• Title/Summary/Keyword: 의료비 통계

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An Analysis of Prognostic Factors Affecting the Outcome of Radiation Therapy for Nasopharyngeal Carcinoma (비인강암의 방사선치료 곁과 및 생존율에 관한 예후인자 분석)

  • Jung, Young-Yeon;Kim, Ok-Bae;Kim, Jin-Hee
    • Radiation Oncology Journal
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    • v.23 no.2
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    • pp.71-77
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    • 2005
  • Purpose: This retrospective study was conduced to analyze the treatment results and to evaluate the prognostic factors affecting the survival of nasopharyngeal carcinoma patients. Materials and Methods: From 1987 to 2002, we analyzed 43 patients who had nasopharyngeal carcinomas that were histologically confirmed and who had also completed the planned radiation therapy course at Keimyung University Dongsan Medical Center According to the 6th edition of American Joint Committee on Cancer staging system, 12 patients ($27.9\%$) were at Stage 11, 13 ($30.2\%$) were at Stage III and 18 ($41.9\%$) were at Stage IV Histopathologically, there were 15 ($34.9\%$) squamous cell carcinomas, 8 ($18.5\%$) nonkeratinizing carcinomas, 17 ($39.5\%$) undifferentiated carcinomas, and 3 ($7.0\%$) lymphoepitheliomas. Among the total 43 patients, 31 patients ($72.1\%$) were treated with only radiation therapy. Neoadjuvant chemotherapy was peformed on 7 patients ($16.3\%$) and concurrent chemoradiotherapy was performed on S patients ($11.6\%$). Cisplatin and 5-Fluorouracil were administered to 11 patients for 4 cycles, and Cisplatin and Taxotere were administered to 1 patient for 6 cycles. The range of the total radiation dose delivered to the primary tumor was from 61.2 to 84 Gy (median 70.4 Gy), The follow-up period ranged from 2 to 197 months with median follow-up of 84 months. Results: The local control rate at 6 months after radiation therapy was $90.7\%$. The five year overall survival and disease free survival rates were $50.7\%$ and $48.9\%$, respectively. On the multivariate analysis, the age, T-stage ($T_{1-3}\;vs\;T_4$), N-stage and AJCC stage were the statistically significant prognostic factors affecting survival (p<0.05). The patterns of failure were as follows: local failure only in 3 patients ($7.0\%$), local and systemic failure in 1 patient ($2.3\%$), and distant metastasis only in 11 patients ($25.6\%$). Conclusion: The prognostic factors affecting the outcome of nasopharyngeal carcinoma were age, T-stage (7$T_{1-3}\;vs\;T_4$), N-stage and stage. Because systemic metastasis was the main failure pattern noted for nasopharyngeal carcinoma, systemic chemotherapy is needed to decrease the rate of distant metastasis for nasopharyngeal carcinoma. In audition, research for more effective chemotherapeutical regimens and schedules is also needed.

Impact of Awareness and Educational Experiences on Cardiopulmonary Resuscitation in the Ability to Execute of Cardiopulmonary Resuscitation among Korean Adults (한국 성인에서 심폐소생술에 대한 인지, 교육경험이 그 시행능력에 미치는 영향)

  • Lee, Jae-Kwang;Kim, Jeongwoo;Kim, Kunil;Kim, Keunhyung;Kim, Dongphil;Kim, Yuri;Moon, Seonggeun;Min, Byungju;Yu, Hwayoung;Lee, Chealim;Jeong, Wonyoung;Han, Changhun;Huh, Inho;Park, Jung Hee;Lee, Moo-Sik
    • Journal of agricultural medicine and community health
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    • v.43 no.4
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    • pp.234-249
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    • 2018
  • This study was performed to identify the impact of awareness and educational experiences on cardiopulmonary resuscitation in the ability to execute of cardiopulmonary resuscitation among Korean adults. This study used original data of 2014 Community Health Data Survey. 228,712 participants in this survey were resident in South Korea who is aged 19 or older on July 2014. Participants in this survey were sampled an average of 900 residents(target error ${\pm}3percent$) per community health center of Korea. Data were analyzed by using R 3.1.3 employing chi-squared test, fisher's exact analysis, and logistic regression analysis. Ability to execute CPR was significantly higher in males(3.34 time), higher the education level (1.61 times), the white color occupation (1.14 times), the higher the income level (1.07 times), the higher the education level (0.91 times), non-hypertensive patients (1.12 times), non-diabetic patients (1.16 times), non-dyslipidemic patients (0.86 times), non-stroke patients (0.30 times), CPR education experience group (3.25 times), CPR experience group with manikin-based training (4.30 times), higher subjective health status (1.08 times, 1.16 times) respectively. This study identified that awareness, educational experience, and mannequin-based learning experience of CPR impacted on the ability to execute CPR. Responding to education-related factors could contribute to reducing the rate of out-of-hospital acute cardiac arrest by improving the ability to execute CPR of the general public.

Effect of Octreotide on Patients with Malignant Bowel Obstruction (악성장폐색 환자에서 Octreotide의 치료 효과)

  • Park, Ji-Chan;Jang, Yi-Sun;Jeon, Eun-Kyoung;Kim, Dong-Kyu;Lee, Wook-Hyun;Lee, Guk-Jin;You, Si-Young;Choi, Hyun-Ho;Park, Suk-Young
    • Journal of Hospice and Palliative Care
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    • v.12 no.4
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    • pp.194-198
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    • 2009
  • Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea Purpose: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. Methods: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. Results: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6$\pm$1.24, and 2.7$\pm$0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day$\pm$2.5, and 0.4/day$\pm$0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975$\pm$1,083 cc/day and 115$\pm$196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). Conclusion: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

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A Study on Exposure to radiation of the patient who visited an emergency room at a University Hospital (한 대학병원 응급실에 방문한 환자의 방사선 피폭에 관한 연구)

  • Ahn, Buyung-Ju;Lee, Sang-Bock;Lee, Jun-Haeng
    • Journal of the Korean Society of Radiology
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    • v.1 no.3
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    • pp.23-34
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    • 2007
  • To find how much radiation was exposed the patients who visit emergency room, a measurement study was made for radiation amount toward 200 patients selected randomly among visitors to an emergency room in a university hospital from March 16 to 31st, 2006. The results are as follows ; 1. Among the subjects 50 person(25.0%) were transferred from other hospitals, 24 persons(8.3) come after traffic accident, 50 persons for other accident and 76 persons for general medical care. 2. The average frequency of X-ray taking was calculated as 6.4 time per person among transferred patients, 14.5 times per person among patients with traffic accident and 2.6 times per person among general medical care. 3. The radiation exposure amount by kind of X-ray showed 28.9mGyfor general X-ray diagnosis, 84.2mGy for CT scanning and 1.02mGy for other special radiation study. 4. Average radiation exposure amount was calculated as 24.6mGy by transferred patients, 55.2mGy by patients with traffic accident, 17.1mGy by patients with other accidents and 17.0mGy by general patients. 5. Through the comparison of radiation exposure amount among to subject with maximum allowance threshold by International Commission on X-ray Radium Protection, transferred patients exceeded 6 times than allowance in whole body except extremities and joints, blood forming organ, reproductive system, vitreous body of eye, bone, thyroid gland, skin and etc, Patient suffered from traffic accidents were exposed 10 times more than allowance. In conclusion, the radiation exposure amount during X-rat diagnosis re too much and exceeded allowance standard by International Commission on X-ray Radium Protection. So further study and preventive measure to decrease radiation exposure by patients who visit emergency room.

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Utilization Level and Associated Factors of Complementary and Alternative Medicine in the Older Population before Death (사망 전 노인들의 보완대체요법 이용수준 및 관련 요인)

  • Cho, Nam-Hong;Woo, Eun-Kyung;Yi, Jee-Joen;Yi, Sang-Wook;Cho, Hang-Sok;Kim, Sun-Hyun
    • Journal of Hospice and Palliative Care
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    • v.7 no.1
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    • pp.37-48
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    • 2004
  • Purpose: Population using complementary and alternative medicine (CAM) and the cost or it are increasing all over the world. In this study, we investigated the utilization state of CAM in the elderly people during the last 6 months of life. Methods: We found 4,210 persons in Seoul, older than 65 years who received a funeral subsidy from health insurance after death during the latter half of the year, 2001. We stratified them by age and gender and selected 301 persons and surveyed them by questionnaire. Results: 247 persons (83.1%) used at least one of CAM during their last 6 months of life. Diet and Nutrition remedy showed the highest utilatization rate (65.5%), and drug therapies also were much used (29.9%). Utilization rate was higher in female (60%) and according to the cause of death, the highest in a geriatric disease groups, and the lowest in the cancer group. Whole satisfaction to CAM was high with average 4.25 points out of total 6, and adverse effects were almost free with average 5.55 points out of total 6. Satisfaction was the highest in Diet and Nutrition remedy but the lowest in Manipulative and Body-Based methods. Adverse-effect score was best in Manipulative and Body-Based methods. According to age and the causative disease of death, there were significant differences in satisfaction and adverse effect levels. Conclusion: Majority of old people used at least one of CAM during their last 6months of life. Whole satisfaction and adverse-effect level were very excellent.

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The Effects of Task-Oriented Circuit Training on The Upper Extremity Function and Quality of Life in Chronic Stroke Patients (유비쿼터스 의료환경에서 순환식 과제 지향적 훈련이 뇌졸중 환자의 상지 기능과 삶의 질에 미치는 영향)

  • Lee, Gue-Dong;Kim, Young-Hun;Moon, Jong-Hoon;Park, Kyung-Young
    • The Journal of the Korea institute of electronic communication sciences
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    • v.13 no.3
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    • pp.651-660
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    • 2018
  • The purpose of this study was to investigate the effects of task-oriented circuit training(: TOCT) on upper extremity function and quality of life in chronic stroke patients. 20 stroke patients were randomized and divided into 2 groups: a preservation therapy group and TOCT group. The intervention sessions were given five times a week for four weeks. The Stroke Impact Scale(: SIS), EuroQual-5Domains(: EQ-5D), Fugl-Myer Assessment(: FMA), Motor Activity Log(: MAL), Canadian Occupational Performance Measure(: COPM) were used to measure the upper extremity function and the quality of life. In results, Two groups improved in upper extremity function after the intervention(p<.05). The EQ-5D scores of TOCT group were a significantly higher than preservation group(p<.05). The Ironing, Folding towels, Hang out towels on drying rack in COPM scores in both of performance and satisfaction have improved more than preservation group(p<.05). In conclusion, the TOCT has significant helpful effect to chronic stroke patients. These findings can be used to chronic stroke patient as an intervention for upper extremity function and quality of life.

Comparison of Attitudes of Nursing Students toward Death, Self-esteem and Life Satisfaction according to Clinical Experience (임상실습경험에 따른 간호대학생의 죽음에 대한 태도와 자아존중감 및 삶의 만족도 비교)

  • Kim, Soon-Hee;Kim, Dong-Hee;Son, Hyun-Mi
    • Journal of Hospice and Palliative Care
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    • v.14 no.3
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    • pp.144-151
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    • 2011
  • Purpose: This study was conducted to compare nursing students' attitudes toward death, self-esteem and life satisfaction according to clinical experience. Methods: We surveyed 1,030 nursing students from two different universities with a questionnaire consisting of items regarding attitudes toward death, self-esteem and life satisfaction. The data were analyzed using a PASW program. Results: Students with clinical experience scored 2.85 on the attitude toward death, while those without clinical experience scored 2.79 (t=2.775, P=0.006). Students with clinical experience had significantly higher self-esteem (t=4.541, P<0.001) and life satisfaction (t=4.050, P<0.001) than those without it. Students with clinical experience showed correlations between attitude toward death and self-esteem (r=0.159, P<0.001) and life satisfaction (r=0.090, P=0.025), while those without it did not (r=0.106, P=0.014). Conclusion: These results provide guidance for developing educational strategies such as educational program to help students build positive attitude toward death through their experience in clinical practice.

Son Preference and Factors of Efforts for Seeking at Least One Son Among Multipara in Taegu (대구지역 경산부의 남아 선호의식 및 아들 낳기 노력의 영향력에 관한 연구)

  • 김한곤;이미경
    • Korea journal of population studies
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    • v.22 no.2
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    • pp.73-96
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    • 1999
  • 본 연구의 목적은 1980년대 중반부터 약 10여년 동안 현저한 출생시 성비불균형을 경험한 대구지역의 경산부들을 대상으로 아들을 낳기 위한 노력에 미치는 요인들을 밝히는데 있다. 1998년 4월부터 6월까지의 3개월동안 대구지역의 6개 종합병원에 내원한 임산부들 가운데 출산 경험이 있는 경산부를 대상으로 실시한 설문조사자료를 사용하였으며 경산부의 아들 낳기 노력에 영향을 미치는 요인들을 규명하기 위하여 로지스틱 회귀분석을 도입하였다. 연구결과에 따르면 대구지역의 경산부들은 여성에 대한 성차별을 많이 느끼고 있을 뿐만 아니라 아들 선호의식 역시 상당히 높은 것으로 나타났다. 연구대상자들의 24.7%는 임신 전 아들을 낳기 위한 노력은 한 경험이 있다고 응답하였으며 12.2%는 태아의 선별적 인공유산을 통하여 아들을 낳기 위한 노력을 시도한 경험이 있는 것으로 밝혀졌다. 로지스틱 회귀분석 결과에 따르면 여성에 대한 성차별, 아들선호의식, 자녀 가운데 아들이 없는 경우, 인공임신중절수술 및 연령 등의 요인들이 조사대상자들의 아들을 낳기 위한 노력에 통계적으로 유의미한 영향을 미치는 것으로 밝혀졌다. 이러한 결과로 미루어 보아 대구지역의 출생시 성비가 다른 지역보다 높은 이유는 아들을 선호하고 여성을 차별하는 의식의 기반이 되었던 과거 농경 중심사회의 오랜 전통이 상대적으로 많이 남아있는 보수적인 성향의 결과라 할 수 있다. 뿐만 아니라 이러한 성향이 소자녀관으로 변화된 현대에 있어도 아들 하나는 꼭 낳아야겠다는 강한 집념이 현대 의료기기의 발달 및 보급과 의료인들의 영리추구와 이해관계가 부합됨으로써 생겨난 결과로 볼 수 있다. 시설입소의 인종간 차이를 통제할 때 소수인종노인이 백인노인보다 쉽게 자녀동거에서 단독거주로 이행하는데 이는 소수인종에서 가족부양체계가 불안정함을 의미한다. 또한 빈곤시에 소수인종 노인은 백인노인에 비하여 쉽게 자녀와 떨어져 살게 된다. 이러한 결과는 소수인종 노인에 대한 가족의 지원은 그 가족의 경제적 제약속에서 매우 안정적이지 못함을 시사한다. 못함을 시사한다.로 판단된다.(가솔린, 등유, 경유)로 회수 가능하였다..01 (n=10), 4세포기배는 1.05$\pm$0.09 (n=10)를 나타냄으로써 수정란의 단계마다 $E_2$의 반응 결과가 차이가 남을 알 수 있었다. 4. $E_2$농도 곡선에서 PMSG 처리 후 $E_2$의 혈중농도는 계속적인 상승을 보이다가 배란시기에 최고치를 나타내었으며, 배란 후 다시 감소하여 8세포기에서는 급격한 감소현상이 나타났다. 이후 다시 상실기를 거쳐 배반포기 임신기간동안 $E_2$의 농도가 상승하였다. 5. $E_2$처리 후 세포내 $Ca^{2+}$ 농도변화의 결과로, $E_2$를 처리하지 않은 난자들의 세포내 $Ca^{2+}$ 농도는 836.4$\pm$131.2 (n=10), $E_2$를 처리한 난자들은 1736.4$\pm$192.0 (n=10)로써 유의한 (P<0.05) 차이를 보였다. 이상의 결과로부터 $E_2$처리에 의한 세포내

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The Analysis of Raw Data of Completion of Off-Line Continuing Education in Nursing in Seoul, 2008-2012 (서울지역 간호사 보수교육 실시 분석 -오프라인교육 중심으로-)

  • Go, Jeong-Hee;Han, Mi-Ra;Hu, Jung
    • Journal of Digital Convergence
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    • v.12 no.6
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    • pp.527-538
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    • 2014
  • The purpose of this paper was to analyze the Data of Continuing Nursing Education(CNE) in Seoul from 2008 to 2012. The subjects were collected from the data of Seoul Nurses Association. Descriptive statics, t-test, ANOVA were performed using SPSS 12.0 program for a total of 165,759 subjects' data. The number of continuing education recipients increased about 28% by the year of 2012. Over 50% of subjects worked at advanced hospitals and about 80% of subjects received education in self-developed program type. According to years since licensed, more than half(55.5%) of the subjects were under 7 years since licensed, followed by 4-6years since licensed(18.5%), 2-3years since licensed(16.2%), and 1year since licensed(9.7%). This study showed significant differences in contents, continuing education programs, workplace, type of continuing education. The findings of this study will contribute to identifying current trends of continuing education for nurses and provide fundamental data for developing continuing nurses education.

A study on the change of complication incidence rate according to introduction of quality evaluation by the DRG payment -focussing on patients with lens surgery (질병군 포괄수가 적정성 평가 도입에 따른 합병증 발생률 변화에 대한 연구 -수정체 수술 환자를 대상으로)

  • Kim, Myoung-Ok;Park, Arma;Lee, Chong Hyung;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.9 no.6
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    • pp.99-106
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    • 2018
  • The purpose of this study is to investigate incidence rates of complications in response to the introduction of quality evaluation of the DRG(diagnosis related group) payments, focusing on an increasing number of patients with lens surgery as the population aging increases.Fourthly, there were three dependent variables ('vitreous prolapse', 'IOP elevations', and 'other complications') in this study, and therefore multivariate logistic regression was performed. The result of the analysis indicates that as the number of hospitalized days increased, vitreous prolapse decreased to 0.27 times(95% CI 0.08~1.00) and IOP elevation decreased by 0.14 times(95% CI 0.03~1.59), compared to other complications, and this was statistically significant. From the above results, this study is meaningful in that it has compared the evaluation results of the appropriateness of DRG payment and the medical quality for lens surgery complications patients, in response to the introduction of quality evaluation by DRG payment.