• 제목/요약/키워드: Patient Outcomes Research

검색결과 451건 처리시간 0.021초

환자진료결과연구에 대한 고찰 -미국의 PORT 연구를 중심으로- (Review on Patient Outcomes Research)

  • 박은철;김한중;조우현;손명세
    • 한국의료질향상학회지
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    • 제5권1호
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    • pp.152-165
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    • 1998
  • Background : In this paper patient outcomes research is going to be reviewed and described, to be compared with relevant studies, and to consider the application in Korea. Methods : We compiled and reviewed the articles and materials related to patient outcomes research especially by PORT(Patient Outcomes Research Team) and rearranged them for seeking the main point and comparing with relevant studies. Results : Patient outcomes research emphasizes patient outcomes as well as conventional clinical outcomes. It is prospective study observing effectiveness in real situation instead of efficacy in ideal condition. Patient outcomes research comprises of 6 fields ; literature review and meta-analysis, use of claims data, decision modeling, outcomes assessment, cost of care, dissemination of research findings. SAA(small-area variations analysis), appropriateness study and clinical practice guideline are connected with patient outcomes research. Conclusion : In view of the fact that current medical policy in Korea is shifting its focus from accessibility to the improvement in quality and cost containment, and is stressing patient-based research, patient outcomes research is one direction for which the medicine is accountable and assessable. Considering that the number of patient receiving medical treatment in Korea is higher than the West, patient outcomes research has competitive power as against the West.

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Nursing Outcomes Classification(NOC)를 이용한 일부 입원환자의 간호결과에 대한 분석 (Analysis of Patient Outcome using Nursing Outcomes Classification(NOC))

  • 김수현;손정태;이은주
    • 간호행정학회지
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    • 제12권2호
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    • pp.181-188
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    • 2006
  • Purpose: The purpose of study was to determine differences in patient outcomes that exists in terms of Nursing Outcomes Classification (NOC) during hospital days of neurosurgical and respiratory patients. Method: Before starting clinical practicum, nursing students were received two hours' lecture on how to apply NOC to patient care plan and they were required to evaluate patient condition using NOC at the beginning and at the end of their clinical practicum. Data were extracted from 62 neurosurgical patients and 66 respiratory patients and analyzed by frequency and paired t-test. Results: The most frequently used NOC were Pain Level (37.1%), Mobility Level (25.8%), and Bowel Elimination (19.4%) in neurosurgical patients and Nutritional Status (37. 9%), Respiratory Status: Ventilation (37.9%) and Pain Level (25.8%) in respiratory patients. The numbers of outcomes used were 75 and 46 neurosurgical and respiratory patients respectively. During the hospital days, the level of patient outcomes increased significantly in all patient groups. Conclusion: The finding clearly suggests that nursing interventions make differences in patient outcomes and make contribution to the patient health achieved. To more effectively use NOC, however, nursing information system should be developed and included standardized nursing languages regarding nursing diagnoses and interventions.

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Occupational Therapy Intervention for Malunion of Distal Radial Fracture: A Case Report

  • Noor Mohammad;Nahid Khan
    • 셀메드
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    • 제13권6호
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    • pp.6.1-6.3
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    • 2023
  • Objective: Malunion of distal radial fracture can result in pain, stiffness, and decreased function of the affected limb. Occupational therapy intervention can improve outcomes in these patients, but there is limited research on the effectiveness of such interventions. Case Description: This case report describes the occupational therapy intervention and outcomes for a 44-year-old female patient with malunion of left distal radial fracture. The patient received 8 weeks of occupational therapy intervention consisting of therapeutic exercises, joint mobilization, and fine motor activities. The patient demonstrated significant improvements in range of motion, grip strength, and activities of daily living (ADL) in her left hand. The patient also reported less pain and greater ease in performing activities of daily living. Conclusion: Occupational therapy intervention can be effective in improving outcomes for patients with malunion of distal radial fracture. This case report highlights the importance of early intervention and interdisciplinary collaboration among healthcare professionals to optimize patient outcomes. Further research is needed to explore the effectiveness of occupational therapy interventions for patients with malunion of distal radial fracture.

백내장 수술환자 진료결과들간의 관계 - 사전 연구를 중심으로 - (Relationship among Patient Outcomes in Cataract Surgical Patient - Pilot study -)

  • 박은철;김한중;홍영재;조우현;손명세;임승정;강형곤;최윤정
    • 한국의료질향상학회지
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    • 제5권1호
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    • pp.106-118
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    • 1998
  • Background : This study was done to assess the relationship among multiple patient outcomes of cataract surgery perioperatively, 3-4 months and 12 months after surgery. The patient outcomes include changes in visual acuity(operated eye, better eye), visual function(VF-14), patient satisfaction, subjective satisfaction with vision, and subjective overall health status. Methods : For the assessment of relationship, prospective study was performed with 92 patients who had undergone either one or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. Patients were interviewed. and clinical data were obtained. Doctors were questioned with self-entered questionnaire forms. Medical record was examined to understand surgery process. The survey was conducted at 4 stages : preoperatively, perioperatively, postoperative 3-4 months, and postoperative 12 months. Results : The correlations within patient outcomes at 4 stages - the visual acuity of operated eye and that of better eye, patient satisfaction and VF-14, subjective overall health status and relative health status as against others - were found to be positively correlated. The change in the visual acuity of operated eye and better eye was correlated with VF-14 as well as with patient satisfaction. The change was also correlated with overall health status. However, the correlations between variables were decreased as the postoperative period got longer. Conclusion : As for the postoperative clinical patient outcomes, VF-14 is acted to linker between visual acuity - clinical outcomes and overall health status - endpoint outcomes. Therefore. VF-14 is the index of patient-sided and disease-specific outcome for cataract surgery.

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의료기관 간호사 확보수준이 수술환자의 사망, 폐렴, 패혈증, 요로감염에 미치는 영향 (Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients)

  • 김윤미;조성현;전경자;신순애;김지윤
    • 대한간호학회지
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    • 제42권5호
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    • pp.719-729
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    • 2012
  • Purpose: This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance. Methods: Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes. Results: An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)=2.99, 95% CI (confidence interval)=1.94-4.60], those with Grades 4-5 (OR=1.78, 95% CI=1.24-2.57) and those with Grades 2-3 (OR=1.57, 95% CI=1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis. Conclusion: Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

치의학 분야에서 SPSS를 이용한 일반화 추정방정식의 단계별 안내 (A step-by-step guide to Generalized Estimating Equations using SPSS in dental research)

  • 임회정;박수현
    • 대한치과의사협회지
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    • 제54권11호
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    • pp.850-864
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    • 2016
  • The Generalized Estimating Equations (GEE) approach is a widely used statistical method for analyzing longitudinal data and clustered data in clinical studies. In dentistry, due to multiple outcomes obtained from one patient, the outcomes produced from an individual patient are correlated with one another. This study focused on the basic ideas of GEE and introduced the types of covariance matrix and working correlation matrix. The quasi-likelihood information criterion (QIC) and quasi-likelihood information criterion approximation ($QIC_u$) were used to select the best working correlation matrix and the best fitting model for the correlated outcomes. The purpose of this study is to show a detailed process for the GEE analysis using SPSS software along with an orthodontic miniscrew example, and to help understand how to use GEE analysis in dental research.

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한국형 Nursing Minimum Data Set(NMDS)구축을 통한 환자결과에 대한 연구 (Study on Patient Outcomes through the Construction of Korean Nursing Minimum Data Set (NMDS))

  • 이은주
    • 간호행정학회지
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    • 제12권1호
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    • pp.14-22
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    • 2006
  • Purpose: The purpose of this study is developing the nursing information system which contains the core elements of nursing practice, the Nursing Minimum Data Set (NMDS) that should be collected and documented all the settings in which nursing care is provided. Method: The program was developed under the hospital information system by TCP/IP protocol and used NANDA, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) to fill out the elements of NMDS. The Oracle was used as DBMS under the Windows 98 environment and Power Builder 5.0 was used as a program language. Results: This study developed linkage among the NANDA-NOC-NIC to facilitate choosing correct nursing diagnosis, interventions, and outcomes and stimulate nurses' critical thinking. Also the system developed includes nursing care sensitive patient outcomes, so nurses can actively involve in nursing effectiveness research by analyzing the data stored in the database or by making relational databases with other health care related databases. Conclusion: The program developed in this study ultimately can be used for the nursing research, policy development, reimbursement of nursing care, and calculating staffing and nursing skill mix by providing tool to describe and organize nursing practice and measure the nursing care effectiveness.

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선천성 심장병 신생아의 개심술 후 금식기간에 따른 영양공급량, 생화학적 영양지표 및 환아결과 (Nutrition Supply, Biochemical Nutrition Indexes and Patient Outcomes in New Born Babies with Open Heart Surgery according to Post Operative Fasting Period)

  • 장지영;김명희
    • Child Health Nursing Research
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    • 제18권3호
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    • pp.119-126
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    • 2012
  • Purpose: The purpose of this study was to examine and analyze the post operative fasting period of neonates in the intensive care unit (ICU) after receiving open heart surgery in order to provide optimal nutrition support for these neonates. The variables included biochemical nutrition indexes (albumin, total lymphocyte count, total cholesterol) and patient outcomes (duration of mechanical ventilation, ICU stay, hospital stay, infectious complication). Methods: The participants were 124 neonates in ICU after receiving open heart surgery, and the design of this study was to investigate their post operative fasting period retrospectively to analyze the biochemical nutrition indexes and patient outcomes according to post operative fasting period. Results: The results for 4 groups according to post operative fasting period showed that the group with less 48 hours of fasting had the best biochemical nutrition indexes and patient outcomes, followed by the 48-72 hour group, the 72-144 hour group, and the over 144 hour group. Conclusion: The results indicate that for new born babies receiving open heart surgery, the period of fasting after the operation should be minimized and tube feeding should be started as soon as possible.

국내 병원약사의 중재활동과 성과에 대한 체계적 문헌고찰 (A Systematic Review of Outcomes Research in the Hospital Pharmacists' Interventions in South Korea)

  • 이소영;조은
    • 한국임상약학회지
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    • 제29권3호
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    • pp.193-201
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    • 2019
  • Background and Objective: Since the introduction of hospital pharmacy residency programs in 1983, hospital pharmacists in South Korea have been expected to expand their roles. However, their services and the outcomes have not been fully understood. In this study, we conducted a systematic review of Korean hospital pharmacist-provided interventions with regard to intervention type, intervention consequences, and target patient groups. Methods: A literature search of the following databases was performed: Embase, PubMed, Medline, KoreaMed, RISS, KMbase, KISS, NDSL, and KISTI. The search words were "hospital pharmacist", "clinical pharmacist", and "Korea". Articles reporting clinical or economic outcome measures that resulted from hospital pharmacist interventions were considered. Numeric measures for the acceptance rate of pharmacist recommendations were subjected to meta-analysis. Results: Of the 1,683 articles searched, 44 met the inclusion selection criteria. Most articles were published after 2000 (81.8%) and focused on clinical outcomes. Economic outcomes had been published since 2011. The interventions were classified as patient education, multidisciplinary team work, medication assessment, and guideline development. The outcome measures were physicians' prescription changes, clinical outcomes, patient adherence, economic outcomes, and quality of life. The acceptance rate was 80.5% (p < 0.005). Conclusion: Studies on pharmacist interventions have increased and showed increased patient health benefits and reduced medical costs at Korean hospital sites. Because pharmacists' professional competency would be recognized if the economic outcomes of their work were confirmed and justified, studies on their clinical performance should also include their economic impact.

Outcomes of Closed versus Open Rhinoplasty: A Systematic Review

  • Gupta, Rohun;John, Jithin;Ranganathan, Noopur;Stepanian, Rima;Gupta, Monik;Hart, Justin;Nossoni, Farideddin;Shaheen, Kenneth;Folbe, Adam;Chaiyasate, Kongkrit
    • Archives of Plastic Surgery
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    • 제49권5호
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    • pp.569-579
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    • 2022
  • Open and closed rhinoplasty are two main approaches to perform nasal modifications. According to current literature, there is no current consensus among plastic surgeons and otolaryngologists on which technique is preferred in terms of aesthetic result, complications, and patient satisfaction. This study uses published research to determine whether open or closed rhinoplasty leads to superior patient outcomes. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews were followed and a literature search was conducted in four databases based on our search strategy. Articles were then imported into COVIDENCE where they underwent primary screening and full-text review. Twenty articles were selected in this study after 243 articles were screened. There were 4 case series, 12 retrospective cohort studies, 1 prospective cohort study, 1 case-control, and 2 outcomes research. There were three cosmetic studies, eight functional studies, and nine studies that included both cosmetic and functional components. Sixteen studies utilized both open and closed rhinoplasty and four utilized open rhinoplasty. Both techniques demonstrated high patient and provider satisfaction and no advantage was found between techniques. Based on available studies, we cannot conclude if there is a preference between open or closed rhinoplasty in terms of which technique leads to better patient outcomes. Several studies determined that open rhinoplasty and closed rhinoplasty leads to comparative patient satisfaction. To make outcome reporting more reliable and uniform among studies, authors should look to utilize the Nasal Obstruction and Septoplasty Effectiveness scale and the Rhinoplasty Outcome Evaluation.