• Journal of Platform Technology
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• v.8 no.3
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• pp.3-9
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• 2020

As the need for sharing for research purposes in the medical field increases, the use of a Common Data Model (CDM) is increasing. However, when sharing CDM data, there are some problems in that access control and personal information in the data are not protected. In this paper, in order to solve this problem, access to CDM data is controlled by using an encryption method in a blockchain network, and information of CDM data is recorded to enable tracking. In addition, IPFS was used to share a large amount of CDM data, and Celery was used to automate the sharing process. In other words, we propose a multi-channel automation system in which the information required for CDM data sharing is shared by a trust-based technology, a distributed file system, and a message queue for automation. This aims to solve the problem of access control and personal information protection in the data that occur in the process of sharing CDM data.

• Journal of Preventive Medicine and Public Health
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• v.55 no.1
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• pp.49-59
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• 2022

Objectives: Access to maternal and neonatal care services (MNCS) is an important goal of health policy in developing countries. In this study, we proposed a 3-level hierarchical location-allocation model to maximize the coverage of MNCS providers in Iran. Methods: First, the necessary criteria for designing an MNCS network were explored. Birth data, including gestational age and birth weight, were collected from the data bank of the Iranian Maternal and Neonatal Network national registry based on 3 service levels (I, II, and III). Vehicular travel times between the points of demand and MNCS providers were considered. Alternative MNCS were mapped in some cities to reduce access difficulties. Results: It was found that 130, 121, and 86 MNCS providers were needed to respond to level I, II, and III demands, respectively, in 373 cities. Service level III was not available in 39 cities within the determined travel time, which led to an increased average travel time of 173 minutes to the nearest MNCS provider. Conclusions: This study revealed inequalities in the distribution of MNCS providers. Management of the distribution of MNCS providers can be used to enhance spatial access to health services and reduce the risk of neonatal mortality and morbidity. This method may provide a sustainable healthcare solution at the policy and decision-making level for regional, or even universal, healthcare networks.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.1
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• pp.7-19
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• 2023

Purpose: Mobility impairment persons are all people who experience mobility difficulties in their daily lives, which makes up about 30% of the population in Seoul Metropolitan City; this number is expected to increase with population aging. As the number of mobility impairment persons in need of vision correction increases, it is necessary to create the Universal Design guidelines and to provide the foundation to access convenience facilities at the entrance of optical shops, a health and medical institution. Methods: Of the 2,282 optical shops located in Seoul, 252 optical shops were chosen for data collection of actual photos, from April 10, 2022 to September 4, 2022. Based on the photographs, the height difference between the entrance and the sidewalk, safety handles, and opening and closing methods of entrances were investigated, as these factors correspond to the accessibility and the mobility of the mobility impairment persons. Results: Of the 252 optical shops surveyed, 114 (45.2%) have resolved the problems of height difference through improving horizontal accessibility (61) or using ramps (53). 36 (14.3%) optical shops chose automatic doors for opening and closing methods of the entrance. Implications: The rate of installation of access convenience facilities for the entrance of optical shops is slightly lower than the rate of installation of ramps, surveyed by the Ministry of Health and Welfare. It is necessary to apply the Universal Design to access convenience facilities for the entrance of optical shops for not only the mobility impairment persons but all people, regardless of age or ability, to conveniently access healthcare services.

• International Journal of Computer Science & Network Security
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• v.24 no.8
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• pp.32-42
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• 2024

The Internet of Things (IoT) is set to transform patient care by enhancing data collection, analysis, and management through medical sensors and wearable devices. However, the convergence of IoT device vulnerabilities and the sensitivity of healthcare data raises significant data integrity and privacy concerns. In response, this research introduces the Smart-Coord system, a practical and affordable solution for securing healthcare IoT. Smart-Coord leverages blockchain technology and coordinate-based access management to fortify healthcare IoT. It employs IPFS for immutable data storage and intelligent Solidity Ethereum contracts for data integrity and confidentiality, creating a hierarchical, AES-CBC-secured data transmission protocol from IoT devices to blockchain repositories. Our technique uses a unique coordinate system to embed confidentiality and integrity regulations into a single access control model, dictating data access and transfer based on subject-object pairings in a coordinate plane. This dual enforcement technique governs and secures the flow of healthcare IoT information. With its implementation on the Matic network, the Smart-Coord system's computational efficiency and cost-effectiveness are unparalleled. Smart-Coord boasts significantly lower transaction costs and data operation processing times than other blockchain networks, making it a practical and affordable solution. Smart-Coord holds the promise of enhancing IoT-based healthcare system security by managing sensitive health data in a scalable, efficient, and secure manner. The Smart-Coord framework heralds a new era in healthcare IoT adoption, expertly managing data integrity, confidentiality, and accessibility to ensure a secure, reliable digital environment for patient data management.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.6
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• pp.2431-2440
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• 2015

Background: Registry data from four major public hospitals indicate trends in clinical care and survival from colorectal cancer over three decades, from 1980 to 2010. Materials and Methods: Kaplan-Meier productlimit estimates and Cox proportional hazards models were used to investigate disease-specific survival and multiple logistic regression analyses to explore first-round treatment trends. Results: Five-year survivals increased from 48% for 1980-1986 to 63% for 2005-2010 diagnoses. Survival increases applied to each ACPS stage (Australian Clinico-Pathological Stage), and particularly stage C (an increase from 38% to 68%). Risk of death from colorectal cancer halved (hazards ratio: 0.50 (0.45, 0.56)) over the study period after adjusting for age, sex, stage, differentiation, primary sub-site, health administrative region, and measures of socioeconomic status and geographic remoteness. Decreases in stage were not observed. Survivals did not vary by sex or place of residence, suggesting reasonable equity in service access and outcomes. Of staged cases, 91% were treated surgically with lower surgical rates for older ages and more advanced stage. Proportions of surgical cases having adjuvant therapy during primary courses of treatment increased for all stages and were highest for stage C (an increase from 5% in 1980-1986 to 63% for 2005-2010). Radiotherapy was more common for rectal than colonic cases. Proportions of rectal cases receiving radiotherapy increased, particularly for stage C where the increase was from 8% in 1980-1986 to 60% in 2005-2010. The percentage of stage C colorectal cases less than 70 years of age having systemic therapy as part of their first treatment round increased from 3% in 1980-1986 to 81% by 1995-2010. Based on survey data on uptake of adjuvant therapy among those offered this care, it is likely that all these younger patients were offered systemic treatment. Conclusions: We conclude that pronounced increases in survivals from colorectal cancer have occurred at major public hospitals in South Australia due to increases in stage-specific survivals. Use of adjuvant therapies has increased and the patterns of change accord with clinical guideline recommendations. Reasons for sub-optimal use of radiotherapy for rectal cases warrant further investigation, including the potential for limited rural access to impede uptake of treatments at metropolitan-based radiotherapy centres.

• Tuberculosis and Respiratory Diseases
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• v.70 no.4
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• pp.307-314
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• 2011

Background: Chronic obstructive pulmonary disease (COPD) is a major cause of death and disability worldwide and one of the most prevalent diseases in Korea. We examined trends and risk factors of health care utilization for COPD in Korea. Methods: We retrospectively analyzed the database of Patient Surveys from 1990 through 2008, which were nationwide surveys of health services utilization through outpatient department (OPD) visits and hospitalization. Physician-diagnosed COPD patients whose ages were 45 years and older were included. Results: OPD visits and hospitalization of COPD patients between 1990 and 2008 were estimated to be 68,552 and 17,774 persons, respectively. Trends in OPD visits and hospitalization for COPD significantly increased from 1990 through 2008 (p=0.019, p=0.001, respectively). The increment rate for OPD visits was 2.0 fold over those years; for hospitalization it was 3.3 fold. Risk factors for OPD visits for COPD were male gender (odd ration [OR], 1.41; 95% confidence interval [CI], 1.39~1.43), those aged 65 years and older (OR, 1.50; 95% CI, 1.47~1.53), residential area other than a metropolis (OR, 1.08; 95% CI, 1.07~1.010) and access to a physician's office (OR, 1.17; 95% CI, 1.14~1.21). Risk factors for hospitalization were male gender (OR, 2.15; 95% CI, 2.07~2.23), those aged 65 year and older (OR, 2.86; 95% CI, 2.72~3.00), residential area other than a metropolis (OR, 1.98; 95% CI, 1.90~2.07) and access to a hospital (OR, 2.88; 95% CI, 2.59~3.22) (p<0.001, both). Conclusion: Health care utilization for COPD subjects increased from 1990 to 2008. Risk factors for the utilization were male gender, older age, and residential area other than a metropolis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.1
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• pp.74-81
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• 2005

In 1974, Casson et. al. reported midfacial degloving approach to repair the midfacial bone fracture. After then, this approach has been used frequently to treat the lesions on nasal cavity, nasopharynx, facial plastic surgery and midfacial trauma. Midfacial degloving approach consists of 1) bilateral sublabial incision 2) complete transfixion incision/ septocolumellar incision 3) bilateral intercartilaginous incision 4) bilateral pyriform aperature incision. This approach provides proper access for midfacial bone structure without facial scar but has post-operative complications such as transient epistaxis, infraorbital nerve paresthesia and nasal crust. We treated three patients using midfacial degloving approach to correct traumatic deformity in midface area. In two patients, rhinoplasty with autogenous rib graft was done simultaneously. So we report these cases with review of literatures.

• Convergence Security Journal
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• v.13 no.6
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• pp.35-41
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• 2013

What is an alternative to medical information security of medical information more secure preservation and safety of various types of security threats should be taken, starting from the software design. Interspersed with medical information systems medical information to be able to integrate the real-time exchange of medical information must be reliable data communication. The software architecture design of medical information systems and sharing of medical information security issues and communication phase allows the user to identify the requirements reflected in the software design. Software framework design, message standard design, design a web-based inter-process communication procedures, access control algorithm design, architecture, writing descriptions, evaluation of various will procedure the establishing architecture. The initial decision is a software architecture design, development, testing, maintenance, ongoing impact. In addition, the project will be based on the decision in detail. Medical information security method based on the design software architecture of today's medical information security has become an important task of the framework will be able to provide.

• The Journal of Korean Medicine
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• v.40 no.1
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• pp.86-98
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• 2019

Objectives: This study analyzes the electronic medical record (EMR) data of the spine specialist oriental hospital and clinic in various regions, and reports the actual number and used cases of Chuna therapy. Methods: 2,470,772 data was extracted retrospectively from electronic medical records of all inpatients and outpatients who were treated chuna therapy at 21 Korean medicine hospitals and clinics from January 1, 2018 to December 31, 2018. The characteristics of medical treatment using chuna therapy reflect the minimum, maximum and average values of the number of hospitalized patients, length of hospitalization, frequency of hospitalization, number of outpatients, frequency of treatment and frequency of visit. Diseases were classified in the proportion of Chuna treatment according to the KCD, 7th edition. The chuna and blindness charts were derived accordingly from illness and disease of each part of the body. Results: During the study period, a total 1,342,022 inpatients and outpatients visited the study sites. The male proportion was a little higher than the females' (male: 53.7%, female: 46.3%). According to age, the 30s and 40s were more than half the total(30s: 33.0% and 40s: 20.1%). Chuna therapy was treated to more outpatients than hospitalized patients (outpatient: 83.6%, hospitalization: 16.4%), and most treatments were related to musculoskeletal illness(99.06%). Conclusions: As a result of this study, 1,342,389 chuna therapy was performed in 21 hospitals for one year. As highly demanded by the public, we look forward to ensuring national health care options and medical access when health insurance for chuna therapy is applied beginning March 2019.

• Journal of Preventive Medicine and Public Health
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• v.18 no.1
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• pp.13-24
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• 1985

This study seeks to provide a framework for understanding differential access to medical care. The framework is provided by Anderson Model, a model of health services utilization which suggests a sequence of predisposing, enabling, illness-morbidity characteristics that determine the number of times people will visit a physician. The framework in this study is composed of two models, one is for Adults and the other is for Non-Adults. Models are operationalized using stepwise multiple regression analysis and path analysis. The data come from a national health survey conducted in 1983. The findings of the analysis can be summarized as follows : First, the causal models used in this study are able to explain only a small amount of the variance in medical care utilization(Adjusted $R^2$ is .144 in the Model for Adults and .243 in that for Non-Adults). This finding suggests that we reconsider the utility of such existing model using the predisposing, enabling, and illness-morbidity characteristics in light of their poor correspondence with these data. Second, while small amount of the valiance in medical care utilization is explained, most of the explained variance is due to the illness-morbidity characteristics. The path coefficients of study variables except illness-morbidity variables show these characteristics to be substantially unrelated to medical care utilization, and the indirect effects of the predisposing and edabling characteristics on medical care utilization are also negligible. This casts doubt on the importance of the predisposing and enabling characteristics in explaining medical care utilization. Third, among the predisposing and enabling characteristics, Medical Security variable is the only one having significant direct effect on medical care utilization in both models for Adults and for Non-Adults. Fourth, the amount of the variance explained in the Model for Non-Adults is more than in the Model for Adults. This suggests that medical care utilization of adults is more influenced by behavioral factors than that of children.