• Title/Summary/Keyword: Patterns of care study

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Measures of Spatial Accessibility to Emergence Medical Services with a Modified Three-Step Floating Catchment Area Model : A Case Study of the Chungnam Province (수정 3SFCA 모형을 활용한 응급의료서비스 접근성 분석: 충청남도를 사례로)

  • Park, Jeong Hwan;Woo, Hyun Jee;Kim, Young Hoon
    • Journal of the Korean association of regional geographers
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    • v.23 no.2
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    • pp.388-402
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    • 2017
  • This paper presents an enhancement of the two-step floating catchment area (2SFCA) method for measuring spatial accessibility between three age groups, addressing the problem of uniform access within the catchment by applying multiple impedance function to account for distance decay and by applying weights to different age groups to account for medical service preference. The enhancement is provided to be another special care of the gravity model. When applying this modified three-step floating catchment area to measure the spatial access to emergency medical services in a study area, Chungnam province in South Korea, we find that it reveals the variation of spatial accessibility patterns between cities and rural areas and delineates more spatially explicit medical service shortage areas in southern Chungnam areas, especially remoted local rural areas. Finally, this method may be used to help the health and medical service divisions and the state departments improve designation of medical shortage areas. From the discussions, it is easy to implement in planning spatial policies of medical service and straightforward to be used as a basic, but core element for health and medical strategies in the province.

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Cardiovascular Risk Factors in Diabetic Patients according Duration of Diabetes Mellitus: The Sixth Korea National Health and Nutrition Examination Survey (당뇨병 유병기간에 따른 당뇨병 환자의 심혈관 위험 인자: 국민건강영양조사 6기 자료 이용)

  • Kim, Hee Sung
    • The Journal of the Korea Contents Association
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    • v.18 no.12
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    • pp.208-217
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    • 2018
  • The purpose of this study was to provide information on the treatment and management of diabetic patients using all the available data of the Korea National Health and Nutrition Examination Survey (KNHANES, 2013-2015) on the serological and complication patterns of cardiovascular disease (CVD) according to the duration of diabetes mellitus (DM). KNHANES consists of health questionnaires, screenings, and nutrition surveys. The study subjects were 1,316 persons who were aged between 18 and 80 years and who answered the duration of DM. DM was classified as 0-5, 6-10, 11-15, 16-20, and over 20 years according to duration of DM. The longer the duration of DM, the older the BMI, the lower the smoker, the higher the HbA1c and the lower the glomerular filtration rate. Total cholesterol, LDL-C and triglyceride levels were low and HDL-C levels were similar. The proportion of patients receiving insulin and oral hypoglycemic agents increased. The longer the duration of DM, the worse blood glucose control and the increased risk of microvascular and macrovascular complications. To prevent these complications, intensive care and monitoring should be used to control the risk factors.

A portable electronic nose (E-Nose) system using PDA device (개인 휴대 단말기 (PDA)를 기반으로 한 휴대용 E-Nose의 개발)

  • Yang, Yoon-Seok;Kim, Yong-Shin;Ha, Seung-Chul;Kim, Yong-Jun;Cho, Seong-Mok;Pyo, Hyeon-Bong;Choi, Chang-Auck
    • Journal of Sensor Science and Technology
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    • v.14 no.2
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    • pp.69-77
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    • 2005
  • The electronic nose (e-nose) has been used in food industry and quality controls in plastic packaging. Recently it finds its applications in medical diagnosis, specifically on detection of diabetes, pulmonary or gastrointestinal problem, or infections by examining odors in the breath or tissues with its odor characterizing ability. Moreover, the use of portable e-nose enables the on-site measurements and analysis of vapors without extra gas-sampling units. This is expected to widen the application of the e-nose in various fields including point-of-care-test or e-health. In this study, a PDA-based portable e-nose was developed using micro-machined gas sensor array and miniaturized electronic interfaces. The rich capacities of the PDA in its computing power and various interfaces are expected to provide the rapid and application specific development of the diagnostic devices, and easy connection to other facilities through information technology (IT) infra. For performance verification of the developed portable e-nose system, Six different vapors were measured using the system. Seven different carbon-black polymer composites were used for the sensor array. The results showed the reproducibility of the measured data and the distinguishable patterns between the vapor species. Additionally, the application of two typical pattern recognition algorithms verified the possibility of the automatic vapor recognition from the portable measurements. These validated the portable e-nose based on PDA developed in this study.

Diagnosis-Specific Analysis of Small Area Variations in Hospital Services (일부 다빈도 진단명들의 지역간 의료이용 변이)

  • 이선희;조우현;남정모;김석일
    • Health Policy and Management
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    • v.4 no.1
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    • pp.49-76
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    • 1994
  • Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.

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A Longitudinal Exploratory Study on Change Research Trends and Patterns of Children's Problem Behaviors for Their Temperament and Parenting Behaviors -Focured on the Category and Content Analysis of Chronological Problem Behaviors from 1970 to 2015- (유아의 기질과 부모의 양육 행동 관련 유아의 문제행동 변화 연구 추이 및 유형에 대한 종단적 탐색 연구 -1970~2015년까지의 연대별 문제행동 범주와 내용분석을 중심으로-)

  • Kim, Joeng Kyoum;Kang, Young-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.10
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    • pp.6722-6742
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    • 2015
  • This study is intended to look for implications through longitudinal exploratory research on the change of children's problem behaviors for their temperament and parenting behaviors. The results are as follows. The factors influencing children's problem behaviors rose to 62 factors between 1990 and 2000, and 93 factors between 2000 and 2010 from total 41 factors between 1970 and 1990, which they were more than doubled after the 2000s compared with the earlier studies, subdividing children's problem behaviors. The proportion of the factors influencing children's problem behaviors showed that parents' moral thinking had the highest, and their negative thinking or emotion for children were higher than their moral thinking, which their problem behaviors were more greatly affected by parenting attitudes toward them than their own temperament or attitudes. The earlier studies were more likely to find the cause of children's problem behaviors for looking into the factors and causes influencing children's problem behaviors in terms of children's personal mental health, but there was more proportion of social environment, peer and teacher relationship while soaring family, relationship, home environment and child care center environment factors as well as children's personal factors after the 2000s. Consequently, the alternative resources or the environments of the times should be applied in other ways.

Factors Related to Smartphone Dependence among Adults in Their 20s (20대 성인의 스마트폰 의존 관련 요인)

  • Park, Jeong-Hye
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.195-204
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    • 2020
  • The purpose of this study was to explore factors associated with smartphone dependence among adults in their 20s. The data were derived from the 2017 Survey on Smartphone Over-dependence conducted by the Ministry of Science and ICT and the National Information Society Agency. There were 3,684 participants. The data were analyzed by frequency, percentage, mean, standard deviation, independent t-test, Pearson's correlation coefficient, and weighted hierarchical multiple regression analysis. For the results, factors related with higher smartphone dependence of participants were duration (β=.18, p=.000) and frequency (β=.04, p=.000) of usage, gaming (β=.15, p=.000), watching videos (β=.09, p=.000), mobile shopping (β=.05, p=.000), working (β=.05, p=.010), e-mailing (β=.13, p=.000), and sports betting (β=.07, p=.000). Music (β=-.07, p=.000) and adult content (β=-.07, p=.000) significantly reduced their smartphone dependence. SNS (Social Networking Services) (β=.01, p=.358) and instant messengers (β=-.02, p=.330) were not factors related to smartphone dependence. However, instant messengers were the most used by participants and had a strong correlation with working (r=.55, p=.000). This study shows that smartphone usage patterns related with smartphone dependence among adults in their 20s are different from those of children and adolescents. These results could be used to more deeply understand smartphone dependence among adults in their 20s and plan early detection and prevention and care of dependence.

Study on the Policy of Supporting University Students in the Beauty Field through Social Big Data Analysis: Based on exploratory data analytics (소셜 빅 데이터 분석을 통한 미용분야 대학생 창업지원 정책에 관한 연구 -탐색적 데이터 분석법을 기반으로-)

  • Mi-Yun Yoon;Nam-hoon Park
    • Journal of the Korean Applied Science and Technology
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    • v.39 no.6
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    • pp.853-863
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    • 2022
  • In order to revitalize start-ups in the beauty field, this study attempted to derive characteristic patterns of changes in demand and differences in emotions and meaning for 'beauty start-ups' by dividing the period by year from 2019 to 2021 based on exploratory data analysis (EDA). Most of the search terms related to the keyword "beauty start-up" showed more interest in institutions or certificates that can learn beauty skills than professional start-up education, which still does not recognize the importance of start-up education, and as an alternative, it is necessary to develop customized start-up education programs for each major. We establish hypotheses through exploratory data analysis and verify hypotheses by combining traditional corroborative data analysis (CDA). There has never been an exploratory data analysis method for beauty startups, and rather than mentioning the need for formal start-up education, analyzing changes in interest in beauty startups and the requirements of prospective start-ups with exploratory data will help develop customized start-up programs.

Morbidity Patterns and Health Care Behavior of Residents in Urban Low Income Area (도시영세지역(都市零細地域) 주민(住民)의 상병(傷病)및 의료이용(醫療利用) 양상(樣相) -대구직할시를 중심으로-)

  • Woo, Kuck-Hyeun
    • Journal of Preventive Medicine and Public Health
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    • v.18 no.1
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    • pp.25-39
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    • 1985
  • This study was conducted to assess the morbidity and medical facilities utilization patterns of the residents in urban low income area. Study population included 2,002 family members of 468 households in the low income area (LA) of Nam-san 4 Dong, Jung Gu of Taegu city and 1,709 family members of 374 households in surrounding neighbourhood control area (CA). Well trained nursing school students interviewed mainly with housewives according to the pretested questionaire between July 1 and July 30, 1984. Age-sex distribution of the study population in LA was similar to that in CA. The average monthly income of a household in LA was 236,000 won and 356,000 won in CA. Educational level of the residents in LA was lower than that in CA; average years of school education of the 20 years old or above in LA was 6.9 years compared with 8.5 years in CA. The average family members per room in LA was 2.6 and 2.2 in CA, and proportion of Medicaid program beneficiary was 29.4% in LA and 1.9% in CA. Prevalence rate of illness during 15-day period was 131 per 1,000 population in LA and 71 in CA(p<0.01) and that of the chronic illness for 1 year was 134 per 1,000 population in LA and 89 in CA(p<0.01). The most common illness experienced during 15 days was respiratory disease(24.0% in LA ana 29.8% in CA) and followed by gastro-intestinal disorders(21.0% in LA, 20.6% in CA). Injury or poisoning was 10.3% in LA and 3.3% in CA. Castro-intestinal disorder was the most common chronic illness in both LA (22.7%) and CA (21.7%), and followed by musculoskeletal disease in LA and neuralgia in CA. Mean activity restricted days among the persons with illness during 15-day period was 4.0 days in LA and 2.2 days in CA. Among persons with illness during 15 days, 17.9% in LA and 11.6% in CA did not seek any medical treatment and the most frequently utilized medical facility was pharmacy in LA (35.5%) and local clinic or hospital OPD in CA (42.1%). Among persons with chronic illness, 15.2% in LA and 9.2% in CA did not seek for medical treatment, and residents in LA as well as residents in CA utilized local clinic or hospital OPD more frequently than pharmacy or drugstores, especially those who have medical insurance. The most common reason for not treating illness experienced during 15-day period and chronic illness was economical constraint in both LA and CA. The higher prevalence rate of illness during 15-day period and chronic illness in LA than that in CA seems to be highly correlated with their lower economic status and educational level and crowded living condition. The utilization pattern of medical facilities was associated with the medical security status. A program to improve the economic status and living condition should be integrated with the health program to promote the health of the population in low income area.

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Molecular Epidemiology and Antimicrobial Resistance of Methicillin-resistant Staphylococcus aureus Isolated from Nasal Swab at Intensive Care Unit (중환자실 입원 환자의 비강 도말에서 메티실린 내성 황색포도알균의 분자역학, 항생제 내성 연구)

  • Kwak, Om Sub;Kwon, Mee Hye;Jeong, Ji Hyun;Kang, Mi-il;Cheun, Ji Young;Lee, Go Eun;Kim, Young Keun;Choi, Eu Gene;Na, Moon Jun;Kwon, Hee Uk;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.65 no.2
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    • pp.91-98
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    • 2008
  • Background: Methicillin-resistant Staphylococcus aureus (MRSA) is the most common organism associated with nosocomial infections. MRSA infections are becoming increasing important because they have emerged no only as healthcare-associated (HA) infections but also as community-associated (CA) ones. This study examined the moleculo-epidemiology of MRSA, which was isolated from nasal swabs in the intensive care unit (ICU) at Konyang University Hospital. MRSA are classified into HA-MRSA and CA-MRSA. Methods: From June to September 2006, 353 patients who were admitted to the ICU in Konyang University Hospital were enrolled in this study. Single nasal swabs were obtained for culture in the ICU on the 1st day. Pulsed-field gel electrophoresis and the antimicrobial resistant patterns were analyzed between HA- and CA-MRSA. An antimicrobial sensitivity test was also performed. Results: Forty two strains of MRSA were isolated from 353 patients (11.9%). Among the 42 isolates, HA-MRSA and CA-MRSA were found in 33 (78.6%), and 9 (21.4%), respectively. Eleven different PFGE types (type A to K) were identified. Types A (n=9) and B (n=7) were the most common for HA-MRSA, and types A (n=2) and B (n=2) were identified in CA-MRSA. The proportion of types A and B in CA-MRSA (44.4%) was similar to that in HA-MRSA (48.5%). The rates of resistance rates to erythromycin and ciprofloxacin were higher in HA-MRSA than in CA-MRSA. Conclusion: The rate of isolation of MRSA in an ICU setting was 11.9%. HA-MRSA was isolated more frequently than CA-MRSA. The rate of resistance of HA-MRSA to erythromycin and ciprofloxacin was higher than that of CA-MRSA. Despite the small number of subjects, the main isolates (type A and B) of CA-MRSA were similar to those of HA-MRSA.

Etiological agents isolated from blood in children with hemato-oncologic disease (2002-2005) (소아 혈액 종양 환자에서 발생한 균혈증의 원인균(2002-2005년))

  • Kim, So-Hee;Lee, Young-Ah;Eun, Byung-Wook;Kim, Nam-Hee;Lee, Jin-A;Kang, Hyoung Jin;Choi, Eun-Hwa;Shin, Hee Young;Lee, Hoan-Jong;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.56-64
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    • 2007
  • Purpose : This study was performed to identify the etiologic agents and antimicrobial susceptibility patterns of organisms responsible for bloodstream infections in pediatric cancer patients for guidance in empiric antimicrobial therapy. Methods : One hundred and ninety-seven episodes of bloodstream infections that developed in 128 pediatric cancer patients were analyzed, which were identified at the Seoul National University Children's Hospital during a 4 year-period from 2002 to 2005. Results : A total of 214 pathogens was isolated, of which 64.0 percent were gram-negative, 31.3 percent were gram-positive bacteria, and 4.7 percent were fungi. The most common pathogens were Klebsiella spp. (21 percent) and Escherichia coli (16.8 percent), and coagulase-negative staphylococci (CNS, 7.9 percent) and viridans streptococci (7.5 percent) emerged as important pathogens. Neutropenic patients were more often associated with gram-negative bacteria than non-neutropenic patients (67.5 percent vs. 51.1%, P=0.018) and patients with central venous catheters were more often associated with CNS and viridans streptococci than those without. Resistance rates of gram-positive bacteria to penicillin, oxacillin and vancomycin were 83.3 percent, 48.5 percent and 0.5 percent, respectively, and those of gram-negative bacteria to cefotaxime, piperacillin/tazobactam, imipenem, gentamicin and amikacin were 24.1 percent, 17.2 percent, 6.6 percent, 21.6 percent, and 14.2 percent, respectively. Gram-negative bacteremias were more often associated with intensive care than gram-positive bacteremias (26.5 percent vs. 10.3 percent, P=0.016), and patients with catheters were more often associated with intensive care (34.4 percent vs. 10.8 percent, P<0.001) and higher fatality rate (16.7 percent vs. 4.8 percent, P=0.012) than those without. Conclusion : This study revealed that gram-negative bacteria are still a dominant organism in bloodstream infections, especially in neutropenic patients, and confirmed that gram-positive bacteria are emerging as important etiological agents in bloodstream infections of pediatric hemato-oncologic patients.