• 한국학교보건학회지
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• 제17권2호
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• pp.47-61
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• 2004

Purpose: The goal of this paper is to offer practical suggestions for developing, implementing, and maintaining a successful school mental health program based on the model of a school mental health program for middle school students at the Namgu Hyosarang adolescent Mental Health Center. The model will be divided into six areas and the challenges and future direction of this program: creative approach to funding, creative staffing, education, training, needs assessment & resource mapping, collaboration and partnerships in a school mental health program, and developing an outcome evaluation research. Method: This is a descriptive study of the school mental health program model for middle school students of Namgu Hyosarang Adolescent Mental Health Center implemented over a four year period. Conclusion: Within this paper, a blueprint that can guide the development and implementation of school mental health programs has been offered. The actual application of this model will vary depending on the structure and goals of individual programs and schools. This model of our center has been identified as an effective school mental health program and the actual application program in regular learning times to middle school students. Establishing guidelines about the types of activities necessary for the successful implementation and sustainability of a school mental health program constitutes the first step in standardizing this process, and the school mental health movement continues to receive national recognition as a viable services delivery model for adolescents in need of mental health services. The recommendations outlined indicate that a school mental health program is more effective and necessary than the clinical service of a psychiatric hospital for adolescents' emotional/behavioral problems.

• 한국응급구조학회지
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• 제15권2호
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• pp.27-42
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• 2011

Purpose: This study intended to improve quality of prehospital emergency care for trauma patients by figuring out its current situations and problems based on run-sheets and questionnaires of 119 emergency medical technicians (EMTs). Methods: This study conducted a research of 425 trauma patients transferred to the 3rd hospital in G-city by 119 ambulances from July 1, 2008 to June 30, 2009. We aslo utilized 114 copies with questionnaires of 119 EMTs working in J-province. The data were analyzed with SPSS 18.0. Results: There were 425 trauma patients including 272 men and 137 patients with traffic accident. When it comes to types of 119 EMTs who delivered cares to patients, there were 206 (48.5%) advanced EMTs, 101 (23.8%) basic EMTs, 50 (11.8%) nurses and 43 (10.2%) rescue education receivers. The most frequent measured vital sign was pulse rate (54.1%). Regarding assessment of systolic blood pressure, pulse rate and respiration rate, there were some significant differences in accordance with type of 119 EMTs. Among the 317 patients evaluated 'emergency' in field, 137 patients returned to their home. Prehospital emergency cares accounted for 861, around 2.0 treatments per a patient. In view of questionnaire, the 74.6% of 119 EMTs hoped supplement of man power for proper prehospital care to trauma patients. Conclusion: This study suggested that it is necessary to develop detailed guidelines for trauma patients so as to improve quality of trauma patient evaluation and prehospital care. Furthermore, improvement of emergency care systems will reduce mortality of trauma patients and lead to their good outcome.

• Asian Pacific Journal of Cancer Prevention
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• 제17권7호
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• pp.3505-3510
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• 2016

Cervical cancer is a major public health problem in Thailand, being ranked second only to breast cancer. Thai women have been reported to have a low rate of cervical cancer screening (27.7% of the 80% goal of WHO). We therefore aimed to apply the social marketing theory and health belief model in promoting cervical cancer screening in Kanthararom District, Sisaket Province. A total of 92 from 974 targeted women aged 30-60 years were randomly divided into two groups. The experimental group underwent application of social marketing theory and a health belief model program promoting cervical cancer screening while the control group received normal services. Two research tools were used: (1) application of social marketing theory and health belief model program and (2) questionnaire used to evaluate perceptions of cervical cancer. Descriptive and inferential statistics including paired sample t-test and independent t-test were used to analyze the data. After the program had been used, the mean score of perception of cervical cancer of experimental group was at a higher level (${\bar{x}}=4.09$; S.D.=0.30), than in the control group (${\bar{x}}=3.82$; S.D.=0.20) with statistical significance (p<0.001). This research demonstrated an appropriate communication process in behavioral modification to prevent cervical cancer. It can be recommended that this program featuring social marketing and the health belief model be used to promote cervical cancer screening in targeted women and it can be promoted as a guideline for other health services, especially in health promotion and disease prevention.

• 디지털융복합연구
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• 제15권3호
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• pp.187-193
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• 2017

사물인터넷 기반의 헬스케어 서비스는 다양한 사물인터넷 디바이스를 통해서 사용자의 생체신호 측정, 질병 진단 및 예방을 포함한 건강관리 및 의료 서비스를 제공하고 있다. 그러나, 사물인터넷 기반의 헬스케어 서비스는 여러 가지 요소 기술들이 통합되어 서비스를 제공하기 때문에 각 요소 기술 자체의 보안 취약성과 연동 시 새로운 보안 취약성이 발생할 수 있는 문제점이 존재한다. 본 논문에서는 모바일 환경에서 IoT 기반의 웨어러블 장비를 이용한 사용자의 헬스케어 정보를 서버에 전달할 때 제 3자로부터 사용자의 헬스케어 정보를 안전하게 처리할 수 있는 사용자 프라이버시 보호 모델을 제안한다. 제안 모델은 사용자의 헬스케어 정보를 안전하게 처리, 보관, 저장할 수 있도록 헬스케어 센서 정보 별로 속성 값을 부여하여 사용자의 프라이버시를 계층적으로 통합 관리한다. 성능평가 결과, 제안모델은 기존모델보다 IoT 장치의 처리율은 평균 10.5% 향상되었고, 서버의 오버헤드는 기존 모델에 비해 평균 9.9% 낮은 결과를 얻었다.

• Tuberculosis and Respiratory Diseases
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• 제73권2호
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• pp.100-106
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• 2012

Background: There are a plethora of literatures showing that high-intensity intensive care unit (ICU) physician staffing is associated with reduced ICU mortality. However, it is not widely used in ICUs because of limited budgets and resources. We created a critical care team (CCT) to improve outcomes in an open general ICU and evaluated its effectiveness based on patients' outcomes. Methods: We conducted this prospective, observational study in an open, general ICU setting, during a period ranging from March of 2009 to February of 2010. The CCT consisted of five teaching staffs. It provided rapid medical services within three hours after calls or consultation. Results: We analyzed the data of 830 patients (157 patients of the CCT group and 673 patients of the non-CCT one). Patients of the CCT group presented more serious conditions than those of the non-CCT group (acute physiologic and chronic health evaluation II [APACHE II] 20.2 vs. 15.8, p<0.001; sequential organ failure assessment [SOFA] 5.5 vs. 4.6, p=0.003). The CCT group also had significantly more patients on mechanical ventilation than those in the non-CCT group (45.9% vs. 23.9%, p<0.001). Success rate of weaning was significantly higher in the CCT group than that of the non-CCT group (61.1% vs. 44.7%, p=0.021). On a multivariate logistic regression analysis, the increased ICU mortality was associated with the older age, non-CCT, higher APACHE II score, higher SOFA score and mechanical ventilation (p<0.05). Conclusion: Although the CCT did not provide full-time services in an open general ICU setting, it might be associated with a reduced ICU mortality. This is particularly the case with patients on mechanical ventilation.

• 한국컴퓨터정보학회논문지
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• 제14권5호
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• pp.157-165
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• 2009

본 논문에서는 일상 공간에서 발생할 수 있는 인간의 일상생활 행위(ADL: Activities of Daily Living)들을 인지하는 분산 모델을 제시한다. 사용자의 환경, 위치 및 행위 정보를 간단한 센서들이 부착된 가정용 기기 혹은 식기들을 통해 무선 센서 네트워크로 수집하며 분석하고, 이 정보를 기반으로 사용자의 생환패턴, 건강상태 등을 파악하여 이에 요구되는 라이프케어 서비스를 제공한다. 하지만 서비스의 제공을 위해서는 높은 수준의 행위인지 데이터가 요구되나 충분히 분석되어지지 않은 센싱 데이터들은 고차원 상창 추론을 위한 일상생활 행위 인지 모델의 구축을 어렵게 한다. 그러나 수집 데이터의 순서를 통해 행위를 인지할 수 있다는 것에 착안하여 센서 데이터들의 순서를 특정 행위 패턴을 분석하는 데 활용하고, 이를 기반으로 한 분산 선형 시간추론 알고리즘을 제안한다. 이 알고리즘은 가정, 사무실 및 병원과 같은 소규모 환경에서 행위를 인지하는 데 적절하다. 제안한 알고리즘의 성능평가를 위해서 MIT Media Lab에서 제공하는 공개 데이터를 사용하였으며, 75% 이상의 평균 행위 인지 정확도를 보였다.

• 농촌계획
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• 제24권1호
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• pp.67-74
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• 2018

The rural areas are large residential space with fewer people than urban areas. That is why they are vulnerable to social services such as health care and security. This research analyzed the vulnerability of emergency relief service in rural village through text mining and the weighting value have been calculated. Based on the calculated statistics data, the police facilities are the most important, While the fire fighting and hospital facilities are important as well. In addition, the distance from the emergency relief service facility to the rural village was confirmed by using Open API. By combining these results, The vulnerable areas of the rural villages and the emergency relief service facilities were calculated and classified into 5 levels. For rural areas, the 1st class will have 33 places, following by 1,179 in 2nd class, 199 in 3rd class, 17 in 4th class and 8 in 5th class. Hence in order to further supplement the vulnerable areas to emergency relief service in villages, geographical relocation and policy approach of emergency relief service facilities are necessary.

• Physical Therapy Rehabilitation Science
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• 제2권1호
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• pp.7-11
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• 2013

Objective: Final goal of nerve advancement therapy is to provide maximum ability to function independently in life to patients. This paper appraises and describes basic concepts of the virtual reality (VR) based exercise program to improve functional movement for neurologically impaired patients. Design: Review article. Methods: Stroke patients from the physical therapy department while wearing comfortable clothing receive therapy and also VR based motion therapy administered by the therapist in charge. After evaluation of stroke patients, therapy includes an exercise program that is suitable for use with stroke patients; stroke patients wear head-mounted display while in front of the computer, where the camera is located; they follow the action on the screen and the computer perceives the operation of the stroke patients according to subject accomplishment. Results: According to obstacle condition of stroke patients using the method, which is various environments after setting, in stroke patients, there is a possibility of presenting suitable therapeutic environments. The display presentation of the method, which is identical, causes difficulty for all stroke patients. According to subject accomplishment; stroke patients result in execution of repetition training and deepening study, which leads to mobility. Conclusions: The VR based rehabilitation training programs is a difference of the existing video training program, is immediate feedback and compensation method. It will provide rehabilitation training services for the family of the patient whose condition could be improved with rehabilitative therapy where it is a continuous circumstance as a matter of the social welfare facility therapy.

• 보건의료산업학회지
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• 제12권3호
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• pp.1-11
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• 2018

Objectives: The purpose of this study is to evaluate patient experience assessment of inpatients, and to prepare measures to improve the quality level of medical services and guarante patient rights. Methods: The study was conducted among 199 patients admitted to hospitals and general hospitals in the metropolitan area. The analysis method used was crossover analysis, including a comparison of means, and logistic regression analysis. Results: The overall average score of satisfaction with healthcare service was 3.39 for nurses, 3.35 for hospitals and 3.42 for general hospitals. Age at the time of hospitalization affected satisfaction. The overall average score of healthcare service satisfaction was 3.09 for doctors, 3.14 for hospitals, and 3.04 for general hospitals. The factors affecting hospital satisfaction were gender and subjective health status. The factors affecting satisfaction in general hospitals were education, medical department, and hospitalization route. Conclusions: Hospitals should also introduce a systematic management system of general hospitals and strengthen the guarantee of the rights of patients who can improve the quality of medical care through positive communication between medical personnel and patients.

• Journal of Preventive Medicine and Public Health
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• 제11권1호
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• pp.123-127
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• 1978

The major objective of this research is to identify those hospital characteristics that best explain cost variation among hospitals and to formulate linear models that can predict hospital costs. Specific emphasis is placed on hospital output, that is, the identification of diagnosis related patient groups (DRGs) which are medically meaningful and demonstrate similar patterns of hospital resource consumption. A casemix index is developed based on the DRGs identified. Considering the common problems encountered in previous hospital cost research, the following study requirements are estab-lished for fulfilling the objectives of this research: 1. Selection of hospitals that exercise similar medical and fiscal practices. 2. Identification of an appropriate data collection mechanism in which demographic and medical characteristics of individual patients as well as accurate and comparable cost information can be derived. 3. Development of a patient classification system in which all the patients treated in hospitals are able to be split into mutually exclusive categories with consistent and stable patterns of resource consumption. 4. Development of a cost finding mechanism through which patient groups' costs can be made comparable across hospitals. A data set of Medicare patients prepared by the Social Security Administration was selected for the study analysis. The data set contained 27,229 record abstracts of Medicare patients discharged from all but one short-term general hospital in Connecticut during the period from January 1, 1971, to December 31, 1972. Each record abstract contained demographic and diagnostic information, as well as charges for specific medical services received. The 'AUT-OGRP System' was used to generate 198 DRGs in which the entire range of Medicare patients were split into mutually exclusive categories, each of which shows a consistent and stable pattern of resource consumption. The 'Departmental Method' was used to generate cost information for the groups of Medicare patients that would be comparable across hospitals. To fulfill the study objectives, an extensive analysis was conducted in the following areas: 1. Analysis of DRGs: in which the level of resource use of each DRG was determined, the length of stay or death rate of each DRG in relation to resource use was characterized, and underlying patterns of the relationships among DRG costs were explained. 2. Exploration of resource use profiles of hospitals; in which the magnitude of differences in the resource uses or death rates incurred in the treatment of Medicare patients among the study hospitals was explored. 3. Casemix analysis; in which four types of casemix-related indices were generated, and the significance of these indices in the explanation of hospital costs was examined. 4. Formulation of linear models to predict hospital costs of Medicare patients; in which nine independent variables (i. e., casemix index, hospital size, complexity of service, teaching activity, location, casemix-adjusted death. rate index, occupancy rate, and casemix-adjusted length of stay index) were used for determining factors in hospital costs. Results from the study analysis indicated that: 1. The system of 198 DRGs for Medicare patient classification was demonstrated not only as a strong tool for determining the pattern of hospital resource utilization of Medicare patients, but also for categorizing patients by their severity of illness. 2. The wei틴fed mean total case cost (TOTC) of the study hospitals for Medicare patients during the study years was $11,27.02 with a standard deviation of $117.20. The hospital with the highest average TOTC ($1538.15) was 2.08 times more expensive than the hospital with the lowest average TOTC ($743.45). The weighted mean per diem total cost (DTOC) of the study hospitals for Medicare patients during the sutdy years was $107.98 with a standard deviation of $15.18. The hospital with the highest average DTOC ($147.23) was 1.87 times more expensive than the hospital with the lowest average DTOC ($78.49). 3. The linear models for each of the six types of hospital costs were formulated using the casemix index and the eight other hospital variables as the determinants. These models explained variance to the extent of 68.7 percent of total case cost (TOTC), 63.5 percent of room and board cost (RMC), 66.2 percent of total ancillary service cost (TANC), 66.3 percent of per diem total cost (DTOC), 56.9 percent of per diem room and board cost (DRMC), and 65.5 percent of per diem ancillary service cost (DTANC). The casemix index alone explained approximately one half of interhospital cost variation: 59.1 percent for TOTC and 44.3 percent for DTOC. Thsee results demonstrate that the casemix index is the most importand determinant of interhospital cost variation Future research and policy implications in regard to the results of this study is envisioned in the following three areas: 1. Utilization of casemix related indices in the Medicare data systems. 2. Refinement of data for hospital cost evaluation. 3. Development of a system for reimbursement and cost control in hospitals.