• Title/Summary/Keyword: Records System

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고혈압 건강진단의 비용분석 (Cost analysis of hypertension screening program)

  • 박은철;유승흠
    • Journal of Preventive Medicine and Public Health
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    • 제22권3호
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    • pp.380-388
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    • 1989
  • To evaluate the costs of the hypertension screening program of the Korea Medical Insurance Corporation, the records of the screening examinations were used. The sample size was 49,983 of the 906,554 people insured by the Corporation and was obtained by two-stage stratification random sampling. The alternatives for efficiency of the screening program, which were divided into three categories : modification of the screening test package, application of other hypertension diagnostic criteria, and selective approach of tested groups by age, were evaluated according to the cost per patient detected. The results of this study were as follows In the hypertension screening system, the cost per patient detected was Won 30,883. The most nonsensitive test for hypertension detection was ophthalmoscopy, which was examined during the second stage of screening. If the ophthalmoscope examination was excluded, olny one person was not detected, which was 0.2% of detected persons, and the cost per patient detected decreased to Won 28,098. The most efficient modification of the screening test package was measurement of blood pressure through the first and second stages of screening. The cost per patient detected by this modification was Won 24,408. The application of other diagnostic critera, which were more restricted criteria, increased the cost per patient detected by 3.7%-6.7%. The cost per patient detected were Won 170,582 for persons less than 39 years old, Won 20,032 for persons 40 to 59 years old, and Won 8,675 for persons 60 years old and over. In conclusion, the best alternative suggested with respect to efficiency and practical application excluded the ophthalmoscope examination of second stage screening and restricted the target population to persons greater than 40 years old. The application of this alternative decreased 54.9% of the screening costs and the cost per patient detected was Won 15,222. This study was limited in that measurement of effectivenes was not of the ultimate goal of screening, which is decreasing morbidity and mortality, but was of disease detection as the short-term objective.

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국내 학부 보건관리학과의 교육과정 분석연구: 취득면허·자격과의 관계를 중심으로 (Curriculum Analysis on Health Management Schools in Republic of Korea: Focusing on Relationship with Licence and Certification)

  • 이유리
    • 보건행정학회지
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    • 제28권1호
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    • pp.23-34
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    • 2018
  • Background: This study aims to conduct curriculum analysis on health management schools focusing on relationship with licence and certification in Republic of Korea. Methods: Possible employment field, licence and certification as well as curriculum were collected from the home page of 30 health management schools. The subjects and credits of curriculum were analyzed using descriptive statistics. Main subjects by areas were drew using categorization and ranking within qualitative methods. Comparative analysis was conducted for checking relationship between main subject and possible employment field, licence and certification. Results: First, major employment fields after graduation were public health officer, general hospital and clinic, and National Health Insurance Service. Possible licence and certificate were hospital administrator, medical recorder, health education specialist, and medical insurance specialist. Second, total graduate credits were 133.9 including 79.0 for major education, 30.5 for of general education, and 30.5 for elective courses. Third, main subjects were reviewed by areas including basic medicine, health management, hospital business & management, medical records & information, insurance billing & assessment, healthcare marketing & tourism, and health education. There were highest number of subjects on health education area among 8 categories. By subjects, many health management schools open health law, medical terminology, introduction to public health, and biostatistics. Relationship between main subjects and possible employment field, licence and certification in health management schools was strong. Conclusion: It is necessary to review curriculum and for improving educational quality in health management schools. Also, development of curriculum standards for courses in health administration and introduction of accreditation system can be considered.

인도네시아의 금속광상과 금광상 분포현황 (The Present of State of the Metal and Gold Deposits, Indonesia)

  • 김인준;이재호;서정률;이사로;김유봉;이규호
    • 자원환경지질
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    • 제37권3호
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    • pp.269-276
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    • 2004
  • 인도네시아 열도는 지구조적으로 유라시아판의 남단부에 위치하며, 그 남부는 인도-호주판과, 그리고 동부와 북동부는 태평양판 및 필리핀판과 각각 경계를 이루고 있다. 인도네시아 지질은 섭입대와 관련된 복합체, 판구조에 수반되는 화강암 및 화산암, 그리고 이와 관련된 변성암들이 주로 분포되는 특징을 보인다. 인도네시아에 산출 발달되어 있는 금속광상은 주로 모암의 암석학적 특징과 지구조적인 환경에 크게 영향을 받았으며, 산성 내지 중성 관입암과 관련된 광상, 초염기성암에 부존하는 광상, 화산암에 수반된 광상과 퇴적층에 부존된 광상으로 크게 4가지로 분류된다. 인도네시아의 금광상은 크게 천열수 금광상, 금이 수반되는 반암형 동광상 및 사광상으로 분류된다. 특히 천열수 금광상은 인도네시아의 지체구조와 관련이 크고, island arc는 천열수 금광상의 큰 가능성을 가지며, 또한 인도네시아의 고기 및 신기 섭입대와 지표상의 칼크알카린 화산암류들은 천열수 금 광화작용의 가망성이 높은 국가임을 지시하고 있다.

RDA 구현 시나리오와 서지 제어의 장래에 대한 고찰 (A Study for RDA Implementation Scenarios and Future Bibliographic Control)

  • 조재인
    • 한국문헌정보학회지
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    • 제43권3호
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    • pp.85-105
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    • 2009
  • 정보환경의 변화와 전통적 도서관 목록의 불일치에 대한 문제가 대두면서 영미를 중심으로 한 도서관계에서는 국제목록원칙을 재천명하였고, 올해 말 최종 발표를 앞두고 RDA의 검토가 진행 중이다. JSC는 RDA에 FRBR 개념을 담아내면서도 수 십년간 고수된 MARC을 존속시킬 수 있는 해법을 찾기 위해 다양한 수준의 구현 시나리오를 제시하고 있다. 본 논문에서는 첫 번째, 새로운 서지의 개념 모델인 FRBR과 최근 재천명된 국제목록원칙규범을 살펴보고 이를 기반으로 전개된 RDA의 구성과 특징을 분석하였다. 두 번째, RDA 구현을 위한 3가지 시나리오를 통해 현행 MARC을 변용해 구현할 근접한 서지 제어 체계의 변화 내용과 FRBR 엔티티를 기반으로 시멘틱 웹 구조를 사용하게 될 미래의 목록 작성 작업을 분석하였다. 마지막으로 해외 주요 서지 기관의 대응 현황을 살펴보고 RDA/FRBR과 KCR의 관계, KORMARC의 변용 및 존속 여부, 전거 통제에 대한 대책이 시급한 우리나라 서지 제어 체계의 대응 방향을 제시하였다.

Treatment Strategy of Multiple Hemangioblastomas

  • Kim, Eui-Hyun;Park, Yong-Sook;Chang, Jong-Hee;Chang, Jin-Woo;Park, Yong-Gou
    • Journal of Korean Neurosurgical Society
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    • 제38권3호
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    • pp.184-189
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    • 2005
  • Objective : Hemangioblastomas are highly vascular and benign neoplasm of the central nervous system[CNS]. They can often be found as multiple lesions, as is commonly observed in von Hippel-Lindau[VHL] disease. The aim of this study is to determine the proper management for multiple hemangioblastomas. Methods : Since 1990, 78cases of hemangioblastoma have been encountered. Among these, 9cases were multiple hemangioblastomas that were treated with surgical resection with or without radiosurgery. The medical, radiological, surgical and histological records were reviewed retrospectively and analyzed statistically. Results : Nine patients presented with multiple hemangioblastomas and were diagnosed as VHL disease. The mean follow-up duration was 75.7months [$6.6{\sim}159.2months$] after the first surgical treatment. Three patients were treated with surgical resection alone and six patients were treated by both surgical resection and radiosurgery. Twenty-one surgical procedures [13 surgical resections and 8 radiosurgery] were performed. One patient required ventriculoperitoneal shunt and a posterior fossa decompressive craniectomy because of post-radiation brain swelling. Another patient refused additional treatment for the newly developed lesions after the successful treatment of initial lesions. The other patient who presented with numerous lesions in the whole brain and spine underwent cranio-spinal irradiation. Remaining patients showed good results. Conclusion : The surgical outcomes for the patients with a single lesion of the CNS hemangioblastoma are favorable. However. the treatment of multiple hemangioblastoma is more difficult, and should be treated by surgical resection and radiosurgery with careful consideration.

데이터 폐기 지침 마련을 위한 기초 연구 (A Study on the Guideline for the Data Deletion)

  • 임태훈;서직수;김선영
    • 정보관리연구
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    • 제41권4호
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    • pp.165-186
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    • 2010
  • 본 연구는 정보시스템의 운영 효율성과 관리 비용 절감을 도모하고자 불필요한 데이터를 폐기할 수 있는 기준과 근거를 탐색해 보았다. 국내외 법령 및 정책을 문헌조사하여 데이터 폐기 지침에 응용할 수 있는 내용을 도출하였으며, 이를 기초로 데이터 폐기를 위한 기초안을 마련하였다. 공공기관과 지자체 실무자를 대상으로 데이터 폐기 현황에 대한 면담조사와 데이터 폐기 지침 초안에 대한 설문조사를 실시하였고, 관련 이슈사항에 대해 의견을 수렴하였다. 그 결과, 데이터 폐기의 대상 유형과 절차, 폐기 방법 등을 포함한 지침을 마련할 수 있었다. 연구 결과로 마련된 데이터 폐기 지침을 시범 적용해 본 결과, 폐기 대상의 선정, 폐기 절차별 역할 담당자의 선정, 폐기 요청과 심의 등에 누락되거나 보완해야 할 사항은 나타나지 않아 지침이 실효성이 있는 것으로 파악되었다.

Clinical Features and Treatment Outcome of Chordoid Meningiomas in a Single Institute

  • Jee, Tae Keun;Jo, Kyung-Il;Seol, Ho Jun;Kong, Doo-Sik;Lee, Jung-Il;Shin, Hyung Jin
    • Journal of Korean Neurosurgical Society
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    • 제56권3호
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    • pp.194-199
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    • 2014
  • Objective : Meningioma is the second most common primary central nervous system neoplasm. In contrast, chordoid meningioma is rare; due to the paucity of cases, little is known about its clinical features or treatment outcomes. The objectives of this study were to describe the clinical characteristics and outcomes for patients with chordoid meningioma. Methods : In total, 16 patients, with newly diagnosed chordoid meningioma who underwent surgical excision between 1999 and 2012 were included. We retrospectively evaluated the medical records, radiological findings, and pathological findings. The median follow-up period was 56.5 (range, 3-170) months. The MIB-1 labeling index ranged from 1 to 26.60% (median, 5.04). Results : Simpson grade I, II, and III resections were performed in four, nine, and three patients, respectively. The overall recurrence rate was 37.5%. Overall progression-free survival (PFS) after resection was 94.7 months (95% CI=62.9-126.6). Of the 4 patients with Simpson grade I resection, recurrence occurred in one patient. Among the Simpson grade II and III resection groups, eight patients underwent adjuvant radiation therapy and they showed significantly longer PFS (121 months, 95% CI=82.1-159.9) than the patients who underwent surgery alone (40.5 months, 95% CI=9.6-71.3) by the log-rank test (p<0.05). Conclusion : Chordoid meningiomas are difficult to manage and have a high rate of recurrence. Complete resection of the tumor is a key determinant of better outcomes. Adjuvant radiation therapy is recommended, eparticulary when Simpson grade I resection was not achieved.

T1 Slope and Cervical Sagittal Alignment on Cervical CT Radiographs of Asymptomatic Persons

  • Park, Ji Hoon;Cho, Chul Bum;Song, Jun Ho;Kim, Seok Woo;Ha, Yoon;Oh, Jae Keun
    • Journal of Korean Neurosurgical Society
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    • 제53권6호
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    • pp.356-369
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    • 2013
  • Objective : We performed a retrospective analysis of medical records and radiographic images of patients who never underwent spinal treatment including diagnosis. The objective of this study is to explain the biomechanical and physiologic characteristics of cervical alignment related to thoracic inlet angle including T1 slope changes in each individual. Methods : We reviewed the cervical CT radiographs of 80 patients who visited ENT outpatient clinic without any symptom, diagnosis and treatment of cervical spine from January 2011 to September 2012. All targeted people were randomized without any prejudice. We assessed the data-T1 slope, Cobb's angle C2-7, neck tilt, sagittal vertical axis (SVA) C2-7 and thoracic inlet angle by the CT radiographs. Results : The relationships between each value were analyzed and we concluded that Cobb's angle C2-7 gets higher as the T1 slope gets higher, while the SVA C2-7 value decreases. Conclusion : We propose that the T1 slope is background information in deciding how much angle can be made in the cervical spinal angle of surgical lordotic curvature, especially severe cervical deformity.

Evaluating Direct Costs of Gastric Cancer Treatment in Iran - Case Study in Kerman City in 2015

  • Izadi, Azar;Sirizi, Mohammad Jaffari;Esmaeelpour, Safa;Barouni, Mohsen
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.3007-3013
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    • 2016
  • Background: Gastrointestinal cancers are common malignancies associated with high mortality rates. Healthcare systems are always faced with high costs of treatment of gastrointestinal cancers including stomach cancer. Identification and prioritization of these costs can help determine economic burden and then improve of health planning by policy-makers. This study was performed in 2015 in Kerman City aimed at estimating the direct hospital costs for patients with gastric cancer. Materials and Methods: In this cross-sectional study, the medical records of 160 patients with stomach cancer admitted from 2011 to 2014 to Shafa Hospital were examined, the current stage of the disease and the patients' health status were identified, and the direct costs related to the type of treatment in the public and private sectors were calculated. SPSS-19 was used for statistical analysis of the data. Results: Of the patients studied, 103 (65%) were men and 57 (35%) were women. The mean age of patients was 65 years. Distribution into four stages of the disease was 5%, 20%, 30%, and 45%, respectively. Direct costs in four stages of the disease were calculated as 2191.07, 2642.93, 2877, and 2674.07 USD (63,045,879, 76,047,934, 82,783,019, and 76,943,800 IRR), respectively. The highest percentage of costs was related to surgery in Stage I and to medication in Stages II, III, and IV. According to the results of direct costs of treatment for stomach cancer in Kerman, the mean total cost of treating a patient in the public sector was estimated at 74,705,158 IRR, of which averages of 60,141,384 IRR and 14,563,774 IRR were the shares of insurance and patients, respectively. Conclusions: The high prevalence and diagnosis of disease in old age and at advanced stages of disease impose great costs on the patients and the health system. Early diagnosis through screening and selecting an appropriate treatment method might largely ameliorate the economic burden of the disease.

인공위성 레이다 영상자료를 이용한 임분구조의 물리적 특성파악 (Analysis of Forest Stand Structure Using Spaceborne Synthetic Aperture Radar(SAR) Data)

  • 이규성
    • 대한원격탐사학회지
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    • 제8권2호
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    • pp.79-91
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    • 1992
  • 최근 지구궤도상 영상레이다 시스템의발전과 더불어 여러 응용분야에서 레이다 원격탐사 자료를 이용하려는 관심이 높아지고 있다. 본 연구는 우주상공에서 얻은 레이다영상자료로부터 얻은 레이다반사치와 산림의 특성과의 상관관계를 밝히고자 하였다. 미국 플로리다 북부 산림지 대의 연구지역을 대상으로 하여 1984년 10월 우주왕복선 비행에서 Shuttle Imaging Radar B(SIR-B) 자료를 얻었다. 여러 종류의 참고자료(임분 조사자료, 임상도, 항공사진, Landsat Thematic Mapper 자료)를 이용하여 약 400여개 의 표본임분을 선정하였다. 각 임분의 물리적 특 성(평균수고, 흉고직경, 수간밀도, 생체량, 하층식생량)과 그에 따른 레이다반사치와를 비교하였고 그들간에 통계학적으로 유의성이 있는 상관관계를 볼 수 있었다. 또한, 동일한 임분특성에서도 레 이다반사치가 세 개의 주사각도별로 다르게 나타나고 있었다. 끝으로 최근 우리에게 이용가능한 인공위성 레이다영상자료의 종류와 특성 및 전망 등을 살펴보았다.