• 제목/요약/키워드: health outcome

검색결과 1,545건 처리시간 0.027초

결핵 입원환자의 치료결과에 영향을 미치는 환자 특성과 의료기관 특성 (The Effects of Patient and Hospital characteristics on Hospital Care Outcome of the Patients with Tuberculosis)

  • 윤경일
    • 한국병원경영학회지
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    • 제19권2호
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    • pp.44-54
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    • 2014
  • In spite of effective curative therapy, morbidity and mortality remain high for hospitalized patients with tuberculosis(TB) in Korea. The purpose of this study was to identify patient and hospital characteristics associated with hospital care outcome. Using annual patient survey data produced by Korea Institute for Health and Social Affair, we identified 8,562 hospital discharge with primary diagnosis of TB. Logistic regression analyses were performed on a model that included age, gender, residence area, insurance status, hospital admission source, length of stay, hospital ownership and class of hospital as the explanatory variables and outcome of treatments as the dependent variable. The results show that negative outcome was associated with the patients older than 65 years, medical aid beneficiary, admission through emergency department, and the patients admitted to public owned hospitals. On the other hand, the patients who were admitted to teaching hospitals were associated with positive outcome. To improve hospital treatment outcome of TB patients, more vigorous strategies should be implemented targeting the older and poor population in regard to social support as well as the clinical management and prevention.

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야뇨의 치료 평가 기준에 관한 연구 (Outcome criteria in nocturnal enuresis treatment)

  • 오주영;김장현
    • 대한한방소아과학회지
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    • 제20권3호
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    • pp.61-74
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    • 2006
  • Objectives : Nocturnal enuresis is one of common disorders in children. However, there are not a lot of researches going on about this disease, and also standardized criteria for analyzing were insufficient in Korea. Therefore, clinical researches were not in the confidence level. Methods : Korean journals which were published in 1990 to 2006, and online journals about nocturnal enuresis were used for analyzing based on outcome criteria. Results : The International Children's Continence Society and the World Health Organization have published outcome criteria about nocturnal enuresis, but different, often idiosyncratic, outcome criteria and/or definitions have been adopted in published research on treatment for nocturnal enuresis in recent years. But a new set of criteria suggested by Butler, Robinson, and et. al. referred to as a "dryness scale", which focuses on the percentage of dry nights accomplished at a point in time, will be an alternative proposal. These criteria will be of help to make standardized and proper outcome criteria in oriental medical studies. Conclusions : Agreed standardized outcome criteria in nocturnal enuresis treatment is needed.

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성과중심교육과정 개발사례: 가톨릭대학교 의과대학 (Development of an Outcome-Based Medical Curriculum: A Case Report from The Catholic University of Korea School of Medicine)

  • 김선;박주현;유남진;이수정
    • 의학교육논단
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    • 제15권1호
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    • pp.39-45
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    • 2013
  • The recent medical education paradigm shift from teacher-centered to student-centered education, has led to a concentration on students' performance and competency. This means that a physician should be able to provide adequate health care in any real medical treatment situation. In order to reflect such a paradigm shift, The Catholic University of Korea School of Medicine launched a new curriculum in 2009 that emphasizes students' performance and competency-based education, known as "outcome-based education." In outcome-based education, the educational process is determined by the desired outcome, signifying the detailed competency that a graduating student should have. Thus, in outcome-based education, we should first determine the competency that results from adequate training and education, followed by specific teaching and learning strategies, methods, and assessment. This paper reviews how The Catholic University School of Medicine developed its new curriculum according to the development steps of outcome-based education.

Prognostically Significant Fusion Oncogenes in Pakistani Patients with Adult Acute Lymphoblastic Leukemia and their Association with Disease Biology and Outcome

  • Sabir, Noreen;Iqbal, Zafar;Aleem, Aamer;Awan, Tashfeen;Naeem, Tahir;Asad, Sultan;Tahir, Ammara H;Absar, Muhammad;Hasanato, Rana MW;Basit, Sulman;Chishti, Muhammad Azhar;Ul-Haque, Muhammad Faiyaz;Khalid, Ahmad Muktar;Sabar, Muhammad Farooq;Rasool, Mahmood;Karim, Sajjad;Khan, Mahwish;Samreen, Baila;Akram, Afia M;Siddiqi, Muhammad Hassan;Shahzadi, Saba;Shahbaz, Sana;Ali, Agha Shabbir
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권7호
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    • pp.3349-3355
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    • 2012
  • Background and objectives: Chromosomal abnormalities play an important role in genesis of acute lymphoblastic leukemia (ALL) and have prognostic implications. Five major risk stratifying fusion genes in ALL are BCR-ABL, MLL-AF4, ETV6-RUNX11, E2A-PBX1 and SIL-TAL1. This work aimed to detect common chromosomal translocations and associated fusion oncogenes in adult ALL patients and study their relationship with clinical features and treatment outcome. Methods: We studied fusion oncogenes in 104 adult ALL patients using RT-PCR and interphase-FISH at diagnosis and their association with clinical characteristics and treatment outcome. Results: Five most common fusion genes i.e. BCR-ABL (t 9; 22), TCF3-PBX1 (t 1; 19), ETV6-RUNX1 (t 12; 21), MLL-AF4 (t 4; 11) and SIL-TAL1 (Del 1p32) were found in 82/104 (79%) patients. TCF3-PBX1 fusion gene was associated with lymphadenopathy, SIL-TAL1 positive patients had frequent organomegaly and usually presented with a platelets count of less than $50{\times}10^9/l$. Survival of patients with fusion gene ETV6-RUNX1 was better when compared to patients harboring other genes. MLL-AF4 and BCR-ABL positivity characterized a subset of adult ALL patients with aggressive clinical behaviour and a poor outcome. Conclusions: This is the first study from Pakistan which investigated the frequency of5 fusion oncogenes in adult ALL patients, and their association with clinical features, treatment response and outcome. Frequencies of some of the oncogenes were different from those reported elsewhere and they appear to be associated with distinct clinical characteristics and treatment outcome. This information will help in the prognostic stratification and risk adapted management of adult ALL patients.

위험분담제도에 대한 고찰: 항암제 사례를 중심으로 (Overview of Risk-Sharing Schemes: Focusing on Anticancer Drugs)

  • 손현순;신현택
    • 한국임상약학회지
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    • 제23권2호
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    • pp.89-96
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    • 2013
  • This article aimed to introduce 'risk sharing' schemes for pharmaceuticals between drug manufacturers and healthcare payer. Published literature review was undertaken to summarize risk sharing concepts and collect information on existing scheme examples in other countries focusing on new anticancer drugs. Risk sharing schemes could be categorized into health outcomes-based and non-outcomes (financial) based ones. Outcome-based schemes could be broken down into performance-linked reimbursement and conditional coverage. Performance-linked reimbursement can be further broken into outcomes guarantee and pattern or process of care and conditional coverage included coverage with evidence development and conditional treatment continuation schemes. Non-outcome based schemes included market share and price volume at population level, and utilization caps and manufacturer funded treatment initiation at patient level. We reviewed the fifteen examples for anticancer drugs that risk sharing agreements in response to the inherent uncertainties and increased costs of eleven anticancer drugs. Of them, eight cases were coverage with evidence development schemes. The anticancer drugs except bevacizumab and cetuximab were all listed on the national health insurance formulary in Korea, with reimbursement criteria defined on the basis of approved indications and administrations. Risk sharing approach may be a useful tool to ensure values for drug expenditure, but there are a number of concerns such as high administration costs, lack of transparency and conflicts of interest, especially for performance-based health outcomes reimbursement schemes.

일부 질환들에서 진료량-진료비, 재원일수와의 관계에 대한 연구 (The Study on Volume Relationships in Several Diseases)

  • 이선희;좌용권
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.793-805
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    • 1994
  • Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negtively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1, cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. Within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.

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한국과 일본의 지역사회간호 연구 동향 고찰 (A Review of Community Health Nursing Research in Korea and Japan)

  • 유호신;다나까 미카;아리따 쿠미;조정현
    • 지역사회간호학회지
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    • 제21권4호
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    • pp.532-540
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    • 2010
  • Purpose: The purpose of this study was to compare similarities and differences in research trends for community health nursing between Korea and Japan. Methods: Comparison was made in terms of research design, data collection and sampling method, and key concepts from community health nursing research by literature review. We analyzed original articles from representative Journals covering community health nursing research from 2004 to 2008. Results: We found that research design was quite different between the two countries. Quantitative research design was dominant in Korea, while qualitative and qualitative research designs were used equally in Japan. In particular, outcome research was found only in Korean papers. Conclusion: Based on the comparison, the following recommendations are suggested related to the strengths and weaknesses of research concepts and methods observed in each country. It is suggested that future collaboration should be undertaken especially to improve the diversity of research design and method. More diverse research designs should be used in both countries. Particularly in today‘s aged society, evidence-based research and outcome research are needed for community health nursing in both countries.

고혈압이 있는 근로자가 인식한 산업간호사 보건관리 활동 평가 - 보건관리 대행사업장을 대상으로 - (Evaluation of Occupational Health Services on Workers with Hypertension in Small and Medium Sized Enterprises -Subject to Enterprises taken the Occupational Health Management Agency-)

  • 조정민;전미영;김명희
    • 한국보건간호학회지
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    • 제16권2호
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    • pp.445-453
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    • 2002
  • Purpose: This study has been designed to evaluate occupational health services on workers with hypertension Method: Study participants were 108 workers having a diagnosed hypertension. The instrument used for this study was the questionnaire developed by Cho(1998). Analysis of the data was done with SPSS Win 10.0 for descriptive statistics, Correlation coefficient. Results: 1. The mean score of process domain was $3.77\pm.43$ The score of process domains were usefulness of health management$(3.98\pm.49)$, education or counselling$(3.87\pm.53)$, follow up in medical examination$(3.79\pm.58)$, usefulness of providing materials$(3.53\pm.62)$, perception of medical examination $(3.37\pm.80)$ 2. The mean score of outcome domain was $3.47 \pm.44$ The score of outcome domains were obstructiveness of social life$(3.90\pm.78)$, habits of living $(3.41\pm.76)$, blood pressure change $(3.25\pm.81)$, perception of seriousness$(3.02\pm.88)$. 3. Blood pressure change was significant correlated with education or counselling(r=.31) and usefulness of providing materials(r=.28).

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