No abstract available.
Delivery of Health Care

No abstract available.
Delivery of Health Care

Hospitals have been very susceptable to changes in external environment. Accordingly, they have been experiencing great financial difficulty due to low insurance rates and increasing competition. As a remedy, hospitals have attempted to use computer in a strategic manner. Such system is called strategic information system (SIS) , and order communication system (OCS) is an example of SIS in hospital setting. While OCS has known to be effective in reducing waiting time for outpatients, many hospitals are reluctant to introduce this system mainly because there are no real data or methods for justifying the cost of the system. Cost-benefit analysis has been traditionally used for such purpose, but this method deals with limited portion of benefits and therefore not very useful for analyzing the economic feasibility of SIS. In this paper, information economics tools which expand cost with value was used to analyze the economic feasibility of OCS. To assist the analysis, financial simulation model was developed using simulation package, called IFPS (Interactive Financial Planning System).
Cost-Benefit Analysis ; Humans ; Information Systems ; Insurance ; Outpatients

Undifferentiated sarcoma of the liver is a highly malignant neoplasm that occurs almost exclusively in children. We present a case of adult undifferentiated sarcoma in a 33-year-old man. The neoplasm was typically hypovascular on hepatic angiography and a globular, cystic and mucoid mass separated from the adjacent liver by a psedocapsule was removed from the left lobe of the liver. Necrosis and hemorrhage were found. Microscopically the neoplasm consisted of myxoid and cellular areas and the basic neoplastic cells were stellate cells showing variable degree of anaplasia and pleomorphism. Eosinophilic globules were PAS-positive and immunohistochemically negative for alpha-fetoprotein. Extramedullary hematopoiesis was present and normal-appearing bile ducts and hepatic cell cords were noted.
Child ; Adult ; Male ; Female ; Humans

PURPOSE: The study tried to suggest the ways to improve the national disability welfare information projects with evaluating the present condition of the projects. METHOD: Firstly, the study analyzed the disability information system and disability websites. Secondly, the study found out the problems of the registration of disability and management system through the situation analysis. Finally, the study conducted a survey of the disabled and the information system workers and performance evaluation of the information system. RESULTS: The study offered a proposal of The Disability Unity Management System(DUMS) for the disability registration and management. When the disabled visit the hospital or the public health center, their information is registered automatically in The Disability Unity Management System(DUMS), which helps not to miss out the disability registration. Through this system, they are given the proper service which they need, and the information can be shared with the facilities providing the service for the disabled. CONCLUSION: The Disability Unity Management System(DUMS) contributes significantly in avoiding the repetition of the support for the disabled and improving the quality of service.
Disabled Persons ; Humans ; Information Systems* ; Public Health ; Registries

No abstract available.
Information Management* ; Occupational Health*

This study was carried out to analyse the economic feasibility of EPR. A hospital with 500 beds under the construction was selected for this study. The economic effect was performed with cost-benefit analysis for 5 years from the year 1998 to 2002. The results of this study were as follows; The economic effect of EPR was classified into direct benefit, value acceleration, and value linking. Each factor was applied and analyzed step by step. In the analysis including only direct benefit, the net present value and the ratio of benefit to cost were minus 82,920,000 won and 0.8. With this traditional cost-benefit analysis alone, the EPR in hospital can be regarded as very unprofitable. However, when value acceleration was added, the net present value and the ratio of benefit to cost rose to 748,637,000 won and 2.7 respectively. Moreover, when value linking was added, the net present value and the ratio of benefit to cost were 1,473,162,000 won and 4.3, respectively. In the results of this study, as EPR has only direct benefit, EPR can be regarded as unprofitable project. However, when value acceleration and value linking were added, EPR can be profitable project.
Acceleration ; Cost-Benefit Analysis ; Humans

BACKGROUND/AIMS: The emergence of lamivudine-resistant mutant hepatitis B virus (HBV), with aminoacid substitution in the YMDD motif of DNA polymerase, has been reported in the long-term lamivudine use group. However there is no report about the emergence of mutant viruses during the short-term lamivudine therapy. The objective of this study was to investigate the emergence of YMDD mutant HBV during short-term lamivudine therapy. METHODS: We evaluated twenty-eight chronic hepatitis B patients who were HBeAg and HBV DNA positive and treated with lamivudine 100mg p.o. daily for 12 weeks. First, we investigated the emergence of YMDD mutants by nested polymerase chain reaction (PCR) method developed by Chayama et al in 19 patients who lost HBV DNA during lamivudine therapy but showed HBV DNA re-emergence 2 weeks after the end of therapy. Second, DNA subcloning and sequencing of HBV DNA polymerase including YMDD motif was undertaken in one patient's serial blood samples at 0, 8, 12 weeks to confirm the results of nested PCR. RESULTS: YMDD motif mutation was detected in 17(90%) out of 19 patients at the end of therapy and the type of mutations were YIDD only. At the end of therapy, mutant was predominant in 5 patients, both mutant and wild type were similar in proportion in 3 patients, and wild type was predominant in 9 patients. When we carried out nested PCR serially with samples of 0, 2, 4, 8, 12, 14 weeks after initiation of therapy in 5 patients who were mutant predominant at 12 weeks, YIDD mutant began to be detected from 2 weeks in 4 patients and from 4 weeks in one patient. However, rapid turnover from mutant to wild type happened after the end of therapy, so only wild type was detected in 3 patients and wild type became predominant in 2 patients at 2 weeks after the end of therapy. All the sequencing results of serial blood samples in one patient were consistent with nested PCR data. CONCLUSIONS: The presence of YMDD motif HBV polymerase mutant may be possible before administration of lamivudine in Korean chronic hepatitis B patients. Nested PCR assay would be an useful method to detect YMDD mutant.
DNA ; Hepatitis B e Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis* ; Humans ; Lamivudine* ; Polymerase Chain Reaction

No abstract available.
Management Information Systems* ; Occupational Health Services* ; Occupational Health*

PURPOSE: This study was conducted to provide basic data on the nursing Happiness Index and identify factors influencing nurses by describing their perception of lifestyle, health behavior, nursing professionalism, Happiness Index, and turnover intention. METHODS: On July 2012, 700 nurses from 10 general hospitals were surveyed, but 23 were omitted due to missing or incomplete data. The focus of this study was the Organization for Economic Co-operation and Development (OECD) Happiness Index, consisting of 11 OECD identified topics concerning living conditions and quality of life. Data were analyzed using chi2-tests, t-test, ANOVA, Pearson correlation coefficients and multiple regression with SPSS/WINdow 14.0. RESULTS: Mean score for nurses' Happiness Index was 3.03 on a scale of 5. There were significant differences on the Happiness Index for the following: age, marriage, children, education, position, work experience, wages, number of beds, medical institution, health behavior, weight, and meal patterns. There was a positive correlation between the happiness index and nursing professionalism but a negative correlation between the happiness index and turnover intention. CONCLUSION: Results indicate that factors influencing happiness are autonomy, sense of calling and turnover intention suggesting the need to improve nursing professionalism for a life of happiness among hospital nurses.
Child ; Happiness ; Health Behavior ; Hospitals, General ; Humans ; Intention ; Life Style ; Marriage ; Meals ; Quality of Life ; Salaries and Fringe Benefits ; Social Conditions