• 제목/요약/키워드: Value-based health care

검색결과 198건 처리시간 0.028초

차 산업 서비스 모델의 변천 패턴에 대한 연구 - 중국 광시 지역 세대별 니즈를 중심으로 (Study on the Evolution pattern of Tea Industry Service Mode: Focusing on the Needs of Each Generation in GuangXi, China)

  • 리핑;장완석;반영환
    • 한국융합학회논문지
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    • 제12권6호
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    • pp.65-74
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    • 2021
  • 2020년부터 중국 광시 지방정부는 차 산업과 레저 문화 관광, 과학 보급 교육, 양생 양로 등 산업의 심층융합에 주목하고 있다. 또한 차 산업이 빠르게 발전하고 있어 3차 산업 생산 목표치를 250억 위안으로 계획하였다. 본 연구는 세대별 소비자에 대한 설문조사, 현지조사, 전문가 인터뷰 등을 통하여 차에 대한 니즈와 선택의 차이에 대해 분석하여 광시 차 산업 서비스 모델의 변화 패턴을 연구하였다. 연구 결과에 따르면, 소비자는 세대별로 생활방식, 쇼핑 습관, 서비스 디자인, 사용자 경험, 사회적 니즈, 개인적 니즈에서 뚜렷한 차이가 있다. 이에 차 제품에 대한 니즈와 행동 패턴을 분석하고 광시 차 산업 서비스 모델의 패턴 변화에 근거해보면, 세대별 소비자의 차 선택의 차이가 차 제품의 수요, 행동 패턴에 유의미한 차이와 패턴 변화를 발견할 수 있다. 끝으로 차 산업의 발전을 위한 서비스 디자인, 사용자 경험 모델 개발의 필요성을 주목하고 있다.

Ability of Biochemical Parameters to Distinguish between Bile Duct Cancer and Gall Bladder Stones - A Case Control Study in a Tertiary Care Hospital of Pokhara Valley

  • Yadav, Shambhu Kumar;Mittal, Ankush;Sapkota, Kumar;Gupta, Satrudhan Prasad;Sathian, Brijesh
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권2호
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    • pp.817-819
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    • 2013
  • Background: The present study was designed to comparatively assess alteration of biochemical parameters in bile duct cancer and gall stone disease. Materials and Methods: A hospital based case-control study was carried out in the Department of Biochemistry of Manipal Teaching Hospital, Pokhara, Nepal between $1^{st}$ January 2010 and $31^{st}$ December 2012. The variables collected were age, gender, serum total cholesterol, total bilirubin, AST, ALT, serum alkaline phosphatase, albumin and hemoglobin. One way ANOVA was used to examine the statistical significance of differences between groups. A post-hoc LSD test was applied for the comparison of means of control versus case groups. A p-value of <0.05 (two-tailed) was considered significant. Results: The mean age of cases and controls was $53.2{\pm}21.2$ years. The levels of serum cholesterol were higher in cases of cancer $192.5{\pm}21.5$ mg/dl in comparison to stone cases $168.7{\pm}16.1$ mg/dl (p value: 0.0001). The total bilirubin showed the marked difference in cases of cancer $7.6{\pm}3.2$ mg/dl in comparison to stone cases $2.5{\pm}0.8$ mg/dl of bile duct. There was discernible divergence in values of alkaline phosphatase in cases of cancer $251.5{\pm}20.1$ IU/l when compared to stone cases $173.2{\pm}12.6$ IU/l of bile duct. In contrast, there was no apparent deviation in values of aspartate transaminases and alanine transaminases in cases of cancer $59.1{\pm}8.9$ IU/l and $105.5{\pm}26.5$ IU/l when compared to stone cases $56.9{\pm}7.9$ IU/l and $84.5{\pm}13.5$ IU/l respectively. Conclusions: LFT analysis for pre-operative assessment was a good predictive marker in setting apart bile duct cancer and gall bladder stone.

Diagnostic Performance of 18F-Fluorodeoxyglucose Positron Emission Tomography/CT for Chronic Empyema-Associated Malignancy

  • Miju Cheon;Jang Yoo;Seung Hyup Hyun;Kyung Soo Lee;Hojoong Kim;Jhingook Kim;Jae Il Zo;Young Mog Shim;Joon Young Choi
    • Korean Journal of Radiology
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    • 제20권8호
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    • pp.1293-1299
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    • 2019
  • Objective: The purpose of this study was to evaluate the diagnostic performance of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for chronic empyema-associated malignancy (CEAM). Materials and Methods: We retrospectively reviewed the 18F-FDG PET/CT images of 33 patients with chronic empyema, and analyzed the following findings: 1) shape of the empyema cavity, 2) presence of fistula, 3) maximum standardized uptake value (SUV) of the empyema cavity, 4) uptake pattern of the empyema cavity, 5) presence of a protruding soft tissue mass within the empyema cavity, and 6) involvement of adjacent structures. Final diagnosis was determined based on histopathology or clinical follow-up for at least 6 months. The abovementioned findings were compared between the 18F-FDG PET/CT images of CEAM and chronic empyema. A receiver operating characteristic (ROC) analysis was also performed. Results: Six lesions were histopathologically proven as malignant; there were three cases of diffuse large B-cell lymphoma, two of squamous cell carcinoma, and one of poorly differentiated carcinoma. Maximum SUV within the empyema cavity (p < 0.001) presence of a protruding soft tissue mass (p = 0.002), and involvement of the adjacent structures (p < 0.001) were significantly different between the CEAM and chronic empyema images. The maximum SUV exhibited the highest diagnostic performance, with the highest specificity (96.3%, 26/27), positive predictive value (85.7%, 6/7), and accuracy (97.0%, 32/33) among all criteria. On ROC analysis, the area under the curve of maximum SUV was 0.994. Conclusion: 18F-FDG PET/CT can be useful for diagnosing CEAM in patients with chronic empyema. The maximum SUV within the empyema cavity is the most accurate 18F-FDG PET/CT diagnostic criterion for CEAM.

산업장 근로자의 건강증진행위와 자아개념 및 건강의 중요성 인식에 관한 연구 (The Determinants of Health Promoting Behavior of Industrial Workers)

  • 김정남
    • 한국직업건강간호학회지
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    • 제7권1호
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    • pp.5-19
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    • 1998
  • This descriptive-correlational study was conducted to identify the major factors affecting health promoting behaviors. 344 workers who employed in four different manutacturing plants in Taegu and Kyungbuk area were selected by convenience sampling method. Data were collected from April let to April 18th, 1998 by ready structured questionaires. The purpose of this study was to offer the basic data for health promotion theory development and health promotion strategy planning. This study was based on Pender's Health Promotion Model and examined three variables health promoting behavior, self-concept and perceived importance of health. The Life Style and Health Habit Assessment scale(LHHA) developed by Pender(1982).The Self-concept scale developed by Choi(1972) and the Health Value scale developed by Wallston, Maides and Wallston(1980) were used for this study. Data was analyzed by percentage, mean. t-test. ANOVA, Pearson Correlation Coefficient, and Stepwise Multiple Regression. The major findings of this study are as follows ; 1. The average level of health promoting behavior practice was 63.2% and possible range was from 62 to 248 point. The mean score of respondent's positive self-concept was 75.8. 81.4% of respondents put a high priority on the importance of health. 2. There was a significant difference between the practice level in the category of general self care and less amount of working hours per day(P=0.000), less amount of working hours per week(P=0.000). There was a significant difference between the practice level in the category of nutrition and age(0.002), marital status(0.000), working hour per day(0.008), working hours per week(0.001), There was a significant difference between the practice level in the category of nutriton and sex(0.000), age(0.000), marital status(0.025), education level(0.000), working hours per day(0.002), working hours per week(0.006). There was a significant difference between the practice level in the category of sleep and rest and age(0.003), marital status(0.002), working hours per day(0.001), working hours per week(0.001). There was a significant difference between the practice level in the category of stress management and working hours per day(0.001), working hours per week(0.002). There was a significant difference between the practice level in the category of self-actualization and working hours per day(0.050). 3. General characteristics influencing the respodent's self-concept were level(P=0.009) and worksite(P=0.001). 4. The results of the hypothesis tests are as follows The first hypothesis, that "The respondent who have more positive self-concept will have higher scores in the practice of health promoting behavior." was supported(r=0.2973, P=0.0001). The second hypothesis that "The respondent who have higher perception level on importance of health will have higher scores in the practice health promoting behavior." was rejected(r=- 0665, P=0.2225). 5. The most important factor that affects health promoting behavior practice was working hours per week(6.0%). The combination of working hours per week, age, education level accounted for 10.0% of the variance in health promoting behavior. In conclusion, the results of this study on industrial workers supported Pender's health promotion model in partial and showed the relatedness between self concept and the practice of health promoting behavior. Further research is required to find factors influencing health promoting behaviors of industrial workers.

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CA 72-4 참고치 설정에 관한 연구 (A Study on Establishment of Reference Value of CA 72-4)

  • 안재석;김지나;조예지;윤상혁;김윤철
    • 핵의학기술
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    • 제25권2호
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    • pp.25-28
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    • 2021
  • CA 72-4는 두 종류의 단일클론항체 CC49와 B72.3을 사용하여 혈청 내 종양관련단백인 TAG-72(tumor associated glycoprotein 72)를 측정 하여 결과를 나타내는 종양표지자이다. CA 72-4는 위암, 난소암, 췌장암등의 진단에 사용되고 있으며 특히 위암에 높은 특이도를 나타내는 것으로 알려져 있다. 본 연구는 CA 72-4의 참고치 재검증을 통하여 제조사에서 제공하는 참고치를 재평가 하고, 나아가 임상에서 보다 정확한 진단을 내리는데 유용한 도움을 주고자 진행하였다. 2020년 11월 국립암센터 건강검진센터에서 건강검진을 진행한 환자 271명을 대상으로 하였다. 대상자의 성별은 남자 140명 여자 131명 이었고, 30대부터 60대까지의 환자를 대상으로 진행하였다. 시약은 CA 72-4 IRMA KIT (ISOTOPES, Hungary)를 사용하였고, 감마카운터는 Dream Gamma-10(신진메딕스, Korea)을 사용하여 측정하였다. 종양표지자 참고치 설정 시 주로 사용하는 Hoffmann 법과 Bayesian 법으로 통계처리 하였다. 대상자 271명의 CA72-4를 측정한 결과 평균(Mean, M)값은 4.54 U/mL 이었고 중앙값(Median)은 3.30 U/mL 이었다. 3SD(standard deviation)를 벗어난 24명의 값을 제외하고 측정한 결과 M값은 3.53 U/mL, 중앙값은 3.00 U/mL, SD는 1.89 이었다. 이 값을 토대로 계산한 참고치 값은 7.31 U/mL 이었다. 제조사에서 제공되는 참고치는 4 U/mL 이하이며 이것은 본 연구에서 계산되어진 값인 7.31 U/mL과는 다소 차이가 있어 검사실 환경에 맞게 참고치 재설정이 필요해 보인다. 현재 국립암센터 위암센터에서는 지속적으로 현재 사용하고 있는 참고치에 관하여 문의가 오고 있다. 이번에 진행된 연구와 더불어 추가적인 연구를 진행한다면 보다 정확한 참고치 설정이 가능할 것이다.

2009년 한국 시도별 미숙아, 저체중출생아의 빈도 및 신생아중환자실의 현황 (Regional Analysis on the Incidence of Preterm and Low Birth Weight Infant and the Current Situation on the Neonatal Intensive Care Units in Korea, 2009)

  • 강병호;정경아;한원호;심계식;장지영;배종우
    • Neonatal Medicine
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    • 제18권1호
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    • pp.70-75
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    • 2011
  • 목적: 한국에서는 최근 저 출산율의 지속과 더불어 미숙아 및 저체중출생아의 출생 빈도가 증가하는 경향을 보인다. 이러한 변화에도 불구하고 지속적으로 신생아중환자실의 병상수가 부족한 상태이다. 이 연구의 목적은 2009년 국가통계포털의 통계청 자료에 의거한 총 출생아 수, 미숙아, 저출생체중아 수 NICU 등록 병상 수를 행정지역별로 검토하여 보다 나은 NICU 운영 및 미숙아 신생아의 생존 향상에 도움을 주고자 하였다. 방법: 한국통계포탈에 공개된 2009년도 인구통계 중 미숙아수, LBWI, 출생통계부분, 총 출생 수, 미숙아 수, LBWI 수, VLBWI 수를 얻었고, 전국 및 지역별 NICU 병상 수의 자료는 한국 건강보험심사평가원에서 획득하였다. 한국의 행정구역 지역별, 미숙아 수, LBWI 수, VLBWI수에 따른 병상수의 비와 각 평균에 대한 부족 지역 등을 조사하였다. 결과: 2009년 전체 출생 수 444,849명 중 미숙아 25,374명(5.7%), LBWI 21,954명(4.9%) 이었으며 미숙아나 LBWI 의 빈도가 평균보다 높은 지역은 부산, 인천, 광주였다. 2009년 NICU 총 병상 수는 1,284병상 이었으며 1병상 당 미숙아나 LBWI의 비율이 평균보다 높은 지역은 인천, 대구, 울산 이었다. 2009년 조사된 NICU 병상보유율은 87.5% (1,284/1,486)로 2005년보다는 증가하였으나 12.5%인 184병상이 여전히 부족하다. 특히 경기도는 159병상이 부족하였다. 결론: 신생아는 환자의 특성상 출생 후 이동의 어려움이 있어 즉각적이고 지속적인 처치가 중요하다. 이를 위해 전국적으로 균형 잡힌 NICU의 지역화가 필수적이다. 본 연구를 통해 NICU의 현황 및 시도별 단위에 대한 부족 병상 수에 대한 기본 자료를 제시하는 바이다.

근치적 전립선적출술 후 요실금에 대한 케겔운동의 효과: 무작위 대조군 실험연구의 체계적 문헌고찰 (Effect of Kegel Exercise on Urinary Incontinence after Radical Prostatectomy: Systematic Review of Randomized Controlled Trials)

  • 박성희;조윤수;곽미정;이희선;강창범
    • 성인간호학회지
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    • 제25권2호
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    • pp.219-230
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    • 2013
  • Purpose: This study is reviewed of the available literature to identify the evidence of the value of Kegel exercise programs as an intervention to decrease urinary incontinence and the improvement of the quality of life following a radical prostatectomy in localized prostate cancer. Methods: We searched studies of randomized controlled trials that utilized the Kegel exercise programs with patient with a radical prostatectomy. The review was conducted electronic bibliographic database of Ovid-Medline, Embase, Scopus, KoreaMed and NDSL, etc. Of 630 publications identified, seven studies that met the inclusion criteria, and all studies analyzed by meta-analysis. To ensure the quality of the studies, we used Cochrane's Risk of Bias. Results: Kegel exercise helped patient to achieve continence more quickly (after 1, 3, 6, 12 months) than men not using Kegel exercises. Especially, Kegel exercise significantly reduced the development of urinary incontinence at one month after prostatectomy. The effectiveness of Kegel exercise after prostatectomy was found to improve the quality of life at a significant level. Conclusion: Based on available evidence, Kegel exercise that nurses can teach improved the return to continence more than usual care in men with prostatectomy urinary incontinence.

임산부 및 수유부의 영양·미용·체형변화에 대한 관심도와 미용 보조 식품에 관한 연구 (Interests in Nutrition·Beauty·Body Shape of Pregnant and Lactating Women·Desires for "Inner Health, Outer Beauty" Functional Foods)

  • 류세자;박미성;박승용
    • Journal of Dairy Science and Biotechnology
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    • 제35권4호
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    • pp.232-243
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    • 2017
  • Although several supplementary foods are available for pregnant and lactating women, there is a need for foods able to maintain a woman's beauty without any changes in body shape. In this study, four questionnaires about nutrition management, skin care, body shape, and the intent of purchasing beauty supplementary foods, were prepared for an online survey (http://pms8011.wixsite.com/project). A total of 95 answers from 293 women were classified into four groups, based on age, income, occupation, and skin type. The data were statistically analyzed using SPSS/WIN Program 22.0. The significances of the F-value analyzed by one-way ANOVA and the differences within the groups were verified by Scheffe's method. All groups were shown to have very high requirements for nutrition management and beauty standards. In the skin patterns, the groups of middle-aged women, house wife and the lower income showed high interests, with a high significance (P<0.01) in ages. With respect to body shape, significant interest was found within the groups of skin type (P<0.05) and age (P<0.001). With regard to supplementary foods, all groups showed a strong intention to purchase, but no significant differences were found. This study indicates the necessity to categorize supplementary foods by the intended target group, such as women planning to conceive, pregnant women, and lactating women.

뇌성마비 아동의 한방의료 이용행태 - 근거이론에 의한 질적연구 (Utilization of Korean Medicine among Children with Cerebral Palsy - Qualitative Study by Grounded Theory)

  • 이현주;김부영;윤영주
    • 대한예방한의학회지
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    • 제23권2호
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    • pp.25-42
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    • 2019
  • Objectives : The purpose of this study was to identify factors that affect the utilization of Korean medicine (KM) among children with cerebral palsy (CP) and explore a processing model of decision-making by their parents. Methods : We conducted an individual in-depth interview with 21 mothers of children with CP who were recruited during the observational study. A grounded theory of Strauss and Corbin was used for qualitative analysis. Thus, collected data were classified into open coding including 121 concepts, 27 sub-categories and 7 categories. Results : The central phenomenon of the process of using KM for children with CP is 'KM as an optional treatment not essential'. Therefore there are many obstacles to starting KM treatment and it is easily interrupted for various reasons, unlike general rehabilitation treatment. However, if the patient experiences the therapeutic effect, the parents want to continue KM treatment. They try to provide treatment as much as possible if they can afford it. The parents give priority to general rehabilitation treatment and value the information and experience provided by the caregivers in similar situation as well as expert opinions. Conclusions : To expand and generalize KM treatment for children with CP, efforts to change interventional conditions such as treatment effect, treatment cost, treatment compliance, and convenience of treatment based on the understanding of the strategy used by the parents in KM utilization.

블록체인기반 의료분야의 문제해결과 이슈 (Issues in the Blockchain-Based Health Care Industry)

  • 우성희;이용주;조영복
    • 한국정보통신학회:학술대회논문집
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    • 한국정보통신학회 2019년도 춘계학술대회
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    • pp.363-366
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    • 2019
  • 블록체인 기술은 기존의 비즈니스 프로세스를 바꿀 새로운 패러다임으로서 특정 산업에 국한되지 않고 전 산업에 큰 영향을 미치고 있다. 의료산업 또한 블록체인 기술이 미치는 영향은 매우 클 것으로 기대하고 있다. 의료산업은 병원을 중심으로 구성된 중앙 집중형 시스템의 구조적 특성으로 인해 정보 비대칭성이라는 문제를 안고 있기 때문에 의료산업에서 블록체인 기술이 적용되어야 한다고 생각한다. 하지만 블록체인 기술의 탈중앙화, 투명성 등의 가치가 절대적으로 옳은 것이라고 그 누구도 확신할 수 없는 상황이며 절대적인 신뢰는 지양해야 할 것이다. 블록체인 기술은 보안성, 확장성 면에서 아직 미성숙하다고 볼 수 있기 때문에 의료 산업에서 블록체인 기술이 적용되는 과정에 많은 한계점을 제공한다. 따라서 본 연구에서는 의료분야의 블록체인 기술 적용사례와 현재 의료분야의 문제점과 블록체인을 통한 해결방안 그리고 이슈를 분석한다.

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