• Title/Summary/Keyword: Patient's Severity

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Sufficient explanation of management affects patient satisfaction and the practice of post-treatment management in spinal pain, a multicenter study of 1007 patients

  • Kim, Jae Yun;Shim, Jae Hang;Hong, Sung Jun;Yang, Jong Yeun;Choi, Hey Ran;Lim, Yun Hee;Moon, Ho Sik;Lee, Jaemoon;Kim, Jae Hun
    • The Korean Journal of Pain
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    • v.30 no.2
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    • pp.116-125
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    • 2017
  • Background: Spinal pain is most common symptom in pain clinic. In most cases, before the treatment of spinal pain, physician explains the patient's disease and treatment. We investigated patient's satisfaction and physician's explanation related to treatments in spinal pain patients by questionnaires. Methods: Anonymous questionnaires about physician's explanation and patient's satisfaction in each treatment and post-treatment management were asked to individuals suffering from spinal pain. Patients who have spinal pain were participated in our survey of nationwide university hospitals in Korea. The relationships between patient's satisfaction and other factors were analyzed. Results: Between June 2016 and August 2016, 1007 patients in 37 university hospitals completed the questionnaire. In the statistical analysis, patient's satisfaction of treatment increased when pain severity was low or received sufficient preceding explanation about nerve block and medication (P < 0.01). Sufficient explanation increased patient's necessity of a post-treatment management and patients' performance rate of post-treatment management (P < 0.01). Conclusions: These results show that sufficient explanation increased patients' satisfaction after nerve block and medication. Sufficient explanation also increased the practice of patients' post-treatment management.

Analysis of Dementia Tests Affecting the Diagnosis of Alzheimer's Disease (알츠하이머 치매 진단에 영향을 미치는 검사도구 분석)

  • Park, E-Rang;Kang, Gwang-Soon
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.1
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    • pp.181-189
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    • 2021
  • The purpose of this study is to investigate the relationship between "Mental Status and Dementia Tests" and "predictive diagnosis of severity of dementia". This is a descriptive research, analyze the data collected from Alzheimer's patients and identify which "Mental Status and Dementia Tests" has the most impact to determine the severity of dementia. For this study, Alzheimer's patient's CDR, MMSE-K, SGDS, NPI-Q, BADL and IADL were collected and analyzed. This study will provide a predictive factor to determine the severity of dementia when "Mental Status and Dementia Testss" are being used and also to provide the right treatment. For this study, a total of 617 cases of data from Alzheimer's patients were collected and analyzed with SPSS Statistics. In addition, effective "Mental Status and Dementia Tests" for evaluating the severity of dementia were CDR, ADL, MMSE-K, and SGDS whereas NPI-Q and IADL. Based on the findings of the study, it was recommended to implement more efficient diagnostic method by utilizing a standardized "Mental Status and Dementia Tests".

Two different Cases of Psoriasis Patients Treated with 2 different Kobangs (고방(古方)으로 치료한 건선 환자 치험 2례)

  • Moon, Young Ho;Oh, Jae Seon;Kim, Seon Jong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.6
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    • pp.650-656
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    • 2014
  • The purpose of this study is to investigate the effect of 2 Kobangs. Daecheongryong-tang and Samhwangsasim-tang on to two psoriasis patients each. The improvement of the skin condition was observed by Psoriasis Area and Severity Index (PASI) score. The patient treated with Daecheongryong-tang showed significant improvement after the patient's state of sweating improved and the PASI score of the patient reduced from 17.6 to 1.8 after five months of treatment. The patient treated with Samhwangsasim-tang showed gradual improvement after the patient's defecation was improved and the PASI score of the patient reduced from 27.3 to 3.6 after three months of treatment. According to the results, we obtained clinically positive effects from 2 Kobangs applied on 2 psoriasis cases respectively. Although there were few reports on psoriasis treated with Kobang, we can suggest effective treatment on psoriasis.

The Medico-Legal and Ethical Problems of Withholding / Withdrawing of Futile Life-Sustaining Mechanical Respirator treatment (연명(延命)치료적 인공기계호흡요법의 보류(保留)/중지(中止)를 전후한, 법의학적 및 윤리적 문제들과 그 대처방안)

  • KIM, Keun-Youl
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.3
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    • pp.213-229
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    • 2005
  • The first and the longest criminal indictment case of Korean medico-legal battle, so called BORAMAE Hospital Incident, was finally on its end by Korean Supreme Court's decision on June 24, 2004, after 7 years long legal dispute via Seoul District Court and Seoul Superior Appeal Court's decision. Boramae Hospital case was the first Korean legal case of Withdrawing Life-sustaining treatment of mechanical respirator on 58 years old Extradural Hematoma victim who was on Respirator under Coma after multi-organ failure postoperatively(APACHE II score: 34-39). Two physicians who have involved patient's care and had helped to make discharge the Near-death patient to home after repeated demand of patient's wife, due to economic reason, were sentenced as homicidal crime. This review article will discuss the following items with the review of US cases, Quinlan(1976), Nancy Cruzan(1990), Barber (1983), Helen Wanglie(1990), Baby K (1994) and Baby L cases, along with Official Statement of ATS and other Academic dignitaries of US and World.: [1] Details of Boramae Hospital incident, medical facts description and legal language of homicidal crime sentence. [2] The medical dispute about the legal misinterpretation of patient's clinical status, regarding the severity of the victim with multi-organs failure on Respirator under coma with least chance of recovery, less than 10% probability. [3] Case study of US, of similar situation. [4] Introduction of ATS official Statement on Withdrawing/ Withholding Life sustaining treatment. [5] Patient Autonomy as basic principle. [6] The procedural formality in Medical practise for keeping the legitimacy. [7] The definition of Medical Futility and its dispute. [8] Dying in Dignity and PAS(Physician Assisted Suicide)/and/or Euthanasia [9] The Korean version of "Dying in Dignity", based on the Supreme Court's decision of Boramae Hospital incident (2004.6.24.) [10] Summary and Author's Note for future prospects.

Severity-Adjusted Mortality Rates of Coronary Artery Bypass Graft Surgery Using MedisGroups (MedisGroups를 이용한 관상동맥우회술의 중증도 보정사망률에 관한 연구)

  • Kwon, Young-Dae
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.218-228
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    • 2000
  • Background : Among 'structure', 'process' and 'outcome' approaches, outcome evaluation is considered as the most direct and best approach to assess the quality of health care providers. Risk-adjustment is an essential method to compare outcome across providers. This study has aims to judge performance of hospitals by severity adjusted mortality rates of coronary artery bypass graft (CABG) surgery. Methods : Medical records of 584 patients who got the CABG surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups was used to quantify severity of patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex. For evaluation of hospital performance, we calculated ratio of observed number to expected number of deaths and z score [(observed number of deaths - expected number of deaths)/square root of the variance in the number of deaths], and compared observed mortality rate with confidence interval of adjusted mortality rate for each hospital. Results : The overall in-hospital mortality was 7.0%, ranged from 2.7% to 15.7% by hospital. After severity adjustment the mortality by hospital was from 2.7% to 10.7%. One hospital with poor performance was distinctly divided from others with good performance. Conclusion : In conclusion, severity-adjusted mortality rate of CABG surgery might be applied as an indicator for hospital performance evaluation in Korea. But more pilot studies and improvement of methodologies has to be done to use it as quality indicator.

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Scenario-Based Optimization of Patient Distribution and Medical Resource Allocation in Disaster Response (시나리오 기반 환자 분배 및 의료진 할당을 위한 재난 대응 최적화 모형 연구)

  • Jin, Sukho;Kim, Jangyeop;Kim, Kyungsup;Jeong, Sukjae
    • Journal of Korean Institute of Industrial Engineers
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    • v.40 no.2
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    • pp.151-162
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    • 2014
  • This study proposes an optimization model to plan the patient distribution and medical resource allocation considering the diverse characteristics of disaster. For reflecting the particularity of disaster response, we configured a few scenarios such as availability of emergency surgery of non-major medical staff and the change in number of patients estimated reflecting the uncertainty, urgency and convergence of disaster. And we finally tested the effects of the scenarios' combination on the objective function defined as maximum number of survival patients. Our experimental results are expected to highlight the significance of the proposed model as well as the applicability of scenarios under disaster response.

A Case Study of a Patient with Atopic Dermatitis improved by Yangdokbaekho-tang (양독백호탕(陽毒白虎湯)으로 개선된 아토피 피부염 환자 치험 1례)

  • Kim, Ji-Hwan;Kim, Min-Ji;Son, Han-Beom;Bae, Hyo-Sang;Park, Seong-Sik
    • Journal of Sasang Constitutional Medicine
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    • v.25 no.4
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    • pp.414-424
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    • 2013
  • Objectives The purpose of this case study was to report the main effect of Yangdokbaekho-tang to a Soyangin atopic dermatitis patient. Methods This patient was treated by Yangdokbaekho-tang, topical herbal extract, moxa and acupuncture according to the result of Sasang constitutional diagnosis. Results and Conclusions The patient's subjective symptoms of atopic dermatitis and general condition were improved after using Yangdokbaekho-tang in spite of patient's loose stool. The SCORAD index (Scoring Atopic Dermatitis Severity Index) which was used to evaluate the therapeutic effect of Sasang constitutional treatment on atopic dermatitis was also decreased from 86.3 to 42.8 without using anti-histamine or steroid medications.

A Case Report of Trigeminal Neuralgia of Pregnant Soeumin Treated by Traditional Korean Medicine (한방치료로 호전된 소음인 임신부의 삼차신경통 치험 1례)

  • Lee, Ji-Yeon;Yoon, Soo-Hyeon;Cho, Hye-Sook;Jeon, Soo-Hyung;Lee, In-Seon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.2
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    • pp.121-130
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    • 2016
  • Objectives: The purpose of this study is to report the effect of Korean medical treatment on a patient with trigeminal neuralgia during pregnancy. Methods: We treated a facial pain patient diagnosed as trigeminal neuralgia during pregnancy with acupuncture, cupping and herbal medicines. Herbal medicines were prescribed according to the patient's Sasang constitution which was Soeumin. The severity of symptom was evaluated by Numeric Rating System (NRS). Results: After treatment, the patient's facial pain caused by trigeminal neuralgia was improved. NRS score was decreased from 6 to 0. Conclusions: This case report shows that traditional Korean medical treatment and Sasang constitution medicine is effective for the patient with trigeminal neuralgia during pregnancy.

A Case Report of a Patient with Rapid Weight Loss due to Nausea, Vomiting and Stomachache (오심, 구토, 복통으로 인해 급격한 체중감소를 보인 환자 치험 1례)

  • Kim, Eun-seo;Son, Jong-seok;Shin, Gil-cho
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.16 no.1
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    • pp.49-56
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    • 2015
  • This patient was 18 year-old man who had severe nausea, vomiting, stomachache but medical examination revealed no abnormality. The symptom lasted for 2 months and he lost 15kilograms. The patient had no underlying diseases. He was treated by korean medicine, containing acupuncture, cupping therapy and herb medicines during 9 days. The severity of nausea was scored by the Numerous Rating Scale and the frequency of vomitng was evaluated by count. After that period, patient's symptom was improved and his other conditions were also better, compared with his admission. This study suggests that Korean medicine could have a therapeutic effect for nausea, vomiting, stomachache and rapid weight loss that the cause has not been diagnosed by Western medicine. It could help to improve patient's symptoms and make general conditions better.

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A study of Priority-setting in Korean National Dental Health Insurance Scheme (치과 건강보험 우선순위 설정을 위한 고찰)

  • Han, Ji-Hyoung;Hwang, Yoon-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.6 no.3
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    • pp.243-261
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    • 2006
  • Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

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