• Journal of Home Health Care Nursing
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• v.12 no.2
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• pp.63-86
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• 2005

Purpose: This study is a descriptive research which is designed to investigate hospitalized patients' intent to use home care nursing according to the types of medical security. Method: This researcher surveyed 236 patients who were hospitalized at B medical center located in Busan,. Data were collected from Sep. 1 to Nov. 30, 2005 using a questionnaire survey, medical records, face-to-face interviews and observations. Collected data were analyzed in terms of frequency, percentage, mean and standard deviation through $x^2$-test and t-test under SPSS WIN 10.0 Program. Result: Out of the total subjects, 59.3% were medical aid clients and the remaining 40.7%, health insurance ones. The hospitalized period and frequency of the former group were 38.0 days and 4.0 times, respectively, while those of the latter, 37.7 and 3.4. When home care nursing clients were examined using a given classification device, it was found that out of the total 236 subjects, 205(86.9%) were needed to receive home care nursing, 121, medical aid and the other 84, health insurance. 24.0% of medical aid clients heard about home care nursing ever before, lower than 39.3% of health insurance clients. 43.8% of the former clients said cost for home care nursing was high while, 47.6% of the latter group responded expense for the nursing intervention was low. 30.6% of medical aid clients had intent to use home care nursing, lower than 47.6% of health insurance clients. 71.7% of those patients whose monthly income was 99 million won or below had no intent to use home care nursing, higher than 62.5% of those who were 100 million or over in monthly income(p<.05). 76.4% of those clients who had no nursing provider intented to use home care nursing, higher than those who had nursing provider(p<.05). Concerning contents of home care nursing, 85.1% of medical aid clients needed education, training and counseling while, 77.4% of health insurance aids wanted medication and injection. Conclusion: In conclusion, the use of home care nursing by medical aid clients should be promoted through improving conditions for home care nursing in terms of expense, family and residence and making public relations about activities and contents of the home care nursing.

• Journal of the Korean Medical Association
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• v.61 no.12
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• pp.765-775
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• 2018

With growing interest in novel digital healthcare devices, such as artificial intelligence (AI) software for medical diagnosis and prediction, and their potential impacts on healthcare, discussions have taken place regarding the regulatory approval, coverage, and clinical implementation of these devices. Despite their potential, 'digital exceptionalism' (i.e., skipping the rigorous clinical validation of such digital tools) is creating significant concerns for patients and healthcare stakeholders. This white paper presents the positions of the Korean Society of Radiology, a leader in medical imaging and digital medicine, on the clinical validation, regulatory approval, coverage decisions, and clinical implementation of novel digital healthcare devices, especially AI software for medical diagnosis and prediction, and explains the scientific principles underlying those positions. Mere regulatory approval by the Food and Drug Administration of Korea, the United States, or other countries should be distinguished from coverage decisions and widespread clinical implementation, as regulatory approval only indicates that a digital tool is allowed for use in patients, not that the device is beneficial or recommended for patient care. Coverage or widespread clinical adoption of AI software tools should require a thorough clinical validation of safety, high accuracy proven by robust external validation, documented benefits for patient outcomes, and cost-effectiveness. The Korean Society of Radiology puts patients first when considering novel digital healthcare tools, and as an impartial professional organization that follows scientific principles and evidence, strives to provide correct information to the public, make reasonable policy suggestions, and build collaborative partnerships with industry and government for the good of our patients.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.58-74
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• 2002

This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

• Journal of Society of Preventive Korean Medicine
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• v.7 no.1
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• pp.17-28
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• 2003

We met results like the followings through the literatures and questionnaires about the tasks and solutions about the insurance fee of packed medical herbs. 1) It's turned out that 74.8% of herb doctors agrees to the insurance fee of packed medical herbs. However, in comparison with the same survey of the herb doctor association the percentage of general approval went somewhat lower, and especially the percentage of 'positive approval' became notably lower$(43.7%{\rightarrow}26.5%)$ and the percentage of 'active objection' raised about 2 times$(6.8%{\rightarrow}12.9%)$. Inquiring into the approval reasons on the insurance fee application of packed medical herbs some heads such as 'development toward treatment medical science' and 'decrease of publics burden' were higher than the one of 'management income and expenditure.' 2) As a result of the research, 36.0% of the patients and 42.8% of the residents recognized that the pay range of Chinese herb health insurance is narrow. They recognized that less people have the experiences of Chinese medical hospital use and internal application of the packed medical herbs as they are older, men rather than women. 85.4% of the patients and 74.9% of the residents agreed on the insurance pay of packed medical herbs. It's shown that they agree on the Chinese medical hospital use more as the economic standard is lower, on the insurance pay as they have ever taken the packed medical herbs. In the aspect of increase of insurance fee, 66.7% of the patients and 44.3% of the residents agreed on the insurance pay of packed medical herbs, and 18.1% and 36.1% disagreed on the insurance pay of packed medical herbs. The main objective reason why they disagree on the insurance pay of packed medical herbs was 'because the insurance fee goes up higher,' which answered 95.2% of the patients and 78.8% of the residents. 7.22% of the patients and 1.80% of the residents answered that they can pay more insurance fee in case of the insurance pay of packed medical herbs. However, in the priority order of the insurance pay, it hold the 5th position between 2 target research groups which was less than medical examination, charges for hospital accommodation and taking MRI. 3) According to the result of analysis about the cost of packed medical herbs, current practice price is 115,000 won and the average prime cost of a packed medical herb is 73,000 to 106,000 won. It's examined that the herb doctors regard that 95,000 won will be reasonable when the packed medical herb is payed in insurance. However, it was found out that the public generally thinks that the price would be appropriate on the level of 30,000 to 40,000 won and the percentage of the answers of 20,000 won to 30,000 was fairly high. 4) the central system of a prescription should be change into the central system of demonstration and the sick and wounded. 5) To solve this problem, the government should regulate it to pass by the circulation gradation of [importer, $peasantry{\rightarrow}manufacturer{\rightarrow}wholesaler{\rightarrow}distributor$(Chinese medical hospital, pharmacy dispensary of Chinese medicine)]And it should intervene into the quality and the circulation steps of Chinese medicine through 'the office or organization which is in charge of certification of Chinese medicine' and 'the office or organization which is in charge of the circulation of Chinese medicine.' And some actions such as simple severance, lavation, drying should be included into the conception of manufacture and the boundary between food and medical supplies should be made at a manufactory. And the regulation of standardized goods at one's own house should be improved so that, the peasantry can sell the materials of Chinese medicine only to the manufacturer. 6) In company with the insurance pay of packed medical herbs, the study about the separation of dispensary from medical practice in the Chinese medicine should be accomplished.

• Progress in Superconductivity
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• v.6 no.1
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• pp.56-63
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• 2004

We consider design factors for a SQUID sensor array to construct a 52-channel magnetocardiogram (MCG) system that can be used to measure tangential components of the cardiac magnetic fields. Nowadays, full-size multichannel MCG systems, which cover the whole signal area of a heart, are developed to improve the clinical analysis with high accuracy and to provide patients with comfort in the course of measurement. To design the full-size MCG system, we have to make a compromise between cost and performance. The cost is involved with the number of sensors, the number of the electronics, the size of a cooling dewar, the consumption of refrigerants for maintenance, and etc. The performance is the capability of covering the whole heart volume at once and of localizing current sources with a small error. In this study, we design the cost-effective arrangement of sensors for MCG by considering an adequate sensor interval and the confidence region of a tolerable localization error, which covers the heart. In order to fit the detector array on the cylindrical dewar economically, we removed the detectors that were located at the corners of the array square. Through simulations using the confidence region method, we verified that our design of the detector array was good enough to obtain whole information from the heart at a time. A result of the simulation also suggested that tangential-component MCG measurement could localize deeper current dipoles than normal-component MCG measurement with the same confidence volume; therefore, we conclude that measurement of the tangential component is more suitable to an MCG system than measurement of the normal component.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.1
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• pp.10-16
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• 2008

With the advent of effective chemotherapy and the realization of high economic cost associated with amputation, limb salvage surgery has become the standard of treatment in children with primary malignant bone tumors. Reconstruction after resection of malignant bone tumors of children has to address the leg length inequality and also has to be durable to cope with high functional demands of young patients. Expandable endoprostheses have been used in children for achieving limb length equality with substantial risk of complications. Recently, significant advances in prosthetic designs have reduced the morbidities associated with these prostheses. The purpose of this study was to review the indications, characteristics, complications and recent developments of expandable endoprostheses used for malignant bone tumors in children.

• The Korean Journal of Emergency Medical Services
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• v.6 no.1
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• pp.27-37
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• 2002

The health and medical service attracts more public attention as the economy of Korea is rapidly growing up and the standard of living is elevated. Especially, the interest and demand on the prehospital emergency medical service that consists of the important part of primary medical service that is directly related to the life of patients are gradually increased. However, as compared with other advanced countries such as America in this area, Korea actually fell behind in the utilization of IT (Information Technology) to maximize the efficiency of emergency service system as well as has a problem in the general service system. This study suggested the necessity to introduce EMD (Emergency Medical Dispatch) system that takes a great role as the core part in the prehospital emergency medical service that is not systemized in Korea yet. In addition, this study proposed the implementation model of EMD ASP system using ASP (Application Service Provider) in EMD system to flexibly deal with the change of IT and efficient implementation and integration of information system as well as to significantly reduce cost through wire/wireless high speed Internet network that is politically promoted in Korea on the basis of EMD. The system analysis and design was executed by HIPO (Hierarchy Plus Input Process Output) analysis that was the conceptual design technology for EMD information system modeling based on ASP and DFD (Data Flow Diagram). This study proposed DB table configuration and data schema to implement the application of web browser interface in EMD system through ERD(ER-Diagram) of EMD ASP system. Finally, this study described how to implement and utilize EMD information system. This study aims to facilitate the qualitative development of emergency medical service in the future as suggesting the concrete models for the implementation of high value-added prehospital emergency medical information system as applying ASP concept to EMD system of prehospital emergency medical service area.

• Journal of Technologic Dentistry
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• v.28 no.1
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• pp.67-81
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• 2006

This research has been attempt to examine closely factors that high cost and value to overall satisfaction state for dental implant prosthesis, re-utilization intention, inducement intention of the general hospital dental service user and provide basis data necessary to establish competitive general hospital dentistry management strategy. Collected data using own recording way questionnaire from April 17, 2004 to May 15, 2004 choosing 142 people that agree on this research and question of 361 people that dental implant prosthetic treatment finished from March 1, 1999 to March 1, 2004 for this. Major analyzation consequences are as follows : First, general satisfaction, re-utilization intention, inducement intention for implant prosthesis that highly correlation variables are kindness, explanation, medical treatment level and appreciation of the aesthetic. Second, correlation is high relatively between re-utilization intention, inducement intention in the 3 variables such as general satisfaction re-utilization intention, inducement intention. Third, the result of multiple regression analysis showed that most significant effective factors are satisfaction with explanation of dental implant prosthesis between the 3 dependant variables such as general satisfaction, re-utilization intention, inducement intention. In looking into these consequence, how to improve that raise satisfaction about dental implant prosthetic treatment and to establish patient focused care service system for dental implant prosthesis, it is consider that explain enough about implant prosthesis and raise quality of medical examination and treatment level, including satisfied with fabrication of good esthetic dental implant prosthesis.

• Genomics & Informatics
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• v.13 no.2
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• pp.31-39
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• 2015

Sequencing depth, which is directly related to the cost and time required for the generation, processing, and maintenance of next-generation sequencing data, is an important factor in the practical utilization of such data in clinical fields. Unfortunately, identifying an exome sequencing depth adequate for clinical use is a challenge that has not been addressed extensively. Here, we investigate the effect of exome sequencing depth on the discovery of sequence variants for clinical use. Toward this, we sequenced ten germ-line blood samples from breast cancer patients on the Illumina platform GAII(x) at a high depth of ${\sim}200{\times}$. We observed that most function-related diverse variants in the human exonic regions could be detected at a sequencing depth of $120{\times}$. Furthermore, investigation using a diagnostic gene set showed that the number of clinical variants identified using exome sequencing reached a plateau at an average sequencing depth of about $120{\times}$. Moreover, the phenomena were consistent across the breast cancer samples.

• Journal of radiological science and technology
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• v.44 no.5
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• pp.495-502
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• 2021

This study aims to provide basic data for elderly health insurance policy and medical radiation safety management by analyzing the general radiography usage and exposure dose of the elderly in Korea. The effective dose for each general radiography was calculated using the ALARA-GR program for 260 general radiography codes selected from 'National Health Insurance Care Benefit Cost'. The usage of general radiography was analyzed in the 2016 elderly patient data of the Health Insurance Review and Assessment Service, and the effective dose for each general radiography was applied. The general radiography usage and exposure dose per person aged 65 years and over was 6.47 cases and 0.56 mSv. Females showed higher value than males as 7.15 cases and 0.66 mSv(p<.001). By age, those between 75 and 79 showed the highest number as 6.97 cases and 0.62 mSv(p<.001). Those who were supported by Medical Aid showed higher value than those who were insured by National Health Insurance as 8.82 cases and 0.76 mSv(p<.001). In addition, the ratio by radiography was in the order of Chest 20.85%, Knee Joint 15.58%, and L-spine 14.67%, and the exposure dose was L-spine 29.40%, Chest 15.82%, Abdomen 7.97%, and Entire Spine 7.20%. General radiography, which is widely used due to the high frequency of diseases in the elderly population should be taken into consideration when establishing health insurance policies. In addition, it is necessary to check whether the general radiography with high exposure dose is performed as a routine examination without considering medical necessity.