• Clinical Endoscopy
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• 제56권3호
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• pp.340-352
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• 2023

Background/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States. Methods: We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared. Results: From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p<0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management. Conclusions: Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

• 보건행정학회지
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• 제34권3호
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• pp.282-292
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• 2024

연구배경: 본 연구는 서울의 인구이동 특성을 반영할 수 있는 생활인구와 지역의 건강결과 간 관계를 파악하는 것을 목적으로 한다. 방법: 본 연구에서는 통계청 마이크로데이터 통합서비스의 사망원인통계 원시자료를 사용하였다. 독립변수인 생활인구를 파악하기 위해 KT 통신사(Korean Telecom)에서 제공하고 있는 서울시 25개 자치구의 생활인구 데이터를 활용하였다. 통제변수는 SDoH (social determinants of health)의 네 가지 영역(경제적 안정, 의료접근성 및 품질, 이웃 및 건축환경, 사회 및 커뮤니티 연결)을 기반으로 하였다. 이후 패널 generalized estimating equations (GEE) 분석을 통해 생활인구와 지역의 건강결과 간 관계를 확인하였다. 결과: 패널 GEE 분석결과 모든 사망 관련 건강결과(회피 가능 사망률, 예방 가능 사망률, 치료 가능 사망률)는 생활인구와 통계적으로 유의미한 음(-)의 관계가 있었다. 이는 생활인구의 증가가 사망 관련 건강결과에 긍정적인 영향을 미친다는 것을 시사하는 결과이다. 결론: 지역의 건강결과와 인구밀도 사이에 유의미한 관계가 있음을 확인한 것은 지역의 건강격차 완화를 목표로 하는 정책 개발의 핵심 지표로써 생활인구지표를 사용해야 함을 강조하는 결과이다. 또한 본 연구결과는 생활인구가 적은 지역을 중심으로 지역의 인프라를 전략적으로 확장해야 함을 시사한다.

• 대한간호학회지
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• 제36권4호
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• pp.662-670
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• 2006

Purpose. This study was performed to develop and test a decision-tree model of treatment-seeking behaviors about when Korean patients visit a doctor after experiencing stroke symptoms. Methods. The study used methodological triangulation. The model was developed based on qualitative data collected from in-depth interviews with 18 stroke patients. The model was tested using quantitative data collected from interviews and a structured questionnaire involving 150 stroke patients. The predictability of the decision-tree model was quantified as the proportion of participants who followed the pathway predicted by the model. Results. Decision outcomes of the model were categorized into immediate and delayed treatment-seeking behavior. The model was influenced by lowered consciousness, social-group influences, perceived seriousness of symptoms, past history of hypertension or stroke, and barriers to hospital visits. The predictability of the model was found to be 90.7%. Conclusions. The results from this study can help healthcare personnel understand the education needs of stroke patients regarding treatment-seeking behaviors, and hence aid in the development of educational strategies for stroke patients.

• Journal of Yeungnam Medical Science
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• 제37권1호
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• pp.22-31
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• 2020

There has been a growing concern and subsequent interest surrounding numerous reproductive toxic agents found in various working and non-working environments. Meanwhile, there have been many efforts in medical fields such as toxicology and epidemiology applying experimental studies to elucidate reproductive toxic agents' characterization and health effects. However, there remains insufficient research data and inadequate evidence in humans. Adverse reproductive outcomes vary from transient, moderate health effects to severely detrimental consequences, such as permanent infertility or childhood cancer of one's offspring. Furthermore, upon exposure to toxic agents, the latent period before reproductive health effects are observed is relatively short compared to other occupational diseases (e.g., occupational cancer); instant action is required once exposure to reproductive toxic agents is detected. Therefore, it is very important for workers and healthcare professionals to know about the reproductive toxic agents they are likely to be exposed to. In this review, we discuss the general epidemiology of reproductive health in Korea, and the information regarding these reproductive toxic agents.

• 간호행정학회지
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• 제23권1호
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• pp.1-7
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• 2017

Nursing research in the United States (US) spans several decades. Many of the priorities/trends have stayed through the years. Today, the goal of producing evidence to support nursing care interventions coupled with the drive for Magnet Recognition has encouraged academic nurses (faculty) to work with nurse clinicians to form research teams. Interdisciplinary research teams have also formed to address growing concerns over patient safety and quality care. These issues are not just US issues but global ones. This article addresses US trends with the link to global research trends. The role that organizations such as the International Council of Nurses (ICN), the World Health Organization (WHO), and the Council of International Neonatal Nurses, Inc. (COINN) pay in shaping research agendas and promoting nursing research is highlighted. It emphasizes the key role that nurses, especially nurse leaders/administrators play in changing health outcomes through support of nursing research.

• 중환자간호학회지
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• 제2권2호
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• pp.68-78
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• 2009

Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.

• 대한간호학회지
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• 제40권6호
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• pp.757-764
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• 2010

Purpose: This paper is a report of a concept analysis of 'quality of pediatric nursing care', Methods: Rodgers's evolutionary method of concept analysis was used. Data were collected from published literature related to quality of pediatric nursing care. Results: Quality of pediatric nursing care was identified with three dimensions and seven attributes: 1) nurse's character: technical competence, interpersonal competence, 2) nurse's activities: developmentally appropriate care, attentiveness, entertainment, 3) nurse-parent interaction: nurse-parent partnership, emotional support. Antecedents of quality of pediatric nursing care were 'child and parent's expectation about pediatric nursing care', 'previous caring experience of pediatric nurses'. Consequences of quality of pediatric nursing care were 'meet child and parent's needs' and 'better health outcomes.' Conclusion: 'Quality of pediatric nursing care' is a core concept in pediatric nursing practice. Appropriate instruments to operationalize the concept need to be developed.

• 약학회지
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• 제54권2호
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• pp.126-133
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• 2010

This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer's perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

• 한국임상약학회지
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• 제20권1호
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• pp.30-38
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• 2010

This study was conducted to analyze cost-effectiveness of neoadjuvant chemotherapy for locally advanced head and neck cancer in Korean healthcare setting. We constructed a decision analytical model to estimate total costs and outcomes of paclitaxel+cisplatin (PC) or docetaxel+cisplatin+5-FU (DCF) for 2 years time horizon in 100 patient cohort with locally advanced head and neck cancer. Base analysis showed that cost savings of PC regimen were 379 million Korean Won and 231 million Korean Won in societal and payer's perspectives, respectively, compared to DCF regimen, and life saved was 0.18. PC regimen as a dominant strategy was found to be robust through sensitivity analyses.

• Korean Journal of Neurotrauma
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• 제13권1호
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• pp.9-14
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• 2017

Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.