• Title/Summary/Keyword: Referral

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Survey on Medical doctors' awareness and perceptions of Bisphosphonate-related osteonecrosis of the jaw (비스포스포네이트 관련 악골괴사 (Bisphosphonate-Related Osteonecrosis of the Jaw)에 관한 의사의 인식도 조사)

  • Kim, Jin-Woo;Jeong, Su-Ra;Pang, Eun-Kyoung;Kim, Sun-Jong
    • The Journal of the Korean dental association
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    • v.53 no.10
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    • pp.732-742
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    • 2015
  • The objective of this study was to identify bisphosphonate-related osteonecrosis of the jaw (BRONJ) awareness and experience level of patients by medical doctors who prescribes bisphosphonate being used, analyze dental examination referral reality and to utilize its result as basic education data for early diagnosis of BRONJ and its prevention. The study was carried out through a self-administered questionnaire distributed among a sample 192 residents and specialists. They belonged to family medicine, internal medicine and orthopedics of 6 tertiary medical centers located in Seoul. The survey consisted of 22 questions; general characteristics, bisphosphonate therapy, awareness of BRONJ, implementation level of dental examination referral. Among 192 medical doctorss, 78.1% (n=150) showed awareness of BRONJ. Only 8.9% (n=17) had correct response in all 5 BRONJ knowledge questions. Dental examination referral by medical doctors was implemented in below 30% of the total patients. At the time of bisphosphonate administration, specialist of oncology most highly recognized necessity of dental examination referral and it was represented in the order of endocrinology, rheumatology, family medicine, orthopedics specialists. As recognition of medical doctors for BRONJ and implementation level of dental referral were represented to be low, it is considered that enhancement of BRONJ recognition for medical doctors and development of high accessible education program for increasing implementation rate of dental examination referral would be required.

Diagnostic Imaging for Lung Lobe Torsion in a Miniature Pinscher (Miniature Pinscher 견에서 발생한 폐염전의 진단영상 1례)

  • Choi, Ji-Hye;Kim, Hyun-Wook;Jang, Jae-Young;Ban, Hyun-Jung;Kim, Hye-Jin;Kim, Jin-Kyung;Kim, Jun-Young;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.410-413
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    • 2007
  • A four-year old, female Miniature Pinscher was presented with intermittent coughing. Thoracic radiography and ultrasonography revealed the consolidation of left cranial lung lobe surrounded by pleural effusion and the extraction of left lung lobe was performed through thoracotomy. This case has the clinical significance because lung lobe torsion was diagnosed by non-cardiac ultrasonographic examination, therefore surgical correction was performed without delay and led good outcome. Moreover, the authors believe the present case was the first report on lung lobe torsion in Miniature Pinscher dog.

Radiographic Changes of Bilateral Partial Avulsion Fracture of Tibial Tuberosity in a Dog (개에서 발생한 양측성 경골조면 부분 견열골절의 방사선학적 변화)

  • Keh, Seo-Yeon;Choi, Mi-Hyun;Lee, Nam-Soon;Jang, Jae-Young;Lee, Hae-Keong;Kim, Hyun-Wook;Yoon, Junghee
    • Journal of Veterinary Clinics
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    • v.30 no.2
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    • pp.134-137
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    • 2013
  • A 4-month-old intact male Jindo dog was presented for left hindlimb lameness. On radiographs, a small mineralized piece was identified beneath the apophysis of tibia with no or minimal displacement of apophysis bilaterally. Subsequently, the cranioproximal bony aspect of the tibia changed radiolucent to radiopaque. The left side recovered after surgical management, but the right side was self-limited with conservative management. The diagnosis was partial avulsion fracture of the tibial tuberosity which has been called 'Osgood-Schlatter disease' in dogs.

Analysis of Status and Success Factor of Referral and Return of Patients to Clinics: Focusing on Patients with Endocrinology and Cardiology at a General Hospital in Goyang (진료회송 사업 현황 및 성공요인 분석: 고양시 소재 종합병원급 내분비내과와 심장내과 환자를 중심으로)

  • Park, Hee Sun;Choi, Jung Kyu;Tae, Eun Sook;Choi, Sang Gil;Kim, Eui Hyeok
    • Health Policy and Management
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    • v.32 no.3
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    • pp.323-329
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    • 2022
  • Background: This study aimed to identify the characteristics of the referral and return of patients to clinics in the endocrinology and cardiology departments at the National Health Insurance Service Ilsan Hospital to evaluate the "referral and return of patients to clinics" program and reduce the rate of returning patients. Methods: From May 2018 to December 2020, we identified the number of visits to referral hospitals and hospital usage status at Ilsan Hospital after returning to clinics. We also identified the patients who returned to Ilsan Hospital within 6 months, defined as "failure to transport," among those recommended to be transported to clinics of the Medical Cooperation Center. Additionally, we evaluated the characteristics of the "failure to transport" patients. Results: Among the returning patients, the rate of visiting Ilsan Hospital within 6 months was higher in cardiology than in endocrinology (25.1% vs. 16.7%). Older age, more severe disease, and more number of visits to the department were associated with a high rate of failure to transport. The rate of failure to return was low in cases diagnosed with hyperlipidemia/lipoprotein metabolism disorder. With respect to diabetes, the rate of failure to transport differed according to each type of diagnosis of diabetes. Conclusion: The success rate of the "referral and return of patient to clinics" program differed based on each patient's characteristics, department of visit, and diagnosis. Individualizing according to the visit department and diagnosis is required to ensure successful transfers, and infrastructure expansion and institutional arrangements must be facilitated.

Development and validation of a novel screening instrument to prioritize the orthodontic referral of developing malocclusion in children: The index for interceptive orthodontics referral

  • Saraswathy Devi Sinniah;Annapurny Venkiteswaran;Najiyatu Nazihah Zakaria
    • The korean journal of orthodontics
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    • v.53 no.2
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    • pp.116-124
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    • 2023
  • Objective: The absence of a guideline to refer to developing malocclusions appropriately, may be a contributing factor to the inadequacy of timely interceptive orthodontics provision. This study aimed to develop and validate a new orthodontic grading and referral index to be used by dental frontliners to prioritize the orthodontic referral of developing malocclusion in children based on its severity. Methods: A cross-sectional study involving clinical assessment with 413 schoolchildren aged between 8.1 and 11.9 years was conducted in 2018. All the presenting malocclusion was listed and graded based on a few dental guidelines to produce the draft index. The validity and reliability of the draft index were tested using twenty study models. Face and content validation was carried out using the content validation index and Modified Kappa Statistics. Results: Fourteen dental and occlusal anomalies were identified as components of malocclusion and three grades of referral (monitor, standard, urgent) were included in the final index. The scale-level content validity index average value of 0.86 and 0.87 was obtained for content and face validation, respectively. There was moderate to excellent agreement in the Modified Kappa Statistics for both validations. Excellent inter- and intra-assessor agreement was obtained. The new index displayed valid and reliable scores. Conclusions: The Index for Interceptive Orthodontics Referral was developed and validated for the dental frontliners to identify and prioritize the developing malocclusion in children based on its severity and refer for orthodontic consultation to increase the possibility for interceptive orthodontics.

Problems of the Current Referral System of the Terminal Cancer Patients in Korea (말기 암 환자의 완화 의료 연계 시스템의 문제점과 개선 방안)

  • Yun, Cho-Hee;Lee, Ju-Young;Kim, Mi-Ra;Heo, Dae-Seok
    • Journal of Hospice and Palliative Care
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    • v.5 no.2
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    • pp.94-100
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    • 2002
  • Purpose : The system to refer terminally ill patients to palliative or hospice care which ultimately give them emotional, psychological, and social support hasn't been fully developed and organized yet in Korea. The controversies concerning the current referral system are being analyzed to present the improvements. Methods : The questionnaires were asked to be filled out by family members of the 76 patients by phone interview, who were referred from the Seoul National University Hospital between April, 2001 to March, 2002. They were referred to the 35 palliative and hospice care-giving institutes and hospitals which were given questionnaires by mail. Results : Of the 76 patient's family members, 47 family members accepted to answer the questionnaire. The first thing that influence to family to determine the referral of patient was solicitation of doctors or nurses (44%). And they were influenced by allowance for the other things such as convenience of patients (32%), convenience of caring family members (24%). In the course of determining of referred institutes, responders had considered at first their dwelling area, and then fame of institutes, the place which patent had wanted to spend last hours or which is suitable for patient's funeral service, and their financial condition. Thirty-eight the 47 responders answered that they had experienced difficulties in referral procedure. The worst among difficulties was unwanted discharge, and followings were lack of information about the referred institutes, concern about patient's suffering, resistance of patient and opposition of other family members, etc. Although they expressed dissatisfaction in referral procedure, most of them answered they had been satisfied with hospice care at referred institute after referral. Merits of referral which responders counted were patient's peace, caring family's comfort and reduced cost in order. Of the 35 referred institutes, 24 institutes' staffs responded mail questionnaires and sent to us in return. Except one responder, the rest approved the referral system and thought that referred patients had been satisfied with their hospice care. And they claimed that systemic support of the government is definitely necessary. The most difficult thing which responders experienced in care of referred patients was lack of information about patients. Besides, there were patient's financial problems, lack of understanding about their institutes of patients or family, and inconvenience of terminal cancer patient's pain control. Conclusion : The development and support of the organized referral system is needed to alleviate the troubles which patients, family members, and palliative or hospice institutes and hospitals have to face through the procedure of the referral.

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Referral Trends of Children in Jeonbuk National University Dental Hospital for Last 3 years (최근 3년간 전북대학교 치과병원의 소아청소년환자 의뢰경향)

  • Bae, Cheolhyeon;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.4
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    • pp.362-368
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    • 2019
  • The purpose of this study was to analyze outpatient referral patterns of children in Jeonbuk National University Dental Hospital. All patients under 16 years old who were consulted from the external facilities were reviewed based on the electronic medical record of Jeonbuk National University Dental Hospital from 2015 to 2018. Total 720 boys and 460 girls with an average age of 7.4 years were referred from local dental clinic (85.2%) for treatment severity (90.2%). 3.2% of patients has disability with the highest number of intellectual disabilities. The patients were usually referred at the pre-treatment stage with higher rates if they had disability or medical problem. Referral rate by chief complaints was highest in surgery, followed by reparative treatment and orthodontic treatment. 2nd referrals in pediatric dentistry had a higher rate of referrals to minor surgery and pulp treatment than of first referrals. The time point of 2nd referral was relatively delayed with increased ratio of 'during treatment'. These results suggest necessities of appropriate case selection and referral based reasonable criteria for pediatric dentist.

The Effects of the Quality of Elderly Day Care Services on Customary Satisfaction, Referral Intention, and Repurchasing Intention (주간보호시설의 서비스품질이 고객만족, 추천의향 및 재이용의사에 미치는 영향)

  • Lee, Jin-Yong;Sohn, Eui-Seong;Yoon, Kyeong-A
    • 한국노년학
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    • v.32 no.3
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    • pp.715-727
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    • 2012
  • This study measured the quality of Elderly Day Care Services by surveying service users; data were analyzed to see the causality between quality of services, customary satisfaction, referral intention, and repurchasing intention, and to find out the mediating effect of customary satisfaction. The quality of Day Care Services has been measured based on the SERVQUAL model, and structural equation model has been used to observe the causal connection between the five factors, tangibles, reliability, responsiveness, assurance and empathy, and customary satisfaction, referral intention, and repurchasing intention. The following is the main result from the causal effect model affecting the customary satisfaction and repurchasing intention by five quality factors of the service quality. First, it was shown that tangibles and responsiveness, as quality factors, directly affected the customary satisfaction, and reliability, credibility, and empathy did not. Second, it was shown that tangibles, reliability, responsiveness and empathy, quality factors, did not directly affected the referral intention and the repurchasing intention. But the effect of service quality on referral and repurchasing intention was mediated by customer satisfaction. Third, it is shown that customary satisfaction directly affected the referral intention and the repurchasing intention.

Mesenteric torsion in a Miniature Schnauzer (Miniature Schnauzer에서 발생한 장간막 염전 1증례)

  • Choi, Jihye;Kim, Hyunwook;Kim, Jinkyung;Jang, Jaeyoung;Kim, Junyoung;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.48 no.1
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    • pp.125-130
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    • 2008
  • Mesenteric torsion was diagnosed in a 2-year-old, spayed female Miniature Schnauzer. The patient was presented with acute depression, vomiting, lethargy and hematochezia. On physical examination, severe dehydration, tachycardia, tachypnea, weak femoral pulse, delayed capillary refill time and pale mucous membrane were found and the dog was in shock. Radiography and ultrasonography revealed intestines distended with gas, ascites and the "C" shaped distended intestine. Medical treatments including fluid therapy, analgesics, antibiotics and lidocaine for reducing reperfusion injury were applied. And then, the mesenteric torsion was definitively diagnosed through exploratory laparotomy and intestinal resection and anastomosis were performed. The dog made an uneventful recovery and was free of clinical sign one week after surgery. Mesenteric torsion is an unusual and life-threatening disease in dogs. It has usually been described in the middle and large breed dogs, especially German Shepherds. However, the mesenteric torsion should be included in the differential diagnostic lists for acute abdomen even in small breed dog. The mortality rate of mesenteric torsion can be reduced through prompt diagnosis, proper preventive therapy for shock and reperfusion injury and emergency surgery.