• 우울조울병
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• 제9권2호
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• pp.126-132
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• 2011

Background and Objectives : This study aims to identify sociodemographic and disease-related variables which predicts continuity of outpatient treatment after discharge among bipolar patients. Materials and Method : The medical records of patients who discharged with the diagnosis of bipolar disorder from Department of Psychiatry, St. Mary's hospital from 2005 to 2009 were reviewed. Data on sociodemographic and disease-related variables were analyzed. Results : It showed older age, higher rate of male and higher rate of being married in 1-year follow-up group than in non-follow-up group. And it showed longer duration of index hospitalization, higher rate of previous psychiatric outpatient treatment within 3 months before index hospitalization, higher rate of involuntary admission in 1-year follow-up group than in non-follow-up group. The univariate logistic regression analysis revealed that older age, being male, previous psychiatric treatment and longer duration of index hospitalization were significantly related to an increased likelihood of 1-year follow-up visits. Conclusion : Age, sex, history of previous psychiatric treatment, and duration of hospitalization seems to have influence on continuity of outpatient treatment after discharge.

• 지역사회간호학회지
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• 제30권4호
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• pp.528-538
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• 2019

Purpose: The purpose of this study was to follow-up the frailty of the old who received home health care by Registered Nurse in Public Health Center over 8 years. Methods: We used the second wave data which was a comprehensive longitudinal data set, Public Health Information System of a public health center located in Seoul from 2010 to 2018. For statistical analysis, a mixed model of repeated measures by R program was used. Results: Frailty (range: 0~31) was getting worse significantly from 5.38 on registration to 6.54 on 4th year, 7.40 on 7th year, 7.69 on 8th year with adjustment for age, sex, economic status, the number of family, and the number diseases. The coefficient of parameters with frailty change was serviced year (β=0.29, p<.001), age (70~79 to 60~69; β=0.98, p=.018) and sex (female to male; β=2.55, p<.001). Conclusion: This study showed that the home visiting health service needs to take attention to aged 70s and over, female. The home health care of public health center need to be extended more practical and effective services in terms of 'community care'and 'ageing in place'.

• Korean Journal of Radiology
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• 제24권8호
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• pp.729-738
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• 2023

Objective: When multiple surveillance mammograms are performed within an annual interval, the current guidance for oneyear follow-up to determine breast cancer status results in shared follow-up periods in which a single breast cancer diagnosis can be attributed to multiple preceding examinations, posing a challenge for standardized performance assessment. We assessed the impact of using follow-up periods that eliminate the artifactual inflation of second breast cancer diagnoses. Materials and Methods: We evaluated surveillance mammograms from 2007-2016 in women with treated breast cancer linked with tumor registry and pathology outcomes. Second breast cancers included ductal carcinoma in situ or invasive breast cancer diagnosed during one-year follow-up. The cancer detection rate, interval cancer rate, sensitivity, and specificity were compared using different follow-up periods: standard one-year follow-up per the American College of Radiology versus follow-up that was shortened at the next surveillance mammogram if less than one year (truncated follow-up). Performance measures were calculated overall and by indication (screening, evaluation for breast problem, and short interval follow-up). Results: Of 117971 surveillance mammograms, 20% (n = 23533) were followed by another surveillance mammogram within one year. Standard follow-up identified 1597 mammograms that were associated with second breast cancers. With truncated follow-up, the breast cancer status of 179 mammograms (11.2%) was revised, resulting in 1418 mammograms associated with unique second breast cancers. The interval cancer rate decreased with truncated versus standard follow-up (3.6 versus 4.9 per 1000 mammograms, respectively), with a difference (95% confidence interval [CI]) of -1.3 (-1.6, -1.1). The overall sensitivity increased to 70.4% from 63.7%, for the truncated versus standard follow-up, with a difference (95% CI) of 6.6% (5.6%, 7.7%). The specificity remained stable at 98.1%. Conclusion: Truncated follow-up, if less than one year to the next surveillance mammogram, enabled second breast cancers to be associated with a single preceding mammogram and resulted in more accurate estimates of diagnostic performance for national benchmarks.

• Journal of Preventive Medicine and Public Health
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• 제28권1호
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• pp.207-223
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• 1995

A new medical delivery system which regulated outpatient department(OPD) use from tertiary care hospitals was adopted in 1989. Under the new system, patients using tertiary care hospital OPD without referral slip from clinics or hospitals could not get any insurance benefit for the services received from the tertiary care hospital. This study was conducted to evaluate the Patient Referral System(PRS) with respect to health care expenditures and utilization. Two data sets were used in this study. One was monthly data set(from January 1986 to December 1992) from the Annual Report of Korea Medical Insurance Corporation(KMIC). The other was monthly joint data set composed of personal data of which 10% were selected randomly with their utilization data of KMIC from January 1988 to December 1992. The data were analyzed by time-series intervention model of SAS-ETS. The results of this study were as follows: 1. There was no statistically significant changes in per capita expenditures following PRS. 2. Utilization episodes per capita was increased statistically significantly after implementation of PRS. The use of clinics and hospitals increased significantly, whereas in tertiary care hospitals the use decreased significantly immediately after implementation of PRS and increased afterwards. 3. Follow-up visits per episode were decreased statistically significantly after implementation of PRS. The decrease of follow-up visits per episode were remarkable in clinics and hospitals, whereas in tertiary care hospitals it was increased significantly after implementation of PRS. 4. There was no statistically significant changes in prescribing days per episode following PRS. Futhermore, clinics and hospitals showed a statistically significant decrease in prescribing days per episode, whereas in tertiary care hospital it showed statistically significant increase after implementation of PRS. 5. Except high income class, the use of tertiary care hospitals showed statistically significant decrease after implementation of PRS. The degree of decrease in the use of tertiary care hospitals was inversely proportional to income. These results suggest that the PRS policy was not efficient because per capita expenditures did not decrease, and was not effective because utilization episodes per capita, follow-up visits per episode. and prescribing days per episode were not predictable and failed to show proper utilization. It was somewhat positive that utilization episodes per capita were decreased temporarily in tertiary care hospitals. And PRS policy was not appropriate because utilization episodes per capita was different among income groups. In conclusion, the PRS should be revised for initial goal attainment of cost containment and proper health care utilization.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1999년도 제51차 추계 학술대회 연제집
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• pp.154-154
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• 1999

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 2002년도 제54차 추계 학술대회 연제집
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• pp.368-368
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• 2002

• 성인간호학회지
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• 제14권1호
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• pp.135-143
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• 2002

Purpose: To explore what particular types of information were important to patients diagnosed with cancer. Methods: Seventy three patients with cancer at an outpatient clinic and hospitalized patients in W Christian Hospital Korea, responded. The structured questionnaire developed by the investigator based on previous studies. Results: There was a significant negative relationship between age and the score of informational need (r=-.307, p<.05). Level of education, and level of monthly income were related to level of informational need. The top three informational priorities according to the time since diagnosis were 'Self care during treatment', 'Health food and diet', 'Likelihood of recurrence', 'Follow up care' and 'Side effects'. The top three informational priorities for patients with breast cancer were 'Likelihood of recurrence', 'Metastasis possibility', 'Treatment options', and 'Side effects. For patients with stomach cancer, they were 'Follow up care', 'Healthy food and diet', 'Likelihood of recurrence', and 'Metastasis possibility', and for patients with colon/rectal cancer, they were 'Side effects', 'Healthy food and diet', 'Likelihood of recurrence', and 'Self care during treatment'. Conclusion: The assessment of information needs based on demographic factors and disease-related factors is critical in helping patients with cancer to manage their illness.

• 대한치과기공학회지
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• 제33권4호
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• pp.441-452
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• 2011

Purpose: Identify the factors that influence following up control and reuse intention of patient who used dental health care institution after dental heath care service and in order to prepare the method which improve the quality of dental health service which dental heath care institution service afford. Methods: Data were collected through random sampling from June 20th to August 20th 2010 (for 60 days). Once we explained the purpose of our survey to people who experienced the dental service within one year, we distributed the questionnaires to someone who volunteered to respond and they answered all questions by themselves based on the actual experience of dental health care organizations. Even if the survey was conducted for 610 people, only 585 properly answered questionnaires were analyzed because responses which had many unanswered questions and had errors in responsive way were excluded. Results: Result of multiple regression analysis, the value of dental clinic service, the following up control after dental treatment, the technique and kindness of dentist, the environment of treatment, type of dental service and the kindness of dental staff is significant main cause to intention of reuse dental clinic. Conclusion: In order to increase the rate of patient reuse, enhance the value of service with following up control after health treatment and the high quality of dental health service.

• Clinical Pain
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• 제20권2호
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• pp.59-69
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• 2021

Patients with pain, numbness, and weakness in their elbows, wrists, and hands often need proper rehabilitation treatments. Among them, musculoskeletal injection therapy should be performed after a full evaluation of the patient, taking into account history and physical examination leading to clinical diagnosis. General rules such as accurate diagnosis and injection materials selection are used to achieve maximum benefit with minimal side effects. During injection, patient location, aseptic care, penetration techniques, follow-up and follow-up care must be maintained. Specific techniques may vary depending on the type, lesion, and location of the injection therapy. For optimal effectiveness, physician should inject directly into the lesion and avoid the injection of surroundings as much as possible. Therefore, ultrasound-guided injections are needed to accurately inject. These conditions and other conditions of the hands, wrists, and elbows can be effectively diagnosed and treated with diagnostic ultrasound and ultrasound-guided injections.

• 지역사회간호학회지
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• 제4권1호
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• pp.5-13
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• 1993

The objective of this study was to analyze the status of health examination, and the health care management of industries in Seoul. This will provide effective industrial health care services. 46 industries were selected as a sample, and were given self administered questionnaire developed by the academic affairs of community health nursing. The results of this study are as follows: (1) The general characteristics of industries: The greater part of the industries were manu facturing companies, 300-900 workers, in a one shift system. (2) The general characteristics of health man ager: 96% of the companies had industrial nurses and the larger industries had comprehensive health managers. 90% of the industrial nurses were full-time employees and 77% of the industrial physician were part time employees. 80% of the industrial physician were age 50 or older, while 59% of the industrial nurses were 25-29 years of age. (3) Health examination and follow up care: The proportions of the workers who took general health examination was 94%. Of those, 12% took secondary examinations. In secondary examinations, 36% were evaluated at the C-grade, 20% were evaluated at the D-grade. The proportion of the workers who were required to take special examination were 29% and of that, the proportion of the workers who actually took the examination was 88%. 85% of the workers who were recommended for follow up cares were given follow up care while working. The physical agents among the special examination were done the most frequently to detect the examination effects. (4) Health care services: Industrial nurses performed health examination most frequently and health education was done the least. There were significant differences in health care services according to the size of the industries. Companies with 300 workers or less had higher health care services than other groups. The three primary reasons of health care management and examinations of workers are: First, industrial nurses are requires to accumulate professional knowledge and experience through continuos' activities. Second, systematic and concert examination for industrial workers should be performed periodically. Third, it needs developing health education strategies that are important workers for health promotion in industries.