술폰화된 Po1Ysebs/PS Blending 필름의 제조

장석용 ( Suk Yong Jang ),한신호 ( Sien Ho Han ) 한국공업화학회 2008 공업화학 Vol.19 No.2

미국의 호스피탈리스트 흐름과 한국형 호스피탈리스트 도입방안

장성인 ( Sung In Jang ),장석용 ( Suk Yong Jang ),박은철 ( Eun Cheol Park ) 대한내과학회 2015 대한내과학회지 Vol.89 No.1

A gap in the number of physicians caring for inpatients is expected in 2014 based on the restricted working hours for Korean medical residents. One potential solution is the use of hospitalists. The US hospitalist movement has proliferated due to high-quality care and economics. This movement has brought positive changes including a shorter length of hospital stay, increased quality of care, and greater patient satisfaction. Because the Korean government controls all suppliers and maintains a low financial compensation level for universal coverage, hospitals do not have the financial resources to introduce hospitalists. Therefore, in contrast to the US, the use of hospitalists must be developed as a cost-compensated system in Korea. Institutional strategies must be introduced to develop a hospitalist system in Korea. A hospitalist system in Korea would be distinct from that in the US. Further studies and specific strategies are needed that consider Korea’s circumstances to effectively introduce a hospitalist system. (Korean J Med 2015;89:1-5)

포괄수가제도 당연적용 효과평가

최재우 ( Jae-woo Choi ),장성인 ( Sung-in Jang ),장석용 ( Suk-yong Jang ),김승주 ( Seung-ju Kim ),박혜기 ( Hye-ki Park ),김태현 ( Tae Hyun Kim ),박은철 ( Eun-cheol Park ) 한국보건행정학회 2016 보건행정학회지 Vol.26 No.2

Background: The voluntary diagnosis-related groups (DRG)-based payment system was introduced in 2002 and the government mandated participation in the DRG for all hospitals from July 2013. The main purpose of this study is to examine the independent effect of mandatory participation in DRG on various outcomes of patients. Methods: This study collected 1,809,948 inpatient DRG data from the Health Insurance Review and Assessment database which contains medical information for all patients for the period 2007 to 2014 and examined patient outcomes such as length of stay (LOS), total medical cost, spillover, and readmission rate according to hospital size. Results: LOS of patients decreased after DRGs (large hospitals: adjusted odds ratio [aOR], 0.87; 95% confidence interval [CI], 0.78-0.97; small hospitals: aOR, 0.91; 95% CI, 0.91-0.92). The total medical cost of patients increased after DRGs (large hospitals: aOR, 1.22; 95% CI, 1.14-1.30; small hospitals: aOR, 1.22; 95% CI, 1.21-1.23). The results reveals that spillover of patients increased after DRGs (large hospitals: aOR, 1.27; 95% CI, 0.70-2.33; small hospitals: aOR, 1.18; 95% CI, 1.16-1.20). Finally, we found that readmission rates of patients decreased significantly after DRGs (large hospitals: aOR, 0.28; 95% CI, 0.26-0.29; small hospitals: aOR, 0.59; 95% CI, 0.56-0.63). Conclusion: The DRG payment system compared to fee-for-service payment in South Korea may be an alternative medical price policy which can reduce the LOS. However, government need to monitor inappropriate changes such as spillover increase. Since this study also is the results based on relatively simple surgery, insurer needs to compare or review bundled payment like new DRG for expansion of various inpatient-related diseases including internal medicine.

응급의료 취약지 거주가 심근경색증 증상 인지에 미치는 영향

조미래 ( Mirae Jo ),오희영 ( Heeyoung Oh ),장석용 ( Suk-yong Jang ) 한국보건정보통계학회(구 한국보건통계학회) 2021 보건정보통계학회지 Vol.46 No.1

The purpose of this study is to investigate the awareness level of myocardial infarction (MI) symptoms for the residents in the underserved and deserved emergency medical services areas and verify the effect of the existence of residence in the underserved emergency medical services areas on the awareness of MI symptoms. Methods: This is a cross sectional study by using the data of the 2017 Korea Community Health Survey. The residence in the underserved emergency medical services areas is defined as being targeted to the residents in 101 areas notified in 『Emergency Medical Service Act』. The awareness of MI symptoms was classified as being aware of all five items of MI symptoms. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) are computed by multivariable logistic regression. Results: Of the total 195,246 subjects, 43.6% were aware of MI symptoms (43.7% and 43.6% of underserved and deserved emergency medical services areas, respectively). The residence in the underserved emergency medical services areas was associated with the awareness of MI symptoms (aOR 1.15, 95% CI=1.11-1.18). In addition, this study has found that gender, age, education level, income level, occupation, subjective stress level, drinking frequency, current smoking, and diagnosis of hypertension and diabetes were factors influencing the awareness of MI symptoms. Conclusions: Continuous efforts are needed to increase the awareness of MI symptoms for the residents in the underserved and deserved emergency medical services areas. Education and promotion should be conducted in consideration of gender, age, education level, income level, and occupation to improve the awareness of MI symptoms.

상급종합병원 비대면 진료 재이용에 영향을 미치는 요인

민선영 ( Sun-young Min ),김태현 ( Tae Hyun Kim ),이상규 ( Sang Gyu Lee ),장석용 ( Suk-yong Jang ) 한국병원경영학회 2023 병원경영학회지 Vol.28 No.4

Purposes: The purpose of this study is to identify and analyze the factors that affect patients reusing non-face-to-face treatments at tertiary general hospitals. Methodology: We retrospectively analyzed a patient's reuse of non-face-to-face treatment from February 1, 2020, to December 31, 2021, at a tertiary general hospital in Seoul within one year of the first non-face-to-face treatment. A frequency analysis was conducted to identify the study subjects’ demographic characteristics, treatment type characteristics, disease characteristics, and hospital use type characteristics. Also, a cross-analysis was conducted to verify the difference in non-face-to-face treatment reuse according to the characteristics a multiple logistic regression analysis was conducted to identify the factors affecting the reuse of non-face-to-face treatment by non-face-to-face treatment patients. Findings: The results of this study can be interpreted as indicating that the following groups are more likely to reuse the non-face-to-face treatment: women, children, the elderly, Patients living far from the hospital, psychiatric patients, pediatric patients, medical benefits recipients, chronic patients, patients with mobility difficulties, and patients with high loyalty to hospitals. Practical Implications: When developing a non-face-to-face treatment system in the future, based on the results of this study, it is possible to target patients who prefer non-face-to-face treatment. And this study will be research material for vitalizing non-face-to-face treatment. In addition, the activation of the non-face-to-face treatment system will be an effective means for improving the quality of medical services and generating profits in hospitals in the future.

암 최초 진단 후 수술 병원 결정요인: 수도권 소재 일개 종합병원을 대상으로

신창호 ( Chang Ho Shin ),김봄결 ( Bomgyeol Kim ),심형섭 ( Hyung Seop Sim ),김태현 ( Tae Hyun Kim ),장석용 ( Suk-yong Jang ),이상규 ( Sang Gyu Lee ) 한국병원경영학회 2021 병원경영학회지 Vol.26 No.4

Purposes: This study aimed to identify relevant factors that determine cancer surgery at a medium-sized general hospital where patients are diagnosed with cancer. Methodology: The study subjects were 1,530 patients diagnosed with cancer between November 2013 and October 2019 at a 400-bed general hospital located in the metropolitan area. Multiple logistic regression analysis was performed to identify the patient characteristics, cancer types, and characteristics of treatment experience of the study subjects, in addition to the determinants of cancer surgery in the hospital. Findings: Among 1,530 cases diagnosed with cancer, 353 cases (23.1%) were operated at the hospital where the cancer diagnosis was made. As determinants of surgery after a fist-time diagnosis at a general hospital, the likelihood of having surgery at the hospital, for colorectal cancer patients compared to stomach cancer patients (Odds Ratio=2.38), bladder and kidney cancer patients (Odds Ratio=1.79). According to the results of an additional survey conducted, it was found that important determinants of decisions on a hospital to receive cancer surgery were the kindness of the staff including doctors and nurses, and the trust in the medical skills and technique of the doctor. Practical Implication: The management of general hospitals should take note of the fact that it is important to establish proactive strategies for hospital management including strengthening the rapport between patients and medical institutions based on the kindness of medical staff (doctors and nurses) and staff, in addition to promoting cancer adequacy evaluation results and introducing one-stop systems.