• Title/Summary/Keyword: Value-based health care

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A Study on the Improvement for Bidet Product-Service Design for Seniors by PSS-based 4D Double Diamond Design Process Model (PSS 기반 4D 더블 다이아몬드 모델을 활용한 시니어를 위한 비데 제품-서비스디자인 개선방안 연구)

  • Seo, Hong-Seok
    • Science of Emotion and Sensibility
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    • v.25 no.1
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    • pp.29-40
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    • 2022
  • This study uses the bidet 4D double diamond design process model to propose an improvement for "senior-oriented bidet product service design" that reflects the characteristics and needs of seniors. This study was based on the product service system concept. To this end, qualitative research on seniors was conducted to derive user value factors, and, based on this, product service ideas were discovered, and a prototype reflecting the usefulness review of a working-level expert group was proposed. First, a "smart application service for user-customized function setting guide" was proposed. A bidet incorporating Internet of Things technology and a smart phone are linked to provide an app service that automatically interprets user characteristic information and information on bidet products to guide customized functions. Second, a control panel and remote control user interface to "user-oriented product service interface" was proposed. In consideration of the usability and cognitive ability of seniors, a simple and intuitive physical user interface such as a configuration centered on main functions, button arrangement according to task sequence, and a touch screen remote control was presented. Third, we proposed a "bidet care service linked with products and health/hygiene care" that provides a wide range of services such as user health and hygiene, cleanliness, entertainment, etc., in addition to regular bidet product service. This study proposed a product-based service design methodology that can improve user experience and relationship quality by discovering and improving the pain points and needs of users (seniors) in the process of using bidet products (before, during, and after use).

Comparative study on Dental fees of Korea, Japan, Germany and United States (국내외 치과 의료수가 비교현황 : 한국, 일본, 독일, 미국을 중심으로)

  • Ryu, Jae-In;Kim, Chul-Shin;Jung, Se-Hwan;Shin, Bo-Mi
    • The Journal of the Korean dental association
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    • v.53 no.4
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    • pp.266-274
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    • 2015
  • The price for health service are decided by very complicated process because many of factors are related with them. The RBRVS(resource-based relative value scale) were used to calculate the Korean health service fees including dental fees. This study aimed to compare dental fees of Korea with other countries, such as Japan, Germany, and the US for evaluating the adequacy. Dental fees were categorized as oral evaluation and imaging, dental treatment including restorative, periodontal, and surgical work, and preventive treatment and compared by each country. The official documents about dental fees were collected from Korea, Japan, Germany, and the US. Each fee was presented as their own currency at first. Then they were converted into Korean won (KRW) by applying the market exchange rates at a specific point of time. Finally the fees were adjusted by purchasing power parities (PPPs) which equalize the different currencies. In general, the level of Korean fees were markedly low compared to those of Japan, Germany, and the US. German fees were similar or higher than that of Japan, and the US. The Korean fees were lower than three other countries 1.2~4.1 times for oral evaluation and 2.2~7.3 times lower for panoramic radiography. The endodontic fees of Japan, Germany, and the US were higher 1.8~15.3 times and 4.0~35.9 times for the deciduous teeth extraction compared to the Korean. In Japan the prophylaxis was 3.2 times more priced than the Korean fee. Exceptionally, the fees for re-evaluation, amalgam filling, and scaling were lower priced in Japan than other countries. This study has limitations on the items in definition and contents of dental practices units which were not exactly comparable and differently determined by countries. However, this study is meaningful because it surveyed the price levels to compare four different countries and then applied PPPs adjustment. This finding can be used to develop the dental RBRVs of Korean national health insurance and will contribute to improving the payment systems of health care.

Evaluation of Health-related Quality of Life for Hypothesized Medical States Associated with Cervical Cancer

  • Murasawa, Hideki;Konno, Ryo;Okubo, Ichiro;Arakawa, Ichiro
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9679-9685
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    • 2014
  • Background: When evaluating health-economics for cervical cancer prevention policies in Japan, it is important to use Japanese value settings. This study aimed to obtain preference-based measures (preference measures) for hypothesized health states among healthy Japanese women, and to examine differences between the EuroQol-5D (EQ-5D) and standard gamble (SG) instruments. Materials and Methods: The investigation was performed among female students at a nursing university. We used written hypothetical scenarios describing three grades of cervical intraepithelial neoplasia (CIN) and eight stages of cervical cancer, both at diagnosis and after medical intervention. Preference measures were evaluated using both EQ-5D and SG. Results: We received responses from 136 women. The mean number of respondents per stage was 24.6 (SD: 2.7). At diagnosis, average EQ-5D scores for CIN1, CIN2, CIN3, IA1, IA2, IB1, IB2, IIA, IIB, III, and IV stages were 0.84 (0.14), 0.78 (0.12), 0.73 (0.10), 0.78 (0.12), 0.72 (0.12), 0.63 (0.13), 0.64 (0.12), 0.68 (0.08), 0.62 (0.13), 0.55 (0.21), and 0.18 (0.24), respectively. Using one-way analysis of variance with the Tukey-Kramer method for multiple comparisons (each stage vs. CIN1), we found significant differences for IB1 and more advanced stages (p<0.05). After medical intervention, corresponding EQ-5D scores were 0.84 (0.12), 0.81 (0.12), 0.84 (0.12), 0.80 (0.15), 0.78 (0.11), 0.64 (0.15), 0.63 (0.15), 0.71 (0.15), 0.50 (0.17), 0.52 (0.17), 0.21 (0.28). The multiple comparisons identified significant differences for IB1 and more advanced stages, excepting IIA (p<0.05). SG evaluations were more variable and relatively higher than EQ-5D evaluations. Conclusions: We obtained preference measures for three grades of CIN1-3 and eight stages of cervical cancer. In combination with appropriate sensitivity analyses, these preference measures will provide a basis for an economic evaluation of cervical cancer prevention in Japan. We suggest that EQ-5D is appropriate for cost-utility analysis of this topic.

Comparison of Piperacillin/Tazobactam Dosing (13.5 g/day vs. 18 g/day) for the Treatment of Hospital-Acquired Pneumonia and Ventilator-associated Pneumonia in Intensive Care Unit (중환자실 내 병원성 폐렴 치료를 위한 Piperacillin/Tazobactam의 용량에 따른 효과와 안전성 비교)

  • Kang, Jeung Yun;Lee, Kyung A;Kim, Jae Song;Kim, Soo Hyun;Son, Eun Sun
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.3
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    • pp.167-173
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    • 2018
  • Background: In July 2016, the Infectious diseases society of america and the american thoracic society (IDSA & ATS) published a guideline recommending piperacillin/tazobactam (Pip/Tazo) 18 g/day as the anti-pseudomonal dose for the treatment of pathogenic pneumonia. After the guideline was published, the Pip/Tazo dose used for the treatment of pathogenic pneumonia was changed from 13.5 g/day to 18 g/day in a superior general hospital intensive care unit (ICU). In this study, we analyzed the effectiveness and safety of the new dose. Methods: Adult patients aged ${\geq}19years$ who were diagnosed with pneumonia in ICU and who received Pip/Tazo for 7 days or more from September 1, 2015 to May 31, 2017 were included in the study. The electronic medical record (EMR) was retrospectively analyzed. Results: At baseline, there was a significant difference between 44 patients treated with 13.5 g/day and 31 patients treated with 18 g/day of Pip/Tazo. The 18 g/day-treatment group comprised more elderly patients than the 13.5 g/day-treatment group (p=0.028). The results of the treatment-effects analysis showed no significant difference between the two groups. In case of safety data, there were significant differences in two parameters related to blood count, namely hemoglobin (p=0.016) and platelet count (p=0.011). Conclusion: Based on the significant difference in baseline age, there is a possibility that high-dose Pip/Tazo showed improved therapeutic effect. However, when high-dose Pip/Tazo was used, the blood cell count was found to drop from the reference value more frequently. Therefore, blood cell count should be monitored carefully when high-dose Pip/Tazo is administered.

A Study on Establishment of Essential Performance Evaluation Criteria for C-arm Computed Tomography (C-arm CT의 필수 성능평가 기준 마련을 위한 연구)

  • Kim, Eun-Hye;Park, Hye-Min;Kim, Jung-Min
    • Journal of radiological science and technology
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    • v.45 no.2
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    • pp.127-134
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    • 2022
  • In order to overcome the image quality limitations of the conventional C-arm, a flat panel detector (FPD) is used to enhance spatial resolution, detective quantum efficiency, frame rate, and dynamic range. Three-dimensional (3D) visualized information can be obtained from C-arm computed tomography (CT) equipped with an FPD, which can reduce patient discomfort and provide various medical information to health care providers by conducting procedures in the interventional procedure room without moving the patient to the CT scan room. Unlike a conventional C-arm device, a C-arm CT requires different basic safety and essential performance evaluation criteria; therefore, in this study, basic safety and essential performance evaluation criteria to protect patients, medical staff, and radiologists were derived based on International Electrotechnical Commission (IEC) standards, the Ministry of Food and Drug Safety (MFDS) standards in Korea, and the rules on the installation and operation of special medical equipment in Korea. As a result of the study, six basic safety evaluation criteria related to electrical and mechanical radiation safety (leakage current, collision protection, emergency stopping device, overheating, recovery management, and ingress of water or particulate matter into medical electrical (ME) equipment and ME systems: footswitches) and 14 essential performance evaluation criteria (accuracy of tube voltage, accuracy of tube current, accuracy of loading time, accuracy of current time product, reproducibility of radiation output, linearity and consistency in radiography, half layer value in X-ray equipment, focal size and collimator, relationship between X-ray field and image reception area, consistency of light irradiation versus X-ray irradiation, performance of the mechanical device, focal spot to skin distance accuracy, image quality evaluation, and technical characteristic of cone-beam computed tomography) were selected for a total of 20 criteria.

Evaluation of In-Vitro Efficacy of Active Ingredients in Dentifrice Used for Different Treatment Times (치약용 약효제의 적용시간에 따른 실험실적 효능 연구)

  • Ahn, Jae-Hyun;Kim, Ji-Hye;Kim, Ji-Young
    • Journal of dental hygiene science
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    • v.16 no.2
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    • pp.176-182
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    • 2016
  • The purpose of this study was to evaluate the in-vitro efficacy of the active ingredients of dentifrice following treatment time. The whitening effect was evaluated by a change in lightness value relative to the contact time of hydrogen peroxide, by using artificially stained hydroxyapatite discs. The anti-calculus effect was assessed based on the amount of calcium eluted from the human dental calculus by sodium pyrophosphate. Remineralization was evaluated by the Vickers hardness test following the application of sodium fluoride to bovine enamel. In order to view dentinal tubules occlusion, the formation of insoluble calcium salts by bovine dentin specimens was observed using scanning electron microscopy. Change in lightness value (${\Delta}L$) was $5.50{\pm}1.51$ after 1 min of treatment, $5.73{\pm}0.43$ after 3 min, $8.64{\pm}0.24$ after 10 min, $18.93{\pm}0.76$ after 30 min, and $27.35{\pm}0.54$ after 60 min. The amount of calcium eluted from the human dental calculus was $4.23{\pm}0.14ppm$ after 1 min of treatment, $4.51{\pm}0.04ppm$ after 3 min, $12.12{\pm}0.16ppm$ after 10 min, $17.85{\pm}0.81ppm$ after 30 min, and $25.15{\pm}0.32ppm$ after 60 min. The Vickers hardness change value (${\Delta}VHN$) was $1.96{\pm}1.44$ after 1 min, $1.52{\pm}1.06$ after 3 min, $9.06{\pm}0.15$ after 10 min, $10.83{\pm}5.13$ after 30 min, and $12.55{\pm}2.09$ after 60 min. Partial dentinal tubules occlusion was observed at 10 min and complete occlusion was evident at 60 min. In summary, the use of patch type dentifrices for 10, 30, or 60 min were 1.57 to 8.26 times more effective than using the paste type dentifrices for 1 to 3 min. Based on these findings, it is reasonable to expect that the use of patch type dentifrices for 10 min would lead to remineralization, anti-calculus and dentinal tubules occlusion effects, and that use for 30 min would result in a whitening effect.

Recently Ongoing Progresses and Future Prospects of Worldwide Dairy Goat Industry (세계 산양유산업의 최근 진보 및 향후 전망)

  • Jung, Hoo-Kil;Kim, Sun-Jin;Seok, Min-Jung;Kang, Kyung-Jin;You, Young-Hyun;Yoon, Seul-Ki;Kim, Sun-Young;Jung, You-Kyung;Park, Jong-Hyun
    • Journal of Dairy Science and Biotechnology
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    • v.34 no.4
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    • pp.217-229
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    • 2016
  • Goat milk production and processing is a dynamic and growing industry that is fundamental to the health of hundreds of millions of people worldwide and is recognized as an important contributor to many national economies. Goat milk has contributed significantly to the economic and nutritional quality of life in developing countries, particularly in the Mediterranean, the Middle East, Eastern Europe, and Latin America. Goat milk has played an important role in the health and nutrition of infants and the elderly, and is also known to be beneficial and therapeutic for people with milk allergies. The potential and value of the nutritional, health, and therapeutic effects of goat milk and specialized goat milk products are now attracting attention. Various products can be made from goat milk based on its chemical properties. In addition, special products such as hair, skin care, products, and cosmetics produced using goat milk have garnered more attention in recent years. Nevertheless, high quality products can only be made from good quality goat milk. Advanced technical treatments are necessary to produce high quality goat milk that meets consumer expectation of nutritional, hygienic, and good sensory products. Good taste has been a critical criterion when deciding to buy and consume goat milk and associated products. However, it may be possible to produce more value-added products that cater to the new trends in consumer needs and thus maintain economic sustainability of goat milk industry.

A STUDY ON THE CLINICAL ANALYSIS AND PERFORMANCE IN COMPREHENSIVE NURSING CARE (전인간호의 임상학적 분석과 실행에 관한 연구)

  • 전산초
    • Journal of Korean Academy of Nursing
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    • v.4 no.1
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    • pp.1-21
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    • 1974
  • A considerable change of the Korean nursing system has been made during the last decade not only in its philosophy but also in its function and structure to meet political and scientific need of the modern society. The main purpose of this study is to develope the new concept of comprehensive nursing care, both its Philosophy and ethics, as the basic of modern clinical nursing theory and practice. Comprehensive nursing care is the concept of human centered nursing care, and it helps a man to meet the basic physical, psychological, environmental, socioeconomic and teaching needs. It also helps him to help himself to meet these needs. This concept starts from the individualized nursing care and its ultimate goal is to improve a man to have a better position in his own community so that he may able to have a meaningful life. To accomplish this goal, an individualized nursing care plan as a nursing diagnosis and problem solving method should be set up for different patients with similar diagnosis to meet their needs, because each patient has a different social background. from this viewpoint, nursing is a science as well as abstruse humanity. The performance of comprehensive nursing care is a goal and issue of modern clinical nursing care. If nursing is a science and a profession for man, it should have ethics which recognize the dignity of man and offers infinite service voluntarily, and should be able to show leadership in carrying out the nursing responsibility. This leadership finds a person's potential and encourages him to utilize it. Such concepts should develop into a nursing ideology and this ideology should become a priority in comprehensive nursing care. The following statements are the conclusion of this study. 1) Modern nursing has been developed from disease centered nursing care to comprehensive nursing care based on humanity. The primary principle of nursing was to assist in the treatment of disease, but it has been changed to the professional nursing system independently. 2) The concept of nursing is one of continuous or endless scope of dispersion. It proves that nursing is grasping the professional responsibility to be able to coordinate scientific principles Patient health problems are according to scientific principles rather than adhering to nursing technical discipline as a daily work. 3) In chapter I and Ⅱ, the philosophy and ideology of nursing have been discussed and the flow of concept of clinical nursing and the rate of progress which emerges from naturalizing performance of the concept of comprehensive nursing in clinical nursing studied. The discussion developed the theory that a nurse should be to embody nursing ideas and objectives by establishing definite conviction of professions and study. 4) In chapter lil, nursing planning based on nursing diagnosis as a method to attain ideal nursing care for humanity with a definite idea of establishing philosophy of nursing was presented. 5) From the result of survey on patient needs about treatment and nursing, it was observed that all patient had emotional stress from unknown factors. Therefore it was concluded that nurses should not only educate the patient but also give them the opportunity to communicate freely their needs and anxieties. Furthermore complaints and doubts of the patient should be carefully noted and must be considered to meet these needs. 6) Patient teaching is the most important part of comprehensive nursing care. In chapter, Ⅲ, the important of patient teaching was emphasized by demonstrating the effect of patient teaching for diabetic patient. 7) In Chapter Ⅳ, from the result of the study on nurses attitudes to comprehensive nursing care, it was pointed that the evolution of nursing education and the establishment of a complete concept and value of comprehensive nursing was necessary.

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Performance Measurement of Diagnostic X Ray System (진단용 X선 발생장치의 성능 측정)

  • You, Ingyu;Lim, Cheonghwan;Lee, Sangho;Lee, Mankoo
    • Journal of the Korean Society of Radiology
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    • v.6 no.6
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    • pp.447-454
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    • 2012
  • To examine the performance of a diagnostic X-ray system, we tested a linearity, reproducibility, and Half Value Layer(HVL). The linearity was examined 4 times of irradiation with a given condition, and we recorded a level of radiation. We then calculated the mR/mAs. And the measured value should not be more than 0.1. If the measured value was more than 0.1, we could know that the linearity was decreased. The reproducibility was analyzed 10 times of irradiations at 80kVp, 200mA, 20mAs and 120kVp, 300mA, 8mAs. The values from these analyses were integrated into CV equation, and we could get outputs. The reproducibility was good if the output was lower than 0.05. HVL was measured 3 times of irradiation without a filter, and we inserted additional HLV filters with 0, 1, 2, 4 mm of thickness. We tested the values until we get the measured value less than a half of the value measured without additional filter. We tested the linearity, the reproducibility, and HVL of 5 diagnostic X-ray generators in this facilities. The linearity of No. 1 and No. 5 generator didn't satisfy the standard for radiation safety around 300mA~400mA and 100mA~200mA, respectively. HVL of No.1 generator was not satisfied at 80kVp. The outputs were higher in the three-phase equipment than the single-phase equipment. The old generators need to maintain and exchange of components based on the these results. Then, we could contribute to getting more exact diagnosis increasing a quality of the image and decreasing an expose dose of radiation.

An Artificial Intelligence-Based Automated Echocardiographic Analysis: Enhancing Efficiency and Prognostic Evaluation in Patients With Revascularized STEMI

  • Yeonggul Jang;Hyejung Choi;Yeonyee E. Yoon;Jaeik Jeon;Hyejin Kim;Jiyeon Kim;Dawun Jeong;Seongmin Ha;Youngtaek Hong;Seung-Ah Lee;Jiesuck Park;Wonsuk Cho;Hong-Mi Choi;In-Chang Hwang;Goo-Yeong Cho;Hyuk-Jae Chang
    • Korean Circulation Journal
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    • v.54 no.11
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    • pp.743-756
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    • 2024
  • Background and Objectives: Although various cardiac parameters on echocardiography have clinical importance, their measurement by conventional manual methods is time-consuming and subject to variability. We evaluated the feasibility, accuracy, and predictive value of an artificial intelligence (AI)-based automated system for echocardiographic analysis in patients with ST-segment elevation myocardial infarction (STEMI). Methods: The AI-based system was developed using a nationwide echocardiographic dataset from five tertiary hospitals, and automatically identified views, then segmented and tracked the left ventricle (LV) and left atrium (LA) to produce volume and strain values. Both conventional manual measurements and AI-based fully automated measurements of the LV ejection fraction and global longitudinal strain, and LA volume index and reservoir strain were performed in 632 patients with STEMI. Results: The AI-based system accurately identified necessary views (overall accuracy, 98.5%) and successfully measured LV and LA volumes and strains in all cases in which conventional methods were applicable. Inter-method analysis showed strong correlations between measurement methods, with Pearson coefficients ranging 0.81-0.92 and intraclass correlation coefficients ranging 0.74-0.90. For the prediction of clinical outcomes (composite of all-cause death, re-hospitalization due to heart failure, ventricular arrhythmia, and recurrent myocardial infarction), AI-derived measurements showed predictive value independent of clinical risk factors, comparable to those from conventional manual measurements. Conclusions: Our fully automated AI-based approach for LV and LA analysis on echocardiography is feasible and provides accurate measurements, comparable to conventional methods, in patients with STEMI, offering a promising solution for comprehensive echocardiographic analysis, reduced workloads, and improved patient care.