• Title/Summary/Keyword: 진료량

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Underweight Related Factors in School-Aged Children in Daegu (대구지역 초등학생의 저체중 현황파악 및 관련요인 분석)

  • Yun, Young-Hee;Park, Kyong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.42 no.10
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    • pp.1592-1599
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    • 2013
  • Despite numerous studies regarding overweight or obese children, only a limited number of studies have investigated the effect of underweight. The purpose of this study is to investigate the determinants of underweight among school-aged children. A total of 493 students (86 underweight and 407 normal weight students) aged 11 to 13 years were included in our study. Socio-demographic characteristics, eating habits, health information, self-perception of weight, weight-control efforts and birth-related information were collected by using survey questionnaires for children and parents. Dietary information was obtained by two 24-hour food records, which were completed by both children and their parents. The prevalence of underweight was significantly higher in girls than boys, and the frequency of medical treatment and flu symptoms were higher in underweight children than normal ones. Overall, girls tended to overestimate their own weight; this misclassification was greater among underweight girls. Birthweight was positively correlated with current weight (P<0.05) and height (P<0.01) in girls, but these correlations were not seen in boys. In conclusion, underweight girls had inappropriate self-perception of weight, and underweight in girls may be related with birthweight and inadequate dietary intakes. Therefore, it is important to build a well-designed framework that integrates efforts of home, school, and community to maintain a healthy weight with balanced diet and exercise throughout the lifetime.

Financial Impact of Off-Pump Coronary Artery Bypass (체외순환 없이 시행하는 관상동맥우회술의 경제성 분석)

  • Lim, Cheong;Chang, Woo-Ik;Kim, Ki-Bong;Kim, Yoon
    • Journal of Chest Surgery
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    • v.35 no.5
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    • pp.365-368
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    • 2002
  • Background: Coronary artery bypass grafting(CABG) imposes large amount of medical costs, which are greatly affected by the surgical approach, quality of perioperative care and associated co-morbidities. Recently, off-pump CABG(OPCAB) has been introduced and performed with increasing frequency. To evaluate the efficacy of OPCAB in view of financial impact, we analyzed the costs and medical resources of OPCAB and compared with conventional CABG. Material and Method: From January 1998 to July 1999, 184 patients underwent CABG operation; 111 patients with OPCAB(group I) and 73 patients with conventional CABG(group II). We prospectively collected clinical data including risk factors and retrospectively reviewed the hospital resources. Result: Preoperative parameters including risk factors, postoperative mortality, morbidity and length of hospital stay were not different between the two groups, Duration of stay in the intensive care unit(ICU) (51.3 vs 128.3 hours, p<0.01) and ventilator, support time(14.9 vs 56.2 hours, p<0.01) were significantly shorter in the OPCAB group. Total hospital coats were 17,220,000 add 21,250,000(Korean Won) in group I and II, respectively(p<0.01). There were significant differences in operation fee, costs for operative materials, transfusion and diagnostic radiology between two groups. In group I, all the resources except diagnostic radiology were significantly decreased compared with group II. Conclusion: OPCAB has a beneficial effect on hospital charge and resource utilization. Shorter duration of the ICU stay and ventilatory support time may reduce the total hospital costs.

RETROSPECTIVE STUDY OF FACE MASK THERAPY (FACE MASK의 치료 효과에 대한 후향적 고찰)

  • Kim, Tae-Woo;Chang, Young-Il;Nahm, Dong-Seok
    • The korean journal of orthodontics
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    • v.26 no.5 s.58
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    • pp.547-556
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    • 1996
  • The purpose of this study was to evaluate the skeletal, dental and soft tissue profile changes following the face mask therapy in growing skeletal class III malocclusion patients. The fifteen patients with the good results were selected among the patients who visited the Department of Orthodontics in Seoul National University Hospital. The mean age was 10.63(range 7.25-13.25) years and the mean treatment duration was 9.84(range 2.00-27.00) months. Lateral cephalograms were taken just before and after face mask application. After tracing the cephalograms, thirty five items(twety angular and fifteen linear) were measured. The differences before and after the face mask therapy were compared statistically by the paired t-test(p<0.05). The results were as follows : SNA and Co-A(effective maxillary length) increased significantly after using the face mask(p<0.001), which reflects the orthopedic changes of maxilla. SNB and Co-Gn(effective mandibular length) also showed an increase(p<0.01), which may be a result of the strong growth trends of the samples. FMA, SN-GoGn and Y-axis angle increased significantly(p<0.01), which means the backward and downward rotation of the mandible. This positional change seemed to have compensated an increase of effective mandibular length. There was no statistically significant difference in angulation of upper and lower incisors between pre-treatment and post-treatment(p>0.05). In soft tissue profile, the upper lip was positioned anteriorly(p<0.01) after treatment and approximated to the normal standards.

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A Study on Reduction Effect of Processing Wastewater by Introduction of PACS (PACS 도입에 의한 현상시스템 폐수 감소효과에 관한 연구)

  • Ko, Shin-Kwan;Han, Dong-Kyoon;Kim, Wook-Dong;Kang, Bung-Sam;Yang, Han-Jun
    • Journal of radiological science and technology
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    • v.30 no.2
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    • pp.167-175
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    • 2007
  • There are some positive effects by the introduction of PACS(Picture Archiving Communication System). This study is to analyze the mutual relation between before and after of the introduction of PACS in terms of the environment effect. It is supposed to cause the reduction of developing and fixing wastewater according to the increase in the rate of a non-film. This study will also show the amount of wastewater. Target places were the department of image medicine(diagnostic radiation) of the general hospitals in Seoul and Gyeonggi-Do, which are equiped with full PACS. The authors examined questionnaires on the number of projection, the number of indirect projection, the amount of the film used, the number of radiation image CD loan, the amount of the developing and fixing solution used, the change of the amount of fixing wastewater. According to the analysis, we analyzed the change of the amount of developing and fixing solution per a film and the change of the amount of developing and fixing wastewater which is supposed to be reduced proportionally by the introduction of PACS. We got conclusion as below after analyzing 8 hospitals except the largest and the least amount of examination, film used, developing and fixing solution and the amount of developing and fixing wastewater in order to decrease the deviation from 10 general hospitals located in Seoul and Gyeonggi-Do. We compared data one year before adopting PACS Versus 3 years after adopting PACS. 1. The frequences of examination increased to 7,357.7 cases per month but the amount of film used decreased to 90%, from 42,774.4 to 4,181.88 after adopting the PACS. 2. 3 years after adopting PACS, monthly average amount of developing solution used decreased to 92% and the monthly average amount of fixing solution decreased to 86%. 3. Monthly average amount of developing solution used per film increased to 1.49 times and fixing solution increased as much as three times. 4. Monthly average wastewater for developing decreased to 88% and wastewater for fixing decreased up to 87%. 5. Monthly average wastewater for developing per film increased to 3.77 times and wastewater for fixing increased to 3.85 times. Although the amount of film used and the amount of developing and fixing wastewater affected by the reduction of the developing and fixing solution became less on the whole by introduction of PACS, they did not decrease proportionally. Moreover the amount of the developing and fixing solution used and the amount of developing and fixing wastewater per a film increased. That means the expectation for an environmental improvement differs from the actual condition.

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Comparison of Blood and Urine Renal Indices Between Hypercalciuric and Non-hypercalciuric Hematuria Patients (혈뇨 환아에서 고칼슘뇨군과 비고칼슘뇨군의 혈액 및 소변화학검사와 신기능 지표들의 비교)

  • Lee, Jin-Hee;Lee, Hyun-Seung;Lee, Keun-Young;Jang, Pil-Sang;Lee, Kyung-Yil;Kim, Dong-Un
    • Childhood Kidney Diseases
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    • v.11 no.2
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    • pp.168-177
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    • 2007
  • Purpose : The purpose of this study was to investigate whether hypercalciuria patients with hematuria show different renal indices compared to non-hypercalciuria patients with hematuria. Methods : We retrospectively reviewed the medical records of patients with gross or microscopic hematuria whose blood chemistry and 24 hour urine chemistry were examined. After excluding the patients with more than $4 mg/m^2/day$ proteinuria or the patients with urinary calcium excretion between 3 and 4 mg/kg/day, we divided the patients into two groups: a hypercalciuria group whose calcium excretion was more than 4 mg/kg/day(n=30) and a non hypercalciuria group whose calcium excretion was less than 3 mg/kg/day(n=41). The urinary excretion, clearance, and fractional excretion(FE) of Na, K, Cl, Ca, P, urea, and creatinine were calculated and compared between the two groups. Results : The hypercalciuria group had more calcium excretion($6.1{\pm}2.9$ vs $1.5{\pm}0.9 mg/kg/day$), more urea excretion($341{\pm}102$ vs $233{\pm}123 mg/kg/day$), greater glomerular filtration rate(GFR) ($93.7{\pm}31.1$ vs $79.5{\pm}32.0 mL/min$) but lower FENa($1.0{\pm}0.4%$ vs $1.3{\pm}0.6%$) than the nonhyper-calciuria group, although the urinary sodium excretion was similar between the two groups. Conclusion : The greater urea excretion and GFR in hypercalciuric patients suggest that they might be on a higher protein diet than the non-hypercalciuria group. The increased glomerular filtration of sodium and calcium induced by the higher GFR in hypercalciuria would have increased their delivery to the distal tubule, where sodium is effectively reabsorbed but calcium is not, which is suggested by the lower FENa but higher FECa in hyercalciuria. It is recommended that the diet of hematuria patients be reviewed in detail at initial presentation and during treatment.

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Clinical and radiographic evaluation of $Neoplan^{(R)}$ implant with a sandblasted and acid-etched surface and external connection (SLA 표면 처리 및 외측 연결형의 국산 임플랜트에 대한 임상적, 방사선학적 평가)

  • An, Hee-Suk;Moon, Hong-Suk;Shim, Jun-Sung;Cho, Kyu-Sung;Lee, Keun-Woo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.2
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    • pp.125-136
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    • 2008
  • Statement of problem: Since the concept of osseointegration in dental implants was introduced by $Br{{\aa}}nemark$ et al, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. Purpose: The aim of this retrospective study was to provide long-term data on the $Neoplan^{(R)}$ implant, which features a sandblasted and acid-etched surface and external connection. Material and methods: 96 $Neoplan^{(R)}$ implants placed in 25 patients in Yonsei University Hospital were examined to determine the effect of the factors on marginal bone loss, through clinical and radiographic results during 18 to 57 month period. Results: 1. Out of a total of 96 implants placed in 25 patients, two fixtures were lost, resulting in 97.9% of cumulative survival rate. 2. Throughout the study period, the survival rates were 96.8% in the maxilla and 98.5% in the mandible. The survival rates were 97.6% in the posterior regions and 100% in the anterior regions. 3. The mean bone loss for the first year after prosthesis placement and the mean annual bone loss after the first year for men were significantly higher than that of women (P<0.05). 4. The group of partial edentulism with no posterior teeth distal to the implant prosthesis showed significantly more bone loss compared to the group of partial edentulism with presence of posterior teeth distal to the implant prosthesis in terms of mean bone loss for the first year and after the first year (P<0.05). 5. The mean annual bone loss after the first year was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. No significant difference in marginal bone loss was found in the following factors: jaws, type of prostheses, type of opposing dentition, and submerged /non-submerged implants (P<0.05). Conclusion: On the basis of these results, the factors influencing marginal bone loss were gender, type of edentulism, and location in the arch, while the factors such as arch, type of prostheses, type of opposing dentition, submerged / non- submerged implants had no significant effect on bone loss. In the present study, the cumulative survival rate of the $Neoplan^{(R)}$ implant with a sandblasted and acid-etched surface was 97.9% up to a maximum 57-month period. Further long-term investigations for this type of implant system and evaluation of other various domestic implant systems are needed in future studies.

The Associated Factors of Health Examinations Behaviors among Some Elderly Persons in Urban and Rural Areas (일부 도시·농촌지역 고령자의 건강검진 수진행동에 관련된 요인)

  • Kim, Yong-Ik;Cho, Young-Chae
    • Journal of agricultural medicine and community health
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    • v.29 no.1
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    • pp.1-14
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    • 2004
  • Objectives: We investigated the factors related to health examination behaviors, sociodemographic aspects and lifestyles of elderly persons with different social backgrounds, and compared sexual and regional differences in urban and rural elderlies. Methods: The total study subjects(464 individuals) from urban(236) and rural areas(228), recruited by a stratified cluster random sampling were interviewed and examined about their sociodemographic profiles, daily lifestyles, subjective health status, conditions concerning use of medical resources, hearing acuity, visual acuity and ADL(activity of daily living), and whether they receive health examination or not. For statistical analysis, Chi-square test was used for sexual and regional comparisons among the groups who have been given a health examination and the one who have not. Results: In urban areas, the rate of having underwent health examination was 54.5% in men and 46.9% in women, and in rural areas, it was 59.8% in men and 42.7% in women, showing its higher rate in men than in women in both areas. For regional differences between the group who have taken a health examination and the one who have not, there was a significant difference in terms of age, family pattern, current job, monthly household income, owning a house, drinking status, eating habit, subjective health status, whether they have taken outpatient medical service for the recent 3 months or not, anxiety for the health, and IADL conditions according to whether the community is rural or urban. In multiple regressions, the influential factors on the health examination behaviors were selected such as having their own house, their family doctor, amnesia, urinary incontinence and chronic disease in urban districts. But in rural districts, the variables were selected such as having or not of their family doctor, urinary incontinence, anxiety for the health, educational level, their own house and chronic disease. Conclusions: It is suggested that the approach to the health examination of an older patient requires substantial consideration of highly variable individual sociodemographic characteristics involving regional attributes as well as their daily life styles, subjective health status, status of performing health examination, physical health status and ADL conditions.

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Levels of Physicians' Self-assessment of Life Satisfaction and Associated Factors (임상의사의 삶의 만족도 자가평가 수준과 관련 요인)

  • Jong Sun Ok;Hyeongsu Kim
    • Journal of agricultural medicine and community health
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    • v.48 no.1
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    • pp.28-40
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    • 2023
  • Objectives: This study aimed to identify the level of self-assessment of life satisfaction and various factors related to the life satisfaction of Korean physicians. Methods: This study is a secondary data analysis using the 2016 Korean physician survey Korean Physician Survey(KPS) data collected by the Research Institute for Healthcare Policy of the Korean Medical Association. The member database(DB) of the Korean Medical Association was used for sampling and the target population was formed and surveyed by using stratified quota sampling. A questionnaire was sent by E-mail as an online survey method and was conducted for a total of 7 weeks from November 21, 2016 to January 8, 2017. The final number of respondents was 8,564 (response rate 13.8%). In this study, a total of 7,228 physicians, excluding residents and public health doctors who are currently treating patients directly, were studied. Factors affecting the life satisfaction of physicians were analyzed using ordinal logistic regression analysis. Results: The physical factors positively related to the life satisfaction of physicians were those who were in their 60s, female, and thought they had good health status. As for psychological factors, stress was low. As for economic factors, satisfaction with income was high. As for social factors, the physicians lived with their families and were satisfied with the time they could spend with them. Also, the physicians were satisfied with the social respect they received as a doctors. Conclusions: Based on the results of this study, it is thought that a multifaceted approach is needed to increase the life satisfaction of physicians.

The Association between Patient Characteristics of Chungnam-do and External Medical Service Use Using Health Insurance Cohort DB 2.0 (건강보험 코호트 자료를 활용한 충청남도 지역 환자의 특성에 따른 관외 의료이용과의 연관성)

  • Yeong Jun Lee;Se Hyeon Myeong;Hyun Woo Moon;Seo Hyun Woo;Sun Jung Kim
    • Health Policy and Management
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    • v.34 no.1
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    • pp.48-58
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    • 2024
  • Background: The purpose of this study was to investigate the association between external medical service use and the characteristics of Chungcheongnam-do patients. We aimed to provide evidence of external medical service use enhance the healthcare delivery system in Chungcheongnam-do. Methods: We used the Health Insurance Cohort DB 2.0 of 2016-2019, and 2,570,439 patients were included in the study. Multivariate logistic regression and multinomial logistic regression were used to identify the association between external medical service use and each patient characteristic. Generalized linear model was used to identify the association between medical costs and external medical service use area. Results: During the study period, 32.2% of inpatients and 12.5% of outpatients had external medical service use in Chungcheongnam-do. In comparison to patients living in Cheonan and Asan, the odds ratio (OR) for external medical services use was higher across all regions. Specifically, hospitalized patients from Gyeryong, Nonsan, and Geumsan (OR, 116.817) and Gongju, Buyeo, and Cheongyang (OR, 72.931) demonstrated extremely high likelihood of external medical service use in the Daejeon area. Furthermore, compared to medical expenses incurred within Chungcheongnam-do, patients with external medical service use in the capitol area (outpatient=17.01%, inpatients=22.11%) and Daejeon area (outpatient=16.63%, inpatients=15.41%) spent more on healthcare services. Conclusion: This study found the evidence of external medical service use among Chungcheongnam-do patients. Further study should be conducted taking into account variables including satisfaction of local medical services, different types of patient diseases, and others. The study's findings may serve as a foundation for policy proposals aimed at ensuring the financial stability of our health insurance system, ensuring the efficient delivery of medical care, and localization of medical care.

Relationship between job satisfaction of dental hygienists and patient safety cultural activities (치과위생사의 직무만족도와 환자안전문화 활동의 관련성)

  • Bo Young Park;Chae-Rin Kang;Yu-gyeong Byun;Eun-Seo Seong;Soo-Young Lee;Ji-Eun Lee;Yu-Jin Ham;Mi Sook Yoon
    • Journal of Korean Dental Hygiene Science
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    • v.6 no.2
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    • pp.115-127
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    • 2023
  • Background: This study was conducted to determine the level of job satisfaction and patient safety cultural activities for dental hygienists and to determine the relationship between job satisfaction and patient safety cultural activities. Methods: A survey was conducted on 214 dental hygienists, and data from the final 180 were analyzed. Job satisfaction consisted of a total of 20 questions, and patient safety cultural activities included a total of 25 questions. The survey was conducted on a 5-point scale. Results: The average job satisfaction score of the study subjects was 3.44 points. Among patient safety cultural activities, infection control had the highest average score (4.12 points) and radiation safety management had the lowest average score (3.10 points). Patients with less than 3 years of clinical experience (4.01 points) had higher patient safety culture activity scores than those with 3 to 10 years of clinical experience (3.72 points) and those with more than 10 years of clinical experience (3.69 points). The level of patient safety cultural activities was statistically significantly higher as age, less clinical experience, and job satisfaction increased (p<0.05). Conclusion: In the case of dental hygienists, patient safety cultural activities must be carried out throughout the entire work, so an active will to practice patient safety cultural activities is necessary. In order to improve the performance of patient safety cultural activities, it is necessary to adjust the workload of dental hygienists to improve job satisfaction and create a work environment in which they can focus on patient safety cultural activities.