• Title, Summary, Keyword: severity

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The Assessment of Severity Adjustment Measures for AMI Patients in Korea (급성심근경색증 환자를 대상으로 한 중증도 보정 방법의 평가)

  • Park, Hyeung-Keun
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.164-175
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    • 2003
  • Objectives: To evaluate the performance of models to predict AMI patients death using severity adjustment measures in Korea. Methods: Medical records of 861 patients treated by AMI in 7 general hospitals during 1996 and 1997 were reviewed by trained nurses. We measured the severity of patients by APACHE III, MedisGroups, CSI and DS. Using each severity method a predictive mortality for each patient was calculated from a logistic regression model including the severity score. The statistical performance of each severity method model was evaluated by using c-statistics and R2. For each hospital, z scores compared actual and expected mortality rates. Results: The overall in-hospital mortality was 14.5%, ranged from 10.0% to 22.2%. The distributions of severity scores for each method was significantly different by hospitals. The four severity-adjusted models to predict AMI patients death varied in their statistical performance for discrimination power of patients death. Order of Severity-adjusted mortality rates and z scores by four severity measures was different. Conclusion: Severity-adjusted mortality rates of AMI patients might be applied as an indicator for hospital performance evaluation in Korea. Because different severity methods frequently produce different impressions about relative hospital performance, more studies has to be done to use it as quality indicator and more attention should be paid to select appropriate severity measures.

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Severity Measurement Methods and Comparing Hospital Death Rates for Coronary Artery Bypass Graft Surgery (관상동맥우회술의 중증도 측정과 병원 사망률 비교에 관한 연구)

  • Ahn, Hyung-Sik;Shin, Young-Soo;Kwon, Young-Dae
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.3
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    • pp.244-252
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    • 2001
  • 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, APACHE III 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 $R^2$ 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.

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Relationship between Severity of Physical Trauma and Subsequent the Severity of PTSD Symptoms in Traffic Accident Related PTSD Patients (교통사고 관련 외상후 스트레스 장애 환자에서 신체적 외상의 정도와 외상후 스트레스 장애 증상의 심각도 사이의 관계)

  • Lee, Ji-Youn;Na, Chul;Cho, Ju-Yeon
    • Korean Journal of Psychosomatic Medicine
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    • v.6 no.1
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    • pp.28-34
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    • 1998
  • Objective: This study was designed to evaluate the etiological factors of the PTSD(post traumatic stress disorder) by examining the relationship between severity of physical trauma and subsequent the severity of PTSD symptom in traffic accident related PTSD patients. Method: Subjects were 21 psychiatric inpatients with history of traffic accident related PTSD(DSM-IV criteria), the purpose of evaluation of mental disability and no evidence of organic brain leisons. The severity of physical trauma was assessed by McBride number of nonpsychiatric department and the presence / absence of loss of conciousness. The severity of PTSD symptom was assessed by Hovens' self rating inventory for PTSD. And then we evaluated the correlation between these two factors. And we also evaluated relationship between severity of PTSD symtom and clinical variables. Results : There were no significant relationship between McBride number of nonpsychiatric department severity and symptomatic severity(r= 0.17, p<0.05), the presence / absence of loss of conciousness and symptomatic severity(p>0.05). And significant relationship between symptomatic severity and clinical varibles such as sex, education level, marital status(p<0.05). Conclusions : These data did not support data of previous studies that traumatic severity was correlated with symptom severity but, suggested that other variables affecting the severity of PTSD symptom is more important indirectly. And that the 'trauma' in PTSD is psychological meaning rather than physical meaning is also suggested.

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A Study on the Severity Classification in the KDRG-KM (Korean Diagnosis-Related Groups - Korean Medicine) (한의 입원환자분류체계의 중증도 분류방안 연구)

  • Ryu, Jiseon;Kim, Dongsu;Lee, Byungwook;Kim, Changhoon;Lim, Byungmook
    • The Journal of Korean Medicine
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    • v.38 no.3
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    • pp.185-196
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    • 2017
  • Backgrounds: Inpatient Classification System for Korean Medicine (KDRG-KM) was developed and has been applied for monitoring the costs of KM hospitals. Yet severity of patients' condition is not applied in the KDRG-KM. Objectives: This study aimed to develop the severity classification methods for KDRG-KM and assessed the explanation powers of severity adjusted KDRG-KM. Methods: Clinical experts panel was organized based on the recommendations from 12 clinical societies of Korean Medicine. Two expert panel workshops were held to develop the severity classification options, and the Delphi survey was performed to measure CCL(Complexity and Comorbidity Level) scores. Explanation powers were calculated using the inpatient EDI claim data issued by hospitals and clinics in 2012. Results: Two options for severity classification were deduced based on the severity classification principle in the domestic and foreign DRG systems. The option one is to classify severity groups using CCL and PCCL(Patient Clinical Complexity Level) scores, and the option two is to form a severity group with patients who belonged principal diagnosis-secondary diagnosis combinations which prolonged length of stay. All two options enhanced explanation powers less than 1%. For third option, patients who received certain treatments for severe conditions were grouped into severity group. The treatment expense of the severity group was significantly higher than that of other patients groups. Conclusions: Applying the severity classifications using principal diagnosis and secondary diagnoses can advance the KDRG-KM for genuine KM hospitalization. More practically, including patients with procedures for severe conditions in a severity group needs to be considered.

A Metrics Set for Measuring Software Module Severity (소프트웨어 모듈 심각도 측정을 위한 메트릭 집합)

  • Hong, Euy-Seok
    • Journal of the Korea Society of Computer and Information
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    • v.20 no.1
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    • pp.197-206
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    • 2015
  • Defect severity that is a measure of the impact caused by the defect plays an important role in software quality activities because not all software defects are equal. Earlier studies have concentrated on defining defect severity levels, but there have almost never been trials of measuring module severity. In this paper, first, we define a defect severity metric in the form of an exponential function using the characteristics that defect severity values increase much faster than severity levels. Then we define a new metrics set for software module severity using the number of defects in a module and their defect severity metric values. In order to show the applicability of the proposed metrics, we performed an analytical validation using Weyuker's properties and experimental validation using NASA open data sets. The results show that ms is very useful for measuring the module severity and msd can be used to compare different systems in terms of module severity.

An Analysis of Factors Affecting Severity of Elderly Driver in Frontal Collision (정면충돌에서 노인운전자의 중증도에 영향을 주는 요인 분석)

  • Jeon, Hyeok-Jin
    • Fire Science and Engineering
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    • v.33 no.2
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    • pp.139-144
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    • 2019
  • The increase in the elderly population also increased the damage and deaths of the elderly drivers. However, studies on the severity and severity of the elderly driver are not actively conducted and the factors are unknown. In this study, I tried to find out the factors affecting the damage and severity of the elderly driver in the frontal collision and to utilize them additionally in the severity classification. Collision Deformation Classification (CDC) Code was used to check the extent of damage to the vehicle. Abbreviated Injury Scale (AIS) was used to determine the injury parts and severity of injury, and the Injury Severity Score (ISS) to confirm the severity of the patient. The odds ratios of severe injury patients were found to be 7.381 in the subjects with 5 or more deformation extent and the ${\beta}$ value of the deformation extent was 0.453 in the analysis of the severity by linear regression analysis. Therefore, the degree of deformation extent of 5 or more can be suggested as a criterion that can be used additionally to the severity classification in the elderly driver.

Patient Severity Classification in a Medical ICU using APACHE Ⅲ and Patient Severity Classification Tool (APACHE Ⅲ를 이용한 중환자 분류도구의 타당도 검증)

  • Lee, Gyeong-Ok;Sin, Hyeon-Ju;Park, Hyeon-Ae;Jeong, Hyeon-Myeong;Lee, Mi-Hye;Choe, Eun-Ha;Lee, Jeong-Mi;Kim, Yu-Ja;Sim, Yun-Gyeong;Park, Gwi-Ju
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1243-1253
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    • 2000
  • The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE Ⅲ and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE Ⅲ developed by Knaus and the Patient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, $x^2$, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing.

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Discriminant Analysis of Factors Affecting Traffic Accident Severity During Daytime and Nighttime (판별분석을 활용한 주·야간 고속도로 교통사고 영향요인 비교연구)

  • Kim, Kyoungtae;Lee, Soobeom;Choi, Jihye;Park, Sinae;Seo, Geumyeol
    • International Journal of Highway Engineering
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    • v.18 no.3
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    • pp.127-134
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    • 2016
  • PURPOSES : Low visibility caused by dark surroundings at nighttime affects the likelihood of accidents, and various efforts, such as installing road safety facilities, have been made to reduce accidents at night. Despite these efforts, the nighttime severity index (SI) in Korea was higher than the daytime SI during 2011-2014. This study determined the factors affecting daytime and nighttime accident severity through a discriminant analysis. METHODS : Discriminant analysis. RESULTS : First, drowsiness, lack of attention, and lighting facilities affected both daytime and nighttime accident severity. Accidents were found to be caused by a low ability to recognize the driving conditions and a low obstacle avoidance capability. Second, road conditions and speeding affected only the daytime accident severity. Third, failure to maintain a safe distance significantly affected daytime accident severity and nonsignificantly affected nighttime accident severity. The majority of such accidents were caused by rear-end collisions of vehicles driving in the same direction; given the low relative speed difference in such cases, the shock imparted by the accidents was minimal. CONCLUSIONS : Accidents caused by a failure to maintain a safe distance has lower severity than do accidents caused by other factors.

Factors Influencing Development and Severity of Grey Leaf Spot of Mulberry (Morus spp.)

  • Kumar, Punathil Meethal Pratheesh;Qadri, Syed Mashayak Hussaini;Pal, Susil Chandra
    • International Journal of Industrial Entomology
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    • v.22 no.1
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    • pp.11-15
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    • 2011
  • Impact of pruning date, shoot age and weather parameters on the severity and development of grey leaf spot (Pseudocercospora mori) of mulberry was studied. The disease severity (%) increased with increase in shoot age irrespective of pruning date. Maximum disease severity was observed in plants pruned during second week of October and minimum in plants pruned during last week of December. Significant (P<0.05) influence of date of pruning, shoot age and their interaction was observed on the severity of the disease. Apparent infection rate (r) was significantly higher during plant growth period from day-48 to day-55. Average apparent rate was higher in plants pruned during first week of September and least in plants pruned during third and fourth week of December. Multiple regression analysis revealed contribution of various combinations of weather parameters on the disease severity. A linear prediction model [$Y=66.05+(-1.39)x_1+(-0.219)x_4$] with significant $R^2$ was developed for prediction of the disease under natural epiphytotic condition.

Calculation of the Area of Severity for Voltage Sag Assessment (순간전압강하 평가를 위한 가혹지역의 계산)

  • Park, Chang-Hyun;Hong, Jun-Hee
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.59 no.6
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    • pp.1034-1040
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    • 2010
  • This paper presents a calculation method of the area of severity for the stochastic assessment of voltage sags. In general, the annual expected numbers of voltage sags at an individual load point can be estimated stochastically. However, in order to assess the system voltage sag performance considering many sensitive load points together, it is necessary to determine and analysis the area of severity for the load points. The area of severity to voltage sags is the network region where the fault occurrences will simultaneously lead to voltage sags at different load points. In this paper, the concept of the voltage sag assessment and the calculation method of the area of severity are addressed. The analysis of the area of severity is performed on the IEEE 30-bus test system by using the proposed method. The method is useful for the stochastic assesment of voltage sags and the establishment of systematic plans for voltage sag mitigation.