This study aims to examine the performance of public municipal hospitals through the analysis of data envelopment analysis, efficiency, profitability, and publicness by using panel data during period from 2006 to 2010. The main findings of the study are as follows. First, as a result of efficiency analysis during the period from 2006 to 2010, it was revealed that the number of staff by each job category, labor cost ratio, the number of operating beds need to be decreased. Second, the performance data represented by the indicators of efficiency, profitability and publicness were complementary and showed a tendency of being increased or decreased in same direction. Third, from the result of panel analysis, the efficiency was mainly influenced by the structural factors, while the profitability was influenced by managerial factors, and the publicness by medical environment. In conclusion, in order to enhance the performance of public municipal hospitals in Korea, it is important to harmonize the effort for efficiency, financial and policy support by central and local government, and the continuous participation of community residents.
Hospitals, Municipal* ; Korea ; Local Government

PURPOSE: It is well known that a terminal cancer condition affects not only patient themselves but their family members because the patients experience a variety of symptoms. This study was aimed to investigate modifiable factors that influence family caregivers' quality of life, depression, and anxiety. METHODS: From January 2015 through May 2015, a survey was conducted with 61 family caregivers of hospice patients who were hospitalized in two university hospitals and one municipal hospital in Busan. The questionnaire was consisted of characteristics of family caregivers and patients, the Korean version of the Caregiver Quality of Life Index-Cancer (CQOLC-K), Beck's Depression Inventory II (BDI-II), Beck's Anxiety Inventory (BAI), and patient's symptom controlling scores rated by family caregivers. RESULTS: Family caregivers' depression was associated with religion. Quality of life and depression of family caregivers were also influenced by monthly household income. Patient age was inversely related to family caregiver's quality of life (rs=-0.259, P=0.043). Family caregivers' quality of life was associated with patient's anxiety (r=0.443, P=0.001). Family caregivers' depression was affected by patient's constipation (r=0.276, P=0.046), anxiety (r=0.508, P<0.001), and daytime drowsiness (r=0.377, P=0.005). And family caregivers' anxiety was influenced by patients' sleep disturbance (r=0.276, P=0.046), depression (r=0.297, P=0.031), and anxiety (r=0.357, P=0.009). CONCLUSION: According to our findings, family caregivers had higher quality of life and less depression and anxiety when symptoms in hospice patients were well controlled.
Anxiety* ; Busan ; Caregivers ; Constipation ; Depression* ; Family Characteristics ; Hospices* ; Hospitals, Municipal ; Hospitals, University ; Humans ; Quality of Life* ; Sleep Stages

In Japan, the average incidence of tinea pedis among dermatology out-patients is around 10%. Obviously this does not reflect the true invasion of dermatophytes on human skin. Several attempts to elucidate the incidence of tinea pedis among the population revealed nearly 40% of randomly chosen patients at dermatology clinics suffered from tinea pedis with an increasing incidence by age group. Furthermore, results obtained from regular medical checks of healthy adults at Nagasaki Municipal Hospital revealed more than 30% of the recruits had only a slight scaling of mild hyperkeratosis which could not be differentiated clinically from other pathological or even age-related changes. Nearly two-thirds of these tinea pedis lesions are left untreated, or even unnoticed as a disease. Several experiments to prove the presence of dermatophytes from healthy-looking skin revealed the possibility of the presence of subclinical lesions or carriers of dermatophytes accumulating around these tinea pedis patients. Uncontrolled tinea pedis lesions are a major cause of tinea unguium, which is expensive and time-consuming to cure especiallyin the aged. There are no standardized treatment modalities for tinea pedis patients focusing on the complete cure. But the difficulties to eradicate the pathogens from their host are common among opportunistic infections. Also the dissociation of the number of patients and the population having the pathogens without apparent lesions, i.e. healthy carrier, is a characteristic of opportunistic infection. Undetected tinea pedis patients are problematic since they are source of infection for others. Discovering and treating the hidden patients is becoming a public health problem, as well as a private hazard. Prevalence of pathogens in the host tissue and low mobility rate are a feature of opportunistic infections. The control methods for tinea pedis as an opportunistic infection should also be taken under consideration.
Adult ; Arthrodermataceae ; Dermatology ; Hospitals, Municipal ; Humans ; Incidence ; Japan ; Onychomycosis ; Opportunistic Infections* ; Outpatients ; Prevalence ; Public Health ; Skin* ; Tinea Pedis* ; Tinea*

PURPOSE: The prognosis after potentially curative resection for stage IV gastric cancer, according to the 5th edition of AJCC/UICC classification, is poorly understood. The aim of this study was to evaluate the feasibility of the curative resection in patients with stage IV gastric cancer, which were considered potentially curable cases. METHODS: From November 1991 to June 1996, 91 patients were confirmed as having stage IV gastric cancer at Seoul Boramae Municipal Hospital. Of these 91 patients, 30 who were potentially curative resected including at least D2 type lymph node dissections were reviewed retrospectively. The average numbers of totally dissected and positive lymph nodes were 43.0 (range: 26~74) and 23.1 (range: 2~47), respectively. RESULTS: The overall 1-, 2-, and 5-year survival rates of patients were 60.0%, 36.7%, 13.3%, respectively. In comparison with stage IIIb (N=20), no significant difference in survival rate was observed (P=0.1178). In univariate analysis, we found that the presence of a recurrence (P=0.0121) and a P (positive lymph nodes)/R (total dissected lymph nodes) >0.6 were correlated with poor survival rates. Long- survivors (N=12, more than 24 months postoperatively) had a tendency to be younger, less recurrent (P=0.017) and less involvement of histological perineural invasion (P=0.028). CONCLUSION: The results of the present study indicate that stage IV patients without distant metastasis may indeed be cured by potentially curative surgery.
Classification* ; Gastrectomy* ; Hospitals, Municipal ; Humans ; Lymph Node Excision ; Lymph Nodes ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Retrospective Studies ; Seoul ; Stomach Neoplasms* ; Stomach* ; Survival Rate ; Survivors

PURPOSE: The incidence of shigellosis had been decreased due to the use of antibiotics and the improvement of environmental sanitation but recently increases again. Shigellosis occurrs in mass outbreak through unsanitized meal preperation refered from welfare facility and school. We observed epidemic aspect and clinical coarse of childhood shigellosis. METHODS: from December 2001 to January 2002, 22 inpatients with shigellosis in Dongbu Municipal Hospital were observed epidemiologically, clinically and microbiologically. RESULTS: 1. The sexual ratio was 1:1 and mean age was 5.5+/-1.4 years (14 months to 11 years). 2. The clinical manifestations were following: diarrhea (95.5%), high feve (10%) and asymptomatic (4.5%). The mean duration was 3.9+/-2.1 days (1 to 12 days). All patients had no complication and normal serologic test. 3. S. sonnei was cultured in rectal swab, and was resistant to TMP/SMX and ampicillin, but susceptible to ampicillin/sulbactam and the 3rd generation cephalosporins. 4. The patients were treated by antibiotics with conservative treatment including electrolytes and fluid therapy for 5 days, resulting in improvement confirmed by negative reaction on stool culture. 5. These cases were all occurred in mass outbreak in day care center and were suspected to be secondary infection by members of family. CONCLUSION: This shigellosis occurred in day care center was secondary infection due to S. sonnei and had mild clinical coarse and improvement after antibiotic treatment.
Ampicillin ; Anti-Bacterial Agents ; Cephalosporins ; Child ; Coinfection ; Day Care, Medical ; Diarrhea ; Dysentery, Bacillary* ; Electrolytes ; Fluid Therapy ; Hospitals, Municipal ; Humans ; Incidence ; Inpatients ; Meals ; Sanitation ; Serologic Tests

BACKGROUND: Lifetime health maintenance program (LHMP) is designed for individualized disease prevention and health promotion through regular health check-ups and improving risk factors. This study aimed to investigate patients' satisfaction of lifetime health clinic (LHC) in a tertiary hospital and to evaluate associated factors in order to support primary health care strengthening policy. METHODS: We conducted surveys for patients, who visited LHC in a department of family medicine at a tertiary hospital from March 1st 2016 to December 31st 2016. We analyzed proportions and characteristics associated with patients, who were willing to recommend LHC. The relationship between willingness to recommend LHC and associated factors were evaluated by multivariate logistic regression analyses. RESULTS: Among the patients who answered the questionnaires, 83.7% responded that they would recommend LHC to others. Results from multivariate analyses suggested that patients living in provinces (odds ratio [OR] 4.21, 95% confidence interval [CI], 1.36-13.02), patients who were recommend by others to visit LHC (OR 3.99, 95% CI, 1.29-12.35), and those who had a large number of medical service preference items (OR 5.91, 95% CI, 1.48-23.58) were significantly associated with willingness to recommend LHC. CONCLUSIONS: LHC pursues the goal of primary care. Findings highlight the fact that high quality health service should be provided in small and municipal hospitals to improve patients' satisfaction. Furthermore, it is essential to establish family physician networks and health service infrastructure that can reflect various opinions.
Health Promotion ; Health Services ; Hospitals, Municipal ; Humans ; Logistic Models ; Multivariate Analysis ; Patient Satisfaction ; Physicians, Family ; Primary Health Care ; Risk Factors ; Tertiary Care Centers*

OBJECTIVES: The purpose of this study was to assess the objective and universal attitudes toward mentally-disabled defendants. The authors examined the criminal characteristics of the mentally-disabled defendants and clarified the differences between psychiatric opinions about the criminal responsibilities of mental patients and the final judicial decisions. METHODS: The subjects consisted of 75 mentally-disabled defendants. They had been referred to Seoul Eunpung Municipal hospital during the period of Jan. 1990 to Mar. 1997. We examined them through psychiatric interview, clinical psychological tests and other tests. The data obtained were analyzed in several aspects: demographic factors, characteristics of crime, psychiatric opinions and legal opinions. RESULTS: Regarding the demographic background, most commonly met subjects were males, single, in their twenties and thirties, with educational background of about 11 years, unemployed, and living in urban districts. Approximately one third(37.5%) of all subjects were diagnosed as schizophrenia, 10.8% an mood disorder and 9.3% as personality disorder. The most frequent criminal act was assault and battery(28.0) and the mental states at the time of the criminal act could be inferred as delusion/hallucination(52.0%) and paroxysmal emotional uncontrollable state(33.3%),etc. About forty perecnt(39.4%) of victims were strangers, 25.3% were public servants 21.3% were family members. According to the psychiatric report out of 75 defenddants, defendants were classified as followes:44 defendants were evaluated to be totally free of criminal responsibility, 22 defendants to be partially responsible, and 5 defendants to be fully responsible. However, the psychiatric evaluation was found to be in contrast with the final judicial decisions by the court:16 defendants were totally free of criminal responsibility, 44 of restricted criminal responsibility and 15 fully responsible. In case of no responsibility, the agreement rate between the judge's opinions and the psychiatric ones was 36.3%, for partial responsibility it was 73.0%, and for full responsibility it was 100%. DISCUSSION: The judges do not completely agree to psychiatric opinions. Therefore, the authors suggest that more facilitated communication between psychiatrists and judges should be necessary for the benefiit of mentally-disabled defendants.
Crime ; Criminals ; Demography ; Disability Evaluation* ; Hospitals, Municipal ; Humans ; Male ; Mentally Ill Persons ; Mood Disorders ; Personality Disorders ; Psychiatry ; Psychological Tests ; Schizophrenia ; Seoul

The purpose of this research was to examine the relationship between the plasma LDL particle size and blood lipid profile, dietary factors and anthropometric values (body mass index, waist circumference and waist/hip ratio). The subjects were 173 adults aged 23 to 81 years, selected from the Outpatient Clinic and Cardiovascular Department of the Seoul Municipal Hospital. Dietary data were obtained using a 3-day food record and analyzed using Korean and US nutrient databases. The subjects were divided into three groups by LDL particle size:type A (large buoyant LDL, > 25.5 nm, n = 96), type I (Intermediate LDL, 25.2 < or = - < or = 25.5 nm, n = 18), and type B (small dense LDL, < 25.2 nm, n = 59) groups. The type B group had higher age, waist circumference, and waist/hip ratio (WHR) than the type A and type I groups. Serum concentration of triglyceride, Apo B, LDL/HDL cholesterol ratio and atherogenic index were significantly higher in the type B group as compared to those in the other two groups. HDL cholesterol level and Apo A-I/Apo B ratio were significantly lower in the type B group than the other two groups. The plasma LDL particle size was highly correlated with triglyceride (r = -0.450), Apo B (r = -0.402) and HDL cholesterol (r = 0.418). However, there was no correlation between plasma LDL particle size and dietary intakes. This study showed that small dense LDL was an important biochemical risk factor that was associated with other risk factors.
Adult* ; Ambulatory Care Facilities ; Apolipoproteins B ; Cholesterol ; Cholesterol, HDL ; Hospitals, Municipal ; Humans ; Particle Size* ; Plasma* ; Risk Factors ; Seoul ; Triglycerides ; Waist Circumference

PURPOSE: Iron deficiency anemia (IDA) is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause serious effects on mental and psychomotor development. We analyzed the hematologic profiles of infants and young children with IDA, comparing them with control group. METHODS: The feeding practices and the iron batteries investigated in 198 anemic patients aged 5 to 36 months who had been brought to Inha General & University Hospital. Control group were 129 healthy infants and children who visited DongBu Municipal Hospital and the local health center for immunizations. They also had hemoglobin concentration (Hb), hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin and red cell distribution width (RDW) tested by the electron counters. Patients with hemoglobin level <11 g/dL who had serum ferritin <10 ng/mL or transferrin saturation <15% were classified as having IDA. RESULTS: Out of the 198 subjects (M:F=1.6:1) with IDA, 81.8% (n=162) was breast feeding more than 6 months. The main causes which they were brought to the clinic were infectious or inflammatory illness, and only 13.1% with IDA were visited for evaluation of pallor or anemia. Correlation between Hb and MCV was much more in IDA group than control group (r=0.709, r=0.368; P<0.001). CONCLUSION: By combining Hb with MCV and RDW as well as iron batteries in screening for iron deficiency and IDA, the accuracy of diagnosis can be increased. We support the use of appropriately iron-fortified formulas or weaning foods, or the routine iron supplement starting at 6 months of age in exclusively breast-fed infants to prevent the iron deficiency.
Anemia ; Anemia, Iron-Deficiency* ; Breast Feeding ; Child* ; Diagnosis ; Erythrocyte Indices ; Erythrocytes* ; Ferritins ; Hematocrit ; Hospitals, Municipal ; Humans ; Immunization ; Infant* ; Iron* ; Mass Screening ; Pallor ; Transferrin ; Weaning

PURPOSE: Iron deficiency anemia is the most common nutrient deficient disorder in infants and young children. Iron deficiency at this age group can cause seroius effects on mental and psychomotor development. The object of this study is to determine the prevalence of iron deficiency and evaluate its relationship with diet during the weaning period. METHODS: We conducted blood tests on 247 healthy, 5-24 months olds, who visited DongBu Municipal Hospital and the local health center for immunizations. One hundred and fifty-two children also had serum iron, TIBC, transferrin-saturation and serum ferritin tested. Mothers of 129 children answered a questionnaire about feeding practices and their children were divided into 3 groups according to age; groupl (5-11 mon.), groupll (12-17 mon.), grouplll (18-24 mon.). RESULTS: Out of the total number of subjects 7.3% (n=18) was anemic (Hbg<11g/dl) and the highest 9.4% was in groupl (5-11 mon.). Among 152, 32.2% (n=49) were in an iron deficient state (ferritin<10ng/ml). In group lll, 57.5% (23/40) were iron deficient. Transferrin saturation<10% was 13.8% (21/152) and ferritin<10ng/ml and/or TS<10% was 37.5%. Analysis of questionnaires is as follows : Total daily caloric intake was 771.9 +/- 264.0 Cal on average. Average daily iron intake was 5.5 +/- 2.7 mg, about half the recommended dietary allowance of 10mg. CONCLUSION: The prevalence of iron deficiency was high (32.9%) in 5-24 months olds. Because iron deficiency without anemia was 27.0%, we recommend to add serum ferritin to routine Hb indices test for iron deficiency evaluation. As average iron intake in weaning period was much less than recommended, it seems appropriate to emphasize feeding iron rich weaning foods.
Anemia ; Anemia, Iron-Deficiency ; Child* ; Diet ; Energy Intake ; Ferritins ; Hematologic Tests ; Hospitals, Municipal ; Humans ; Immunization ; Infant* ; Iron* ; Mothers ; Prevalence ; Surveys and Questionnaires ; Recommended Dietary Allowances ; Transferrin ; Weaning