• Title/Summary/Keyword: 병원이용률

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A Study of Clinical Model for Radiation Therapy in Lung Cancer Patients of Busan and South Gyeongnam Province (부산, 경남지역 폐암 환자의 방사선치료 이용에 대한 임상 결정 모델 연구)

  • Son, Jongki;Kim, Yunjin;Jo, Deokyoung
    • Journal of the Korean Society of Radiology
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    • v.9 no.6
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    • pp.393-401
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    • 2015
  • Radiation therapy for lung cancer is an effective treatment during monotherapy or combination therapy. Studies have reported that the optimum utilization rate of radiation therapy is estimated at 61% to 74%. Radiation therapy in Korea has been investigated to be low; further studies are needed. This study was intended to assess the appropriateness of the use of radiation and to reveal the use of radiation therapy-related factors by examining radiation therapy in lung cancer patients of Busan and South Gyeongnam Province. This study was aimed at the population diagnosed with lung cancer in Busan and South Gyeongnam Province. To conduct the study, 1036 patients enrolled in two hospitals were collected and 897 appropriate as subjects were selected. We compared the optimum utilization rate and actual rate of radiation therapy, and revealed the adequacy and related factors for use of radiotherapy. Of 897 patients, 503 (56%) were treated with medical therapy and 394 (44%) were given radiotherapy. The radiotherapy utilization rate of all lung cancer patients was 42%. The proportion of non-small cell lung cancer by histologic type was 33% and that of small cell lung cancer was 90%. Factors related to radiation therapy used in cancer were age, histological type, clinical stage, doctor refereed to, and clinical examination. Compared to radiation utilization by region (site), curative chest therapy was 42%; palliative treatment was 26%. In the comparison of histologic types, utilization of small-cell lung cancer is lower; the lowest especially in the stage III. Utilization of radiation therapy in Busan and South Gyeongnam Province was lower than the reasonable one. Utilization difference could be explained by patient factors, tumor factors, and health service factors. To improve utilization,development ofoutreach service programs and activation of the multidisciplinary team are required.

The Comparison of Risk-adjusted Mortality Rate between Korea and United States (한국과 미국 의료기관의 중증도 보정 사망률 비교)

  • Chung, Tae-Kyoung;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.11 no.5
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    • pp.371-384
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    • 2013
  • The purpose of this study was to develop the risk-adjusted mortality model using Korean Hospital Discharge Injury data and US National Hospital Discharge Survey data and to suggest some ways to manage hospital mortality rates through comparison of Korea and United States Hospital Standardized Mortality Ratios(HSMR). This study used data mining techniques, decision tree and logistic regression, for developing Korea and United States risk-adjustment model of in-hospital mortality. By comparing Hospital Standardized Mortality Ratio(HSMR) with standardized variables, analysis shows the concrete differences between the two countries. While Korean Hospital Standardized Mortality Ratio(HSMR) is increasing every year(101.0 in 2006, 101.3 in 2007, 103.3 in 2008), HSMR appeared to be reduced in the United States(102.3 in 2006, 100.7 in 2007, 95.9 in 2008). Korean Hospital Standardized Mortality Ratios(HSMR) by hospital beds were higher than that of the United States. A two-aspect approach to management of hospital mortality rates is suggested; national and hospital levels. The government is to release Hospital Standardized Mortality Ratio(HSMR) of large hospitals and to offer consulting on effective hospital mortality management to small and medium hospitals.

Antimicrobial resistance rates changes according to the amount of the antimicrobial agent in clinically important strain isolated from blood cultures (혈액배양에서 분리된 임상적 주요 균주의 항균제사용량에 따른 내성률 변화)

  • Kim, Jae-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.653-659
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    • 2016
  • The purpose of the study is to investigate the correlation between the amount of antimicrobial agent (Defined Daily Dose, DDD) and antimicrobial resistance rate (%). The treatment of infectious diseases is becoming increasingly difficult, due to the increase in the number of multi-drug resistant bacteria, making it a clinically significant problem. Among the various factors, antimicrobial abuse is a major cause of antimicrobial resistance. The study was conducted on inpatients in a secondary university hospital in the central region utilizing the hospital's computerized statistical data and microbiological program of laboratory medicine from January 2010 to December 2014 pertaining to the dose of antimicrobial drugs for Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Escherichia coli strains isolated from blood culture. We analyzed the antimicrobial resistance rate per dose with the Pearson correlation coefficient. A significant (positive?) correlation was detected between the cefepime dose and the resistance of E. coli (P<0.033; r=0.907), while a significant negative correlation was found between the tobramycin dose and the resistance of E.coli. (P<0.028; r=-0.917). The aminoglycoside resistance of A. baumannii showed a significant negative correlation (P<0.048; r=-0.881), and the aminoglycoside resistance of E. coli showed a significant negative correlation as well (P<0.001; r=-0.992). In conclusion, the amount of antimicrobial agent (Defined Daily Dose, DDD) (is partly related to) the bacterial strain and its antimicrobial resistance rate (%).

A Study on the Utilization of Complementary and Alternative Medicine on Children with Atopic Dermatitis (아토피 피부염 환아의 보완대체요법 이용 실태)

  • Kim, Chae-Bong;Kim, KyooSang
    • The Journal of the Korea Contents Association
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    • v.17 no.1
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    • pp.58-68
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    • 2017
  • Atopic dermatitis (AD) is prevalent in preschoolers and schoolchildren. The utilization of complementary and alternative medicine (CAM) is increasing in patients with AD as well as the general population. This study is based on the utilization of CAM for children with AD. Subjects were children suffering from AD who participated in the project of 'Seoul Atopy Asthma Free School'. In 6,800, the number of subject available data to final analysis was 4,985 for children with AD. Independent variables were age, monthly income of households, sleep disturbance, and dependent variables were medical treatment (MT), oriental medicine clinic (OMC), home remedy (HR) use experience during the past 12 months. As a result, MT was 76.5%, OMC was 24.6%, and HR was 62.3%, while multiple treatment from OMC and HR was 34.2%, and MT with OMC and HR was 18.8%. And variables influenced on CAM were age, monthly income of households, and sleep disturbance. However, some parents, tended to recognize that home remedy was effective and safe than other treatments. Therefore, it is recommended to counsel with physician about the merits and demerits of CAM.

Tongue detection using Haar-like Feature and Connected Component Labeling (Haar-like Feature와 Connected Component Labeling을 이용한 혀 영역 검출)

  • Lee, Min-Taek;Oh, Min-Seok;Lim, Yeong-Hoon;Lee, Kyu-Won
    • Proceedings of the Korea Information Processing Society Conference
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    • 2014.04a
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    • pp.861-864
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    • 2014
  • 본 논문은 혀 미각 영역별 분석을 통해 신체의 이상 여부에 대한 정보를 제공하는 설진 진단 시스템의 첫 단계로 얼굴 영상에서 혀 영역을 검출하는 실험을 통하여 미각 영역별 분석의 기반을 다진다. 제안하는 알고리즘은 혀 영상을 획득한 후, Haar-like Feature를 이용하여 혀를 검출한다. 검출된 혀 영역은 HSV컬러모델의 특징을 이용하여 이진화 한 후, Connected Component Labeling을 이용하여 혀 영역 분리한다. 한방병원의 환자들의 혀 사진 100장을 이용하여 90%의 검출률을 확인하였다.

Comparative Evaluation of Chest Image Pneumonia based on Learning Rate Application (학습률 적용에 따른 흉부영상 폐렴 유무 분류 비교평가)

  • Kim, Ji-Yul;Ye, Soo-Young
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.595-602
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    • 2022
  • This study tried to suggest the most efficient learning rate for accurate and efficient automatic diagnosis of medical images for chest X-ray pneumonia images using deep learning. After setting the learning rates to 0.1, 0.01, 0.001, and 0.0001 in the Inception V3 deep learning model, respectively, deep learning modeling was performed three times. And the average accuracy and loss function value of verification modeling, and the metric of test modeling were set as performance evaluation indicators, and the performance was compared and evaluated with the average value of three times of the results obtained as a result of performing deep learning modeling. As a result of performance evaluation for deep learning verification modeling performance evaluation and test modeling metric, modeling with a learning rate of 0.001 showed the highest accuracy and excellent performance. For this reason, in this paper, it is recommended to apply a learning rate of 0.001 when classifying the presence or absence of pneumonia on chest X-ray images using a deep learning model. In addition, it was judged that when deep learning modeling through the application of the learning rate presented in this paper could play an auxiliary role in the classification of the presence or absence of pneumonia on chest X-ray images. In the future, if the study of classification for diagnosis and classification of pneumonia using deep learning continues, the contents of this thesis research can be used as basic data, and furthermore, it is expected that it will be helpful in selecting an efficient learning rate in classifying medical images using artificial intelligence.

Differences in Longevity Factors amongst Korean Centenarians, Octogenarians, and Sexagenarians (한국 백세인, 팔순인, 환갑인의 장수요인의 차이)

  • Kim, Jong-In
    • Korean Journal of Health Education and Promotion
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    • v.24 no.5
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    • pp.55-68
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    • 2007
  • The purpose of this study was to investigate differences in longevity factors for 3 age groups: centenarians, octogenarians, and sexagenarians. There were 389 elderly Korean subjects who participated in this study. This included 109 centenarians who participated in the 1-wave study that examined the longevity factors using the health behaviors and psychological reactions. The study that examined the longevity factors by using odds ratio of the logistic regression analysis. The major findings indicate that female centenarians and octogenarians scored the highest in abstinence from alcoholic drinking than males from these same 2 age groups (OR=9.04, CI=4.04, 20.24). Centenarians scored higher in non-visiting hospitals (OR=11.48, CI=5.56, 23.70) and showed little emotion when watching sad scenes, upon comparison with the younger 2 age groups. Also, centenarians scored higher in laughter (OR=11.59, CI=5.04, 26.63), showing no anxiety (OR=12.49, CI=6.42, 24.32), and displaying indifference towards games, when compared with the younger 2 age groups. The findings imply that Korean centenarian leads to a life of longevity is the result not only of psychological reactions but also of health behaviors. Also, these results support future studies of improvement of longevity factors.

Characteristics of Blood Mixed Cement in Percutaneous Vertebroplasty (경피적 척추 성형술에서 혈액 혼합 시멘트의 특성)

  • Seo, Jin-Hyeok;Woo, Young-Ha;Jeong, Ju-Seon;Kim, Do-Hun;Kim, Ok-Gul;Lee, Sang-Wook;Park, Chan-Ho
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.5
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    • pp.435-439
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    • 2019
  • Purpose: This study evaluated the efficacy of blood mixed cement for osteoporotic vertebral compression fractures in reducing the complications of percutaneous vertebroplasty using conventional cement. Materials and Methods: This study was performed retrospectively in 80 patients, from January 2016 to January 2017. Porous cement was formed by mixing 2, 4, and 6 ml of blood with 20 g of cement used previously. A tube with a diameter and length of 2.8 mm and 215 mm, respectively, was used and the polymerization temperature, setting time, and optimal passing-time were measured and compared with those using only conventional cement. Radiologically, the results were evaluated and compared. Results: The polymerization temperature was 70.3℃, 55.3℃, 52.7℃, and 45.5℃ in the conventional cement (R), 2 ml (B2), 4 ml (B4), and 6 ml (B6), respectively, and the corresponding setting time decreased from 960 seconds (R) to 558 seconds (B2), 533 seconds (B4), and 500 seconds (B6). The optimal passing-time was 45 seconds (B2), 60 seconds (B4), and 78 seconds (B6) at 73 seconds (R), respectively and as the amount of blood increased, it was similar to the cement passing-time. The radiological results showed that the height restoration rates and the vertebral subsidence rates similar among the groups. Two cases of adjacent vertebral compression fractures in the R group and one in the B2 and B4 groups were encountered, and the leakage rate of the cement was approximately two times higher than that in the conventional cement group. Conclusion: In conventional percutaneous vertebroplasty, the procedure of using autologous blood with cement decreased the polymerization temperature, reduced the setting time, and the incidence of cement leakage was low. These properties may contribute to more favorable mechanical properties that can reduce the complications compared to conventional cements alone.

Result of a Long-Term Follow-Up of Arthroscopic Partial Repair for Massive Irreparable Rotator Cuff Tears Using a Biceps Long Head Auto Graft (봉합 불가능한 광범위 회전근 개 파열에서 상완 이두근 건 장두를 이용한 관절경하 부분 봉합술의 장기 추적 관찰 결과)

  • Ko, Sang-Hun;Park, Ki-Bong;Park, Gil-Young;Kwon, Sun-Hwan;Kim, Myung-Seo;Park, Sun-Jae
    • Journal of the Korean Orthopaedic Association
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    • v.55 no.2
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    • pp.135-142
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    • 2020
  • Purpose: This paper presents the long term follow-up results of arthroscopic partial repair for massive irreparable rotator cuff tears using a biceps long head auto graft. Materials and Methods: Forty-one patients with massive irreparable rotator cuff tear, who underwent arthroscopic repair, were reviewed retrospectively. Patients who underwent arthroscopic partial repair using a biceps long head auto graft were assigned to group 1, and patients in group 2 underwent arthroscopic partial repair alone. Patients with a less than 50% partial tear of the long head biceps tendon were included in this study. The clinical scores were measured using a visual analogue pain scale (VAS) for pain, range of motion (ROM), The University of California, Los Angeles shoulder score (UCLA), American Shoulder and Elbow Surgeons Shoulder Score (ASES), and Korean Shoulder Scoring System (KSS) scores preoperatively and at the final follow-up. The acromiohumeral interval (AHI) was measured using plain radiographs taken preoperatively and at the final follow-up, and re-tear was evaluated using postoperative ultrasound or magnetic resonance imaging at the last follow-up. Results: The mean age of the patients was 62.1±12.7 years, and the mean follow-up period was 90.3±16.8 months. No significant differences in the VAS and ROM (forward flexion, external rotation, internal rotation) were found between the two groups (p=0.179, p=0.129, p=0.098, p=0.155, respectively). The UCLA (p=0.041), ASES (p=0.023), and KSS (p=0.019) scores showed functional improvements in group 1 compared to group 2. At the last follow-up, the measured AHI values were 9.46±0.41 mm and 6.86±0.64 mm in group 1 and 2, respectively (p=0.032). Re-tear was observed in six out of 21 cases (28.6%) in group 1 and nine out of 20 cases (45.0%) in group 2; the retear rate was significantly lower in group 1 than in group 2 (p=0.011). Conclusion: Arthroscopic partial repair for a massive irreparable rotator cuff tear using a biceps long head auto graft has significant clinical usefulness in functional recovery and decreases the re-tear rates after surgery than arthroscopic partial repair alone, showing favorable results after a long-term follow-up.

The Result of Repeat Discectomy for Ipsilateral Recurrent Lumbar Disc Herniation (재발성 요추 추간판 탈출증에 대한 추간판 재절제술의 결과)

  • Kim, Woo-Sung;Na, Hwa-Yeop;Oh, Sang-Hoon;Park, Sub-Ri;Son, Eui-Young
    • Journal of the Korean Orthopaedic Association
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    • v.52 no.1
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    • pp.59-64
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    • 2017
  • Purpose: To analyze the result of a repeat discectomy for ipsilateral recurrent lumbar disc herniation and to investigate the potential factors that influenced the outcomes for this surgery. Materials and Methods: Fifty-nine patients, who underwent reoperation after lumbar discectomy with a minimum follow-up period of 2 years, were reviewed. The surgical outcome was assessed using the visual analogue scale (VAS) and Macnab classification, and the recovery rate was calculated in accordance with VAS. A statistical analysis was carried out by SPSS to evaluate the possible factors that may have influenced the outcomes of the reoperation. Results: The rate of reoperation after lumbar disc surgery due to the recurrent disc herniation was 6.0% (59/983 cases). The average recovery rate of VAS from the 1st operation was approximately 77%, and from the 2nd operation was 71%. According to the Macnab criteria, the results were "excellent" or "good" in 96% of cases. Statistical analysis revealed that there was no difference of the average recovery rate (p<0.05). There is no additional instability after repeat discectomy. Factors, such as smoking, precipitating traumatic events, and diabetes mellitus did not have much influence on the average recovery rate after repeat discectomy for ipsilateral recurrent lumbar disc herniation. Conclusion: The outcomes of repeat discectomy were satisfactory. Moreover, factors, smoking, trauma history and diabetic mellitus, only had a minor impact on the outcomes of a repeat discectomy.