• 제목/요약/키워드: Emergency Bed

검색결과 61건 처리시간 0.028초

의무기록자료를 이용한 중증질환자의 재원일수에 미치는 요인 분석 (Analysis of Factors Affecting Length Of Stay for A Serious Patients Using Medical Records)

  • 김석환;이정아
    • 한국학교ㆍ지역보건교육학회지
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    • 제20권2호
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    • pp.69-80
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    • 2019
  • Objectives: In this study, we tried to analyze the factors affecting Length Of Stay for serious patients in Republic of Korea. Methods: The study included 139,172 serious patients in the 2012-2016 discharge details. Using the SPSS 23.0 program, we conducted a rank regression analysis with social and social demographic characteristics as control variables, medical institution characteristics and medical use characteristics as independent variables, and Average Length Of Stay as a dependent variable. Results: Average Length Of Stay for participants was found to be 9.92days. And the location and bed size of medical institutions were not statistically significant, the hospitalization path was more urgent(B=0.43) than the outpatient (p<0.001), and there was no secondary diagnosis(B=0.35). However, Average Length Of Stay was higher (p<0.001) than there was no main surgery(B=0.80). After discharge, Average Length Of Stay for funding(B=0.43) and death(B=0.72) was long (p<0.001). Average Length Of Stay for participants was found to be 9.92days. And the location and the bed size of the medical institution were not statistically significant, and the hospitalization pass had longer Length Of Stay for emergency patients(B=0.43) than for outpatients(p<0.001). There was a longer Length Of Stay(B=0.35) than none was diagnosed. There were longer Length Of Stay(p<0.001) than there was no major surgery(B=0.80). After discharge, the outpatients had longer Average Length Of Stay(B=0.43) and deaths(B=0.72) than those who returned home(p<0.001). Conclusion: As a result of analyzing the factors affecting Average Length Of Stay of the participants, it was confirmed that regardless of the location and bed size of medical institutions, hospitalization route, department diagnosis, main surgery, and whereabouts after discharge. Therefore, appropriate interventions and necessary support must be provided so that efficient Length Of Stay can be managed according to the medical use characteristics of serious patient.

Quasi real-time post-earthquake damage assessment of lifeline systems based on available intensity measure maps

  • Torbol, Marco
    • Smart Structures and Systems
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    • 제16권5호
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    • pp.873-889
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    • 2015
  • In civil engineering, probabilistic seismic risk assessment is used to predict the economic damage to a lifeline system of possible future earthquakes. The results are used to plan mitigation measures and to strengthen the structures where necessary. Instead, after an earthquake public authorities need mathematical models that compute: the damage caused by the earthquake to the individual vulnerable components and links, and the global behavior of the lifeline system. In this study, a framework that was developed and used for prediction purpose is modified to assess the consequences of an earthquake in quasi real-time after such earthquake happened. This is possible because nowadays entire seismic regions are instrumented with tight networks of strong motion stations, which provide and broadcast accurate intensity measure maps of the event to the public within minutes. The framework uses the broadcasted map and calculates the damage to the lifeline system and its component in quasi real-time. The results give the authorities the most likely status of the system. This helps emergency personnel to deal with the damage and to prioritize visual inspections and repairs. A highway transportation network is used as a test bed but any lifeline system can be analyzed.

지상레이저스캐너 성능평가를 위한 테스트베드 구축 방안 (Test-Bed Establishment Scheme for Terrestrial Laser Scanner' Performance Evaluation)

  • 이인수;차득기;김수정;김진
    • Spatial Information Research
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    • 제17권1호
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    • pp.39-49
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    • 2009
  • 3차원 지상레이저스캐너는 짧은 시간에 대상물의 수많은 위치에 대한 고정도의 3차원 좌표를 얻을 수 있는 장비로서 측지분야를 포함하여 토목공학, 고고학 및 건축, 그리고 응급서비스 및 국방 등 다양한 분야에서 널리 응용되고 있다. 그러나 국내에서 이용되는 지상레이저스캐너 장비는 대부분 외국에서 수입되고 있으며, 현재 측량장비로서 공인되지 않은 상태이다. 따라서 지상레이저스캐너를 다양한 분야에서 활용하기 위해서는 장비 검정과 성능평가를 위한 실외 표준 테스트베드가 필요하다. 본 연구에서는 지상레이저스캐너의 테스트베드 구축과 관련하여 국외 사례를 고찰하여 이를 통해 국내 테스트베드 구축 방안을 제시하고자 한다.

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주요 상병 별 환자의 의료기관 선택성향 분석 (An Analysis of the Diseases Specific Medical Service Organization Selection Factors of Patients)

  • 윤경일;도세록
    • 한국병원경영학회지
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    • 제12권4호
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    • pp.1-21
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    • 2007
  • The relaxation of the regulation in selection of medical institution allows patients to use their own judgement in choosing proper institution for their diseases. Since the change of the regulation, there should have been many changes in medical institution selection behavior. The analysis of the change in disease specific selection pattern is critical because there be an optimal selection criteria that ensure the efficient and effective utilization of medical resources. This study analysis the institution selection factors by comparing the choice among the cases of acute diseases, the cases of chronic diseases, inpatient services, outpatient services, and emergency medical service. The comparisons performed in terms of size, class and other characteristics of medical institutions. For the study the nationally surveyed database was used and the data were analyzed using logistic regression procedure. The results indicates that the primary care facilities were not properly utilized. This study speculates that the reason for the undesirable pattern of utilization is that the roles of primary care facilities in the healthcare delivery system was not clearly defined. Based on the results, the medical policy implications are discussed.

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이중화 자동복구 보안기능이 구비된 배전반의 보안성 평가를 위한 테스트베드 구성에 대한 고찰 (An Inquire into Test Bed Compositions in Assessing the Security of a Soft Redundancy Sub-Station System with Auto-Restoration)

  • 최형석;진창기;배기덕
    • 조명전기설비학회논문지
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    • 제26권7호
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    • pp.99-109
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    • 2012
  • Sub-station, key equipment in electric power infrastructure, are being exposed to increasing risk of hacking. For this, soft redundancy sub-station system needs to be formulated with automatic restoration mechanism. For this it is important to assess the reliability of the applicable range of data that are used in actual system operation, as well as the methods and findings of the tests. At the same time performance of soft redundancy system and total security mechanism, which are aligned for the protection of the sub-station, need to be tested. For testing the above-mentioned, this paper presented a viable formation of a soft redundancy practical VPN system within a panel to protect the latter from hacking or cracking incidences, and conducts a test to check if the considered system actually serves the protection function in the actual operation setting, gathering evidence from the data from the testing of the actual performance of the system as well as of emergency scenario simulation operations. Because tested soft-redundancy & restorative sub-station system is expected to be widely applicable for various cases such as Smart-grid or electricity IT system, where VPN with enhanced level of security is required.

피톤치드 흡입이 대학생의 활력징후, 생활 스트레스 및 혈중 코티졸 수치에 미치는 효과 (Effects of Phytoncides Inhalation on Serum Cortisol Level and Life Stress of College Students)

  • 남은숙;엄동춘
    • 성인간호학회지
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    • 제20권5호
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    • pp.697-706
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    • 2008
  • Purpose: The purpose of this study was to identify the effects of the phytoncides on serum cortisol level, vital signs and life stress of college students. Methods: This study was nonequivalent control group non-synchronized design. The subjects consisted of 60(control group: 28, experimental group: 32). The phytoncides mixed the pine(pinus sylvestris) oil with the cypress(cupressus sempervirens) oil in the same rate. In the experiment, it was put in an aroma-necklace bottle and inhaled 3 times per day(9AM, at noon, before going to bed) for 2 weeks. The data were analyzed by the SPSS version 12.0 program. Results: In the experimental group systolic BP(F=15.603, p=.000), diastolic BP(F=29.489, p=.000) and serum cortisol level(F=4.968, p=.000) were significantly decreased. Conclusion: The phytoncides inhalation is a partly help to reduce college students' life stress. The phytoncides is the incense of the familial tree. We recommended to examine what differences between the green shower and the phytoncides inhalation for the stress reduction.

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일개 노인요양병원의 피난안전성능 평가에 관한 연구 (A Study on the Evaluation of Evacuation Safety Function of an Elderly Care Hospital)

  • 김종범;김자옥;백은선
    • 한국화재소방학회논문지
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    • 제24권3호
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    • pp.9-19
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    • 2010
  • 최근 우리나라는 노인요양병원이 꾸준히 증가하고 있으며 화재등과 같은 비상 상황에서 노인의 행동 특성과 신체 상태를 고려한 종합적인 피난계획의 수립이 요구된다. 또한 시설 이용자의 대부분이 중증의 치매 및 뇌졸중을 앓고 있는 환자이기 때문에 자력으로 피난이 곤란하고 환자의 보행상태(침대, 휠체어, 각종 보조기구) 등에 따라 피난시간이 상이하여 이용자 전원을 피난시키는 것이 어렵기 때문이다. 본 논문은 성능위주의 설계 시 참고가 될 자료를 제시하기 위해 의료시설인 노인요양병원을 모델로 여러 수집된 자료들로 Simulex를 이용하여 피난시간을 측정하였다. 이 연구의 과정에서 몇 가지 문제시 되는 사항을 발견할 수 있었다.

발목굽힘 재활운동을 위한 발목재활로봇 개발 (Development of an Ankle Rehabilitation Robot for Ankle-Bending Rehabilitation Exercise)

  • 정재현;김갑순
    • 제어로봇시스템학회논문지
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    • 제22권1호
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    • pp.31-39
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    • 2016
  • This paper describes the design of an ankle rehabilitation robot for the force measurement of a severe stroke patient staying in a bed ward. The developed ankle rehabilitation robot was attached to a three-axis force/torque sensor that could detect force Fx, Fz, and torque Tz and measure the ankle rotation force (Fx) exerted on the ankle and the signal force Fz and torque Tz to be used as a safety device. The robot was designed and manufactured for bedridden stroke patients, and the robot program was manufactured to perform the flexibility rehabilitation exercise for ankle bending and to measure the ankle force to judge the degree of rehabilitation. According to the result of the characteristics test of the developed rehabilitation robot, it was safely operated while the ankle-bending flexibility rehabilitation exercise and the emergency situation were performed. Therefore, it is thought that the developed rehabilitation robot can be used for severe stroke patients.

The corrosion of aluminium alloy and release of intermetallic particles in nuclear reactor emergency core coolant: Implications for clogging of sump strainers

  • Huang, Junlin;Lister, Derek;Uchida, Shunsuke;Liu, Lihui
    • Nuclear Engineering and Technology
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    • 제51권5호
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    • pp.1345-1354
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    • 2019
  • Clogging of sump strainers that filter the recirculation water in containment after a loss-of-coolant accident (LOCA) seriously impedes the continued cooling of nuclear reactor cores. In experiments examining the corrosion of aluminium alloy 6061, a common material in containment equipment, in borated solutions simulating the water chemistry of sump water after a LOCA, we found that Fe-bearing intermetallic particles, which were initially buried in the Al matrix, were progressively exposed as corrosion continued. Their cathodic nature $vis-{\grave{a}}-vis$ the Al matrix provoked continuous trenching around them until they were finally released into the test solution. Such particles released from Al alloy components in a reactor containment after a LOCA will be transported to the sump entrance with the recirculation flow and trapped by the debris bed that typically forms on the strainer surface, potentially aggravating strainer clogging. These Fe-bearing intermetallic particles, many of which had a rod or thin strip-like geometry, were identified to be mainly the cubic phase ${\alpha}_c-Al(Fe,Mn)Si$ with an average size of about $2.15{\mu}m$; 11.5 g of particles with a volume of about $3.2cm^3$ would be released with the dissolution of every 1 kg 6061 aluminium alloy.

일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究) (A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea)

  • 김용익;윤덕로;신영수
    • Journal of Preventive Medicine and Public Health
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    • 제16권1호
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    • pp.135-152
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    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

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