• 근관절건강학회지
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• 제26권3호
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• pp.241-250
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• 2019

Purpose: This study was conducted to identify influencing factors on the performance of healthcare-associated infection control and microbiological hand contamination among caregivers at a tertiary hospital. Methods: The participants of this study were 59 caregivers woring at a tertiary hospital. Data were collected from July 1 to 30, 2018. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients and stepwise multiple regression by SPSS 23.0 Win program. Results: Multiple regression analysis revealed that factors influencing performance of healthcare-associated infection control were awareness (β=.63, p<.001) and the experience of infection-related education (β=-3.40, p=.042). Regression equations describing the performance of healthcare-related infection control were found to be appropriate (F=27.29, p<.001) and accounted for 68% of variance. Factors affecting the degree of microbiological hand contamination were work experience (β=-0.28, p=.026) and healthcare-related infection performance (β=-0.28, p=.029). A regression equation describing the microbiological hand contamination was appropriate (F=6.10, p=.004) and accounted for 42% of variance. Conclusion: The findings of this study suggest that it is necessary to increase performance of healthcare-associated infection control by caregivers. Also, educations for preventing healthcare-associated infection and guidelines for increasing compliance with healthcare-associated infection control are recommended to improve performance of healthcare-associated infection control.

• Radiation Oncology Journal
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• 제32권3호
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• pp.179-186
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• 2014

Purpose: To study the long-term outcomes and tolerance in our patients who received dose escalated radiotherapy in the early salvage post-prostatectomy setting. Materials and Methods: The medical records of 54 consecutive patients who underwent radical prostatectomy subsequently followed by salvage radiation therapy (SRT) to the prostate bed between 2003-2010 were analyzed. Patients included were required to have a pre-radiation prostate specific antigen level (PSA) of 2 ng/mL or less. The median SRT dose was 70.2 Gy. Biochemical failure after salvage radiation was defined as a PSA level >0.2 ng/mL. Biochemical control and survival endpoints were analyzed using the Kaplan-Meier method. Univariate and multivariate Cox regression analysis were used to identify the potential impact of confounding factors on outcomes. Results: The median pre-SRT PSA was 0.45 ng/mL and the median follow-up time was 71 months. The 4- and 7-year actuarial biochemical control rates were 75.7% and 63.2%, respectively. The actuarial 4- and 7-year distant metastasis-free survival was 93.7% and 87.0%, respectively, and the actuarial 7-year prostate cancer specific survival was 94.9%. Grade 3 late genitourinary toxicity developed in 14 patients (25.9%), while grade 4 late genitourinary toxicity developed in 2 patients (3.7%). Grade 3 late gastrointestinal toxicity developed in 1 patient (1.9%), and grade 4 late gastrointestinal toxicity developed in 1 patient (1.9%). Conclusion: In this series with long-term follow-up, early SRT provided outcomes and toxicity profiles similar to those reported from the three major randomized trials studying adjuvant radiation therapy.

• 보건행정학회지
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• 제28권1호
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• pp.91-94
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• 2018

Unmet healthcare needs do not end with the phenomenon itself, but lead to possibilities of increased severity of illness. Missed opportunities for treatment at the right timing increase possibilities of complications, and affect prognosis of disease. To examine current status and trends of unmet needs in Korea, we used data from four sources: the Korea National Health and Nutrition Examination Survey (KNHNES, '2007-2016); the Community Health Survey (CHS '2008-2016); the Korea Health Panel Survey (KHP '2011-2014); and the Korean Welfare Panel Study (KOWEPS '2006-2016). The proportion of individual reporting unmet healthcare needs as of 2016 was 8.8% (KNHNES), 11.5% (CHS), and 12.8% (KHP, as of 2014). Annual percentage change which characterizes trend for the follow-up period was -9.9%, -3.1%, and -1.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost was 1.8% (KNHNES), 1.5% (CHS), and 3.0% (KHP). The proportion of households reporting unmet healthcare needs due to cost was 1.0% (KOWEPS). Annual percentage change was -10.0%, -15.2%, -5.4%, and -17.5%, respectively. Low income populations had more unmet healthcare needs than high income populations. Therefore, in order to improve unmet healthcare needs, it is necessary to focus on low income populations.

• Clinical and Experimental Reproductive Medicine
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• 제37권2호
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• pp.115-124
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• 2010

목 적: 임신 전 $CD3^-/CD56^+/CD16^+$ 말초혈액 자연살해세포 (pbNK cell)의 분획과 세포용해 활성도를 정상군과 습관성 유산의 기왕력을 가진 환자군으로 나누어 비교, 분석하고 습관성 유산의 위험도를 제시할 수 있는 각각의 cut-off value를 설정하고자 하였다. 연구방법: 전향적 연구로서 습관성 유산의 기왕력이 있는 여성을 환자군 (n=35)으로 하였으며, 대조군으로 불임이나 습관성 유산의 기왕력이 없으며 정상아의 출산 경험이 있는 여성을 대조군 (n=15)으로 설정하였다. 유세포분석기를 이용하여 pbNK cell 분획 및 세포용해 활성도를 측정 후 그 결과를 비교 분석하였다. 결 과: pbNK cells의 분획은 습관성 유산 환자군에서 대조군에 비해 통계적으로 유의하게 높은 결과를 보였다($14.2{\pm}5.2$ vs. $9.4{\pm}3.7%$, p=0.002, 95% confidence interval [CI] 1.8~7.8). Receiver operating characteristic curve (ROC) 곡선을 이용하여 pbNK cell의 분획에 대한 cut-off values을 12.1%로 정하였을 때 습관성 유산의 위험도는 8.4배 증가하였다. pbNK cell의 K562 세포용해 활성도를 3가지 다른 Effector to Target (E:T) 비율 (50:1, 25:1, 12.5:1)을 사용하여 측정한 결과 각각의 경우에 있어 습관성 유산 환자군에서 대조군에 비해 통계적으로 유의하게 증가된 결과를 보였다 ($48.3{\pm}19.0$ vs. $31.3{\pm}11.9%$ in 50:1 ratio, p=0.002; $37.0{\pm}18.1$ vs. $20.2{\pm}9.2%$ in 25:1 ratio, p<0.001; $23.5{\pm}12.7$ vs. $12.4{\pm}7.3%$ in 12.5:1 ratio, p=0.001). ROC 곡선을 이용하여 각각 E:T 비율에서 세포용해 활성도의 cut-off values (43.1% in 50:1, 26.9% in 25:1, and 17.4% in 12.5:1)을 설정하여 분석한 결과 습관성 유산의 위험도는 각각 10.0배, 11.4배, 그리고 15.0배 증가된 결과를 보였다. 결 론: 원인이 분명하지 않은 습관성 유산 환자에서 pbNK cell의 분획과 세포용해 활성도를 측정하는 것은 면역학적 원인, 특히 동종면역 요인에 의한 습관성 유산의 유용한 진단 지표로 이용될 수 있을 것으로 사료된다. 향후 동종 면역반응에 의한 습관성 유산 환자에서 면역학적 원인의 치료 전, 후 pbNK cell의 분획과 세포용해 활성도를 측정, 비교하여 그 효과를 증명하는 연구가 필요할 것으로 생각된다.

• 간호행정학회지
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• 제14권2호
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• pp.176-181
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• 2008

Purpose: This study was performed to identify the relationship between patient's perceived quality of healthcare services and intention to re-visit. Method: The study subjects were 242 patients from three local clinics. The data were analyzed using SPSS PC+ 12.0 program for descriptive, Pearson's correlation coefficient, and multiple regression analysis. Result: Patients' perceived quality of healthcare services was measured 5.73$\pm$0.71 using the 7-point scale. The patients' perceived quality was moderately correlated with patient satisfaction (r=0.647, p<0.001) and intention to re-visit (r=0.604, p<0.001). Also, patient satisfaction was highly correlated with intention to re-visit (r=0.788, p<0.001). 3) the reliability factor of patients' perceived quality of healthcare services and patient satisfaction were found significant predictors of intention to re-visit. Conclusion: In conclusion, service quality evaluated by patients influenced on their intention of re-visit and especially, reliability was the most significantly influential variable.

• 한국콘텐츠학회논문지
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• 제13권12호
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• pp.379-388
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• 2013

유헬스케어 서비스는 미래의 서비스로 각광받고 있음에도 불구하고 그 도입이 기대보다 느리게 진행되고 있다. 본 연구는 유헬스케어 서비스의 활성화를 위한 요소를 파악하기 위해 의료기관 종사자들의 이용의도를 성과기대와 노력기대, 사회적 영향, 촉진조건, 그리고 인지된 위험과 조절변수인 자발성으로 설명하고자 한다. 국내 의료기관의 종사자 98명으로부터 설문조사를 통해 자료를 수집해서 분석했는데, 촉진조건을 제외한 성과기대와 노력기대, 사회적 영향, 인지된 위험이 이용의도에 통계적으로 유의한 영향을 주는 것으로 확인되었다. 자발성은 성과기대와 노력기대, 인지된 위험이 이용의도에 미치는 영향의 강도를 조절하는 것을 알 수 있었다.

• 보건행정학회지
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• 제32권2호
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• pp.237-243
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• 2022

Unmet healthcare is an important indicator to measure accessibility of healthcare services. To examine the latest status of unmet healthcare needs in South Korea, four different data which is composed of nationally representative sample of South Korean population were used; the Korea National Health and Nutrition Examination Survey (KNHANES, 2007-2020), the Community Health Survey (CHS, 2008-2020), the Korea Health Panel Survey (KHP, 2011-2018), and the Korean Welfare Panel Study (KOWEPS, 2006-2020). The proportion of individuals reporting unmet healthcare needs were 6.4% (KNHANES), 5.4% (CHS), and 12.2% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.9%, -9.1%, and -5.5%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.0% (KNHANES), 0.4% (CHS), 2.2% (KHP), and 0.4% (KOWEPS). The APC was -11.3%, -17.0%, -12.2%, and -21.2%, respectively. Overall, the low-income and the elderly population reported a higher rate of unmet health care needs. Although the overall experience rate of unmet medical care due to cost decreased over the past decade, the disparity between the lowest and highest income groups still remained in 2020. Disparity between income levels and age groups is a challenge to address in healthcare system, and these results suggest the need for adequate health coverage for the low-income and the elderly populations.

• 한국병원경영학회지
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• 제28권3호
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• pp.27-38
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• 2023

Objectives: This study explores the impact of age groups on social presence and trust among users of medical artificial intelligence chatbots. Furthermore, we investigate the existence of gender differences within these relationships. Method: We collected data through a survey from people who had interacted with general hospital chatbot services, either by making reservations or seeking consultations. Multiple linear regression analysis was conducted to examine the relationship between general characteristics of study population and social presence and trust of artificial intelligence chatbots. Additionally, we conducted stratified analysis to confirm the presence of gender differences within these relationship. Results: Among 300 participants, those aged 50 and older had higher social presence of artificial intelligence chatbots and greater trust of artificial intelligence chatbots (social presence, 𝛽=0.543, p=0.003; trust, 𝛽=0.787, p=0.000). In stratified by sex, women aged 50 and older had higher social presence and trust of artificial intelligence chatbots compared to those in their 30s age group (social presence, 𝛽 = 0.925, p=0.002; trust, 𝛽=0.645, p=:0.007). However, there was no statistically significant relationship between age and chatbot social presence and trust in men. Conclusion: This study demonstrates that advanced age plays a significant roles in users' social presence and trust in medical artificial intelligence chatbots. Futhermore, our findings reveal gender differences with women aged 50 and older showing the most substantial levels of social presence and trust. Therefore, it is expected that this finding can serve as valuable evidence to enhance the satisfaction of medical institution service users, offering crucial insights into the effective utilization of chatbot services.

• 보건행정학회지
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• 제33권1호
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• pp.107-113
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• 2023

Unmet healthcare is an important indicator for measuring accessibility of healthcare services. We analyzed the following four data from a nationally representative sample of South Korean population: Korea Health and Nutrition Examination Survey (KNHANES, 2007-2021), Community Health Survey (CHS, 2008-2021), Korea Health Panel Survey (KHP, 2011-2019), and Korean Welfare Panel Study (KOWEPS, 2006-2021). The proportion of individuals reporting unmet healthcare needs were 6.0% (KNHANES), 5.1% (CHS), and 13.1% (KHP). Annual percentage change (APC) which identifies trend for the follow-up period was -9.4%, -9.4%, and -5.3%, respectively. The proportion of individuals reporting unmet healthcare needs due to cost were 1.2% (KNAHANES), 0.5% (CHS), 2.7% (KHP), and 0.4% (KOWEPS). The APC was -10.4%, -16.1%, -11.5%, and -19.1%, respectively. Compared to the previous year, the rate of unmet healthcare needs decreased slightly, but the rate of unmet health care needs due to cost tended to increase. Overall, higher rates of unmet healthcare needs were reported in the low-income and the elderly population. Although it was confirmed through the APC that the rate of unmet healthcare experience has decreased over the past decade, it can be seen that there is still a disparity by income level and age. These results suggest the need for an appropriate health benefit coverage policy for the low-income and the elderly.

• Clinical and Experimental Reproductive Medicine
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• 제42권3호
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• pp.118-125
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• 2015

Objective: The goal of this study was to evaluate the pregnancy potential of immature (metaphase I or germinal vesicle stage) oocytes retrieved in intracytoplasmic sperm injection (ICSI) cycles. Methods: A total of 1,871 couples with infertility underwent 2,984 ICSI cycles. Cycles in which three or fewer oocytes were retrieved were included in this study in order to evaluate the pregnancy potential of immature oocytes. Cycles were divided into five groups (group I-V), according to the maturation status of the oocytes at the time of cumulus cell removal and ICSI. The fertilization and pregnancy rates after ICSI were analyzed and compared among the study groups based on the maturation status of the retrieved oocytes. Results: The retrieval of only immature oocytes was associated with a significant decrease in the fertilization rate ($76.1%{\pm}37.3%$ vs. $49.0%{\pm}49.1%$, $66.7%{\pm}48.7%$; group I vs. group II, group III, respectively) and the average number of transferred embryos ($1.5{\pm}0.7$ vs. $1.1{\pm}0.4$, $1.1{\pm}0.6$). The cycle cancellation rate was significantly higher when only immature oocytes were retrieved. The clinical pregnancy rate decreased significantly when the transferred embryos had originated from immature oocytes (16.9% vs. 10.3%, 1.2%). Conclusion: In ICSI cycles, the fertilization potential and pregnancy potential of the immature oocytes retrieved in ICSI cycles were inferior to those of mature oocytes. Therefore, increasing the number of injectable oocytes and transferrable embryos by using immature oocytes after their spontaneous in vitro maturation does not necessarily improve pregnancy outcomes.