• Molecules and Cells
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• v.41 no.3
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• pp.179-187
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• 2018

Proteomic analysis of extracellular vesicles (EVs) from biological fluid is a powerful approach to discover potential biomarkers for human diseases including cancers, as EV secreted to biological fluids are originated from the affected tissue. In order to investigate significant molecules related to the pathogenesis of bladder cancer, EVs were isolated from patient urine which was analyzed by mass spectrometry based proteomics. Comparison of the EV proteome to the whole urine proteome demonstrated an increased number of protein identification in EV. Comparative MS analyses of urinary EV from control subjects and bladder cancer patients identified a total of 1,222 proteins. Statistical analyses provided 56 proteins significantly increased in bladder cancer urine, including proteins for which expression levels varied by cancer stage (P-value < 0.05). While urine represents a valuable, non-invasive specimen for biomarker discovery in urologic cancers, there is a high degree of intra- and inter-individual variability in urine samples. The enrichment of urinary EV demonstrated its capability and applicability of providing a focused identification of biologically relevant proteins in urological diseases.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2014.05a
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• pp.844-847
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• 2014

'Healthcare 3.0' paradigm, which comes from the convergence of medical and department of ICT(Information and Communication Technology), meets the government's 'creative economy'. It has emerged as new higher value-added markets and industries, created jobs, and got the 'land of opportunity'. Despite of the global recession, the health care market in the world from 2009 to now has earned a steady growth. The annual growth rate in domestic industrial scale is expected to more than 10% higher based on 153 trillion won in 2010. In particular, combination of health care and ICT, BT(BioTechnology), NT(NanoTtechnology), which is so called 'super-convergence', leap in the health care industry, is expected to open up a new paradigm. In addition, by 2020 all of the health care industry, the IT convergence industries account for the largest proportion, and more than 50,000 of the employment are to be expected. In this study, we survey and analyze problems of medical and IT convergence technology, the future of the medical and health care industry, the demanded healthcare IT staff, finally suggest education plan of human resources required in convergence industry of medical and IT.

• International Journal of Contents
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• v.10 no.2
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• pp.47-58
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• 2014

Physiological signals provide important clues in the diagnosis and prediction of disease. Analyzing these signals is important in health and medicine. In particular, data preprocessing for physiological signal analysis is a vital issue because missing values, noise, and outliers may degrade the analysis performance. In this paper, we propose PhysioCover, a system that can recover missing values of physiological signals that were monitored in real time. PhysioCover integrates a gradual method and EM-based Principle Component Analysis (PCA). This approach can (1) more readily recover long- and short-term missing data than existing methods, such as traditional EM-based PCA, linear interpolation, 5-average and Missing Value Singular Value Decomposition (MSVD), (2) more effectively detect hidden variables than PCA and Independent component analysis (ICA), and (3) offer fast computation time through real-time processing. Experimental results with the physiological data of an intensive care unit show that the proposed method assigns more accurate missing values than previous methods.

• Korean Journal of Adult Nursing
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• v.20 no.1
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• pp.163-175
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• 2008

Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

• Health Policy and Management
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• v.15 no.2
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• pp.16-36
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• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.33-43
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• 2024

Purpose:The acute hospital accreditation program launched in South Korea has shown positive effects on safety culture and quality of care. However, relative weights have not yet been investigated for accreditation criteria with a hierarchical structure. This study aimed to derive the relative weights of acute-care hospital accreditation criteria. Methods: We conducted an online survey using the analytic hierarchy process (AHP) technique to assess the validity, importance, and urgency of acute hospital accreditation criteria. The AHP online survey link was distributed in November 2022 after obtaining informed consent from 10 experts in hospital accreditation. Results: 'Basic value system' ranked highest, while 'patient care system' ranked second in terms of validity, importance, and urgency. 'Performance management system' had the lowest validity and urgency, while 'organizational management system' carried the lowest importance. Within the 'patient care system' domain, 'surgery and anesthesia sedation management' scored highest in validity and importance, and 'patient care' scored highest in urgency. 'Care delivery system and evaluation' received the lowest scores for all three aspects. In the 'organizational management system' domain, infection control ranked highest in terms of validity, importance, and urgency. The lowest validity was observed for 'management and organizational operation' and the lowest importance and urgency were noted for 'human resource management'. Conclusion: The weights for validity, importance, and urgency, as shown in each domain and chapter, and the number of measurable elements included, are largely inconsistent. This study will contribute to the development of the structure and scientific improvement of accreditation standards.

• Journal of agricultural medicine and community health
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• v.29 no.2
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• pp.237-247
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• 2004

Objectives: The purpose of this study is to estimate the needs of long-term care in S-city Gyeonggi-do according to ADL and IADL. Methods: We surveyed to investigate the needs of 397 study samples which had been selected by stratified randomized sampling, 2.7% in each Dong of S-city. We estimated the disability of elderly by using standards based on ADL and IADL of OECD and Korea Institute for Health and Social Affairs. Results and Conclusions: According to standards of OECD, the elderly with severe disability were 4,712(31.2%). According to standards of Korea Institute for Health and Social Affairs, the severe disabled elderly with helper were 3,776(24.9%) and the severe disabled elderly without helper 2,130(14.1%) So We concluded that the long-term care beds estimated by need were from 2,130 to 4,712. To estimate the long-term care beds, we have to consider together physical, mental, nutrition, and cognition status, existence of helper, helper characteristics, and emotional relationship between elderly and helper. But we considered only disability grades of physical states and existence of helper in this study. So it will be useful to conduct study to consider these other factors in future. At the same time this study is of value to estimate objectively long-term care needs based on physical needs in one region.

• Korea Journal of Hospital Management
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• v.2 no.1
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• pp.96-113
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• 1997

This study was performed to analyze of market segmentation of outpatient services on the based of consumption values. Self-reported questionnaires of six hospital outpatients 600 were analyzed by six consumption values categories: functional values, social values, emotional value, rarity value, situational values, health related values. The main results of this research is as following; 1. The consumption values were significantly different in that sociodemographic characteristics. Especially, the more older aged group, farmer and married people, the more they preferred to functional value, social value, emotional value and rarity value than younger aged group and unmarried people. But in the cases of situational vaue, younger aged people and white-callar workers recognized more positively. Also, housewives, married people and female recognized more positively than white-callar workers, unmarried people and male. 2. In the results of CHAID analysis, market of general hospital were analyzed by 9 categories and major market were groups who ignored or were unconcerned about newness/classiness and preferred to nearness to residence. The market of university hospital were analyzed by 8 categories and major market were groups who considered to reliability/social reputation importantly. The market of corporate hospitals were analyzed by 8 and major market were group who considered to classiness/newness importantly. Therefore, above results show that health care market can be divided to various market by demand and market segmentation is very important for marketing strategy.

• Journal of Preventive Medicine and Public Health
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• v.31 no.3 s.62
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• pp.516-539
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• 1998

The objective of this study is to identify the difference in attitude toward medical care between patients who visited a university hospital or an oriental medical hospital of oriental medical college, and physicians who engaged in the same hospitals. The subjects of this study were 397 cases who agreed to respond the prepared questionnaire, including 288 patients(146 university hospital utilizers and 142 utilzers for an oriental medical hospital) and 109 physicians(76 physicians and 33 oriental medical doctors). The attitude toward medical care was measured by the structured questionnaire developed for this study, which had high validity and reliability according to factor analysis, item discriminant validity, and Cronbach's $\alpha$ coefficients. On the criteria of mean value of care and cure score, the attitude toward medical care was classified into 4 groups encompassing a group with dependent attitude on medical care, a group with skeptical attitude toward it, a group with cure-oriented attitude, and a group with care-preferred attitude. The results of chi-square test, discriminant analysis, and logistic regression analysis were as follows; patients who visited a univisity hospital, patients who visited an oriental hospital, physicians, and oriental medical doctors included in the group with dependent attitude, the group with cure-oriented attitude, the group with skeptical attitude, and the group with care-preferred attitude, retrospectively. Among the subdomains of care and cure domains, which classified in reference to the result of factor analysis on pilot study, those that patients ranked more importantly than physicians were 'the importance of medical equipment for diagnosis and treatment', 'authority of physician, 'aggressiveness of treatment', 'information giving', 'personal interest' in the case of western medicine. In the case of oriental medicine, those were 'the importance of equipment for diagnosis and treatment', 'aggressiveness of treatment', 'amenities and accessibility', 'coordination of medical staff'. Both physicans and patients put the subdomain, 'physicians' medical knowledge and skillfulness' on the highest rank. The differences in ranking the important attributes of medical care between patients and physicians were apparent in the area of an 'importance of medical equipment for diagnosis and treatment' and so on. It meant that patient had over-expectation on medical care and suggested that the policy on demanad side such as the developement and dissemination of an evidence-based recommendation protocol for health care consumers might be important in Korea. In addition, regarding the attitude of physicians, during the medical education and training it may be neccessary to emphasize the aspect of 'care' of medical care rather than 'cure'. In planning on heath care delivery system, it should be considered that there is a difference in the attitude toward medical care between western medicine and oriental medicine as well as between health care providers and consumers. We expect that more valid measurement tool be developed in this area, which may be major limitation of this study and that this kind of research be expanded into the non-academic settings.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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• pp.576-590
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• 1996

Advanced countries such as the USA and Japan are eagerly seeking ways to improve health and welfare of the elderly. One of the services is home health care service using the telephone. Various types of services using the telephone have been developed, improved and are being utilized ranging from the basic consulting to emergency response systems in the area of health care for the elderly. A demonstration project was launched to study the feasibility of a consulting system and telemedicine for the elderly using the public phone system in Korea. For this project, a gathering site for the elderly was selected and those who visited this place were interviewed to find out what kinds of services they wanted and what kind of system they needed to provide the required services. Based on the users' requests and the surrounding environment, a telephone consulting facility was established at the Research Institute of Nursing Science at Seoul National University and consulting personnel was recruited, trained and posted at the center. An Application program for home health care nurses to use when they visited the patients at their homes was developed. This system operates on a notebook Computer and allows nurses to communicate with a doctor at a local hospital through a modem and telecommunication line. These systems were implemented for three months and problems which developed during operation of the systems were identified and progressively modified. Through system evaluation, it was found that a consulting system using phone service will be an invaluable system for the welfare of the elderly in the future. But in order to meet the elderly's need, more services than mere consultation are needed. That is, communication with physicians and hospitals are needed. Thus, when there is any need for physicians' attention, physicians or hospitals should be contacted directly. Similarly for telemedicine, when the home health care nurse visits elderly patients she can assess the patient's problem and provide nursing care, access a physician or hospital to refer her patient to or consult directly using the telecommunication the system. The above mentioned system is a basic form of futuristic telemedicine for the elderly and those who have chronic disease problems. This kind of system will be of great value when it is used on the national information super-highways in the future. In order to get to that stage, of course, this project needs great improvement in the technical, academic, and legal aspects.