• 제목/요약/키워드: Hospital utilization

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The Impact of Weekend Admission and Patient Safety Indicator on 30-Day Mortality among Korean Long-Term Care Insurance Beneficiaries

  • Shin, Jaeyong;Kim, Jae-Hyun
    • 보건행정학회지
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    • 제29권2호
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    • pp.228-236
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    • 2019
  • Background: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. Methods: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. Results: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI. Conclusion: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

한·양방 협진에 관한 일반인들의 인식 조사 (Survey on Perception Level of the East-West Collaborative Medical Practices among the General Public)

  • 정연민;조성우
    • 한방재활의학과학회지
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    • 제29권1호
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    • pp.41-61
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    • 2019
  • Objectives The purpose of this survey was to investigate the using experiences and attitudes of general public toward the East-West collaborative medical practices (EWCMP). Methods We selected objects in general public and structured questionnaires were administrated to both 295 offline participants and 795 online participants. The data was collected from 15 to 28 February 2016 and analyzed statistically by frequency, ${\chi}^2$ cross-over analysis with SPSS software. Results The total number of participants was 1,090 and 66.1% of them has heard but only 19.5% has ever used EWCMP. For participants who has used EWCMP, the decision to use it was made by themselves (53.2%), 44.0% of them was satisfied with EWCMP, 89.4% of them showed revisiting intention to EWCMP hospital, and 72.2% of them showed the intention to introduce EWCMP to others. And 52.3% of them were optimistic about the prospects of EWCMP, especially in the field of disease treatment (49.9%) and rehabilitation (20.6%). On the reasons for lack of development of EWCMP, 31.9% of them listed prejudices existing on both sides firstly (31.9%). Preferred type of EWCMP was to use both western and Korean medical treatment at the same weight (53.9%). To promote EWCMP, it is required to confirm the concept of collaborative medical practice to the medical professions and government authorities (29.5%). Conclusions Considering low proportion of utilization and positive attitude toward the EWCMP among general populations, it is need to introduce or advertise EWCMP to them.

인체 골격의 좌표형 임상용어체계 표준 개발 : SNOMED CT 기반의 융복합 연구 (Development of Clinical Terminology System for Human Body : Convergence Research of SNOMED CT)

  • 최병관;최은아;남문희
    • 디지털융복합연구
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    • 제17권4호
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    • pp.177-185
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    • 2019
  • 본 연구는 인체 골격의 좌표형 임상용어체계 표준을 개발하기 위한 방법론적 연구이다. 문헌고찰과 자료 수집을 통해 연구 계획을 수립하여 예비 표준(안)을 만들고 전문가 세미나와 자문을 통해 수정 표준(안)을 만든 후 내용타당도 검증 후 최종(안)을 제시하는 4단계를 거쳐 표준을 개발하였다. 좌표형 임상용어체계 표준은 인체 이미지를 2D는 x, y축, 3D는 x,y,z축으로 좌표화하고, 좌표의 개념과 정의는 SNOMED CT의 FSN, Synonym, Preferred name으로 선조합하고 후조합은 개발 된 18개의 Relationship을 통해 정의되고, 개발된 Relationship 표준의 내용타당도 지수는 평균 4.01점이었다. 본 연구를 통해 인체 골격 이외의 뇌, 장기, 조직 등의 인체의 다른 부분에 대한 후속 표준 개발을 제언하고 임상에서 활용성을 높이기 위한 방법 연구를 제언한다.

외래에서 시행하는 경윤상갑상막 접근 성대주입술 중 주입 위치를 정확하게 파악하는 방법에 관한 기술적 고찰 (Technical Review of How to Determine the Exact Location of Needle Tip During Office-Based Injection Augmentation of the Vocal Folds Via Cricothyroid Approach)

  • 박성준;권택균
    • 대한후두음성언어의학회지
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    • 제29권2호
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    • pp.70-75
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    • 2018
  • The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.

CareDose 4D 사용 시 동일한 스캔조건에서 조직기반설정을 다르게 적용함에 따른 선량 비교: 성인과 소아팬텀 연구 (Radiation Dose Comparison according to Different Organ Characteristics at Same Scan Parameters Using CareDose 4D: An Adult and Pediatric Phantom Evaluation)

  • 공효금;이기백
    • 대한방사선기술학회지:방사선기술과학
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    • 제42권4호
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    • pp.271-277
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    • 2019
  • CareDose 4D which is the Siemens's Automatic Exposure Control (AEC) can adjust the level of radiation dose distribution which is based on organ characteristic unlike other manufacturer's AEC. Currently, a wide scan range containing different organs is sometimes examined at once (defined as one scan). The purpose of this study was to figure out which organ characteristic option is suitable when one scan method is utilized. Two types of anthropomorphic phantoms were scanned in the same range which were from frontal bone to carina level according to three different organ characteristics such as Thorax, Abdomen, and Neck. All scans and image reconstruction parameters were equally applied and radiation dose were compared. Radiation dose with Thorax organ characteristic was lower than that with Neck. Also, that with Abdomen oran characteristic was lower than Thorax. There were significant differences in radiation dose according to different organ characteristics at the same parameters (P<0.05). Usage of Neck organ characteristic had a result of the highest radiation dose to all phantom. On the other hand, utilization of Abdomen organ characteristic showed the lowest radiation dose. As a result, it is desirable to set appropriate organ characteristic according to examined body part when you checkup patients. Also, when you implement one scan method, selection of Abdomen-based organ characteristic has reduced more radiation dose compared with two different organ characteristic.

개인의 건강정보 제공의도에 영향을 미치는 요인: 프라이버시 계산 관점에서 (Factors Affecting an Individual's Intention to Disclose Personal Health Information: From Privacy Calculus Perspective)

  • 정의선;이상철;서영호
    • 품질경영학회지
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    • 제46권4호
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    • pp.877-898
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    • 2018
  • Purpose: This study empirically examines the effect of Communication Privacy Management(CPM) factors and Privacy Calculus factors to the intention to disclose Personal Health Information(PHI) in the context of healthcare ecosystem. Also, it investigates the moderating effects of CPM factors in the relationship between privacy calculus variables and the intention to disclose PHI. Methods: We conducted scenario-based repeated-measures quasiexperiment and used total 364 samples for analysis. Confirmatory factor analysis and repeated-measure ANOVA were employed using SPSS 24.0. Results: All CPM factors, such as type of information, requesting purpose, and requesting stakeholder, directly influence to the intention to disclose PHI, whereas only the medium trust out of the Privacy Calculus factors has direct influence on the intention to disclose PHI. With regard to the moderating effects, the requesting stakeholder is the most influential and the information type is the least influential construct. Conclusion: The findings suggest that healthcare system should be designed to provide more definite and personalized benefits to customers to enhance social and individual benefits by getting more participation from customers. Also, it is desirable that the requesting stakeholder of PHI would be non-profit organizations such as hospital, government or public agencies to secure more willingness of PHI from people. Furthermore, it is implied that extensive information gathering and utilization, instead of excluding sensitive information or critical patients' records, is recommended which is substantial to invigorate the healthcare industry.

판정행렬을 기반한 일체형 PET-MRI의 폐암 진단 유용성 평가 (Evaluation of Usefulness for Diagnosis of Lung Cancer on Integrated PET-MRI Using Decision Matrix)

  • 김정수;양현진;김유미;권형진;박찬록
    • 대한방사선기술학회지:방사선기술과학
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    • 제44권6호
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    • pp.635-643
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    • 2021
  • The results of empirical researches on the diagnosis of lung cancer are insufficient, so it is limited to objectively judge the clinical possibility and utilization according to the accuracy of diagnosis. Thus, this study retrospectively analyzed the lung cancer diagnostic performance of PET-MRI (Positron Emission Tomography-Magnetic Resonance Imaging) by using the decision matrix. This study selected and experimented total 165 patients who received both hematological CEA (Carcinoembryonic Antigen) test and hybrid PET-MRI (18F-FDG, 5.18 MBq/kg / Body TIM coil. VIVE-Dixon). After setting up the result of CEA (positive:>4 ㎍/ℓ. negative:<2.5㎍/ℓ) as golden data, the lung cancer was found in the image of PET-MRI, and then the SUVmax (positive:>4, negative:<1.5) was measured, and then evaluated the correlation and significance of results of relative diagnostic performance of PET-MRI compared to CEA through the statistical verification (t-test, P>0.05). Through this, the PET-MRI was analyzed as 96.29% of sensitivity, 95.23% of specificity, 3.70% of false negative rate, 4.76% of false positive rate, and 95.75% of accuracy. The false negative rate was 1.06% lower than the false positive rate. The PET-MRI that significant accuracy of diagnosis through high sensitivity and specificity, and low false negative rate and false positive rate of lung cancer, could acquire the fusion image of specialized soft tissue by combining the radio-pharmaceuticals with various sequences, so its clinical value and usefulness are regarded as latently sufficient.

4-Chloro-2-Isopropyl-5-Methylphenol Exhibits Antimicrobial and Adjuvant Activity against Methicillin-Resistant Staphylococcus aureus

  • Kim, Byung Chan;Kim, Hyerim;Lee, Hye Soo;Kim, Su Hyun;Cho, Do-Hyun;Jung, Hee Ju;Bhatia, Shashi Kant;Yune, Philip S.;Joo, Hwang-Soo;Kim, Jae-Seok;Kim, Wooseong;Yang, Yung-Hun
    • Journal of Microbiology and Biotechnology
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    • 제32권6호
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    • pp.730-739
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    • 2022
  • Methicillin-resistant Staphylococcus aureus (MRSA) causes severe infections and poses a global healthcare challenge. The utilization of novel molecules which confer synergistical effects to existing MRSA-directed antibiotics is one of the well-accepted strategies in lieu of de novo development of new antibiotics. Thymol is a key component of the essential oil of plants in the Thymus and Origanum genera. Despite the absence of antimicrobial potency, thymol is known to inhibit MRSA biofilm formation. However, the anti-MRSA activity of thymol analogs is not well characterized. Here, we assessed the antimicrobial activity of several thymol derivatives and found that 4-chloro-2-isopropyl-5-methylphenol (chlorothymol) has antimicrobial activity against MRSA and in addition it also prevents biofilm formation. Chlorothymol inhibited staphyloxanthin production, slowed MRSA motility, and altered bacterial cell density and size. This compound also showed a synergistic antimicrobial activity with oxacillin against highly resistant S. aureus clinical isolates and biofilms associated with these isolates. Our results demonstrate that chlorinated thymol derivatives should be considered as a new lead compound in anti-MRSA therapeutics.

틱장애 아동 보호자의 일상 및 한의치료 이용 경험에 대한 질적 연구 (A Qualitative Study on Experiences of Daily Life and Korean Medicine Utilization of Caregivers of Children with Tic Disorders)

  • 윤석인;서효원;이미선;홍성규;정선용
    • 동의신경정신과학회지
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    • 제33권4호
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    • pp.361-376
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    • 2022
  • Objectives: To understand experiences of daily life and Korean medicine treatment process and perspectives of caregivers caring for children with tic disorder. Methods: A semi-structured interview was conducted with caregivers of patients under 13 years who were experiencing Korean medicine treatment for tic disorder. A total of five participants were interviewed. The analysis was performed according to a four-step phenomenological method. Results: The following four components were derived from the experience of caring for children with tic disorder: general perception of tics, negative emotions caused by tics, social deprivation, and living with a child with tics. The following four components were derived from Korean medicine treatment experience for tic disorders: criteria for selecting treatment, awareness of Korean medicine, treatment experience in Korean medicine, and what needs to be improved. Conclusions: According to results of this study, caregivers caring for children with tic disorder experienced negative emotions such as frustration, guilt, and anxiety. They also experienced social deprivation such as stigma and prejudice. Korean medicine treatment can be an effective alternative for improving symptoms of tic disorders. The application of insurance benefits to Korean medicine is needed for patients and caregivers to autonomously choose treatment.

빅데이터를 활용한 근골격계 표준의료용어에 대한 키워드 네트워크 분석 (A Keyword Network Analysis of Standard Medical Terminology for Musculoskeletal System Using Big Data)

  • 최병관;최은아;남문희
    • 디지털융복합연구
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    • 제20권5호
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    • pp.681-693
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    • 2022
  • 본 연구는 근골격계 질환으로 입원한 환자의 의무기록지 키워드 네트워크 분석을 통해 근골격계와 관련된 표준의료용어를 유추하여 보건의료현장의 비정형화된 데이터 활용 방안을 제시하기 위함이다. 분석 대상은 2010년부터 2019년까지 근골격계 질환 환자의 입퇴원요약지 145부로, 더아이엠씨(The IMC)에서 개발한 빅데이터 분석 솔루션인 TEXTOM을 활용하여 분석하였다. 1차·2차 정제과정을 통해 도출된 177개의 근골격계 관련 용어를 최종 분석하였다. 연구결과 다빈도 용어는 'Metastasis', 의료용어 체계별 분석 결과에서 임상소견은 'Metastasis', 증상은 'Weakness', 진단은 'Hepatitis', 처치는 'Remove', 신체구조는 'Spine', 약물은 'Oxycodone'이 가장 많이 사용되었다. 이러한 결과를 바탕으로 정형화되지 않은 의료데이터의 분석과 활용 및 관리 방안에 대한 시사점을 제안하고자 한다.