effective in leading hospitals to increase nurse staffing.

• The Korean Society of Law and Medicine
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• v.22 no.4
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• pp.89-115
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• 2021

Korea's health care delivery system is based on the Medical law and the National Health Insurance Act. In order to efficiently operate limited medical resources, it is classified to use medical institutions according to the severity of the disease. The question is whether a tertiary care hospital can terminate a medical contract for a patient, if treatment for severe diseases has already been performed at a tertiary care hospital. In the case of termination of treatment, the Korean court has both a judgment that recognizes the right to terminate and a judgment that denies the termination. Among the U.S. rulings, there are rulings that order transfer to a skilled nursing facility or nursing home or home if acute treatment is no longer needed. Considering that medical resources are limited, it is necessary to acknowledge the right to terminate the contract of the medical institution when treatment by a medical institution is completed.