• 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.

• 한국임상약학회지
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• 제22권4호
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• pp.304-315
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• 2012

Today, suicide by self-poisoning of prescribed or non-prescribed drugs on purpose has been increasing and is a major cause of mortality. It is very important to treat promptly and properly for saving the lives from those suicides. There is neither an organization such as poison control center nor measurement in S. Korea, though. The object of this study was to evaluate information of frequently used substances for suicide attempt in S. Korea. Our results also can provide healthcare provider including pharmacists and doctors, etc and contribute to increasing health and welfare for Korean. From June $1^{st}$ 2006 to April $30^{th}$ 2012, we retrospectively studied patients visiting emergency room due to suicide attempt. We collected information of underlying disease, history of past medical condition and suicide attempt, ingredient and getting route of ingesting substances, emergency treatment, and outcome by reviewing electronic medical record. We also evaluated actual treatment of self-poisoning and made guide information about antidote medication for S. Korean healthcare provider. Among total 242 cases of suicidal attempts, cases ingesting substances including prescription, non-prescription drugs and agricultural chemicals were 86.4%. The most frequently used drugs for suicide attempt were sedatives-hypnotics (53.6%), followed by analgesics (16.7%) and antidepressants (12.4%). Analgesics including acetaminophen and aspirin were most in teenagers but sedatives-hypnotics including benzodiazepines, non-benzodiazepine (zolpidem) and antihistamine were most in other ages including elderly people. Most frequently used antidote was activated charcoal (62.7%) and specific antidotes for some substances (acetaminophen, aspirin, agricultural chemicals) were also treated properly, accompanying with medication for supportive care. In conclusion, the most used substances for suicide attempt were sedatives-hypnotics and treatments for self-poisoning in emergency room were appropriate based on existing references. Therefore, information of frequently used substances and antidote reflecting these results will be useful for South Korean healthcare provider.

• 한국정보통신학회:학술대회논문집
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• 한국해양정보통신학회 2000년도 추계종합학술대회
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• pp.278-283
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• 2000

정보 통신 기술이 발전함에 따라 가정에서 손쉽게 혈압, 맥박, 심전도, 혈중산소포화도, 혈액검사까지 할 수 있는 재택 의료기기와 무선 공중망을 연동하여 일반 국민들이 이제 집에서 간편하게 건강 검진을 받을 수 있는 서비스가 가능하게 되었다. 사람의 몸에서 검출되는 생체 데이터를 가정에서 무선 공중망을 이용하여 원격지 병원의 시스템에 전송함으로써 효율적인 원격 모니터링 의료 서비스에 활용될 수 있다. 무선 근거리 통신망을 이용한 의료 정보 전송 시스템에서 개인이 소지한 단말기를 통해 취득한 생체 신호를 무선으로 병원 내에 있는 기저 시스템을 통해 중앙의 시스템에 전송한다. 원격 모니터링 시스템은 필요한 무선 매체 액세스 프로토콜을 이용하여 구현한다. 이러한 매체 액세스 프로토콜로는 IEEE 802.11 의 CSMA/CA(Carrier Sense Multiple Access with Collision Avoidance) 프로토콜에 폴링 방식을 접목시켜 구현하였다. 본 연구에서는 심전도, 혈압, 혈중산소포화도 측정장치를 가지는 재택 원격 모니터링 시스템 중에서 심전도 측정 부분을 구현하기 위해 이동형 단말기 내부에 심전계 기능을 내장하였다. 이동형 단말기에 900MHz 대역을 사용하는 무선 공중망 인터페이스를 첨가하여, 가정에서의 일반인, 허약 노인, 환자 등의 심전도를 취득하여 저장, 기록함으로써 건강 진단을 받거나 또는 심장 질환을 가졌을 경우, 복잡한 심장 질환을 효과적으로 감시·관리할 수 있는 시스템을 개발하였다. 제안한 무선 공중망에 기반한 의료 정보 전송 시스템을 구현함에 있어서, 이동형 단말기는 생체 신호 데이터 중에서 심전도 데이터를 무선 공중망 모뎀과 NCL(Native Con운ol Language) 프로토콜을 사용하여 무선 공중망과 접속되어 전송되고, 공중망에듣 SCR(Standard Context Routing) 프로토콜을 사용하여 유선 접속되어 있는 관리 호스트 컴퓨터에 등록되어 있는 개인 정보와 취득한 심전도 데이터를 검토하고 그에 상응하는 검진을 이동형 단말기로 보냄으로써, 무선 공중망을 이용한 의료 정보 전송 시스템을 구현될 수 있음을 검증하였다.

• 대한한방부인과학회지
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• 제32권4호
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• pp.132-143
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• 2019

Objectives: The purpose of this study is to provide basic information on Korean medical research and treatment through analysis of breast cancer patients, who visited ${\bigcirc}{\bigcirc}$ university Korean medicine hospital. Methods: To analyze characteristics of breast cancer patients who visited korean medicine hospital, we searched medical records from January 1, 2016 to May 13, 2019, and 86 breast cancer patients were analyzed. Results: 1. The general characteristics of the subjects are as follows. The average age was $47.65{\pm}9.62years$ and 40's was the most (46.51%). The average height was $159.78{\pm}4.91cm$ and the average weight was $57.29{\pm}9.34kg$. The average body mass index (BMI) of the patients was $22.40{\pm}3.50kg/m^2$. 2. The stage distribution record indicated stage０ (9.72%), stageI (31.94%), stageII (34.72%), stageIII (20.83%) and stageIV (2.78%). 14 patients with unknown stage were excluded. 3. Before coming to the korean medicine hospital, of the 86 patients, 72 (83.72%) patients received surgical therapy, 55 (63.95%) patients received chemotherapy and 44 (51.16%) patients received radiotherapy. 11 (12.79%) patients chose oriental medicine as their primary treatment option. 4. The mean duration from diagnosis to hospital visit was $13.87{\pm}15.53months$. Among the total 86 patients, 46 (53.49%) patients visited for symptom relief during the follow-up period. 5. The most common symptom was general weakness in 29 (33.72%) patients, followed by hot flash, myalgia, insomnia, digestion disorder, numbness, edema, arthralgia, operation site pain, cold sensation and mastalgia. 6. Among 86 patients, 55 (63.95%) patients received acupuncture and moxibustion together. The most prescribed herbal medicine to subjects was Sibjeondaebo-tang-gamibang and Cheonhye-dan (25%). Conclusions: These results could be helpful to provide basic data on the Korean medical approach of breast cancer patients.

• Journal of Gastric Cancer
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• 제4권1호
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• pp.15-26
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• 2004

This nationwide survey was conducted to evaluate the current status of the database system on gastric cancer patients in Korea. The Information Committee of Korean Gastric Cancer Association (KGCA) sent questionnaires about the database management to all 402 KGCA members in 110 institutes. In addition, we asked them to send the gastric cancer sheet and the pathologic report of gastric cancer used in their institutes. Response rates were $18.9\%$ (76/402) for individuals and $51.8\%$ (57/110) for institutes, respectively. Most of the university hospitals responded to the questionnaire (response rate of university hospital: $74.6\%$, 44/59). A regular conference of gastric cancer and a digitalization of the database on gastric cancer patients were performed in 29 ($50.9\%$) and 43 ($75.4\%$) out of 57 institutes, respectively. MS excel was most commonly used for the digitalization of the database, followed by MS access and SPSS. A regularly formed gastric cancer sheet and pathologic report were used in 38 ($66.7\%$) and 49 ($86.0\%$) institutes, respectively. Hospital computerization, such as an Order Communicating System, an Electric Medical Record, and a Picture Archiving/Communicating System had been set up previously or would be set up in the near future in most institutes. In 25 gastric cancer sheets collected, the mean number of total items was 72.9 ($15\∼177$). Identification datafor the patients, surgical data, and pathologic data were included on most of the sheets, but preoperative status, preoperative diagnostic data, and postoperative hospital course were not.

• Safety and Health at Work
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• 제3권2호
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• pp.140-145
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• 2012

Objectives: To understand the personal experiences of mine workers that have experienced job relocation due to silicosis at the Andina Division of Corporaci$\acute{o}$n Nacional del Cobre (CODELCO), Chile. The purpose of the study was to provide useful information for the development of new local, business and public policies for the care of workers with silicosis. Methods: A qualitative study based on a practical case study of 5 workers. The information was collected by means of structured individual interviews. The method of analysis was phenomenology. Results: The corporal axis was the most commented upon. It included awareness of the illness, body pains, fatigue, and antagonistic mood disorders (sadness, or the difficulty in finding meaning in life). As far as personal relationships, there was evidence of strong relationships with family, coworkers and friends, as well as extended family. Over all, the experience of relocation was positive with periods of impatience and uncertainty. The job reassignment provided a new and pleasant context for the relocated workers and in the process improved their perception of their quality of life. Conclusions: A multidisciplinary team should attend mine workers relocated because of silicosis by addressing the mental and physical aspects of their disease, along with the integral participation of close family members. It is suggested that this investigation be maintain over time to record the personal experiences in the medium-term, adding new cases with the intention of shedding more light on the phenomenon being studied. As a preventive measure, continual workshops are needed on the proper use of respiratory protection in addition, a group of monitors is required.

• 대한화상학회지
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• 제22권2호
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• pp.49-52
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• 2019

Purpose: Little information has been published regarding minor burn injuries in infants, most of which are preventable. To fill this research gap, this study explored the patterns and mechanisms of burn injuries in infants to ascertain whether such incidents can be prevented. Methods: This was a retrospective study, based on data collected prospectively from all infants (<12 months old) admitted to our hospital with burns in the four-year period between January 1, 2015 and December 31, 2018. A medical record review provided basic demographic information, such as age at the time of injury, sex, cause of injury, duration of treatment, operative treatment, and the extent and type of burn, as well as the anatomical region involved. Results: Fifty-seven infants were diagnosed with burn injuries, with scalding being the most common type (47%), followed by contact (32%) and steam (14%). Seven infants of eight steam burn patients injured by pressure cooker. Superficial second degree was the most common depth of injury (72%) followed by first degree (17%) and deep second degree (8%). Average age per injury type was calculated by independent T-test. Average ages of patients with contact and steam burns were significantly lower (7.06 months; P=0.19) and higher (9.25 months; P=0.005), respectively, than for other burn types. Conclusion: Given that infants cannot control their body movements, talk, or manage by themselves, they are entirely dependent on the proper care of adults. Consequently, in addition to the prevention of burns, special care should be taken for the pressure cooker.

• 한국정보전자통신기술학회논문지
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• 제17권2호
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• pp.99-107
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• 2024

최근 많은 산업 분야에서 진행되고 있는 디지털 트랜스포메이션은 데이터의 폭발적인 증가를 가져왔으며, 동시에 기업이 생성하고 처리해야 하는 데이터의 양을 기하급수적으로 증가시켰다. 이에 기업은 ERP 시스템을 활용해 실시간으로 대량의 데이터를 관리하고 분석하는 데 노력을 기울이고 있다. 그러나 기존 ERP 시스템에서 대량의 데이터를 처리하는 데 있어 비용 및 시간 문제가 발생하고 있어, 기존 시스템에서 데이터를 실시간으로 압축하고 저장할 수 있는 데이터 아카이빙 기술의 적용이 필수적이다. 이에 본 논문에서는 ERP 기반 실시간 데이터 아카이빙 기술에 관한 특허 데이터를 활용하여 대상 기술의 동향을 파악하고, 핵심 특허를 분석하여 이를 기반으로 신규 핵심특허를 창출하고자 한다.

• 가정간호학회지
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• 제6권
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• 대한예방한의학회지
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• 제19권2호
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• pp.103-112
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• 2015

Objective : To evaluate the status of mobile personal health records (mPHR) applications of Atopic Dermatitis, assessing general characteristics, information content, features of PHR content and functions. Method : Searches were conducted from Android's Google Play and iOS's App Store. Main criteria used to include mPHRs were: providing health information of PHR function of Atopic Dermatitis; operating in Korean or English; for human. Selected mPHRs were analyzed considering general characteristics, information contents, data elements, and application features. Results : 19 applications were included in this study. 15 were providing health information. Data elements of information included general information, symptom, diagnosis, treatment, prevention, management and FAQ. No single application contained all seven data elements. Only Eight applications had PHR function. In the features analysis, one PHR applications contained all eight PHR functional features; saving profile function, profiles supported, password, import data, export data, information provided, progress chart and push-up alarm. Conclusion : mPHR is an emerging health care technology. The majority of existing mPHR applications only provide one-way information. Application designed to help users and doctors to exchange mutual information was the only one. Also, there was no application that can record the Traditional Korean Medicinal treatment information. However, as the mobile market continues to expand it is likely that more comprehensive mPHRs will be developed in the near future. New advancements in mobile technology can be utilized to enhance Tranditional Korean Medical health care.