• Journal of Biomedical Engineering Research
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• v.20 no.1
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• pp.75-80
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• 1999

Since a Holter monitor records a patients' ECG when he is in motion, it can monitor complex heart disease effectively. But it can not handle a sudden heart disease because the diagnosis process will be done only after 24 hours. So in this study, a model of ambulatory monitoring system using wireless data communication network is proposed. And a mobile ECG equipment and a doctors' terminal are developed for the proposed system implementation. As a result, we can evaluate that the proposed ambulatory monitoring system is suitable for the management of ambulatory patients who may be at risk form sudden cardiac abnormalities.

• Health Policy and Management
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• v.16 no.1
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• pp.17-40
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• 2006

With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

• Journal of The Korea Institute of Healthcare Architecture
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• v.1 no.2
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• pp.7-16
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• 1996

As surgical technologies advanced, ambulatory surgery was proposed for reduction hospital stay and patient-oriented health care delivery system. And in recent years, ambulatory surgery is also introduced in this country as medical demands expands. This study aims to represent the standards for architectural planning of the ambulatory surgery center in a general hospital according to domestic situations. For this, the present conditions and space programs of 5 general hospitals were investigated and analyzed. This study also aims to represent the unit area proposal of each departmental operation room and the methodology for deciding the number of the operation threatres in Ambulatory Surgery Center.

• Journal of Sensor Science and Technology
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• v.19 no.4
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• pp.278-284
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• 2010

Indoor localization for pedestrian is the key technology for caring the elderly, the visually impaired and the handicapped in health care districts. It also becomes essential for the emergency responders where the GPS signal is not available. This paper presents newly developed pedestrian localization system using the gyro sensors, the magnetic compass and pressure sensors. Instead of using the accelerometer, the pedestrian gait is estimated from the gyro sensor measurements and the travel distance is estimated based on the gait kinematics. Fusing the gyro information and the magnetic compass information for heading angle estimation is presented with the error covariance analysis. A pressure sensor is used to identify the floor the pedestrian is walking on. A complete ambulatory system is implemented which estimates the pedestrian's 3D position and the heading.

• Proceedings of the KOSOMBE Conference
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• v.1997 no.05
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• pp.330-333
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• 1997

In this paper, we designed a low power and small-sized, light weighted intelligent ambulatory monitoring system using a flash memory card. The system's hardware specifications are as follows: 2 channels, 8bit/250Hz sampling rate, 20M byte storage capacity, a single-chip microcontroller (68HC11E9). To easily interface with PC based system, FFS(Flash File System) was used. We obtained the QRS detection rate of 99.14 through the evaluation with MIT/BIH database.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.58 no.3
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• pp.645-654
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• 2009

In this study, we present an efficient ambulatory speech audiometric system to detect one's hearing problems at an earlier stage as possible without his or her visit to the audiometric testing facility such in a hospital or a clinic. To estimate a person's hearing threshold level in terms of speech sound response in his or her local environment, a digital assistant(PDA) device is used to generate the speech sound with implementing audiometric Graphic User Interface(GUI) system. Furthermore, a supra-aural earphone is used to measure a subject's hearing threshold level in terms of speech sound by the compensating the transducer's gain by adopting speech sound calibration system.

• Journal of Biomedical Engineering Research
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• v.12 no.4
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• pp.277-284
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• 1991

This study describes the ambulatory ECG monitoring system for the remote autom atic diagnosis. System: tlardware is based on one chip microcomputer(80c31) and its peripherals which consists of A/D, EPROM, RAM, LCD display and two preamplifiers, Power circuits, control logic circuits. A/D converted data were differentiated and low pass filtered. The detection of QRS complex and R point were accomplished by software algorithm based on adaptive threshold computed on low pass fi:leered signal. Rhythm analysis is performed by RR interval and average RR interval. The performance of QRS detection algorithm is evaluated by using MIT/BIH data base. Using this system, the trends of the arrythmia during the long term could be saved and displayed.

• Health Policy and Management
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• v.13 no.1
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• pp.98-115
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• 2003

Concerns about growing health insurance expenditures became a national Issue in 2001 when the National Health Insurance went into a deficit. Increases in spending for ambulatory care shared the largest portion of the problem. Methods and systems to control the spending should be developed and a system to measure case mix of providers is one of core components of the control system. The objectives of this article is to examine the feasibility of applying Korean Diagnosis Related Groups (KDRGs) to classify health insurance claims for ambulatory care and to identify problem areas of the classification. A database of 11,586,270 claims for ambulatory care delivered during January 2002 was obtained for the study, and the final number of claims analyzed was 8,319,494 after KDRG numbers were assigned to the data and records with an error KDRG were excluded from the study. The unit of analysis was a claim and resource use was measured by the sum of charges incurred during a month at a department of a hospital of at a clinic. Within group variance was assessed by th coefficient of variation (CV), and the classification accuracy was evaluated by the variance reduction achieved by the KDRG classification. The analyses were performed on both all and non-outlier data, and on a subset of the database to examine the validity of study results. Data were assigned to 787 KDRGs among 1,244 KDRGs defined in the classification system. For non-outlier data, 77.4％ of KDRGs had a CV of charges from tertiary care hospitals less than 100％ and 95.43％ of KDRGs for data from clinics. The variance reduction achieved by the KDRG classification was 40.80％ for non-outlier claims from tertiary care hospitals, 51.98％ for general hospitals, 40.89% for hospitals, and 54.99% for clinics. Similar results were obtained from the analyses performed on a subset of the study database. The study results indicated that KDRGs developed for a classification of inpatient care could be used for ambulatory care, although there were areas where the classification should be refined. Its power to predict tile resource utilization showed a potential for its application to measure case mix of providers for monitoring and managing delivery of ambulatory care. The issue concerning the quality of diagnostic information contained in insurance claims remains to be improved, and significance of future studies for other classification systems based on visits or episodes is guaranteed.

• Journal of Preventive Medicine and Public Health
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• v.48 no.4
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• pp.188-194
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• 2015

Objectives: The goal of this study was to identify association between the continuity of ambulatory care of diabetes patients in South Korea (hereafter Korea) and the incidence of macrovascular complications of diabetes, using claims data compiled by the National Health Insurance Services of Korea. Methods: This study was conducted retrospectively. The subjects of the study were 43 002 patients diagnosed with diabetes in 2007, who were over 30 years of age, and had insurance claim data from 2008. The macrovascular complications of diabetes mellitus were limited to ischemic heart disease and ischemic stroke. We compared the characteristics of the patients in whom macrovascular complications occurred from 2009 to 2012 to the characteristics of the patients who had no such complications. Multiple logistic regression was used to assess the effects of continuity of ambulatory care on diabetic macrovascular complications. The continuity of ambulatory diabetes care was estimated by metrics such as the medication possession ratio, the quarterly continuity of care and the number of clinics that were visited. Results: Patients with macrovascular complications showed statistically significant differences regarding sex, age, comorbidities, hypertension, dyslipidemia and continuity of ambulatory diabetes care. Visiting a lower number of clinics reduced the odds ratio for macrovascular complications of diabetes. A medication possession ratio below 80% was associated with an increased odds ratio for macrovascular complications, but this result was of borderline statistical significance. Conclusions: Diabetes care by regular health care providers was found to be associated with a lower occurrence of diabetic macrovascular complications. This result has policy implications for the Korean health care system, in which the delivery system does not work properly.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.2
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• pp.309-321
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• 2002

Purpose: A cost analysis for nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing unit was performed using patient classification system by nursing intensity in order to determine an appropriate nursing fee schedule. Method: The data were collected from 4 secondary hospitals and 5 tertiary hospitals from November 14th 2000 to January 15th 2001. The study was conducted through four phases as follows: 1) Nursing hours of each nursing service in special nursing units were measured using three kinds of patient classification systems by nursing intensity. 2) The nursing cost of nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing units was estimated based on patient classification system by nursing intensity. Results: As a result, nursing hours by nursing intensity of each special nursing unit were measured, and every nursing cost by nursing intensity in operation room and emergency room was estimated, meanwhile, the cost of nursing services in ambulatory care units was estimated only per visit as shown in chapter 4. Conclusion: Future research on nursing cost should be extended to other special nursing units such as various intensive nursing care units, delivery room, and so on. In addition, the patient classification system should be refined for its appropriateness to apply all levels of medical institutions.