• Health Policy and Management
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• v.24 no.4
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• pp.396-412
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• 2014

Background: As a reform plan of health care system, Accountable Care Organization (ACO) has became an object of attention in the United States after Patient Protection and Affordable Care Act was enacted. ACO is a group of various health care providers and provide coordinated care to its assigned beneficiaries. If ACOs improve the quality level and reduce the cost of care, they can get financial incentives. Under the discussion for a quite long time and demonstration projects, ACO has been established. We aimed to analysis and discuss the history, policy mechanism, contents, status and outcomes of ACO. Also, we intended to suggest political implication Korean health care system with regard to ACO. Methods: We searched the articles related ACO in PubMed and selected several available papers about ACO. Total 56 studies were reviewed and categorized three parts; demonstration projects for formation of ACO, policy mechanism and agenda, empirical results of ACO performance. Results: As a result, establishment of ACO was successful partly in the US. It seems to be due to various project and pilot test for verification in the long time. The empirical effect of ACO was also identified in a few study but it needs more evidences to judge its positive effect. Conclusion: In Korea, there are arguments for the application of ACO. However it is difficult to implement a ACO by different political conditions between Korean and US. Nevertheless ACO proposed us the necessity of paradigm shift in our health policy and could be significant to national policy orientation in the future.

• Journal of dental hygiene science
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• v.5 no.1
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• pp.25-32
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• 2005

The dental hygiene process of care is a model for providing integrated dental hygiene care. It was developed by Mueller-Joseph and Petersen in 1995. The purpose of the dental hygiene process is to provide a framework within which the individualized needs of the client can be met. This model enables the dental hygienist to focus on patient need. The process is composed of five components: assessment, diagnosis, planning, implementation and evaluation. The process of dental hygiene has to move from simple clinical procedure to comprehensive and systemic dental hygiene care. The dental hygiene diagnostic model broadens the biomedical dental model to the behavioral model to include health behavior and health function of individuals. The dental hygiene process will provide a mechanism to develop dental hygienist's role and scope of practice in Korea.

• Health Policy and Management
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• v.3 no.1
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• pp.53-83
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• 1993

A small number of high cost patients usually spend a larger proportion of scarce health resources. Korea is no exception. Under the national health insurance, 12% of the insured persons have consumed approximately half of the national health insurance expenditures. Therefore, it is necessary to identify the characteristics of the high cost patient group, if we would like to reduce them. This study has defined high cost patients as those who have spent one and half million won and over per 6 months. The study reveals that high cost users are those who have a longer length of stays(LOS), 40days of LOS in the 6 months, have multiple admissions, 2 to 3 admissions per 6 months and are the elderly patients. They have spent 814.126won per on the average, and commonly suffered from malignant neoplasms, circulatory diseases, fracture, diabetes mellitus, etc. Unlike the case of western developed countries, early readmissions are not the major causes of high cost spending in Korea. Undoubtedly, a lengthy admission is the main cause of large spending. Health policies should vigorously be explored to respond appropriately. There are evidences that hospital beds are often misused. As the Korean health care system is lacking in a mechanism of patient evaluation under the fee-for-service remuneration system, an idea of progressive patient care needs to be tested. The Goverment should set up health policy to diversify the role of long-term care facilities and encourage people to establish them. Further studies are needed to identify factors influencing large medical bills necessary for formulating the health policy on cost containment.

• Journal of information and communication convergence engineering
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• v.19 no.3
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• pp.166-174
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• 2021

A large volume of patient data is generated from various devices used in healthcare applications. With increase in the volume of data generated in the healthcare industry, more wellness monitoring is required. A cloud-enabled analysis of healthcare data that predicts patient risk factors is required. Machine learning techniques have been developed to address these medical care problems. A novel technique called the radix-trie-based Tanimoto kernel regressive infomax boost classification (RT-TKRIBC) technique is introduced to analyze the heterogeneous health data in the cloud to predict the health risks and send alerts. The infomax boost ensemble technique improves the prediction accuracy by finding the maximum mutual information, thereby minimizing the mean square error. The performance evaluation of the proposed RT-TKRIBC technique is realized through extensive simulations in the cloud environment, which provides better prediction accuracy and less prediction time than those provided by the state-of-the-art methods.

• Journal of Korean Academy of Nursing Administration
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• v.13 no.1
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• pp.40-52
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• 2007

Purpose: The purpose of this paper was to investigate opinions and experiences of hospital CEOs' and QI managers toward the National Hospital Evaluation Program which was implemented in 2004 and to recommend various strategies to improve the program. Methods: We conducted a mail survey with CEOs and QI　managers' of 78 hospitals with 500 beds or more that participated the 2004 National Hospital Evaluation Program. Results: About 70.8% of the participating CEOs and 64.0% of the QI　managers felt that the objectives of the evaluation program weren't fully achieved. Most respondents said that the current program required a partial or an overall change. Evaluation Criteria was the most often cited area for a change. Many respondents pointed out the importance of including clinical quality indicators in the evaluation tool. Conclusions: To upgrade hospital services with better quality, it is most important to first reach consensus on objectives and approaches of the evaluation program among various players. For a consistent planning and implementation, it is urgent to set up a more systematic organization and financing mechanism. Also, evaluation approaches, including evaluation criteria, methods, patient satisfaction assessment, as well as ways to summarize and publicize each hospital's performance should be improved.

• Journal of Korean Academy of Nursing
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• v.41 no.4
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• pp.568-579
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• 2011

Purpose: The purpose of the study was to understand and describe the hospital workers' experience related to the hospital evaluation program implemented in Korea between 2004 and 2009. Methods: During 2010, data were collected using focus group interviews. Four focus group interviews were held with a total of 28 hospital workers participating. All interviews were recorded and transcribed as they were spoken, and data were analyzed using qualitative content analysis. Results: Nine themes emerged from the analysis: 1) Positive change in the necessity of the evaluation; 2) Improvement in the hospital system, facilities, and human resources; 3) Unity through cooperation among departments; 4) Nursing work overload; 5) Lack of physicians' awareness and responsibilities; 6) Unfair and unrealistic evaluation items; 7) Lack of credibility of the outcome; 8) Shifting responsibility for negative outcomes to the workers; 9) Lack of pragmatic utility. Conclusion: The results of the study demonstrate that the hospital evaluation program played a key role in improving some work environments and communication among departments. At the same time, they show various negative themes resulting from the context of very authoritarian hospital systems and a connection-oriented society in Korea.

• Journal of Digital Convergence
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• v.14 no.9
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• pp.479-484
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• 2016

This study was designed to secure the basis for developing the health tea that may help promote healthy blood vessels by natural herbal ingredients formulated in accordance with the basic principles of oriental medicinal materials. We investigated the vessels contracted by concentrations and safety assessment carried out by the cell viability of Taraaci Herba, Cnidii Rhizoma, Citri Percarpium, and Ophiopoginis Radix composition and concentration. We found cell survival rate was higher than the control group, showing a beneficial trend in the growth of normal liver and kidney cells. As a result, this study will be the basis to develop the health tea differentiated in the future Chinese medicine resources. Medicinal resources will be health tea based on clinical trials utilizing herbal western and oriental medicine convergence principle and vascular relaxation mechanism. And this study tried to make health tea industrialization possible.

• Journal of Digital Contents Society
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• v.15 no.1
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• pp.11-18
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• 2014

The strength of our country is based on high-speed networks to build a nationwide health information network to improve the quality of health care is needed. However, nature of the medical services in the hospital medical record form, so that all departments characterize each medical department, a common format that can be used for all disease is a very difficult challenge. This study is one of the ways to improve this priority issue on health information sharing medical information system(PACS/HIS) information linkage between the problem of information, compatibility and security issues derived. The problem is derived from the requirements of theorem 3 to 6 items. This is effective in order to improve sharing of medical information for the purpose of designing the software system. Sharing of medical information software system design are derived from stakeholders, requirements analysis, architecture design, software framework, configuration, architecture evaluation process. This study is based on the medical information standardization environmental diagnosis of a medical information system design. Software design philosophy is based on a new framework for deriving the function and mechanism made up.

• Journal of Korean Neurosurgical Society
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• v.65 no.3
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• pp.370-379
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• 2022

Abusive head trauma (AHT) is the most severe form of physical abuse in children. Such injury involves traumatic damage to the head and/or spine of infants and young children. The term AHT was introduced to include a wider range of injury mechanisms, such as intentional direct blow, throw, and even penetrating trauma by perpetuator(s). Currently, it is recommended to replace the former term, shaken baby syndrome, which implicates shaking as the only mechanism, with AHT to include diverse clinical and radiological manifestations. The consequences of AHT cause devastating medical, social and financial burdens on families, communities, and victims. The potential harm of AHT to the developing brain and spinal cord of the victims is tremendous. Many studies have reported that the adverse effects of AHT are various and serious, such as blindness, mental retardation, physical limitation of daily activities and even psychological problems. Therefore, appropriate vigilance for the early recognition and diagnosis of AHT is highly recommended to stop and prevent further injuries. The aim of this review is to summarize the relevant evidence concerning the early recognition and diagnosis of AHT. To recognize this severe type of child abuse early, all health care providers maintain a high index of suspicion and vigilance. Such suspicion can be initiated with careful and thorough history taking and physical examinations. Previously developed clinical prediction rules can be helpful for decision-making regarding starting an investigation when considering meaningful findings. Even the combination of biochemical markers may be useful to predict AHT. For a more confirmative evaluation, neuroradiological imaging is required to find AHT-specific findings. Moreover, timely consultation with ophthalmologists is needed to find a very specific finding, retinal hemorrhage.

• Journal of Intelligence and Information Systems
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• v.25 no.3
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• pp.117-140
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• 2019

As the aging phenomenon accelerates and various social problems related to the elderly of the vulnerable are raised, the need for effective elderly care solutions to protect the health and safety of the elderly generation is growing. Recently, more and more people are using Smart Toys equipped with ICT technology for care for elderly. In particular, log data collected through smart toys is highly valuable to be used as a quantitative and objective indicator in areas such as policy-making and service planning. However, research related to smart toys is limited, such as the development of smart toys and the validation of smart toy effectiveness. In other words, there is a dearth of research to derive insights based on log data collected through smart toys and to use them for decision making. This study will analyze log data collected from smart toy and derive effective insights to improve the quality of life for elderly users. Specifically, the user profiling-based analysis and elicitation of a change in quality of life mechanism based on behavior were performed. First, in the user profiling analysis, two important dimensions of classifying the type of elderly group from five factors of elderly user's living management were derived: 'Routine Activities' and 'Work-out Activities'. Based on the dimensions derived, a hierarchical cluster analysis and K-Means clustering were performed to classify the entire elderly user into three groups. Through a profiling analysis, the demographic characteristics of each group of elderlies and the behavior of using smart toy were identified. Second, stepwise regression was performed in eliciting the mechanism of change in quality of life. The effects of interaction, content usage, and indoor activity have been identified on the improvement of depression and lifestyle for the elderly. In addition, it identified the role of user performance evaluation and satisfaction with smart toy as a parameter that mediated the relationship between usage behavior and quality of life change. Specific mechanisms are as follows. First, the interaction between smart toy and elderly was found to have an effect of improving the depression by mediating attitudes to smart toy. The 'Satisfaction toward Smart Toy,' a variable that affects the improvement of the elderly's depression, changes how users evaluate smart toy performance. At this time, it has been identified that it is the interaction with smart toy that has a positive effect on smart toy These results can be interpreted as an elderly with a desire to meet emotional stability interact actively with smart toy, and a positive assessment of smart toy, greatly appreciating the effectiveness of smart toy. Second, the content usage has been confirmed to have a direct effect on improving lifestyle without going through other variables. Elderly who use a lot of the content provided by smart toy have improved their lifestyle. However, this effect has occurred regardless of the attitude the user has toward smart toy. Third, log data show that a high degree of indoor activity improves both the lifestyle and depression of the elderly. The more indoor activity, the better the lifestyle of the elderly, and these effects occur regardless of the user's attitude toward smart toy. In addition, elderly with a high degree of indoor activity are satisfied with smart toys, which cause improvement in the elderly's depression. However, it can be interpreted that elderly who prefer outdoor activities than indoor activities, or those who are less active due to health problems, are hard to satisfied with smart toys, and are not able to get the effects of improving depression. In summary, based on the activities of the elderly, three groups of elderly were identified and the important characteristics of each type were identified. In addition, this study sought to identify the mechanism by which the behavior of the elderly on smart toy affects the lives of the actual elderly, and to derive user needs and insights.