Journal of Preventive Medicine and Public Health

Original Articles

Assessing Hospital Surgical Functions in Korea: A Functional Analysis Using the Disease Control Priorities, 3rd Edition Essential Surgery List (2013-2022): Haibin Bai, Jin-Hwan Kim, Yukyung Park; J Prev Med Public Health. 2025;58(6):635-646. Published online September 23, 2025; DOI: https://doi.org/10.3961/jpmph.25.407

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Abstract Summary PDF Supplementary Material: Objectives
Korea has achieved near-universal health coverage through a predominantly privatized healthcare system. However, this structural fragmentation has created significant ambiguity regarding the roles of different healthcare organizations, particularly in ensuring equitable provision of essential surgical services across geographic and institutional boundaries.
Methods
We conducted a retrospective study using the full national health insurance claims database provided by the Health Insurance Review & Assessment Service (2013-2022). Essential surgical procedures from the Disease Control Priorities, 3rd edition Essential Surgery List were mapped to insurance claims codes, and their provision was analyzed across healthcare facilities and regions. Functional capacity was defined using minimum annual volume thresholds of 12, 24, 60, and 120 procedures.
Results
Essential surgery more than doubled between 2013 and 2022, increasing from 2.79 million to nearly 6 million cases. Superior general hospitals and general hospitals consistently delivered high volumes of essential surgeries, while hospital-level facilities experienced marked functional decline, particularly in obstetric services. We observed increasing centralization of surgical services in higher-tier and metropolitan facilities, alongside selective decentralization for lower-risk procedures such as cataract surgery. Regional disparities were especially pronounced for obstetric care.
Conclusions
Functional capacity for essential surgery remains highly uneven across hospitals and regions, undermining equitable access. Policy efforts should focus on strengthening lower-tier hospitals in underserved areas and implementing minimum functionality standards tailored to local needs. Clarifying institutional roles within Korea’s mixed healthcare system is essential to improving accountability and ensuring equitable distribution of essential surgical services.; Summary

Korean summary
본 연구는 DCP3 Essential Surgery List를 한국의 건강보험 청구자료(2013–2022)에 적용하여 필수수술 제공기관의 기능적 변화를 평가하였다. 전체 필수수술 건수는 크게 증가했음에도 불구하고 이를 제공하는 의료기관 수는 지속적으로 감소하며 지역 간 격차도 확대되고 있었다. 필수수술 접근성을 강화하기 위해서는 우선 의료기관 수준별로 제공해야 할 필수 기능을 명확히 규정하는 정책적 가이드가 필요하며, 이를 기반으로 지역 단위의 종합병원·병원급 기능을 지속적으로 모니터링하고 관리하는 체계를 마련해야 한다.

Key Message
This study applies the DCP3 Essential Surgery List to South Korea’s national health insurance claims data (2013–2022) and shows that, despite a substantial rise in essential surgery volumes, the number of institutions providing these procedures has declined, widening regional disparities. Strengthening access to essential surgery requires first establishing clear guidance on the functions expected at each level of care, followed by systematic monitoring to ensure that general and hospital-level facilities maintain the capacity to deliver these core services. Such a combined approach is critical for securing equitable and regionally sustained surgical access.

Experience of Medical Personnel Dispatched to Isolated Psychiatric Institution in Korea During COVID-19: Content Analysis: Youngjoo Kim, Jung Hee Hyun, Jacob Lee, Yoonyoung Nam, Eunshil Yim, Kyounga Lee, Baegju Na; J Prev Med Public Health. 2025;58(4):431-439. Published online June 18, 2025; DOI: https://doi.org/10.3961/jpmph.24.680

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Abstract Summary PDF: Objectives
This study investigates problems related to medical response, and the support system among medical personnel dispatched to the psychiatric hospital when the first cluster of infections occurred in a psychiatric hospital in Korea.
Methods
Contents analysis was conducted for the responses of the medical personnel who responded to the interview. Training about basic quarantine rules, and safety management is not provided in the early dispatch stages.
Results
No guidance is available regarding the human rights protection of medical staff. Additionally, no on-site situation-control tower is available. Participants reported that temporary quarantine measures implemented at Hospital D to restrict the movement of patients and medical staff from the external world are problematic. The most significant problem is the insufficient governmental systemic support and consideration for protecting. Both the human rights of psychiatric patients and the human rights of the medical staff who care for them.
Conclusions
Future responses to new infectious diseases should include the establishment of a continuous support system in the community by changing the collective and closed-room environments as well as isolation-centered mental healthcare systems to protect the human rights of patients with mental disorders. Additionally, response drills for people with mental illness in closed environments should be practiced in response to emerging infectious diseases at ordinary times. Finally, training and emergency measures for medical staff dispatched to these facilities and a manual for the protection of the human rights of medical staff should be prepared.; Summary

Korean summary
이 논문은 COVID-19 초기 확산 시기, 한국 청도군의 한 정신병원에서 집단감염이 발생했을 때 파견된 의료진의 경험을 질적 내용 분석을 통해 조사한 연구입니다. 연구 결과, 정부의 준비 부족, 현장 통제 시스템 부재, 감염병 대응 훈련 미비, 인권 보호 기준 부재 등 여러 문제점이 드러났으며, 향후 정신질환자 대상 감염병 대응을 위해 지역사회 기반의 지속 가능한 지원체계와 의료진 인권 보호 매뉴얼 마련이 필요하다고 제안합니다.

Key Message
This study qualitatively analyzed the experiences of medical personnel dispatched to a psychiatric hospital in Cheongdo-gun, Korea, during a COVID-19 outbreak. It revealed critical issues such as lack of governmental preparedness, absence of on-site control systems, inadequate training, and insufficient protection of human rights for both patients and staff. The findings highlight the need for a sustainable, community-based mental healthcare system and the development of emergency manuals and human rights protection protocols for medical personnel in future infectious disease responses.

Vaccination Status and In-hospital Mortality Among Adults With COVID-19 in Jakarta, Indonesia: A Retrospective Hospital-based Cohort Study: Hotma Martogi Lorensi Hutapea, Pandji Wibawa Dhewantara, Anton Suryatma, Raras Anasi, Harimat Hendarwan, Mondastri Korib Sudaryo, Dwi Gayatri; J Prev Med Public Health. 2023;56(6):542-551. Published online October 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.360

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Abstract Summary PDF Supplementary Material: Objectives
Prospective studies on vaccination status and mortality related to coronavirus disease 2019 (COVID-19) in low-resource settings are still limited. We assessed the association between vaccination status (full, partial, or none) and in-hospital mortality among COVID-19 patients at most hospitals in Jakarta, Indonesia during the Delta predomination wave.
Methods
We conducted a retrospective cohort study among hospitalized COVID-19 patients who met the study criteria (>18 years old and admitted for inpatient treatment because of laboratory-confirmed severe acute respiratory syndrome coronavirus 2 infection). We linked individual-level data in the hospital admission database with vaccination records. Several socio-demographic and clinical characteristics were also analyzed. A Cox proportional hazards regression model was used to explore the association between vaccination status and in-hospital mortality in this patient group.
Results
In total, 40 827 patients were included in this study. Of these, 70% were unvaccinated (n=28 543) and 19.3% (n=7882) died during hospitalization. The mean age of the patients was 49 years (range, 35-59), 53.2% were female, 22.0% had hypertension, and 14.2% were treated in the intensive care unit, and the median hospital length of stay across the group was 9 days. Our study showed that the risk of in-hospital mortality among fully and partially vaccinated patients was lower than among unvaccinated adults (adjusted hazard ratio [aHR], 0.43; 95% confidence interval [CI], 0.40 to 0.47 and aHR, 0.70; 95% CI, 0.64 to 0.77, respectively).
Conclusions
Vaccinated patients had fewer severe outcomes among hospitalized adults during the Delta wave in Jakarta. These features should be carefully considered by healthcare professionals in treating adults within this patient group.; Summary

Key Message
During the COVID-19 pandemic the Delta variant of SARS-CoV-2 was dominating and challenging. Vaccination is one of many approaches to control the pandemic. We assessed the association between vaccination status and in-hospitalized mortality in COVID-19 patients. We found that vaccination status was associated with lower mortality, and fully vaccinated patients experienced lower risk of in-hospitalized mortality compared to partially vaccinated ones.

Trends in the Quality of Primary Care and Acute Care in Korea From 2008 to 2020: A Cross-sectional Study: Yeong Geun Gwon, Seung Jin Han, Kyoung Hoon Kim; J Prev Med Public Health. 2023;56(3):248-254. Published online April 12, 2023; DOI: https://doi.org/10.3961/jpmph.23.015

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Abstract Summary PDF

Objectives
Measuring the quality of care is paramount to inform policies for healthcare services. Nevertheless, little is known about the quality of primary care and acute care provided in Korea. This study investigated trends in the quality of primary care and acute care.
Methods
Case-fatality rates and avoidable hospitalization rates were used as performance indicators to assess the quality of primary care and acute care. Admission data for the period 2008 to 2020 were extracted from the National Health Insurance Claims Database. Case-fatality rates and avoidable hospitalization rates were standardized by age and sex to adjust for patients’ characteristics over time, and significant changes in the rates were identified by joinpoint regression.
Results
The average annual percent change in age-/sex-standardized case-fatality rates for acute myocardial infarction was -2.3% (95% confidence interval, -4.6 to 0.0). For hemorrhagic and ischemic stroke, the age-/sex-standardized case-fatality rates were 21.8% and 5.9%, respectively in 2020; these rates decreased since 2008 (27.1 and 8.7%, respectively). The average annual percent change in age-/sex-standardized avoidable hospitalization rates ranged from -9.4% to -3.0%, with statistically significant changes between 2008 and 2020. In 2020, the avoidable hospitalization rates decreased considerably compared with the 2019 rate because of the coronavirus disease 2019 pandemic.
Conclusions
The avoidable hospitalization rates and case-fatality rates decreased overall during the past decade, but they were relatively high compared with other countries. Strengthening primary care is an essential requirement to improve patient health outcomes in the rapidly aging Korean population.

Summary

Korean summary
본 연구에서는 급성심근경색증과 뇌졸중 치명률, 외래진료 민감질환의 예방 가능한 입원율을 사용하여 한국의 의료 질 수준을 분석하였다. 2008~2020년 동안 치명률과 예방 가능한 입원율은 감소하는 추세이다. 그러나, 예방 가능한 입원율은 다른 국가에 비해 상대적으로 높아 환자의 건강결과 향상을 위하여 일차의료 강화가 요구된다.

Citations

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National Expenditures on Anticancer and Immunomodulating Agents During 2013–2022 in Korea
Jieun Yun, Youngs Chang, Minsol Jo, Yerin Heo, Dong-Sook Kim
Journal of Korean Medical Science.2025;[Epub] CrossRef
Evidence of Overlapping Roles Between Clinics and Hospitals in Primary Care
Boram Sim, Jihye Shin, Hyun Woo Kim, Jin Yong Lee, Min-Woo Jo
Journal of Korean Medical Science.2025;[Epub] CrossRef
Impacto da COVID-19 na Atenção Primária à Saúde e suas Condições Sensíveis: Revisão de Escopo
Vinicius Paim Brasil, Juliana Prestes Ferigollo, Felipa Amadigi, Fúlvio Borges Nedel
Saúde Coletiva (Barueri).2025; 16(101): 17732. CrossRef
Mortality and Disparities of Acute Myocardial Infarction and Stroke in Korea, 2008–2019
Ji-Sook Choi, Soomin Kim, Choon-Seon Park, Hyejin Lee, Jin Yong Lee, Sun Min Kim
Yonsei Medical Journal.2024; 65(9): 534. CrossRef

Changes in the Hospital Standardized Mortality Ratio Before and During the COVID-19 Pandemic: A Disaggregated Analysis by Region and Hospital Type in Korea: EunKyo Kang, Won Mo Jang, Min Sun Shin, Hyejin Lee, Jin Yong Lee; J Prev Med Public Health. 2023;56(2):180-189. Published online March 20, 2023; DOI: https://doi.org/10.3961/jpmph.22.479

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Abstract Summary PDF

Objectives
The coronavirus disease 2019 (COVID-19) pandemic has led to a global shortage of medical resources; therefore, we investigated whether COVID-19 impacted the quality of non-COVID-19 hospital care in Korea by comparing hospital standardized mortality rates (HSMRs) before and during the pandemic.
Methods
This retrospective cohort study analyzed Korean National Health Insurance discharge claim data obtained from January to June in 2017, 2018, 2019, and 2020. Patients’ in-hospital deaths were classified according to the most responsible diagnosis categories. The HSMR is calculated as the ratio of expected deaths to actual deaths. The time trend in the overall HSMR was analyzed by region and hospital type.
Results
The final analysis included 2 252 824 patients. In 2020, the HSMR increased nationwide (HSMR, 99.3; 95% confidence interval [CI], 97.7 to 101.0) in comparison to 2019 (HSMR, 97.3; 95% CI, 95.8 to 98.8). In the COVID-19 pandemic zone, the HSMR increased significantly in 2020 (HSMR, 112.7; 95% CI, 107.0 to 118.7) compared to 2019 (HSMR, 101.7; 95% CI, 96.9 to 106.6). The HSMR in all general hospitals increased significantly in 2020 (HSMR, 106.4; 95% CI, 104.3 to 108.5) compared to 2019 (HSMR, 100.3; 95% CI, 98.4 to 102.2). Hospitals participating in the COVID-19 response had a lower HSMR (HSMR, 95.6; 95% CI, 93.9 to 97.4) than hospitals not participating in the COVID-19 response (HSMR, 124.3; 95% CI, 119.3 to 129.4).
Conclusions
This study suggests that the COVID-19 pandemic may have negatively impacted the quality of care in hospitals, especially general hospitals with relatively few beds. In light of the COVID-19 pandemic, it is necessary to prevent excessive workloads in hospitals and to properly employ and coordinate the workforce.

Summary

Korean summary
코로나19 대유행 지역은 비감염 지역과 달리 2019년에 비해 2020년에 HSMR이 크게 증가했고, 상대적으로 병상 수가 적은 종합병원에서 HSMR이 증가했다. 코로나19 대응에 참여하는 병원은 병원 규모와 관계없이 HSMR이 낮은 경향을 보였다. 감염병 유행 시 병원의 과도한 업무량이 부여되지 않게하고 인력을 적절하게 고용하여 조정하는 것이 필요하다.

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National Expenditures on Anticancer and Immunomodulating Agents During 2013–2022 in Korea
Jieun Yun, Youngs Chang, Minsol Jo, Yerin Heo, Dong-Sook Kim
Journal of Korean Medical Science.2025;[Epub] CrossRef
The Impact of COVID-19 on Admissions and In-hospital Mortality of Patients With Stroke in Korea: An Interrupted Time Series Analysis
Youngs Chang, Soo-Hee Hwang, Haibin Bai, Seowoo Park, Eunbyul Cho, Dohoung Kim, Hyejin Lee, Jin Yong Lee
Journal of Preventive Medicine and Public Health.2025; 58(1): 60. CrossRef
Impact of COVID-19 on admission and in-hospital mortality of patients with acute myocardial infarction in Korea: An interrupted time series analysis
Soo-Hee Hwang, Youngs Chang, Haibin Bai, Jieun Yun, Hyejin Lee, Jin Yong Lee, Dong Keon Yon
PLOS ONE.2025; 20(2): e0316943. CrossRef
국내 호흡기세포융합바이러스의 동절기 유행 규모 예측모형 개발
경덕 민, 현경 김, 보영 류, 민규 유, 재훈 김
Public Health Weekly Report.2025; 18(21): 771. CrossRef
Variations in length of stay and cost of pediatric pneumonia hospitalizations according to patient and institutional factors
Hyejin Lee, Jin-Won Noh, Sanghee Lee, Jung-Kyu Choi, Jung-Hoe Kim, Hae-jong Lee, Jin Yong Lee, Erica Barbazza
International Journal For Quality In Health Care.2025;[Epub] CrossRef

Identification of Unmet Healthcare Needs: A National Survey in Thailand: Sukanya Chongthawonsatid; J Prev Med Public Health. 2021;54(2):129-136. Published online March 4, 2021; DOI: https://doi.org/10.3961/jpmph.20.318

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Abstract PDF Supplementary Material

Objectives
This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand.
Methods
The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis.
Results
Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were—in descending order of frequency—insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors.
Conclusions
Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

Summary

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Jaranya Hunsrisakhun, Supawadee Naorungroj, Watcharawalee Tangkuptanon, Pissamai Wattanasit, Kittiwara Pupong, Samerchit Pithpornchaiyakul
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Unmet healthcare needs, out-of-pocket payments and catastrophic health expenditures among hypertensive adults in Bangladesh
Md. Mizanur Rahman, Md. Safayet Hossain, Ryota Nakamura, Md. Ashraful Alam, Syed Khurram Azmat, Motohiro Sato
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Factors associated with poor self-rated health among chronic kidney disease patients and their health care utilization: Insights from LASI wave-1, 2017-18
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COVID-19: Original Article

Associations Between General Perceptions of COVID-19 and Posttraumatic Stress Disorder in Korean Hospital Workers: Effect Modification by Previous Middle East Respiratory Syndrome Coronavirus Experience and Occupational Type: Youngrong Lee, Kwanghyun Kim, Sungjin Park, Sun Jae Jung; J Prev Med Public Health. 2021;54(2):86-95. Published online January 19, 2021; DOI: https://doi.org/10.3961/jpmph.20.540

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Abstract Summary PDF Supplementary Material

Objectives
This study investigated associations between perceptions of coronavirus disease 2019 (COVID-19) and the prevalence of posttraumatic stress disorder (PTSD) in workers at hospitals designated to treat COVID-19, as well as the difference in the magnitude of these associations by occupational type and previous Middle East respiratory syndrome coronavirus (MERS-CoV) experience.
Methods
The participants were workers at hospitals designated to treat COVID-19 who completed a questionnaire about their perceptions related to COVID-19, work experience during the previous MERS-CoV outbreak, and symptoms of PTSD ascertained by the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders. Participants’ characteristics were compared using the chi-square test. Multivariable logistic regression was performed to evaluate the associations between perceptions and the prevalence of PTSD, stratified by occupational type and previous MERS-CoV experience.
Results
Non-medical personnel showed stronger associations with PTSD than medical personnel according to general fear (odds ratio [OR], 6.67; 95% confidence interval [CI], 1.92 to 23.20), shortages of supplies (OR, 1.29; 95% CI, 1.07 to 1.56), and issue-specific fear (OR, 1.29; 95% CI, 1.05 to 1.59). Those with prior MERS-CoV quarantine experience were more prone to PTSD than those without such experience in terms of general fear (OR, 1.70; 95% CI, 1.22 to 2.37), shortages of supplies (OR, 1.24; 95% CI, 1.10 to 1.40), and issue-specific fear (OR, 1.21; 95% CI, 1.06 to 1.38).
Conclusions
During the COVID-19 pandemic, non-medical personnel tended to have higher odds of being categorized as having PTSD. Workers with prior MERS-CoV experience were more susceptible than those without such experience. These findings suggest the need for timely interventions to manage human resources for a sustainable quarantine system.

Summary

Korean summary
본 연구는 COVID-19관련 인식과 COVID-19 안심 병원 근로자들의 외상 후 스트레스 장애 (PTSD) 유병률 사이의 연관성에서 직업 유형과 이전 중동 호흡기 증후군 (MERS-CoV) 방역 경험 여부로 인한 연관성의 크기 차이를 조사하였다. 비의료인이 의료인보다 PTSD유병에 더 강한 연관성을 보였고, 이전 메르스 방역 경험이 있는 근로자들이 COVID-19에 대한 "일반적 공포", "물품 부족 공포" 및 "특정 문제에 따른 공포"로 구분한 인식의 크기가 클 수록 방역 경험이 없는 근로자들보다 PTSD유병과의 관련성이 더 컸다. 결론적으로 COVID-19 대유행 기간 중 비의료 인력은 PTSD유병 확률이 더 높은 경향이 있었다. 이전 MERS-CoV 경험이 있는 근로자는 그러한 경험이 없는 근로자보다 더 취약했다.

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Prevalence of post-traumatic stress disorder in Peruvian military: a cross-sectional study
Mario J. Valladares-Garrido, Cinthia Karina Picón-Reátegui, J. Pierre Zila-Velasque, Virgilio E. Failoc-Rojas, César Johan Pereira Victorio, Danai Valladares-Garrido, Víctor J. Vera-Ponce
Frontiers in Psychiatry.2025;[Epub] CrossRef
Association between social networks and symptoms of post-traumatic stress during the pandemic: Cohort study in South Korea
Ji Su Yang, Yu Jin Lee, Hyeon Chang Kim, Chul-Hyun Cho, Alexander C. Tsai, Sun Jae Jung
Comprehensive Psychiatry.2023; 127: 152432. CrossRef
Development and Validation of COVID-19 Stress Scale (CSS) in an Iranian Non-clinical Population
Roghieh Nooripour, Nikzad Ghanbari, Laurel E. Radwin, Simin Hosseinian, Peyman Hassani-Abharian, Mohsen Hosseinbor, Keyvan Kakabraee, Mojtaba Amiri Majd, Serge Brand, Esmaeil Soleimani, Hossein Ilanloo
Zahedan Journal of Research in Medical Sciences.2022;[Epub] CrossRef

Brief Report

Determinants of Hospital Inpatient Costs in the Iranian Elderly: A Micro-costing Analysis: Ebrahim Hazrati, zahra Meshkani, Saeed Husseini Barghazan, Sanaz Zargar Balaye Jame, Nader Markazi-Moghaddam; J Prev Med Public Health. 2020;53(3):205-210. Published online May 16, 2020; DOI: https://doi.org/10.3961/jpmph.19.250

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Abstract PDF

Objectives
Aging is assumed to be accompanied by greater health care expenditures. The objective of this retrospective, bottom-up micro-costing study was to identify and analyze the variables related to increased health care costs for the elderly from the provider’s perspective.
Methods
The analysis included all elderly inpatients who were admitted in 2017 to a hospital in Tehran, Iran. In total, 1288 patients were included. The Mann-Whitney and Kruskal-Wallis tests were used.
Results
Slightly more than half (51.1%) of patients were males, and 81.9% had a partial recovery. The 60-64 age group had the highest costs. Cancer and joint/orthopedic diseases accounted for the highest proportion of costs, while joint/orthopedic diseases had the highest total costs. The surgery ward had the highest overall cost among the hospital departments, while the intensive care unit had the highest mean cost. No statistically significant relationships were found between inpatient costs and sex or age group, while significant associations (p<0.05) were observed between inpatient costs and the type of ward, length of stay, type of disease, and final status. Regarding final status, costs for patients who died were 3.9 times higher than costs for patients who experienced a partial recovery.
Conclusions
Sex and age group did not affect hospital costs. Instead, the most important factors associated with costs were type of disease (especially chronic diseases, such as joint and orthopedic conditions), length of stay, final status, and type of ward. Surgical services and medicine were the most important cost items.

Summary

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BMC Research Notes.2024;[Epub] CrossRef

Original Articles

Reliability and Validity of the Appropriateness Evaluation Protocol for Public Hospitals in Korea: Clara Lee, Stella Jung-Hyun Kim, Changwoo Lee, Euichul Shin; J Prev Med Public Health. 2019;52(5):316-322. Published online September 12, 2019; DOI: https://doi.org/10.3961/jpmph.19.125

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Abstract Summary PDF

Objectives
This study was conducted to assess the applicability of the Appropriateness Evaluation Protocol (AEP) for public hospitals in Korea.
Methods
In May 2016, 1500 admission claims were collected from Korean public district hospitals using stratified random sampling. Of these claims, 560 admissions to 37 hospitals were retrieved for analysis. Medical records administrators determined the appropriateness of admission using the criteria detailed in the AEP, and a physician separately assessed the appropriateness of admission based on her clinical judgment. To examine the applicability of the AEP, the concordance of the decisions made between a pair of AEP reviewers and between an AEP reviewer and a physician reviewer was compared.
Results
The results showed an almost perfect inter-rater agreement between the AEP reviewers and a moderate agreement between the AEP reviewers and the physician. The sensitivity and specificity of the AEP were calculated as 0.86 and 0.56, respectively.
Conclusions
Our findings suggest that the AEP could potentially be applied to Korean public hospitals as a reliable and valid instrument for assessing the appropriateness of admissions.

Summary

Korean summary
이 연구는 우리나라 공공병원을 대상으로 Appropriateness Evaluation Protocol(AEP) 도구를 적용가능성을 검토하기 위해 실시되었다. 우리나라의 지역공공병원 입원자료(2016년 5월 기준)를 층화무작위추출을 통해 1,500건을 추출하였으며, 이중 37개 병원의 560건에 대해 입원적정성을 분석하였다. 의무기록사 2인은 AEP 도구를 이용하여 입원적정성을 각각 검토하였고, 의사 1인은 전문가적 판단을 기준으로 검토하였다. AEP 도구의 적용가능성을 판단하기 위해 의무기록사간 그리고 의무기록사-의사간 일치율을 산출하였다. 의무기록사간 일치율은 거의 완벽한 수준으로 나타났고, 의무기록사-의사간은 중등도의 일치율을 보였다. 민감도, 특이도는 각각 0.86 그리고 0.56이었다. 이러한 결과는 AEP 도구가 우리나라 공공병원의 입원적정성을 평가하기 위한 일관적이고 정확한 도구임을 제시한다.

Citations

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Development of an evaluation index system for inappropriate hospital admissions after colorectal cancer surgery in the context of enhanced recovery after surgery
Jianan Sun, Qing Zhang, Jingyu Ma, Dongxue Wang, Luyao Zhang, Liang He, Xuan Sun, Yuchen Guo, Yinquan Zhao, Yanpeng Xing, Haiyan Hu, Quan Wang
BMC Nursing.2025;[Epub] CrossRef
Inappropriate hospital admission as a risk factor for the subsequent development of adverse events: a cross-sectional study
Diego San Jose-Saras, Jorge Vicente-Guijarro, Paulo Sousa, Paloma Moreno-Nunez, Jesús María Aranaz-Andres, Cristina Díaz-Agero Pérez, Miguel Ignacio Cuchi Alfaro, Juan Manuel Ramos López, Mercedes García Haro, Abelardo Claudio Fernández Chávez, Cornelia B
BMC Medicine.2023;[Epub] CrossRef
Inappropriate Hospital Admission According to Patient Intrinsic Risk Factors: an Epidemiological Approach
D. San Jose-Saras, J. Vicente-Guijarro, P. Sousa, P. Moreno-Nunez, M. Espejo-Mambié, J. M. Aranaz-Andres
Journal of General Internal Medicine.2023; 38(7): 1655. CrossRef
Strategies to improve the flow of admissions and hospital stays: a Delphi study of an adaptation of the Appropriateness Evaluation Protocol (AEP)
A. Morillo-Rodríguez, S. Alonso-Fernández, J.M. Mòdol Deltell, B. Soldevila Madorell, Ll. Benito-Aracil, D. Parés
Revista Clínica Española (English Edition).2023; 223(5): 270. CrossRef
Estrategias para mejorar el flujo de ingresos y estancias hospitalarias: adaptación del cuestionario Appropriateness Evaluation Protocol (AEP): estudio Delphi
A. Morillo-Rodríguez, S. Alonso-Fernández, J.M. Mòdol Deltell, B. Soldevila Madorell, Ll. Benito-Aracil, D. Parés
Revista Clínica Española.2023; 223(5): 270. CrossRef

Cancer Patients’ Utilization of Tertiary Hospitals in Seoul Before and After the Benefit Expansion Policy: Sanghyun Cho, Youngs Chang, Yoon Kim; J Prev Med Public Health. 2019;52(1):41-50. Published online January 4, 2019; DOI: https://doi.org/10.3961/jpmph.18.166

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Abstract Summary PDF Supplementary Material

Objectives
The aim of this study was to investigate cancer patients’ utilization of tertiary hospitals in Seoul before and after the benefit expansion policy implemented in 2013.
Methods
This was a before-and-after study using claims data of the Korean National Health Insurance Service from 2011 to 2016. The unit of analysis was inpatient episodes, and inpatient episodes involving a malignant neoplasm (International Classification of Diseases, Tenth Revision codes: C00-C97) were included in this study. The total sample (n=5 565 076) was divided into incident cases and prevalent cases according to medical use due to cancer in prior years. The tertiary hospitals in Seoul were divided into two groups (the five largest hospitals and the other tertiary hospitals in Seoul).
Results
The proportions of the incident and prevalent episodes occurring in tertiary hospitals in Seoul were 34.9% and 37.2%, respectively, of which more than 70% occurred in the five largest hospitals in Seoul. Utilization of tertiary hospitals in Seoul was higher for inpatient episodes involving cancer surgery, patients with a higher income, patients living in areas close to Seoul, and patients living in areas without a metropolitan city. The utilization of the five largest hospitals increased by 2 percentage points after the policy went into effect.
Conclusions
The utilization of tertiary hospitals in Seoul was concentrated among the five largest hospitals. Future research is necessary to identify the consequences of this utilization pattern.

Summary

Korean summary
2014년부터 2016년까지 암 발생자 입원의 34.9%가 서울 소재 상급종합병원에서 이루어졌으며, 그중 73.9%가 5대 상급종합병원에서 이루어졌다. 4대 중증질환 보장성 강화 정책 후에 암환자의 서울 소재 상급종합병원 이용은 6.1%(2% 포인트) 증가하였으며, 5대 상급종합병원 이용률은 증가(정책 전: 23.6%, 정책 후: 25.8%), 그 외 서울 소재 상급종합병원 이용률은 감소하였다(정책 전: 9.3%, 정책 후: 9.1%).

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Areca Nut Chewing and the Risk of Re-hospitalization and Mortality Among Patients With Acute Coronary Syndrome in Pakistan: Muhammad Tariq Karim, Sumera Inam, Tariq Ashraf, Nadia Shah, Syed Omair Adil, Kashif Shafique; J Prev Med Public Health. 2018;51(2):71-82. Published online February 19, 2018; DOI: https://doi.org/10.3961/jpmph.17.189

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Abstract PDF

Objectives
Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events.

Summary

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Bacterial Contamination and Disinfection Status of Laryngoscopes Stored in Emergency Crash Carts: Jae Hyung Choi, Young Soon Cho, Jung Won Lee, Hee Bong Shin, In Kyung Lee; J Prev Med Public Health. 2017;50(3):158-164. Published online April 4, 2017; DOI: https://doi.org/10.3961/jpmph.17.013

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237 Download
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Abstract PDF

Objectives
To identify bacterial contamination rates of laryngoscope blades and handles stored in emergency crash carts by hospital and area according to the frequency of intubation attempts.
Methods
One hundred forty-eight handles and 71 blades deemed ready for patient use from two tertiary hospitals were sampled with sterile swabs using a standardized rolling technique. Samples were considered negative (not contaminated) if no colonies were present on the blood agar plate after an 18-hour incubation period. Samples were stratified by hospital and according to the frequency of intubation attempts (10 attempts per year) using the χ²-test and Fisher exact test.
Results
One or more species of bacteria were isolated from 4 (5.6%) handle tops, 20 (28.2%) handles with knurled surfaces, and 27 (18.2%) blades. No significant differences were found in microbial contamination levels on the handle tops and blades between the two hospitals and two areas according to the frequency of intubation attempts. However, significant differences were found between the two hospitals and two areas in the level of microbial contamination on the handles with knurled surfaces (p<0.05).
Conclusions
Protocols and policies must be reviewed to standardize procedures to clean and disinfect laryngoscope blades and handles; handles should be re-designed to eliminate points of contact with the blade; and single-use, one-piece laryngoscopes should be introduced.

Summary

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Review

Short-term Effect of Fine Particulate Matter on Children’s Hospital Admissions and Emergency Department Visits for Asthma: A Systematic Review and Meta-analysis: Hyungryul Lim, Ho-Jang Kwon, Ji-Ae Lim, Jong Hyuk Choi, Mina Ha, Seung-Sik Hwang, Won-Jun Choi; J Prev Med Public Health. 2016;49(4):205-219. Published online July 14, 2016; DOI: https://doi.org/10.3961/jpmph.16.037

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Abstract PDF

Objectives
No children-specified review and meta-analysis paper about the short-term effect of fine particulate matter (PM_2.5) on hospital admissions and emergency department visits for asthma has been published. We calculated more precise pooled effect estimates on this topic and evaluated the variation in effect size according to the differences in study characteristics not considered in previous studies.
Methods
Two authors each independently searched PubMed and EMBASE for relevant studies in March, 2016. We conducted random effect meta-analyses and mixed-effect meta-regression analyses using retrieved summary effect estimates and 95% confidence intervals (CIs) and some characteristics of selected studies. The Egger’s test and funnel plot were used to check publication bias. All analyses were done using R version 3.1.3.
Results
We ultimately retrieved 26 time-series and case-crossover design studies about the short-term effect of PM_2.5 on children’s hospital admissions and emergency department visits for asthma. In the primary meta-analysis, children’s hospital admissions and emergency department visits for asthma were positively associated with a short-term 10 μg/m³ increase in PM_2.5 (relative risk, 1.048; 95% CI, 1.028 to 1.067; I²=95.7%). We also found different effect coefficients by region; the value in Asia was estimated to be lower than in North America or Europe.
Conclusions
We strengthened the evidence on the short-term effect of PM_2.5 on children’s hospital admissions and emergency department visits for asthma. Further studies from other regions outside North America and Europe regions are needed for more generalizable evidence.

Summary

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Zhenjiang Li, Donghai Liang, Dongni Ye, Howard H. Chang, Thomas R. Ziegler, Dean P. Jones, Stefanie T. Ebelt
Environmental Research.2021; 193: 110506. CrossRef
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European Respiratory Journal.2021; 57(3): 2002981. CrossRef
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Veronica A. Southerland, Susan C. Anenberg, Maria Harris, Joshua Apte, Perry Hystad, Aaron van Donkelaar, Randall V. Martin, Matt Beyers, Ananya Roy
Environmental Health Perspectives.2021;[Epub] CrossRef
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Agnes S. Y. Leung, Elizabeth Huiwen Tham, Jing Li, Punchama Pacharn, Takumi Takizawa, Eun Lee, Yuhan Xing, Ting‐Fan Leung, Soo‐Jong Hong, Gary W. K. Wong, Ömer Kalaycı
Pediatric Allergy and Immunology.2021; 32(6): 1152. CrossRef
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Brandy M. Byrwa-Hill, Albert A. Presto, Sally Wenzel, James P. Fabisiak
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John K. Kodros, Katelyn O’Dell, Jonathan M. Samet, Christian L’Orange, Jeffrey R. Pierce, John Volckens
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James P. Fabisiak, Erica M. Jackson, LuAnn L. Brink, Albert A. Presto
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Angelica I. Tiotiu, Plamena Novakova, Denislava Nedeva, Herberto Jose Chong-Neto, Silviya Novakova, Paschalis Steiropoulos, Krzysztof Kowal
International Journal of Environmental Research and Public Health.2020; 17(17): 6212. CrossRef
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Annals of the Academy of Medicine, Singapore.2020; 49(2): 78. CrossRef
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Guang-jun Yu, Jian-lei Gu, Wen-bin Cui, Jian-ping Jiang, Yang Wang, Georgi Z. Genchev, Ting Lu, Hui Lu
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Chi-Yung Cheng, Shih-Yu Cheng, Chien-Chih Chen, Hsiu-Yung Pan, Kuan-Han Wu, Fu-Jen Cheng
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Nicolas Borchers Arriagada, Joshua A. Horsley, Andrew J. Palmer, Geoffrey G. Morgan, Rachel Tham, Fay H. Johnston
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Yi Zhang, Liangliang Cui, Dandan Xu, Mike Z. He, Jingwen Zhou, Lianyu Han, Xinwei Li, Tiantian Li
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Lijun Bai, Xi Su, Desheng Zhao, Yanwu Zhang, Qiang Cheng, Heng Zhang, Shusi Wang, Mingyu Xie, Hong Su
Journal of Epidemiology and Community Health.2018; 72(5): 426. CrossRef
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Journal of Preventive Medicine and Public Health.2018; 51(6): 275. CrossRef
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Atmospheric Pollution Research.2017; 8(3): 465. CrossRef
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Julie E. Goodman, Christine T. Loftus, Xiaobin Liu, Ke Zu, Alexander Larcombe
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Special Article

Legal Issues in Quarantine and Isolation for Control of Emerging Infectious Diseases: Cheonsoo Kim; J Prev Med Public Health. 2016;49(1):1-17. Published online January 29, 2016; DOI: https://doi.org/10.3961/jpmph.16.009

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Abstract PDF Supplementary Material

The Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in South Korea in 2015 has drawn public attention regarding the legal regulation of infectious disease control in Korea. This paper discusses the interpretive and legislative concerns regarding the Infectious Disease Prevention and Control Act, its ordinance and enforcement regulations, as well as public statements from the relevant administrative agency. Future improvements are also proposed.

Summary

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Original Articles

The Impact of an Emergency Fee Increase on the Composition of Patients Visiting Emergency Departments: Hyemin Jung, Young Kyung Do, Yoon Kim, Junsoo Ro; J Prev Med Public Health. 2014;47(6):309-316. Published online November 24, 2014; DOI: https://doi.org/10.3961/jpmph.14.044

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Abstract PDF: Objectives
This study aimed to test our hypothesis that a raise in the emergency fee implemented on March 1, 2013 has increased the proportion of patients with emergent symptoms by discouraging non-urgent emergency department visits.
Methods
We conducted an analysis of 728 736 patients registered in the National Emergency Department Information System who visited level 1 and level 2 emergency medical institutes in the two-month time period from February 1, 2013, one month before the raise in the emergency fee, to March 31, 2013, one month after the raise. A difference-in-difference method was used to estimate the net effects of a raise in the emergency fee on the probability that an emergency visit is for urgent conditions.
Results
The percentage of emergency department visits in urgent or equivalent patients increased by 2.4% points, from 74.2% before to 76.6% after the policy implementation. In a group of patients transferred using public transport or ambulance, who were assumed to be least conscious of cost, the change in the proportion of urgent patients was not statistically significant. On the other hand, the probability that a group of patients directly presenting to the emergency department by private transport, assumed to be most conscious of cost, showed a 2.4% point increase in urgent conditions (p<0.001). This trend appeared to be consistent across the level 1 and level 2 emergency medical institutes.
Conclusions
A raise in the emergency fee implemented on March 1, 2013 increased the proportion of urgent patients in the total emergency visits by reducing emergency department visits by non-urgent patients.; Summary

Variations in the Hospital Standardized Mortality Ratios in Korea: Eun-Jung Lee, Soo-Hee Hwang, Jung-A Lee, Yoon Kim; J Prev Med Public Health. 2014;47(4):206-215. Published online July 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.4.206

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Abstract PDF

Objectives
The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care.
Methods
All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities.
Results
For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR.
Conclusions
We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.

Summary

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Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki Park, Ji-Sook Choi, Min Sun Shin, Soomin Kim, Hyekyoung Kim, Nahyeong Im, Soon Joo Park, Donggyo Shin, Youngmi Song, Yunjung Cho, Hyunmi Joo, Hyeryeon Hong, Yong-Hwa Hwang, Choon-Seon Park
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A machine learning model for predicting severity-adjusted in-hospital mortality in pneumonia patients
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Differences in trends in discharge location in a cohort of hospitalized patients with cancer and non-cancer diagnoses receiving specialist palliative care: A retrospective cohort study
Michael Bonares, Kalli Stillos, Lise Huynh, Debbie Selby
Palliative Medicine.2023; 37(8): 1241. CrossRef
Functional training and timed nutrition intervention in infectious medical patients
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European Journal of Clinical Nutrition.2016; 70(9): 1039. CrossRef

Validation Studies

Construction and Validation of Hospital-Based Cancer Registry Using Various Health Records to Detect Patients with Newly Diagnosed Cancer: Experience at Asan Medical Center.: Hwa Jung Kim, Jin Hee Cho, Yongman Lyu, Sun Hye Lee, Kyeong Ha Hwang, Moo Song Lee; J Prev Med Public Health. 2010;43(3):257-264.; DOI: https://doi.org/10.3961/jpmph.2010.43.3.257

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Abstract PDF

OBJECTIVES
An accurate estimation of cancer patients is the basis of epidemiological studies and health services. However in Korea, cancer patients visiting out-patient clinics are usually ruled out of such studies and so these studies are suspected of underestimating the cancer patient population. The purpose of this study is to construct a more complete, hospital-based cancer patient registry using multiple sources of medical information. METHODS: We constructed a cancer patient detection algorithm using records from various sources that were obtained from both the in-patients and out-patients seen at Asan Medical Center (AMC) for any reason. The medical data from the potentially incident cancer patients was reviewed four months after first being detected by the algorithm to determine whether these patients actually did or did not have cancer. RESULTS: Besides the traditional practice of reviewing the charts of in-patients upon their discharge, five more sources of information were added for this algorithm, i.e., pathology reports, the national severe disease registry, the reason for treatment, prescriptions of chemotherapeutic agents and radiation therapy reports. The constructed algorithm was observed to have a PPV of 87.04%. Compared to the results of traditional practice, 36.8% of registry failures were avoided using the AMC algorithm. CONCLUSIONS: To minimize loss in the cancer registry, various data sources should be utilized, and the AMC algorithm can be a successful model for this. Further research will be required in order to apply novel and innovative technology to the electronic medical records system in order to generate new signals from data that has not been previously used.

Summary

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The role of Hospital-Based Cancer Registries (HBCRs) as information systems in the delivery of evidence-based integrated cancer care: a scoping review
Sheela Tripathee, Sara Jane MacLennan, Amudha Poobalan, Muhammad Imran Omar, Aravinda Meera Guntupalli
Health Systems.2024; 13(3): 177. CrossRef
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Jihyun An, Seheon Chang, Ha Il Kim, Gi‐Won Song, Ju Hyun Shim
Cancer Medicine.2019; 8(15): 6624. CrossRef
Chronic hepatitis B infection and non-hepatocellular cancers: A hospital registry-based, case-control study
Jihyun An, Jong Woo Kim, Ju Hyun Shim, Seungbong Han, Chang Sik Yu, Jaewon Choe, Danbi Lee, Kang Mo Kim, Young-Suk Lim, Young-Hwa Chung, Yung Sang Lee, Dong Jin Suh, Jin Hyoung Kim, Han Chu Lee, Yury E Khudyakov
PLOS ONE.2018; 13(3): e0193232. CrossRef

English Abstracts

A Comparative Study on Comorbidity Measurements with Lookback Period using Health Insurance Database: Focused on Patients Who Underwent Percutaneous Coronary Intervention.: Kyoung Hoon Kim, Lee Su Ahn; J Prev Med Public Health. 2009;42(4):267-273.; DOI: https://doi.org/10.3961/jpmph.2009.42.4.267

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Abstract PDF

OBJECTIVES
To compare the performance of three comorbidity measurements (Charlson comorbidity index, Elixhauser's comorbidity and comorbidity selection) with the effect of different comorbidity lookback periods when predicting in-hospital mortality for patients who underwent percutaneous coronary intervention. METHODS: This was a retrospective study on patients aged 40 years and older who underwent percutaneous coronary intervention. To distinguish comorbidity from complications, the records of diagnosis were drawn from the National Health Insurance Database excluding diagnosis that admitted to the hospital. C-statistic values were used as measures for in comparing the predictability of comorbidity measures with lookback period, and a bootstrapping procedure with 1,000 replications was done to determine approximate 95% confidence interval. RESULTS: Of the 61,815 patients included in this study, the mean age was 63.3 years (standard deviation: +/-10.2) and 64.8% of the population was male. Among them, 1,598 (2.6%) had died in hospital. While the predictive ability of the Elixhauser s comorbidity and comorbidity selection was better than that of the Charlson comorbidity index, there was no significant difference among the three comorbidity measurements. Although the prevalence of comorbidity increased in 3 years of lookback periods, there was no significant improvement compared to 1 year of a lookback period. CONCLUSIONS: In a health outcome study for patients who underwent percutaneous coronary intervention using National Health Insurance Database, the Charlson comorbidity index was easy to apply without significant difference in predictability compared to the other methods. The one year of observation period was adequate to adjust the comorbidity. Further work to select adequate comorbidity measurements and lookback periods on other diseases and procedures are needed.

Summary

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High‐Intensity Statin Reduces the Risk of Mortality Among Chronic Liver Disease Patients With Atherosclerotic Cardiovascular Disease: A Population‐Based Cohort Study
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Journal of the American Heart Association.2023;[Epub] CrossRef
Impact of comorbidity assessment methods to predict non-cancer mortality risk in cancer patients: a retrospective observational study using the National Health Insurance Service claims-based data in Korea
Sanghee Lee, Yoon Jung Chang, Hyunsoon Cho
BMC Medical Research Methodology.2021;[Epub] CrossRef
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Jill Hardin, Jenna M. Reps
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Comorbidity and cervical cancer survival of Indigenous and non-Indigenous Australian women: A semi-national registry-based cohort study (2003-2012)
Abbey Diaz, Peter D. Baade, Patricia C. Valery, Lisa J. Whop, Suzanne P. Moore, Joan Cunningham, Gail Garvey, Julia M. L. Brotherton, Dianne L. O’Connell, Karen Canfell, Diana Sarfati, David Roder, Elizabeth Buckley, John R. Condon, Stéphanie Filleur
PLOS ONE.2018; 13(5): e0196764. CrossRef
Comorbidity Adjustment in Health Insurance Claim Database
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Health Policy and Management.2016; 26(1): 71. CrossRef
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Lorenzo Azzalini, Kunle Tosin, Malorie Chabot-Blanchet, Robert Avram, Hung Q. Ly, Benoit Gaudet, Richard Gallo, Serge Doucet, Jean-François Tanguay, Réda Ibrahim, Jean C. Grégoire, Jacques Crépeau, Raoul Bonan, Pierre de Guise, Mohamed Nosair, Jean-Franço
JACC: Cardiovascular Interventions.2015; 8(14): 1854. CrossRef
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Young-Suk Seo, Sung-Hong Kang
Journal of Digital Convergence.2015; 13(12): 245. CrossRef
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S.-R. Kil, S.-I. Lee, Y.-H. Khang, M.-S. Lee, H.-J. Kim, S.-O. Kim, M.-W. Jo
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The Trend of Risk-adjusted Hospital Mortality Rates of Coronary Artery Bypass Graft Patients from 2001 to 2003.: Kwang Soo Lee; J Prev Med Public Health. 2007;40(1):29-35.; DOI: https://doi.org/10.3961/jpmph.2007.40.1.29

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Abstract PDF: OBJECTIVES
To assess whether the risk-adjusted inhospital mortality rates for non-emergent and isolated coronary artery bypass graft surgery (CABG) patients exhibited a consistent trend from 2001 to 2003. METHODS: The data used in this study came from CABG claims that were submitted to a Korean Health Insurance Review Agency (HIRA) in 2001, 2002, and 2003. Study datasets included data from 17 tertiary hospitals, which had at least 25 claims each year over 3 years. The interhospital differences in patients' risk-factors were identified and controlled in the risk-adjustment model. Actual and predicted mortality rates for each hospital were calculated in 2001, 2002, 2003, and 2001+2002, and were then examined to identify consistent rate patterns over time. Kappa analysis was applied to assess the agreements between rates. RESULTS: Hospitals with lower-than-expected inpatient mortality rates showed more consistent rates than those with higher-than-expected mortality rates. The mortality rates that were calculated based on data obtained over multiple years had less variation among hospitals than rates based on single year data. Based on the Kappa score, the highest agreement was found when the rates were compared between the 2-year combined data (2001+2002) and 2003. CONCLUSIONS: Consistent patterns over 3 years were most evident for hospitals which had lower-than expected mortality rates. Policy makers can use this information to identify the degree of outcomes in hospitals and help motivate or channel the behaviors of providers.; Summary

Original Articles

Association of Hospital Procedure Volume with Post-Transplant Survival for Allogeneic Bone Marrow Transplantation.: Choon Seon Park, Hee Kyung Moon, Hye Young Kang, Yoo Hong Min, Woo Hyun Cho; J Prev Med Public Health. 2004;37(1):26-36.

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Abstract PDF: OBJECTIVE
To examine the association between hospital procedure volume and treatment outcomes following allogeneic bone marrow transplantation (allo-BMT). METHODS: Out of 1, 050 patients who received allo-BMTs between 1998 and 2000 in 21 Korean hospitals, 752 with first allo-BMT and complete data were included in this study. Study subjects were divided into the following three groups according to cumulative hospital experience of all-BMTs during the study period: low (< 30 cases), medium (30-49) and high (> or =50 cases) volume. Patient outcome was defined as early survival at day 100 and one-year survival. Multiple logistic regression analyses were performed to examine the association between hospital experience and survival at day 100 and one year. RESULTS: When the low volume group was defined as the reference group, the adjusted relative risks (RR) of survival at day 100 for the high volume group were 2.46 (95% CI, 1.13-5.36) for all patients, 2.61 (1.04-6.57) for those with leukemia, and 2.20 (0.47-10.32) for those with aplastic anemia. For one-year survival, adjusted RR for the high volume group were 2.52 (1.40-4.51) for all patients, 1.99 (1.01-3.93) for leukemia, and 6.50 (1.57-26.80) for aplastic anemia. None of the RR for the medium volume group was statistically significant. Patient factors showing significant relationship with survival were donor-recipient relation, human leukocyte antigen matching status, time from diagnosis to transplant, and disease stage. CONCLUSION: The study results suggest that the cumulative experience of hospitals in providing allo-BMT is positively associated with patient survival.; Summary

Comparing Difference of Volume of Psychiatric Treatments between the Patient with Health Insurance and Those with Medical Assistance: For Inpatients of Korean Psychiatric Hospitals.: Dae Hee Lee, Eun Cheol Park, Chung Mo Nam, Sang Gyu Lee, Dong Han Lee, Seung Hum Yu; Korean J Prev Med. 2003;36(1):33-38.

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Abstract PDF: OBJECTIVES
To assess the difference in the volume of psychiatric treatments provided to health insurance inpatients, compared with those on medical assistance (the medical aid program) Korean psychiatric hospitals, and to determine factors which affect the volume of the services. METHODS: 21 psychiatrists, from 3 Korean psychiatric hospitals recorded the frequencies psychiatric treatments provided to inpatients in one week (February18-24, 2002). The records of 329 patients were analyzed through t-tests, and random effectmixed model analyses to define the difference between the two groups, and to find other factors affecting the volume of service. RESULTS: A significant difference in the volume of psychiatric treatments provided was observed between the health insurance and medical assistance groups. The variation in the volume of service between hospitals was prominent, and other factors (gender, agegroup, length of stay and mental disorder) were also found to be significant. The patients on medical assistance received only 70% of the psychiatric treatments of those on health insurance. CONCLUSIONS: More effort is required to improve the methods of payment to increase the level of fee scheduling for medical assistance. Further studies on the mechanisms causing these differences in the volume of service are required.; Summary

Current Status of Hospital-based Health Promotion Programs in Korea and the Factors Influencing Their Introduction.: Sang Gyu Lee, Choon Seon Park, Myung Guen Kang, Myung Il Hahm, Soon Young Lee, Woo Hyun Cho; Korean J Prev Med. 2001;34(4):399-407.

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Abstract PDF: OBJECTIVES
To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. METHODS: We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. RESULTS: 106 of 125 hospitals responding (84.8%) had more than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. CONCLUSION: Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.; Summary

Inter-hospital Comparison of Cesarean Section Rates after Risk Adjustment.: Sang Il Lee, Young Ho Khang, Beom Man Ha, Moo Song Lee, Weechang Kang, Hee Jo Koo, Chang Yup Kim; Korean J Prev Med. 2001;34(4):337-346.

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Abstract PDF: OBJECTIVE
To determine the clinical risk factors associated with the mode of delivery decision and to compare cesarean section rates after adjusting for risk factors identified among Korean hospitals. METHODS: Data were collected from 9 general hospitals in two provincial regions by medical record abstraction during February 2000. A total of 3,467 cases were enrolled and analyzed by stepwise logistic regression. Performance of the risk-adjustment model (discrimination and calibration) was evaluated by the C statistic and the Hosmer-Lemeshow test. Crude rates, predicted rates with 95% confidence intervals, and adjusted rates of cesarean section were calculated and compared among the hospitals. RESULTS: The average crude cesarean section rate was 53.2%, ranging from 39.4% to 65.7%. Several risk factors such as maternal age, previous history of cesarean section, placenta previa, placental abruption, malpresentation, amniotic fluid abnormality, gestational anemia, infant body weight, pregnancy-induced hypertension, and chorioamnionitis were found to have statistically significant effects on the mode of delivery. It was confirmed that information about most of these risk factors was able to be collected through the national health insurance claims database in Korea. Performance of the risk-adjustment model was good (c statistic=0.815, Hosmer-Lemeshow test=0.0621). Risk factor adjustment did lead to some change in the rank of hospital cesarean section rates. The crude rates of three hospitals were beyond 95% confidence intervals of the predicted rates. CONCLUSIONS: Considering that cesarean section rates in Korean hospitals are too high, it is apparent that some policy interventions need to be introduced. The concept and methodology of risk adjustment should be used in the process of health policy development to lower the cesarean section rate in Korea.; Summary

Severity Measurement Methods and Comparing Hospital Death Rates for Coronary Artery Bypass Graft Surgery.: Youngdae Kwon, Hyungsik Ahn, Youngsoo Shin; Korean J Prev Med. 2001;34(3):244-252.

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Abstract PDF: OBJECTIVE
Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. METHODS: The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHElll and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. RESULTS: The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and R2 than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. CONCLUSION: These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.; Summary

Severity-Adjusted Mortality Rates: The Case of CABG Surgery.: Hyeung Keun Park, Hyeongsik Ahn, Young Dae Kwon, You Cheol Shin, Jin Seok Lee, Hae Joon Kim, Moon Jun Sohn; Korean J Prev Med. 2001;34(1):21-27.

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Abstract PDF: OBJECTIVES
To develop a model that will predict the mortality of patients undergoing Coronary Artery Bypass Graft (CABG) and evaluate the performance of hospitals. METHODS: Data from 564 CABGs performed in six general hospitals were collected through medical record abstraction by registered nurses. Variables studied involved risk factors determined by severity measures. Risk modeling was performed through logistic regression and validated with cross-validation. The statistical performance of the developed model was evaluated using c-statistic, R2, and Hosmer-Lemeshow statistic. Hospital performance was assessed by severity-adjusted mortalities. RESULTS: The developed model included age, sex, BUN, EKG rhythm, Congestive Heart Failure at admission, acute mental change within 24 hours, and previous angina pectoris history. The c-statistic and R2 were 0.791 and 0.101, respectively. Hosmer-Lemeshow statistic was 10.3(p value=0.2415). One hospital had a significantly higher mortality rate than the average mortality rate, while others were not significantly different. CONCLUSION: Comparing the quality of service by severity adjusted mortality rates, there were significant differences in hospital performance. The severity adjusted mortality rate of CABG surgery may be an indicator for evaluating hospital performance in Korea.; Summary

Factors Affecting Users' Satisfaction with Order Communicating System.: Jin Seok Lee, Chang Yup Kim, Bum Man Ha, Gilwon Kang, Byoung Yik Kim, Yong Ik Kim; Korean J Prev Med. 2000;33(4):436-448.

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Abstract PDF: OBJECTIVES
To identify the factors affecting users' satisfaction with the Order Communicating System(OCS) and to highlight the factors important for the successful establishment of OCS. METHODS: A Users Satisfaction survey was sent to 4,513 people, consisting of 1,503 doctors, 2,379 nurses, 255 pharmacists and 370 administrative workers in 16 hospitals which had introduced OCS. The response rate was 63.9%. Measurement of users' satisfaction was performed with the instrument which was used in Doll's study. Some aspects of Doll's instrument were adjusted according to the aims of this study. The classifying sections of this survey included age, job and status classification, computer experience , OCS education, duration of daily OCS use, type of order entering, number of personnel in the Hospital Information System's department, cost of OCS, problem frequency, proportion of work managed by hand, OCS type, and Hospital establishment type. RESULTS: There was a positive correlation between satisfaction level and managerial status throughout all job classifications. Irrespective of the importance of OCS education as a factor relating to users' satisfaction, the additional work load caused by OCS lowered users' satisfaction. Different factors affected users' satisfaction according to job and status classification. The composition of factors affecting the pharmacist and administrative worker satisfaction levels was simpler than that of the doctor and nurse levels. There were no statistically significant differences between the actual computer experience duration of daily OCS use and users' satisfaction with OCS. CONCLUSIONS: There was an understandable relationship between users' attitude to OCS and factors affecting users' satisfaction. The results of this study could be used as a basis for the successful expansion of the operation of OCS. But more detailed studies on users' satisfaction and further improvements of methodologies are required for the successful establishment of OCS.; Summary

Analysis of influencing factors on self-employed physician's income.: Woong Sub Park, Han Joong Kim, Myong Sei Sohn, Eun Cheol Park; Korean J Prev Med. 1998;31(4):770-785.

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Abstract PDF: This study describes the relation of physician's income and price of medical service and social welfare through microeconomic view, reviews the literature of influencing factor on physician's income, and it describes general distribution of physician's income, and analyzes influencing factor of physician's income. A total of 844 persons responded to the mail survey, through stratified sampling by 23 branches of medical society in Korean RBRVS study. The design of the study is cross sectional study, and the unit of analysis is a physician. To examine the change of average income per month, multiple regression was used to test the change according to physician's characteristics, demographic characteristics, scale of clinic(or hospital), average intensity of ordinary work, and specialty. The major findings of this study are as follows; 1. As for self-employed physicians, the difference of average income per month among specialties was 4,850,000won, but the difference was 6,020,000won under the control of control variables, and average income per month was significantly higher for physicians who had sick-beds than physicians who had no sick-beds. 2. The number of average out-patients per month and number of nurses and nursing aides significantly positively associated, but the number of physician significantly negatively associated with average income per month. In conclusion, the number of out-patient and number of nurses and nursing aides is the major influencing factor, and the difference of average income per month among specialties existed in self-employed physicians. So this study suggests basic hypothesis that the price of medical service and supply of physician by specialties are not pertinent. Being a cross-sectional study, this study can not suggest causal explanations. In the future, further study is needed for causal explanations.; Summary

Chromosome Aberrations and Sister Chromatid Exchanges of Hospital Workers Exposed to Radiation.: Ae Ri Cha, Mi Sun Kim, In Kyung Hwang, Su Ill Lee, Byung Mann Cho, Don Kyoun Kim; Korean J Prev Med. 1998;31(4):616-627.

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Abstract PDF: In order to evaluate the cytogenetic hazard among hospital workers potentially exposed to low dose of radiation, the analysis of chromosome aberrations(CA) and sister chromatid exchanges(SCE) in lymphocytes were performed in 79 hospital workers and 79 non-exposed workers. The mean frequency of chromosomal exchange and deletion(respectively, 0.20X10-2/cell and 0.39X10(-2)/cell) in the exposed group were significantly higher than those(0.07X10(-2)/cell and 0.23X10-2/cell) in control group. The frequency of sister chromatid exchanges was 5.04/cell in the control vs. 6.57/cell in the exposed group. There were also significant differences in the mean frequencies of CA and SCE adjusted for age, sex, smoking, drinking between two groups. There were no evidence of significant increase of CA and SCE according to the department or duration of employment. But the frequency of cells having chromosome aberration was significantly higher in the exposed group than in the control group related to duration of employment. There was no dose-effect relationship between the cumulative doses and the frequency of CA and SCE. But in the case of last 1 yr cumulative dose, there were evidence of significant dose-dependant increase of chromosome type CA and percentage of cells with aberration. The result suggest that there is cytogenetic hazard in risk group like hospital workers handling low dose radiation. And the analysis CA and SCE are useful biological indicators for the exposure of low dose level of radiation.; Summary

Predicting hospital bankruptcy in Korea.: M S Lee, Y J Seo; Korean J Prev Med. 1998;31(3):490-502.

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Abstract PDF: This study purports to find the predictor of hospital bankruptcy in Korea and to examine the predictive power of the discriminant function model of hospital bankruptcy. Data on 17 financial and 4 non-financial indicators of 31 bankrupt and 31 profitable hospitals of 1, 2, and 3 years before bankruptcy were obtained from the hospital performance databank of Korea Institute of Health Services Management. Significant variables were identified through mean comparison of each indicator between bankrupt and profitable hospitals, and the discriminant function model of hospital bankruptcy was developed. The major findings are as follows : 1. As for profitability indicators, net worth to total assets, operating profit to total capital, operating profit ratio to gross revenues, normal profit to total assets, normal profit to gross revenues, net profit to total assets were significantly different in mean comparison test in 1, 2, and 3 years before hospital bankruptcy. With regard to liquidity indicators, current ratio and quick ratio were signifiant in 1 year before bankruptcy. For activity indicators, patients receivable turnover was significant in 2 and 3 years before bankruptcy and added value per adjusted inpatient days was significant in 3 years before bankruptcy. 2. The discriminant function in 1, 2, and 3 years before bankruptcy were; Z=-0.0166Xquick ratio - 0.1356Xnormal profit to total assets - 1.545 x total assets turnarounds in 1 year before bankruptcy, Z=-0.0119Xquick ratio - 0.1433Xoperating profit to total assets - 0.0227Xvalue added to total assets in 2 years before bankruptcy, and Z=-0.3533Xnet profit to total assets - 0.1336Xpatients receivables turnrounds - 0.04301Xadded value per adjusted patient + 0.00119Xaverage daily inpatient census in 3 years before bankruptcy.3. The discriminant function's discriminant power in 1, 2, and 3 years before bankruptcy was 77.42, 79.03, 82.25% respectively.; Summary

A Study of Hospital Choice on the basis of Consumption Values Theory.: Sun Hee Lee; Korean J Prev Med. 1997;30(2):413-427.

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Abstract PDF: This research is based on the Consumption Values theory proposed by Sheth(1991). The purpose of this research is finding the factors related to the process of hospital choice. The expectation of six hospital outpatients 600 was analyzed by six consumption values categories: functional values, social values, emotional value, rarity value, situational values, health related values. The main results of this research is as following; 1. In the result of factor analysis 22 consumption value factors which affect the hospital preference were extracted; kindness/clearness, service speed, comfortabness of space, technical competence in functional values, high income/active social life, low income/blue calar, unmarried/man, middle aged/big family, woman/married, introvert in social values, high-class, comfortableness, reliability in emotional value, newness, classiness in rarity value, social relationship, close to residence, social reputation in situational values, priority on health, health behavior, active sense of value on health in health related values. 2. The difference of consumption values among hospital types were analyzed. The critical factors in reference for corporate hospitals newly established were kindness/ clearness, service speed, convenience, classiness, comfortableness, and newness. University hospitals were preferred by the factors of reliability, and social reputation. In general hospital, convenience and close to residence were critical factor. 3. In logistic regression, age, marital status, education level and income as sociodemographic variables were significaltly related to general hospital choice. Also service speed and close to residence were positively and high income/active social life and high class value were negatively related to general hospital choice. On university hospital choice, age and marital status, education show posive relationship whereas income showing negative relationship. Kindness/clearness, service speed, comfortableness of space, unmarried/man, comfortable feeling, newness and close to residence showed negative relationship with university hospital selection whereas technical competence, reliability in emotional value, classiness in rarity value, social relationship in functional values showed positive relationship. Lastly kindness/clearness, comfortableness of space, high income/active social life, unmarried/man, high-class, comfortableness and newness were positively related to corporate hospitals newly established choice in contast to negative relationship in reliability in emotional value and classiness. In summary, we found that hospital user also choose to hospital in base of various consumption value. Further studis to investigate the hospital consumer behavior will be needed.; Summary

The Economic Impact of a Rural Hospital to local Economy.: Im Ok Kang, Sun Hee Lee, Han Joong Kim; Korean J Prev Med. 1996;29(4):831-842.

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Abstract PDF: 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 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.; Summary

A study on a hospital services evaluation method b physician survey.: Won Gi Jhang, Ok Ryun Moon; Korean J Prev Med. 1996;29(4):815-830.

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Abstract PDF: A physician survey was done by mailing for the purpose of performing hospital services evaluation and ranking. A slightly over one thousand samples were drawn from the list of professional societies, and 324 physicians(about 32 percent) replied. This study has focused on developing easy and simple method to evaluate hospital services, and providing patients with useful information. Hospital service structure and process were evaluated without outcome evaluation, because it is difficult to obtain reliable data regarding health services outcome indicators. Clinical specialty was targeted to evaluate, and three specialties were chosen, that is obstetrics & gynecology, cardiology, and proctology. Among 16 structural indicators, four indicators were finally chosen in each specialty by respondent specialists. And then using these indicators, structural score was calculated for study hospitals. For process evaluation, physicians were requested to nominate five most famous hospitals. The nomination score and structural score were summed up to produce final score and hospital ranking. This method is very easy to conduct rather than other hospital services evaluation methods prevailing in Korea. And it is more useful for patients to choose hospitals, according to his/her own purpose, because it gives high ranking hospitals with specific clinical specialty.; Summary

Relationship between structural characteristics and hospital mortality rates on tertiary referral hospitals in Korea.: Tae Yong Sohn, Seung Hum Yu; Korean J Prev Med. 1996;29(2):279-294.

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Abstract PDF: This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are: 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. we concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard the proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.; Summary

A Study on the Health Risk Agents in the Workplace of a General Hospital.: Yang Ok Kim, Ki Soon Kim, Jong Park, So Yeon Ryu, Hee Yeon Yang; Korean J Prev Med. 1996;29(1):1-14.

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Abstract PDF: To evaluate the health risk of the workplace environment of a general hospital toward the hospital workers, a questionnaire survey on the perception of risk at the workplace environment and environmental measurements at 27 locations with 240 workers in the hospital were made from October 25th, 1993 to October 30th, 1994. The results were as follows; 1. By the environmental measurements, 86 workers(36%) were found to be exposed to poor or harmful degree of general illumination, 193 workers(80%) were exposed to poor or harmful local illumination, 34 workers(14%) were exposed to poor or harmful degree of thermal condition and l80 workers(75%) were exposed to poor or harmful noise level, but nobody was exposed to poor or harmful dust and toluene concentration. Also nobody was exposed to poor or harmful level of radiation or anticancer/antibiotic agents. 2. The subjective perceptions on the environmental conditions felt by the workers were different from the objective findings by the environmental measurements. The workers underscored the poor illumination state and overscored the dust concentrations. Also workers oversensitized about the thermal condition, the noise level, the radiation level, the toluene concentration and anticancer/antibiotic agents. 3. The sources of noise were the dialogue(179 workers) and the office instruments(131workers). The sources of dust came from the clothes(108 workers) and the building materials(79 workers). 4. The questionnaire survey showed that the 28 workers were exposed to poor or harmful level of the antibiotics, 10 workers to alkali or acid and 6 workers to drug dust in the pharmacy but the above findings could not be proved by the environmental measurements.; Summary

A Study on Image Difference between University Hospitals and Corporation Hospitals.: Haejong Lee, Kinam Jin, Heejung Chung; Korean J Prev Med. 1995;28(4):885-898.

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Abstract PDF: The objectives of this research are 1) to access different images held by three consumer groups (patients in university hospital, patients in corporation hospital, persons who are not currently visiting hospitals) on two types of hospitals(university hospitals and corporation hospitals), and 2) to investigate the personal factors affecting images of two types of hospitals. The data for this analysis were collected by questionnaire survey. A total of 403 interviews were conducted. Of these cases, 43 percent are male and 57 percent are female. The major statistical methods used for the analysis are paired t-test, factor analysis and multiple regression. The three consumer groups show a consensus that corporation hospitals are better than university hospitals in some aspects, such as kindness, facilities, and equipments. However, these groups disagree in certain images on two types of hospitals, such as popularity, credibility, and readiness for emergency. The images on two types of hospitals are varied by the respondents' sociodemographic characteristics such as age, sex, and by the type of hospital they are currently visiting.; Summary

Job Satisfaction and Commitment of General Hospital Employees.: Dong Woon Han, Seung Sub Eom, Ok Ryun Moon; Korean J Prev Med. 1995;28(3):588-608.

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Abstract PDF: This study was intended to enhance the level of hospital personnel management through analysing job satisfaction of hospital employees in terms of structural, personal and environmental variables. The sample of this study consist of a total of 790 persons including doctors, residents, interns, pharmacists, nurses, medical engineers, office workers and manual workers who have worked for general hospitals with 200 beds, 300 beds and 800 beds respectively. The Likert's 5 scales were used for the measurement of satisfaction. The results can be summarized as follows: 1. Structural variables. The level of satisfaction on the job itself was generally low 2.8 in Likert`s 5 scales, with the order of role ambiguity(3.87), routinization(2.6), work overload (2.45) and autonomy(2 37). Hospital employees are aware of their responsibility and they regarded their work as heavy one. The compensatory satisfaction degree was 2.5 which was also low: There were in the order stability(3.l), distributive justice(2.57), pay(2.3) and promotion(l.9). Usually hospital employees showed high degree of stability, while, their satisfaction on promotion possibility is quite low due to specially differentiated structures of hospitals. The degree of satisfaction on the internal conditions of organizational culture was relatively higher as 2.92: They were co-worker's support(3.69), supervisory support(3.15), role conflict(2.64) and welfare(2.17) in order. The satisfaction on welfare as an economic condition was the lowest. 2. Personal Variables. The level of satisfaction on personal variables was 3.27 which seemed to be quite high: contribution to the hospital(3.38), attitude on job performance(3.28) and pride as a member of the, hospital(3.07). They seem to believe that their work has been helpful to the performance of hospitals. 3. Environmental Variables. The degree of satisfaction on these variables was 3.07 the average which was derived from environmental factors such as family-role conflict and community support related to hospital employees' environment. The order of satisfaction for each variable is community support(3.2) and family-role conflict(2.94). They turned out to be fairly satisfied with their job in community and yet, they wanted more spare time to spend with their family.; Summary

Changes in Medical Practice Pattern before and after Covering Intraocular Lens in the Health Insurance.: No Ah Choi, Seung Hum Yu, Hey Young Min, Eun Wook Chung; Korean J Prev Med. 1994;27(4):807-814.

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Abstract PDF: This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6 86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 won in 1992 to 444,000 won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate in order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.; Summary

An Analysis of Small Area Variations of Hospital Services Utilization in Korea.: Woo Hyun Cho, Sun Hee Lee, Eun Cheol Park, Myong Sei Sohn, Se Ra Kim; Korean J Prev Med. 1994;27(3):609-626.

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Abstract PDF: This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main finding of the research can be summarized as follows: 1. External Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and coefficient of variation (CV) were 0.14,both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is cbansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than 5 years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of lhe private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.; Summary

The epidemiology of delays in a teaching hospital.: Yoon Kim, Kun Sei Lee, Chang Yup Kim, Yong Ik Kim, Young Soo Shin, Sang Il Lee; Korean J Prev Med. 1993;26(4):650-660.

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Abstract PDF: This study aims to describe the causes of medically unnecessary hospital stay at a teaching tertiary hospital, using modified version of Delay Tool in which the causes of delay are divided into six major categories ; delay related to test scheduling, test results, surgery, medical staff, patient/family, and administration. For the analysis of hospital stay, 6,479 inpatient-days were reviewed in two medical and four surgical departments for one month. Initially inappropriate hospital stays were identified using Appropriateness Evaluation Protocol(AEP), and causes of delay listed in Delay Tool were assigned to each of them. In both medical and surgical services, the most important cause of delay was related to medical staffs, ranging from 3.6% to 51.6% of total inpatient days. Next important category was delay related to test scheduling in medical services(4.7~9.2%), and delay related to surgery in surgical services(7.3~15.0%). Among subcategories of delay related to medical staffs, delay due to conservative care was the most important cause of inappropriate hospital stay(2.9~46.4%). Each clinical departments had different distribution among delay categories, which could not be fully justified by their clinical characteristics. The Delay Tool would be helpful in exploring factors related to the inefficient use of hospital beds. As a measurement tool of inappropriate hospital stay, however, the Delay Tool should be refined in the definitions of categories and its contents.; Summary

A study on the repeat tests for diagnosis at a tertiary hospital in Taegu city.: Jae Yong Park, Gui Young Kim; Korean J Prev Med. 1993;26(3):457-468.

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Abstract PDF: This study was conducted to investigate the repeat test rate for diagnosis at a tertiary hospital for the outpatients who were referred themselves to the hospital by the clinics and other medical facilities. The study population consisted of 498 patients who visited outpatient department of internal medicine, general surgery, orthopedic surgery and neurosurgery in the hospital between March 16 and April 11, 1992. This study was surveyed by the questionnaire about the tests for diagnosis at first level medical facilities, and then, was investigated by the medical record about the tests for diagnosis at a tertiary hospital. The proportion of test among the patients who utilized the first level medical facilities was 20.9% for the X-ray test, 10.6% for the urinalysis, 9.0% for the electrocardiogram, 3.4% for the computer tomogram and 6.4% for the ultrasonogram. At the tertiary hospital, the X-ray test was 45.2%, the liver function test was 24.7%, the urinalysis was 19.1%, and the electrocardiogram was 15.7%. The proportion of patients who possessed results of test for diagnosis at the first level medical facilities was 76.5% for the computer tomogram, and 31.3% for the ultrasonogram. As the repeat test rate between the first level medical facilities and the tertiary hospital, the thyroid function test was the first rank as 71.4%, the second rank was the routine CBC as 67.9%, and the third rank was the X-ray test as 64.4%. But among the patients that brought the result for tests at the first level medical facilities, the repeat test rate was as follow ; the routine CBC was 75.0%, the liver function test was 72.7%, and the computer tomogram was 15.4%.; Summary

A study on the determinants of hospital profitability.: Ki Hong Chun, Woo Hyun Cho; Korean J Prev Med. 1993;26(3):442-456.

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Abstract PDF: Financial stability is the foremost prerequisite for the continuous growth and development of hospitals. The present study aimed at developing a deterministic model using the factors which affect the hospitals profitability and at discovering which factor affected the hospital profitability. The study conducted questionnaire surveys on all general hospitals, with the exception of special hospitals, with over eighty hospital beds. Of the 274 subject hospitals, 136 of them, consituting 49.6% of the whole, were used in the study. The results are as follow. 1. In the deterministic model, outpatient revenue was affected more by the number of physician visits than by outpatient service intensity. Inpatient revenue was found to be affected more by the number of discharged patients than by inpatient service intensity. However, the increase rate of the service intensity not only contributed in stepping up the operating margin by 4~8% in outpatient and 3~6% in inpatient, but it was statistically significant. 2. Among the factors which determined the operating cost within the deterministic model, the number of patients had a greater impact on the operating cost than the resource consumption per patient. 3. The resource consumption per patient were proved to have the greatest effect on the profitability within the probabilistic model. The management cost per adjusted patient, in particular, was proven to have a statistically significant effect on the profitability in all hospitals.; Summary

A Comparative Study on the Pattern of Outpatient Department Utilization at a Tertiary Level Hospital before and after Implementation of the Patient Referral System.: Kyeong Soo Lee, Chang Yoon Kim, Pock Soo Kang; Korean J Prev Med. 1992;25(1):88-100.

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Abstract PDF: This study was conducted to assess the effects of implementation of the patient referral system started July 1st, 1989. A comparison on the pattern of outpatient services of the Departments of Internal Medicine, General Surgery, and Pediatrics at the Yeungnam University Hospital was conducted for each one year period before and after implementation of the patient referral system. The pre-implementation period was from July 1. 1988 to June 30, 1989 and the post-implementation period was from July 1. 1989 to June 30, 1990. The information used for this study was obtained from official forms, prepared by the Yeungnam University Hospital, and submitted to the Korean Medical Insurance Cooperatives. After implementation of the patient referral system, the number of outpatient cases in the Department of Internal Medicine decreased 36.1% from 9,669 cases to 6,181 cases a year. Cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of General Surgery decreased 23.7% from 1,864 cases to 1,422 cases a year. The number of cases in the Department of Pediatrics decreased 36.9% from 3,372 cases to 2,128 cases a year. After implementation of the patient referral system, the average age of cases in the Departments of Internal Medicine and General Surgery was 52.5 and 49.7 years old, respcetively. This was a significant increase in comparison with the pre-implementation period. After implementation of patient referral system, the proportion of new outpatients in the Department of Internal Medicine decreased form 24.1% to 14.6%, the Department of General Surgery from 36.0% to 23.4%, and the Department of Pediatrics from 15.5% to 8.3%. The number of visits per case decreased significantly in the Department of Internal Medicine(from 1.74 to 1.61), but there was no significant change in the Department of General Surgery and Pediatrics. The length of treatment per case increased significantly in all three departments (form 16.1 days to 19.3 days in the Department of Internal Medicine, from 12.0 days to 15.2 days in the Department General Surgery, and 8.9 days to 11.2 days in the Department of Pediatrics). The number of clinical tests per case increased significantly in the Department of Internal Medicine (from 22. to 2.5), in the Department of Pediatrics(from 0.8 to 1.1) and increased in the Department of General Surgery(from 6.4 to 6.6). The average medical cost per case decreased form 43,900 Won to 42,500 Won in the Department of Internal Medicine, while the cost increased from 75,900 Won to 78,500 Won in the Department of General Surgery and from 12,700 Won to 13,500 Won in the Department of Pediatrics. In case-mix, the chronic degenerative disease(i. e. hypertension, diabetes mellitus, angina pectoris, malignant neoplasm, and pulmonary tuberculosis) ranked higher and acute infectious diseases and simple cases(i. e. gastritis and duodenitis, haemorrhoids, anal fissure, carbuncle, acute URI, and bronchitis) ranked lower after implementation of the patient referral system compared to before implementation.; Summary

An analysis of the physician productivity in general hospitals.: Jung Un Lee, Ki Hyo Lee, Ok Ryun Moon; Korean J Prev Med. 1991;24(3):400-413.

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Abstract PDF: The purpose of this paper is to identify factors affecting the optimum mix of required inputs and other relevant factors which account for the variation in physician's productivity in general hospitals, and to find out their implications for the efficient health planning and management. An extended version of Cobb-Douglas production function and cross sectional data of one day patient census from all general hospitals in Korea in 1988 were used in the analysis. Main results of the analysis and their implications could be summarized as follows ; (1) The production function for physician's inpatient service shows the evidence of economies of scale, but the production function for physician's outpatient and adjusted-patient service, which combines both out- and inpatient service, shows that of dis-economies of scale. (2) The physician's role for production for all service is smaller than auxiliary personnel's, which imply that more intensive utilization of nurses, nursing aides and other auxiliary personnel is desirable for improving general hospital productivity. (3) In case of physician's inpatient and adjusted-patient service, nurses is recommended for the efficient operation of general hospitals. (4) The factor of hospital beds plays the leading role among required inputs in the production for physician's in- and adjusted-patient service. (5) The physician's productivity of general hospitals in rural area is lower than that in urban area. And the productivity of teaching hospitals is lower than that of the other hospitals. Further analysis was made in physician production function based upon the size of hospitals, namely those hospitals below 250 beds and those above. Explained variances by the factor of hospital beds was significantly increased in the case of those hospitals above 250. A more detailed and thorough investigation is needed for verifying factors influencing physician's productivity in general hospitals in Korea.; Summary

A Study on the Regional Self-sufficiency for In-patient Care Services.: Dal Sun Han, Soon Ho Kwon; Korean J Prev Med. 1990;23(3):285-295.

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Abstract PDF: The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows: 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved by health policy measure. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characteristics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.; Summary

Analysis of charges per case by hospital characteristics: In regard to acute appendicitis and NSVD.: Sang Hyuk Jung, Seung Hum Yu, Han Joong Kim; Korean J Prev Med. 1990;23(2):216-223.

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Abstract PDF: To identify the factors influencing the charges per case of acute appendicitis and normal spontaneous vaginal delivery (NSVD), the personal data-base files and hospital-characteristics-reporting data files of Korea Medical Insurance Corporation were analyzed. One hundred and twenty-nine institutions were selected. The results of this study were as follows: 1. The differences of charges per case with respect to hospital ownership, location, and equipment levels were statistically significant. 2. The results of multiple regression analysis revealed that bed capacity was the most significant variable in both diseases. 3. Ownership was significant variable in acute appendicitis. In NSVD, ownership and hospital equipment level were statistically significant. In conclusion, bed capacity was statistically the most significant variable in the analysis of charges per case. And we thought that the results of this study would influence the policy of the hospital bed supply.; Summary

Effect of the non-Medical Services on Attitude to Hospital Utilization.: Hyun Kyung Lee, Im Won Chang; Korean J Prev Med. 1988;21(2):442-450.

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Abstract PDF: Effects of various factors related to the process of social action of hospital services on the selecting a hospital were investigated by using of questionnaires answered by 1,319 patients in a certain University Hospital, in Chungchongnam-Do, from November, 1986 to November, 1987. The results summarized were as follows ; 1. Each of the examined factors, that is, sincerity of an attendant physician in medical treatment and explaining the condition of a disease, confidence to doctor and nurse, doctor's and nurse's response to calling by patient, kindness of the hospital staffs and food handlers, sanitariness of hospital, cleanness of clothes and bed sheets, hospital foods, and rest surroundings, are not solely decisive to attitude of hospital utilization, but the factors effects compositely on hospital utilization. 2. Hospital services of the social action process are more effective to hospital utilization in cases of the hospitalization caused by the traffic facility than for the medical skill and facilities.; Summary

Causes of Burn and Emergency Care on the Spot for the Patients Admitted to Three Hospitals in Taegu.: Min Chu, Jung Han Park; Korean J Prev Med. 1988;21(2):238-244.

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Abstract PDF: This study was conducted to investigate the causes of burn and emergency cares taken on the spot for the burn patient. study population included 161 burn patients admitted to 2 university hospitals and 1 general hospital in Taegu from November 1, 1987 to April 30, 1988. Patients or guardians were interviewed with a structured questionnaire. Out of 161 burn patients 111(69.8%) were males and 50(31.1%) females. Preschool children of 1-4 years old accounted for 29.8% of the total patients. Burns of children under 15 years of age took place at home in 91.0%, while 48.3% of burns of adult (15 years and over) males occurred at the working place, and 68.0% of adult females occurred at the home. Out of total burns occurred at home 39.8% took place at kitchen/dining room and 24.1% in the room. The most common cause of burns in children was the boiling water or hot food (74.3%). In adults the common causes were electrical burn(22.4%), hot water or food(19.0%) and explosion(12.1%) for males, and hot water or food(32.0%) and explosion(20.0%) for females. Common emergency cares for the burn taken on the spot were undressing(64.6%), pouring Soju(liquor)(13.7%), and pouring cold water(5.0%). There were a few cases who applied ash, soy or salt. To prevent burn, it is recommended to remodel the traditional kitchen and coal-briquet hole, to strengthen the safety control of LP Gas and LN Gas supply, to educate the public for the handling method for such gases, to strengthen the occupational safety control, to improve the safety device for the electric wire and socket, and to limit the temperature of hot water at home and public baths.; Summary

Causes of Childhood Injuries Observed at the Emergency Rooms of Five Hospitals in Taegu.: Jung Han Park, Yeong Sook Bae; Korean J Prev Med. 1988;21(2):224-237.

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Abstract PDF: To determine the causes of and related factors to childhood injuries, the emergency room records and inpatient medical records were reviewed for 4,849 injured children out of 15,790 pediatric patients(<15 years old) who visited the emergency rooms of 3 university hospitals and 2 general hospitals in Taegu from 1 January to 31 December 1987. Out of total injured children, 54.6% were 3-8 years old and the male to female ratio of the total injured children was about 2 : 1. The leading causes of injury were falls and slips (29.1%) and traffic accident(28.2%). The frequency of injury was higher in May-October than the rest of months and 51.6% of the injuries occurred between 15 and 20 o'clock. Falls and slips took place most frequently at the stairway(25.7%). The most common interpersonal violence was inflicted injuries(85.6%) and there were 11 child rapes. Dog bites accounted for 67.6% of all biting injuries and it occurred 2.9 times more in male than in female. CO intoxication was the most common cause of poisoning (45.3%) and scalding accounted for 85.2% of all burns. Common places of drownings were river (32.2%), swimming pool (22.6%) and construction site(19.3%). To prevent childhood injuries, it is recommended to eliminate the hazardous environmental factors, to provide safe playgrounds, to educate the children for safety from kindergarten and the general public through mass communication, to establish a strict safety standard for houses, public buildings and facilities, and playgrounds.; Summary

Development of the Standard Blood Inventory Level Decision Rule in Hospitals.: Byoung Yik Kim; Korean J Prev Med. 1988;21(1):195-206.

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Abstract PDF: Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation gas gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better'. The shortage itself by no means unnecessitated inventory control. In fact, in spite of shortage, no small amount of blood is out dated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this study is to develop formulate forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study information of A+ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated. 48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measure of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study were as follows ; 1. the formulate to calculate the standard blood inventory level(S*)was. S*=2.8617 x (d)0.9342. where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performance-outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level-were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.; Summary

English Abstract

Does a Higher Coronary Artery Bypass Graft Surgery Volume Always have a Low In-hospital Mortality Rate in Korea?.: Kwang Soo Lee, Sang Il Lee; J Prev Med Public Health. 2006;39(1):13-20.

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Abstract PDF: OBJECTIVES
To propose a risk-adjustment model with using insurance claims data and to analyze whether or not the outcomes of non-emergent and isolated coronary artery bypass graft surgery (CABG) differed between the low- and high-volume hospitals for the patients who are at different levels of surgical risk. METHODS: This is a cross-sectional study that used the 2002 data of the national health insurance claims. The study data set included the patient level data as well as all the ICD-10 diagnosis and procedure codes that were recorded in the claims. The patient's biological, admission and comorbidity information were used in the risk-adjustment model. The risk factors were adjusted with the logistic regression model. The subjects were classified into five groups based on the predicted surgical risk: minimal (<0.5%), low (0.5% to 2%), moderate (2% to 5%), high (5% to 20%), and severe (=20%). The differences between the low- and high-volume hospitals were assessed in each of the five risk groups. RESULTS: The final risk-adjustment model consisted of ten risk factors and these factors were found to have statistically significant effects on patient mortality. The C-statistic (0.83) and Hosmer-Lemeshow test (x2=6.92, p=0.55) showed that the model's performance was good. A total of 30 low-volume hospitals (971patients) and 4 high-volume hospitals (1,087patients) were identified. Significantdifferences for the in-hospital mortality were found between the low- and high-volume hospitals for the high (21.6% vs. 7.2%, p=0.00) and severe (44.4% vs. 11.8%, p=0.00) risk patient groups. CONCLUSIONS: Good model performance showed that insurance claims data can be used for comparing hospital mortality after adjusting for the patients' risk. Negative correlation was existed between surgery volume and in-hospital mortality. However, only patients in high and severe risk groups had such a relationship.; Summary

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