• 보건행정학회지
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• 제24권4호
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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.

• 치위생과학회지
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• 제5권1호
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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.

• 보건행정학회지
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• 제3권1호
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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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• 제19권3호
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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.

• 간호행정학회지
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• 제13권1호
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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.

• 대한간호학회지
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• 제41권4호
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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.

• 디지털융복합연구
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• 제14권9호
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• pp.479-484
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• 2016

본 연구는 상기생, 진피, 국화 및 맥문동 혼헙물이 혈관건강을 증진 시킬 수 있는 건강차를 개발하는데 기초 자료를 확보하고자 한다. 이에 따라 상기생, 진피, 국화 및 맥문동의 혼합 조성물이 농도별로 수축혈관에 미치는 영향과 농도에 따른 조성물이 세포생존율에 미치는 영향을 통해 안정성을 검증하였다. 조성물의 농도가 높을수록 혈관의 이완효과가 큰 것으로 나타났으며, 본 조성물이 혈관의 수축 이완에 영향을 미칠 수 있음을 확인하였다. 또한 세포생존율이 대조군보다 높게 나타나 정상 간과 신장 세포의 성장에 유익한 경향을 보임을 알 수 있었다. 본 연구의 결과는 향후 한약자원을 활용한 차별화된 건강차 개발의 기초자료이며, 개발된 차로 혈관 수축률 억제 기전연구가 이루어진다면 동양의 한약자원을 활용한 현대화된 분석법을 통해 융복합적 방법으로 건강차 개발에 기초자료로 제공하고자 한다.

• 디지털콘텐츠학회 논문지
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• 제15권1호
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• pp.11-18
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• 2014

우리나라는 강점인 초고속 통신망을 기반으로 전국적인 의료정보망을 구축하여 의료서비스의 질을 향상시키는 것이 필요하다. 그러나 의료서비스의 속성상 의무기록 서식이 병원, 진료 부서마다 특성화 되어 있어 모든 부서, 모든 질병에 사용할 수 있는 공통된 서식 완성이 매우 어려운 난제이다. 본 연구는 이를 개선하기 위한 하나의 방안으로 우선 의료정보 공유상의 문제인 의료정보시스템(PACS/HIS)간 정보연동 문제, 정보의 호환성, 보안성 문제를 도출하였다. 도출된 문제는 3개영역 6개 요구사항으로 정리된다. 이를 개선하기 위해서 의료정보의 효과적 공유를 목적으로 한 소프트웨어시스템 설계가 요구된다. 소프트웨어시스템 설계는 의료정보 이해관계자 도출, 설계 요구사항 분석, 소프트웨어 프레임워크 구성, 아키텍처 평가절차를 필요로 한다. 본 연구는 의료정보 표준화 환경 진단을 기반으로 시스템 설계로 새로운 설계사상을 기반으로 프레임워크를 도출하고 기능 메커니즘을 구성했다.

• Journal of Korean Neurosurgical Society
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• 제65권3호
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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.

• 지능정보연구
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• 제25권3호
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• pp.117-140
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• 2019

고령화 현상이 가속화되고, 취약계층 노인과 관련된 다양한 사회문제가 제기됨에 따라 노인세대의 건강과 안전을 보호하기 위한 효과적인 노인 돌봄 솔루션의 필요성이 커지고 있다. 최근에는 노인 돌봄의 수단으로 첨단화된 ICT 기술을 탑재한 스마트 토이를 활용하고자 하는 사례가 늘고 있다. 특히 스마트 토이를 통해 기록되는 노인 행태에 대한 로그 데이터는 노인 돌봄 관련 정책 수립, 노인 돌봄 서비스 컨셉 기획 및 개발과 같은 분야에 정량적이고 객관적인 설명지표로써 활용 가치가 높을 것으로 전망된다. 그러나 현재까지 노인 돌봄 스마트 토이와 관련된 연구 중 스마트 토이를 통해 기록된 사용자 행동 로그에 주목하여 이를 의사결정에 활용하고자 하는 연구는 부족한 실정이다. 본 연구는 기존에 충분히 논의되지 않았던 스마트 토이 사용자 행동 로그 데이터에 대한 분석을 중심으로, 노인 돌봄 솔루션의 사용자 경험 증진을 위한 효과적인 인사이트를 도출하는 것을 목적으로 한다. 구체적으로 사용자 프로파일링 기반 행태 분석과 사용 행태에 따른 삶의 질 변화 메커니즘 도출을 단계적으로 수행하였다. 분석 결과, 5개의 노인 생활관리 요인으로부터 노인집단 유형을 분류할 수 있는 2개의 중요한 차원을 도출하였으며, 도출한 차원에 근거하여 전체 노인 사용자를 3개의 유형으로 분류하고 유형별 스마트 토이 사용 행태 차이를 프로파일링 분석을 통해 확인할 수 있었다. 이후 스마트 토이 사용 행태에 따른 삶의 질 변화 메커니즘을 도출하기 위한 단계적 회귀분석을 수행하였으며, 스마트 토이와의 상호작용, 스마트 토이의 콘텐츠 사용, 스마트 토이가 관찰한 노인의 가정 내 활동 정도가 노인의 우울감 개선과 생활패턴 개선에 미치는 영향 및 이를 중재하는 경로로써 스마트 토이에 대한 사용자의 성능평가와 만족감의 역할을 밝혀내었다.