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김기훈 ( Key Hoon Kim ),박재용 ( Jae Yong Park ),한창현 ( Chang Hyun Han ) 한국병원경영학회 2009 병원경영학회지 Vol.14 No.4
This study was conducted to present strategies for efficient use of older people`s medical expense and efficient management of hospital beds 삭제by analyzing factors which influenced medical charge of inpatients with stroke and medical charge of each medical treatment. The subjects was 1,070 inpatients with stroke in Academic hospital. The result of this study can be summarized as follows. In the case of cerebral hemorrhage, the rate of female was higher than that of male. In the case of cerebral infarction, the rate of male was higher than that of female. With increase of age, patients with cerebral hemorrhage decreased and patients with cerebral infarction increased. Medical charge for cerebral hemorrhage was 12,600,000 won, while that for cerebral infarction was 572,000 won. The medical charge with surgery was four times of that with non-surgery. The total medical charge for inpatients with stroke was 6,860,000 won. The patient payed 2,240,000 won(32.6%) and National Health Insurance Corporation payed 4,620,000 won(67.3%). Among charges of specific medical treatments, operation and treatment charge was highest(27.7%) in the case of cerebral hemorrhage, while examination charge was highest(32.2%)in the case of cerebral infarction. This study will provide basic information for efficient use of Medical Charge for Inpatients with Stroke.
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윤순길 ( Soon Gil Yun ),박재용 ( Jae Yong Park ),김기훈 ( Key Hoon Kim ),한창현 ( Chang Hyun Han ) 한국병원경영학회 2010 병원경영학회지 Vol.15 No.3
As a cross-sectional study, this study was aimed to investigate and compare the job efficiency and satisfaction of nurses according to the hospital grade. Survey was conducted by mail on June 2009, and the respondents were 1,016 nurses working in 15 hospitals which are 9 high-grade general hospitals and 6 general hospitals. The percent of nurses acknowledging their hospital grades is 34.5%, and that is 20.5% at high-grade general hospitals. As the result of review of studies, it is concluded that under the circumstance that differential rates are contracted to calculate fees for hospital services and copayment of patients are according to nursing grades and hospital grades, the degree of nurses` awareness of insurance fees impact on their performance like recording of care and prescription. In order to improve nurses` performance, they need to be educated about the national insurance fee system. In hospitals with higher nursing grade and more beds, the levels of nursing quality and faithfulnes and their job satisfaction were higher. Nurses` awareness of their hospital nursing grade was related to the quality of nursing but not the faithfulness. Nurses working in higher nursing-grade hospital are more self-respect and satisfied at their jobs, and their job efficiencies are not significantly different. The current nursing fees based on the proper number of nurses per beds of nursing units should be changed to be based on the amount of job per nurse by their nursing protocol, and the nurse staffing standard should be differentiated between nursing grades. As the aspect of nursing, 24-hours patient care, it is difficult to improve nurses` job satisfaction, and in the other hand, that tends to depend on their income level. In the current circumstance, comprehensive research is required to investigate the propriety of 25% of the inpatient fees as the nursing management charge.
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대장암의 근치적 절제술 후 발생한 이시성 간전이에 대한 고주파 온열치료와 절제술의 장기 종양학적 결과 비교
이현구(Hyun Gu Lee),이병철(Byoung Chul Lee),박인자(In Ja Park),김소연(So Yeon Kim),김기훈(Ki-Hun Kim),하태용(Tae Yong Ha),이재훈(Jae Hoon Lee),김찬욱(Chan Wook Kim),이종률(Jong Lyul Lee),윤용식(Yong Sik Yoon),임석병(Seok-Byung Lim),유 대한종양외과학회 2016 Korean Journal of Clinical Oncology Vol.12 No.1
Purpose: We compared oncologic outcomes between surgery and radiofrequency ablation (RFA) in patients with metachronous isolated hepatic metastases from colorectal cancer. Methods: We retrospectively analyzed 123 patients treated with hepatic resection and 82 patients treated with RFA for metachronous hepatic metastases between April 2000 and October 2011. Re-recurrence pattern and 3-year re-recurrence free survival (RFS) rate compared between groups. Factors associated with RFS were evaluated. Results: The patients in the two groups were similar in age, gender, location of primary tumor, disease-free interval to hepatic metastasis, pathological stage of primary disease, number of metastatic lesions. The mean diameter of the biggest hepatic metastatic lesion was significantly larger in the resection group than in the RFA group. The RFS rate after hepatic metastasis treatment was significantly higher in the resection group than in the RFA group (48.6% vs. 33.7%, respectively; P=0.015). Marginal recurrence at the RFA site was observed in 14 of the 82 patients (17.1%). The size and number of metastatic lesions, stage of primary disease, disease-free interval to hepatic metastasis, and modality of treatment were confirmed as re-recurrence-associated factors after hepatic metastasis treatment. Among patients with solitary metastases of ≤3 cm, the RFS rate was not different between the resection and RFA groups (52.4% vs. 53.4%, respectively; P=0.491). Conclusion: Surgical resection for metachronous hepatic metastases achieved higher RFS and lower local recurrence rates. However, the RFS rate in patients with a solitary hepatic metastasis of ≤3 cm was similar between the resection and RFA groups.
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Gini 계수와 Lorenz 곡선에 의한 지역별 병상분포 양상 분석
안병기 ( Byeung Ki An ),박재용 ( Key Hoon Kim ),김기훈 ( Jae Yong Park ) 한국병원경영학회 2011 병원경영학회지 Vol.16 No.3
In this study, population census(2005 & 2008) from Statistics Korea and the statistical data of the number of hospital beds by healthcare facilities classification from Ministry of Health and Welfare were used. For analyzing distribution of hospital beds, hospital beds were classified as acute care beds, long-term care beds and all hospital beds, which is including acute and long-term care beds. Regional areas, which are city(si), county(goon) for the study and district(gu) were reclassified as metropolitan city, city(si) and county(goon). Because there were 165 regional areas in 2005 and 2008, 84 and 81 areas were classified as metropolitan city and/or city and county, respectively. Gini index were calculated for hospital beds from each year, and Lorenz curves were drawn. The following summary presents the findings of this study. Compared to the year 2005 and 2008, the Gini index was 0.24472, and hospital bed numbers increased slightly by 0.80% than in 2005. In case of acute care beds, the Gini index was 0.23797(0.13%), and there was no big difference; however, the Gini index for long-term care beds was 0.41091, and there was a 30.25% decrease, which shows improvement to reduce disparities. It might result from an increase in long-term care beds up to 476.2%. For geographical equality of hospital beds, the Gini index and Lorenz curve, which can be compared the degree of inequality in the distribution of hospital beds reasonably and possibly show statistical data, should be used. Through this study, the distribution policy of hospital beds should be established.
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