• Clinics in Shoulder and Elbow
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• 제25권2호
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• pp.121-128
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• 2022

Background: To determine the reasons and factors that contribute to the cancellations of shoulder surgeries at a tertiary referral center and to analyze the characteristics of these patients. Methods: Patients scheduled for shoulder surgery from June 2017 to July 2019 were allocated to a surgery group (n=224) or a cancellation group (n=96). These groups were compared with respect to patient characteristics, types of surgery, distance from patient's home to the hospital, traveling time to the hospital, and waiting period before surgery. Reasons for cancellation and responses were acquired using a telephone interview and were subsequently analyzed. Results: The cancellation group was older, had a less frequent history of trauma, and had a lower proportion of patients undergoing arthroscopic rotator cuff repair than the surgery group (p=0.009, p=0.014, and p=0.017, respectively). In addition, mean distance from the patients' homes to the hospital and preoperative waiting time were both longer in the cancellation group (p=0.001 and p<0.01, respectively). The most common reason given for cancellation was another medical condition (28.1%). Conclusions: Older age, need for arthroscopic rotator cuff repair surgery, longer distance from the patient's home to the hospital, and longer waiting period significantly increased the chance of cancellation. The main reason for canceling surgery was a concurrent medical condition. Therefore, identification of other medical conditions in advance is an important consideration when surgeons recommend shoulder surgery to patients. Surgeons should also consider patient's age, type of surgery, distance from the hospital, and waiting time when assessing the possibility of surgery cancellation.

• 한국산학기술학회논문지
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• 제11권1호
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• pp.361-367
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• 2010

이 연구는 2007년 1월 1일부터 동년 12월 31일까지 1년간 대전 소재 일개대학병원에서 수술 취소된 총 146명의 환자를 대상으로 하였으며, 계획된 수술의 취소율을 극소화하여 병원 경영의 합리적 개선과 진료 만족도를 증가시키고자하는 목적에서 이루어졌다. 조사대상자의 성별 분포를 보면, 남자 56.8%, 여자 43.2%로 여자보다 남자가 높은 분포를 보였다. 수술 취소 원인을 살펴보면 수술취소까지 이르지 않을 수 있었던 사항과 불가항력적으로 수술을 취소해야 할 사항으로 나눌 수 있는데, 이런 분류를 통해 전체 수술 취소 사유 중 60.0%는 예방이 가능했던 사항이라고 했다. 본 연구결과를 기초로 타 연구자와 병원관리자에게 수술 취소율 감소 개선을 위한 정책방향의 수립을 제언한다.

• 한국정밀공학회지
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• 제26권12호
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• pp.146-153
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• 2009

One of the most important issues in the wearable healthcare sensors is to minimize the motion artifacts in the vital signals for continuous monitoring. This paper presents a reflected type photoplethysmograph (PPG) sensor for monitoring heart rates at the artery of the wrist. Active noise cancellation algorithm was applied to compensate the distorted signals by motions with Least Mean Square (LMS) adaptive filter algorithms, using acceleration signals from a MEMS accelerometer. Experiments with a watch type PPG sensor were performed to validate the proposed algorithm during typical daily motions such as walking and running. The developed sensor is suitable for ubiquitous healthcare system and monitoring vital arterial signals during surgery.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.60-66
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• 2024

Purpose: This study investigated changes in interpersonal violence and utilization of trauma recovery services during the COVID-19 pandemic. At an urban level I trauma center, trauma recovery services (TRS) provide education, counseling, peer support, and coordination of rehabilitation and recovery to address social and mental health needs. The COVID-19 pandemic prompted considerable changes in hospital services and increases in interpersonal victimization. Methods: A retrospective analysis was conducted between September 6, 2018 and December 20, 2020 for 1,908 victim-of-crime patients, including 574 victims of interpersonal violence. Outcomes included length of stay associated with initial TRS presentation, number of subsequent emergency department visits, number of outpatient appointments, and utilization of specific specialties within the year following the initial traumatic event. Results: Patients were primarily female (59.4%), single (80.1%), non-Hispanic (86.7%), and Black (59.2%). The mean age was 33.0 years, and 247 patients (49.2%) presented due to physical assault, 132 (26.3%) due to gunshot wounds, and 76 (15.1%) due to sexual assault. The perpetrators were primarily partners (27.9%) or strangers (23.3%). During the study period, 266 patients (mean, 14.9 patients per month) presented before the declaration of COVID-19 as a national emergency on March 13, 2020, while 236 patients (mean, 25.9 patients per month) presented afterward, representing a 74.6% increase in victim-of-crime patients treated. Interactions with TRS decreased during the COVID-19 period, with an average of 3.0 interactions per patient before COVID-19 versus 1.9 after emergency declaration (P<0.01). Similarly, reductions in length of stay were noted; the pre-COVID-19 average was 3.6 days, compared to 2.1 days post-COVID-19 (P=0.01). Conclusions: While interpersonal violence increased, TRS interactions decreased during the COVID-19 pandemic, reflecting interruption of services, COVID-19 precautions, and postponement/cancellation of elective visits. Future direction of hospital policy to enable resource and service delivery to this population, despite internal and external challenges, appears warranted.

• 보건행정학회지
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• 제15권4호
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• pp.26-45
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• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• 한국산학기술학회논문지
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• 제22권2호
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• pp.434-439
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• 2021

본 논문은 복강경 자궁근종절제술을 받은 여성에서 정맥 내 아스코르브산 주입이 피로에 미치는 영향 알아보고자 하였다. 우리는 무작위 배정 양측맹검 위약대조 임상시험의 2차 평가변수의 결과를 분석하였다. 복강경 자궁근종절제술을 받은 환자 50명은 수술 중 아스코르브산 (2g)이나 위약을 수술 중 투여받았다. 환자 비율은 임의로 1:1 비로 하였다. 수술 후 2일차에는 간이 피로 평가지 (Brief Fatigue Inventory-Korean version, BFI-K)을 사용하여 피로수준을 평가하였다. 대상자가 동의를 철회하거나 수술을 취소한 경우 또는 평가변수가 측정되지 않은 5명은 제외되어 총 45명(시험군 23명, 대조군 22명)을 대상으로 분석하였다. 분석에 포함된 대상자의 임상적 특성은 실험군과 대조군간의 차이가 없었으며, 전체 피로도 점수도 실험군 (4.56 ± 2.63). 대조군 (5.21 ± 2.02 P = 0.351)으로 두 군간에 차이를 보이지 않았다. 그러나 대조군의 피로도 점수는 대부분의 영역에서 대조군의 피로도 점수보다 낮은 경향을 보였다. 결론적으로 복강경 자궁근종절제술을 시행받은 여성에서 정맥 내 아스코르브산 주입은 피로도를 크게 줄이지 못했으며, 추가적인 연구가 필요하다.

• 대한치과마취과학회지
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• 제10권1호
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• pp.7-12
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• 2010

Background: This study was carried out to contribute to effective management of operated patients by analyzing cooperative details about patients who were taken elective operation and consulted to the department of anesthesiology. Patients and Methods: One thousand patients who have been consulted to department of Anesthesiology, Chonnam National University Hospital from 2008. November to 2009. March were analyzed. The gender, age, cooperative departments, cooperative reason, the number of cancelled cases and cancelled reason were evaluated. Results: Among 1000 patients, there were 470 females and 530 males. After adjusting for age, middle-aged people which range 45 to 64 year-old are 39.9% and over 65 year-old people are 30.3%. Cooperative department is distributed to orthopedics which is highest occupying 20.6%, neurosurgery, otorhinolaryngology, obstetrics and gynecology in order. Dentistry occupied 2.0%. By specifying reasons of cooperation, cardiovascular diseases distribute to 38.4% which is the highest, the respiratory diseases, 17.5% and the endocrine diseases including diabetes 13.2%. Arranging details, hypertension is 23.9%, ECG abnormality 14.5%, chronic bronchitis in chest radiographic interpretation 14.2%. Of 1,000 consulted patients, delayed or cancelled cases are 58. And the reasons were 26 cases of need of appropriate the blood-sugar level. 26 cases needed appropriate treatment for comorbidities and others 6. Conclusion: Thoroughly evaluating patients before operation and maintenace of active cooperative system between operative department and anesthesiology department can contribute to reduction of cancellation rate and effective management of both hospitalizing and operating rooms.