• Title/Summary/Keyword: 진료량

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Comparison of Health Care Utilization and Morbidity of Children With and Without Disabilities in Korea (장애아동과 비장애아동의 의료이용 및 질병특성 비교)

  • Kim, Eu-Gene;Kim, Kyung-Mee;Yoo, Dong-Chul
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.696-706
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    • 2017
  • This study is to examine health care utilization and morbidity of disabled and non-disabled children in Korea to evaluate the health disparities. We used medical claim data of 2010 from the National Health Insurance Service-National Sample Cohort data. As a result of the analysis, the disabled children are not in good health condition because they have more frequency of medical service use, hospitalization rate, and more number of diseases and spent more on medical expenses than non-disabled children. Patterns of the most frequent disease differ from significantly between disable and non-disabled. Disabled children had a higher prevalence of selected birth defects and selected health conditions associated with physical disability and a lower prevalence of selected infection disease than children without disability. In conclusion, Health policy changes that would extend the access to health service for children with disabilities characterized by frequent medical care, hospitalization, excessive medical expenditure and complex diseases.

THE NITROUS OXIDE CONCENTRATION IN BREATHING ZONE ACCORDING TO SCAVENGING METHODS DURING DEEP SEDATION OF PEDIATRIC DENTAL PATIENTS (소아치과 환자의 깊은 진정시 호기가스 제거 방법에 따른 호흡대역에서 Nitrous Oxide 농도 변화)

  • Lee, Chung-Won;Yoon, Hyung-Bae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.30 no.1
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    • pp.124-131
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    • 2003
  • The concentration of nitrous oxide in dental environment has increased especially in pediatric department. In pediatric department frequently met the behavior disordered patients who need the deep sedation. As the deeply sedated patients could not respond well to verbal command, the amount of mouth breathing would be increased especially with mouth prop which backward transposition of mandible. Inhalation of low concentration of nitrous oxide for a long duration has caused various side effects such as spontaneous abortion and inhibition of methionine synthetase activity which is harmful to DNA synthesis. For evaluation of factors of mouth breathing during deep sedation. The author measured the concentration of nitrous oxide in breathing zone by the change of the scavenging methods. One is drain the gas through the tail part of reservoir bag of Jackson Ree's system naturally. Another is scavenge from tail portion of reservoir bag with negative pressure. Last one is scavenge from nasal mask with negative pressure. The nitrous oxide concentration in breathing zone was the lowest in nasal part drainage but high above the recommended concentration of NIOSH. The order of nitrous concentration in breathing zone was: natural drainage, tail part with negative pressure, nasal part with negative pressure. This would reflect the order of resistance of nasal airway and showed the amount of mouth breathing. From the above experiment, the resistance of nasal airway by the increment of gas flow in corrugating tube and reservoir bag would be one of the causative factors of mouth breathing in deeply sedated patients.

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A Clinical Analysis of Intussusception by Non-operative Management (비수술적 처치가 시행된 장중첩증의 임상적 고찰)

  • Han, Dong-Hyun;Jeong, Gi-Lyang
    • Journal of the Korean Society of Radiology
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    • v.1 no.2
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    • pp.5-11
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    • 2007
  • Intussusception is one of the most common cause of bowel obstruction in infant under the two years old, especially in male. Clinical analysis was enrolled on 54 intussusception cases who were diagnosed by ultrasound and treated by non-operative reduction at the Presbyterian Medical Center from June 2005 to May 2007. The results were as follow. 1) There was the most common(40.7%)between thirteen and twenty four months on the distribution of age. Male(72.2%) and female(27.8%) were in the ratio of 2.6:1 on the distribution of gender 2) The frequent symptoms were abdominal pain with grizzle(100.0%), vomiting(66.7%) and diarrhea(33.3%). There was a significant difference among them(p<0.05). There was the most common(46.3%) between 10,000/$mm^3$ and 15,000/$mm^3$ in the result of WBC. 3) 42.6% of patient at a private hospital performed primary care. The treatment after initiating the symptom of intussusception was performed between 6 hrs and 12hrs (37.0%). 4) The most common type and portion of intussusception were ileo-colon(98.1%) and hepatic flexure (68.5%). 5) 88.0% at air reduction and 86.2% at barium reduction were successful. The reduction rate were similar to both techniques. There was no significant difference between them(p>0.05).

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Effects of Price Discount on the Demand and Revenue of Oriental Medical Clinic (한방의료의 가격인하전략이 한방의료에 대한 수요와 경영수지에 미치는 영향)

  • Kim, Jin-Hyeon;;Park, Yeong-U
    • The Journal of Korean Medicine
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    • v.17 no.2 s.32
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    • pp.34-47
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    • 1996
  • We have seen a sharp increase in the utilization rate of medical services since the launch of Nation Health Insurance system in 1989. However, the market share of oriental medicine in the Korean health sector has been gradually diminished mainly due to low insurance coverage and high price. Especially high price as an entry barrier to oriental medical services has played a major role in decreasing market share. This paper investigated the effects of price discount on the financial condition and market share of oriental medical institutions. Microeconomic theory and multiple regression analysis were used as a methodology in testing the alternative hypothesis: price discount of enveloped herb drug will result in increases in both the revenue and market share of oriental medical institutions. Data was collected from the statistical yearbook and sample survey. The price elasticity of demand for enveloped herb drug was estimated at 5.8 during 1987-1995 period, which means that a 1% decrease in price will bring about a 5.8% increase in the utilization of oriental medical services. The empirical result shows that a drastic price discount for the enveloped herb drug will eventually improve the financial status of the oriental medical institutions and enlarge the market share of oriental medicine in the Korean health care sector.

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Telepointing for Synchronous Co-Authoring and Presentation (동기적 공동저작 및 프리젠테이션을 위한 텔리포인팅)

  • 전재우;오삼권
    • Proceedings of the Korean Information Science Society Conference
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    • 1998.10c
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    • pp.279-281
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    • 1998
  • CSCW는 지리적으로 분산된 작업자 간의 효율적인 의사소통을 위해 화상회의, 채팅(chatting), 화이트 보드(white board), 그리고 텔리포인팅(telepointing)과 같은 기능들을 제공한다. 이 중 텔리포인팅은 지역 시스템(local system)의 공유 윈도우(shard window)에서 텔리포인터(telepointer)를 통해 발생한 이벤트를 원격지 시스템(remote System)의 공유 윈도우에서 나타낼 수 있도록 하는 기능을 제공함으로써 작업자 간의 보다 효율적인 의사소통을 가능하게 한다. 이러한 의사소통 기능으로써의 텔리포인팅은 원격진료, 공동작업 플랫폼에 관한 연구에서 응용된 바 있으나 공동저작을 위한 텔리포인팅 기능에 관한 연구 및 이를 공동저작 관리 시스템 구조에 관한 연구가 미흡하다. 공동제작에서의 텔리포인팅은 저작자 간의 의사소통을 위한 기능 뿐만 아니라 동기적 공동저작과 동기적 프리젠테이션을 위한 기능으로써 응용될 수 있어야 한다. 이를 위해 공동저작 관리 시스템은 저작자 그룹인 세션(session) 단위로 텔리포인터에 대한 권한 관리와 텔리포인팅을 통한 공유객체 엑세스(access) 기능을 제공해야 한다. 또한 텔리포인팅 구조(telepointing architecture)는 텔리포인팅 이벤트의 멀티캐스팅(multicasting) 및 동기화(synchronization)를 위해 중앙에서 이벤트를 조정하는 텔리포인팅 조정 에이전트 (telepointing coordination agent)와 각 저작자의 지역 시스템에 존재하며 공유 윈도우로부터 지역 이벤트(local event)를 인식하고 텔리포인팅 이벤트를 공유 윈도우에 알리는 텔리포인팅 지역 에이전트(telepointing local agent)로 구성되어야 한다. 본 논문은 공동저작을 위한 텔리포인팅의 기능들과 이를 위한 공동저작 관리 시스템 구조를 설명하고 텔리포인팅 구조를 제시한다.cid 함량이 가장 많이 용출된 분획은 sodium hydroxide 부분으로서 hemicellulose구조가 polyuronic acid의 형태인 것으로 사료된다. 추출획분의 구성단당은 여러 곡물연구의 보고와 유사하게 glucose, arabinose, xylose 함량이 대체로 높게 나타났다. 점미가 수가용성분에서 goucose대비 용출함량이 고르게 나타나는 경향을 보였고 흑미는 알칼리가용분에서 glucose가 상당량(0.68%) 포함되고 있음을 보여주었고 arabinose(0.68%), xylose(0.05%)도 다른 종류에 비해서 다량 함유한 것으로 나타났다. 흑미는 총식이섬유 함량이 높고 pectic substances, hemicellulose, uronic acid 함량이 높아서 콜레스테롤 저하 등의 효과가 기대되며 고섬유식품으로서 조리 특성 연구가 필요한 것으로 사료된다.리하였다. 얻어진 소견(所見)은 다음과 같았다. 1. 모년령(母年齡), 임신회수(姙娠回數), 임신기간(姙娠其間), 출산시체중등(出産時體重等)의 제요인(諸要因)은 주산기사망(周産基死亡)에 대(對)하여 통계적(統計的)으로 유의(有意)한 영향을 미치고 있어 $25{\sim}29$세(歲)의 연령군에서, 2번째 임신과 2번째의 출산에서 그리고 만삭의 임신 기간에, 출산시체중(出産時體重) $3.50{\sim}3.99kg$사이의 아이에서 그 주산기사망률(周産基死亡率)이 각각 가장 낮았다. 2. 사산(死産)과 초생아사망(初生兒死亡)을 구분(區分)하여 고려해 볼때 사산(死産)은 모성(母性)의 임신력(姙娠歷)과 매우 밀접한 관련이 있는 것으로 사료(思料)되었고 초생아사망(初生兒死亡)은 미숙아(未熟兒)와 이에 관련된 병발이 거의 결정적(決定的) 원인(原因)이 된다고 사료(思料)되었다. 3. 주산기사망률(周産基死亡率)을 감소시키는 관점(觀點)에서의 모자보건사업(母子保健事業)은 미숙아방지책(未熟兒防止策

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Comparative Study for Basic Protocol of High Dose Ablation Therapy (고용량 방사성옥소 치료의 기본 Protocol 비교)

  • Moon, Jae-Seung;Jeong, Hee-Il;Lee, Chi-Young
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.147-156
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    • 2008
  • Purpose: All acts which are enforced from the radioactive iodine therapeutic team is a in its own way principle and provision. Therefore unification of all acts can not be appropriately. We will make the standard coherence. Materials & Methods: From 5 November, 2007 to 17 November 2007, we conducted a questionnaire survey of the nuclear medicine manager of 30 hospitals. The contents of a questionnaire is medical treatment section, patient management, prosecuting attorney section, waste management and safety supervision in about the patient and a questionnaire was drawn up in the method which selects an item. Results: 30 hospital agencies are operating purely for I-131 high dose ablation therapy. Diagnostic study and daily schedule had the difference of some. The most of education for the patients took charge of doctor and nurse. The satisfaction of education was evaluated as the high thing. The safety supervision of waste management accomplishment and Safety supervision the patient and the worker observed on the basis of atomic energy law. Conclusion: Specific standards with sufficient amount of information and practical contents should have been presented through the following data. However, it seems to be lacking in many aspects. Nevertheless, respondents rated 70.9%, which is relatively high, on the value of clinical utilization, and I am very thankful for the evaluation. For many years from now, it may seem necessary for a lot of research on the specific matters based on these data to be conducted.

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Is the Utilization of MID Services affected by the Implementation of Insurance Coverage?: Based on Claim Data of a General Hospital (MRI 보험급여 적용이 진료이용량에 미치는 영향 : 한 종합병원의 청구자료를 중심으로)

  • Kim, Seon-Hee;Kim, Chun-Bae;Cho, Kyung-Hee;Kang, Im-Ok
    • Health Policy and Management
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    • v.18 no.2
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    • pp.1-18
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    • 2008
  • As medical insurance had been implemented for Magnetic Resonance Imaging (MRI) from January 1, 2005, this study investigated whether there had been any change in the amount of the medical care utilization of patients who undertook MRI before and after the insurance coverage, and was to examine factors affecting the amount of medical care utilization of MRI. Data were collected from patients who undertook MRI before and after the insurance coverage for a year at a general hospital in Kyeanggi-do. $X^2$ and t-test were used for the analysis of their general characteristics, the number of MRI, and its medical costs before and after the insurance coverage, and hierarchical multiple regression analysis for the factors affecting the amount of the medical care utilization of MRI. The results of this study were as follows. First, the number of MRI after the insurance coverage was significantly decreased. Second, there was no significant difference in the total medical costs of MRI after the insurance coverage, but a significant difference was found in patient's share of medical costs. Third, six variables were found to be affecting the amount of the medical care utilization of MRI, and the variables showed to lead the number of MRI decrease after the insurance coverage. These six factors explained 21.4% of the total number of MRI. As MRI had been covered by insurance, the use of MRI and patient's share of the costs were deceased, but the total medical costs were not affected. Reasons for that could be found in that MRI insurance, different from the case of CT insurance coverage, was allowed not to cover some items and the kinds of diseases subjected to the insurance coverage were extremely limited, lowering insurance prescription rate. In addition to that, the average medical cost of MRI was not changed after the insurance coverage. Therefore, as future measures for the MRI insurance, coverage, it should be considered to allow insurance coverage to no coverage items and to expand the scope of benefit coverage, or to lower patient's share of the costs. Furthermore, researches should be done to explore how recipients will act and how suppliers will react if the coverage is expanded, including expanding the scope of coverage and reducing patient's share of the costs, as well as to conduct research on its economic analysis according to case mix.

The Relationship between Life Style and Periodontal Health Status (생활습관과 치주건강상태의 관련성)

  • Ryu, Hae-Gyum;Lee, Jung-Hwa
    • Journal of dental hygiene science
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    • v.13 no.4
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    • pp.418-425
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    • 2013
  • This study was investigated in order to provide basic data for prevention of periodontal disease and maintenance through proper lifestyle by finding the relevance of periodontal health with lifestyle habits. Data were collected from total of 326 subjects in their forties and fifties by using questionnaire and examination of periodontal health status. Results were analyzed by using IBM SPSS Statistics 19.0. The smoking status were statistically significant to gingival index (p<0.01), pocket depth (p<0.001), and clinical attachment loss (p<0.001). Smoking amount per day were statistically significant to gingival index (p<0.05), pocket depth (p<0.01), and clinical attachment loss (p<0.001). Duration of smoking were statistically significant to gingival index (p<0.05), pocket depth (p<0.01), and clinical attachment loss (p<0.001). Drinking cycle were statistically significant to gingival index (p<0.05), and clinical attachment loss (p<0.05). It is investigated that smoking (p<0.05) influence on clinical attachment loss. Dental care institute needs to make patients be aware of the fact that excessive smoking and drinking affect the periodontal health status for prevention of periodontal disease and maintenance of oral health. Therefore systematic educational programs to stop smoking and drinking should be prepared.

Design and Implementation of a Real-time Bio-signal Obtaining, Transmitting, Compressing and Storing System for Telemedicine (원격 진료를 위한 실시간 생체 신호 취득, 전송 및 압축, 저장 시스템의 설계 및 구현)

  • Jung, In-Kyo;Kim, Young-Joon;Park, In-Su;Lee, In-Sung
    • Journal of the Institute of Electronics Engineers of Korea SC
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    • v.45 no.4
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    • pp.42-50
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    • 2008
  • The real-time bio-signal monitoring system based on the ZigBee and SIP/RTP has proposed and implemented for telemedicine but that has some problems at the stabilities to transmit bio-signal from the sensors to the other sides. In this paper, we designed and implemented a real-time bio-signal monitoring system that is focused on the reliability and efficiency for transmitting bio-signal at real-time. We designed the system to have enhanced architecture and performance in the ubiquitous sensor network, SIP/RTP real-time transmission and management of the database. The Bluetooth network is combined with ZigBee network to distribute traffic of the ECG and the other bio-signal. The modified and multiplied RTP session is used to ensure real-time transmission of ECG, other bio-signals and speech information on the internet. The modified ECG compression method based on DWLT and MSVQ is used to reduce data rate for storing ECG to the database. Finally we implemented a system that has improved performance for transmitting bio-signal from the sensors to the monitoring console and database. This implemented system makes possible to make various applications to serve U-health care services.

A Study on Developing an Objective Evaluation Method of the Signs and Symptoms of Temporomandibular Joint Internal Derangement (악관절내장증의 증상과 징후의 객관적 평가법의 개발에 관한 연구)

  • 김영구;이승우;정성창
    • Journal of Oral Medicine and Pain
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    • v.22 no.1
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    • pp.31-44
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    • 1997
  • 저자들은 악관절내장증의 증상과 징후의 객관적 평가법을 개발하기 위하여 서울대학교치과 병원 구강진단과 악안면동통진료실을 내원한 환자중 좌우 양 관절중 한 관절 이상의 관절에 악관절내장이 있는 남자 8명(평균연령 19.9$\pm$2.9세), 여자 34명(평균연령:32.8$\pm$11.8세) 총 42명(84개 관절)에 대하여 VAS 및 압통역치 측정, 악관절조영술, 골신티그래피 검사 및 악관절 활액의 분석을 시행하였다. 악관절 동통의 심도는 VAS로 측정을 하였으며 PPT는 electronic algometer로 평가를 하였다. 악관절조영사진을 얻기 직전 활액을 채취하였으며 그 성분중 Hyaluronic acid, 총단백질, IgG, IgM과 albumin을 분석하여 그 상관관계를 분석한 결과 다음과 같은 결론을 얻었다. 1. 악관절 내장증으로 내원한 환자 42명, 총 84개 관절중, 무통성이고 관절잡음이 없는 경우가 7개 관절, 무통성이고 단순관절음만 존재하는 경우가 18개 관절, 동통 및 단순관절음이 존재하는 경우가 18개 관절, 간헐적인 폐구 과두걸림이 있는 경우가 11개 관절, 급성 폐구성 과두걸림의 경우가 11개 관절, 만성 폐구성 과두걸림의 경우가 3개 관절, 퇴행성 관절질환이 존재하는 경우가 16개 관절이었다. 2. 연구대상중 18명의 환자, 총 36개 관절에 대한 골 신티그래피 검사 결과, 활동성으로 나타난 경우가 33개 관절이었고 이중 23개 관절이 동통성이었으며, 활동 상태 관절의 VAS 항목과 압통역치 항목 및 여러 검사 항목들은 비활동 상태 관절의 항목과 유의한 차이를 나타내지 않았다. 3. 악관절내장의 진행정도에 따른 악관절부위의 동통의 측정에 있어서는 압통역치의 측정보다는 VAS에 의한 방법이 더 유용하며 특히, 후방부의 촉진시에 유의한 정보를 얻을 수 있었다. 4. 악관절 내장즈으이 진행 단계에 따라, VAS항목과 압통역치 항목을 비교해 본 결고, 주기적인 과두걸림(II) 단계에서 가장 높은 VAS 수치와 가장 낮은 압통역치를 나타내었으며 상방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계와 증상 및 징후가 없는(0) 단계 사이와 후방 촉진시 VAS 항목에서 주기적인 과두걸림(II) 단계 및 퇴행성 관절 질환(V) 단계와 증상 및 징후가 없는(0) 단계 사이에서만 유의성을 나타내었다. 5. 활액내 총단백질량, albumin 량, IgG 및 IgM 농도는 악과?ㄹ 내장증의 진행에 따라 유의성을 나타내지는 않았으나 퇴행성 관절 질환(V) 단계에서 증가되는 양상을 나타내었다. 6. 활액내 hyaluronic acid의 농도는 악관절 내장증의 진행에 따라 유의성을 나타내지는 않았으나 만성 폐구성 과두걸림(IV) 단계에서 감소되는 양상을 나타내었다.

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