• Title/Summary/Keyword: healthcare outcomes

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중환자 간호실무 질 향상을 위한 근거중심 임상실무지침서의 개발 (Development of Evidence Based Clinical Practice Guideline to Improve Quality of Critical Care Nursing)

  • 박명화
    • 중환자간호학회지
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    • 제2권2호
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    • pp.68-78
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    • 2009
  • Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.

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아동간호의 질에 대한 개념분석 (Quality of Pediatric Nursing Care: Concept Analysis)

  • 최미영;방경숙
    • 대한간호학회지
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    • 제40권6호
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    • pp.757-764
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    • 2010
  • Purpose: This paper is a report of a concept analysis of 'quality of pediatric nursing care', Methods: Rodgers's evolutionary method of concept analysis was used. Data were collected from published literature related to quality of pediatric nursing care. Results: Quality of pediatric nursing care was identified with three dimensions and seven attributes: 1) nurse's character: technical competence, interpersonal competence, 2) nurse's activities: developmentally appropriate care, attentiveness, entertainment, 3) nurse-parent interaction: nurse-parent partnership, emotional support. Antecedents of quality of pediatric nursing care were 'child and parent's expectation about pediatric nursing care', 'previous caring experience of pediatric nurses'. Consequences of quality of pediatric nursing care were 'meet child and parent's needs' and 'better health outcomes.' Conclusion: 'Quality of pediatric nursing care' is a core concept in pediatric nursing practice. Appropriate instruments to operationalize the concept need to be developed.

우리나라 폐동맥고혈압환자에 대한 Bosentan과 Iloprost의 비용-효용 분석 (Cost-Utility Analysis of Bosentan Versus Iloprost in Korean Patients with Pulmonary Arterial Hypertension)

  • 손현순;이태진
    • 약학회지
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    • 제54권2호
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    • pp.126-133
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    • 2010
  • This study was conducted to analyze cost-utility of bosentan versus iloprost indicated for pulmonary arterial hypertension (PAH) in a Korean healthcare setting from a payer's perspective. We constructed a Markov model to estimate total costs and outcomes for 1-year time horizon in a hypothetical cohort of 50-year-old patients with PAH. Base analysis showed that bosentan resulted in KW 5.5 billions saving and 18 quality-adjusted life year (QALY) gains per 100 patients compared to iloprost. Bosentan as a dominant strategy was found to be robust through various sensitivity analyses.

국소진행성 두경부암에서 선행항암화학요법제로 사용되는 Paclitaxel과 Cisplatin 병용요법의 비용-효과성 (Cost-Effectiveness of Paclitaxel plus Cisplatin as a Neoadjuvant Chemotherapy for Locally Advanced Head and Neck Cancer)

  • 손현순;이태진
    • 한국임상약학회지
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    • 제20권1호
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    • pp.30-38
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    • 2010
  • This study was conducted to analyze cost-effectiveness of neoadjuvant chemotherapy for locally advanced head and neck cancer in Korean healthcare setting. We constructed a decision analytical model to estimate total costs and outcomes of paclitaxel+cisplatin (PC) or docetaxel+cisplatin+5-FU (DCF) for 2 years time horizon in 100 patient cohort with locally advanced head and neck cancer. Base analysis showed that cost savings of PC regimen were 379 million Korean Won and 231 million Korean Won in societal and payer's perspectives, respectively, compared to DCF regimen, and life saved was 0.18. PC regimen as a dominant strategy was found to be robust through sensitivity analyses.

Review of cranioplasty after decompressive craniectomy

  • Cho, Yong Jun;Kang, Suk Hyung
    • Korean Journal of Neurotrauma
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    • 제13권1호
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    • pp.9-14
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    • 2017
  • Cranioplasty is an in evitable operation conducted after decompressive craniectomy (DC). The primary goals of cranioplasty after DC are to protect the brain, achieve a natural appearance and prevent sinking skin flap syndrome (or syndrome of the trephined). Furthermore, restoring patients' functional outcome and supplementing external defects helps patients improve their self-esteem. Although early cranioplasty is preferred in recent year, optimal timing for cranioplasty remains a controversial topic. Autologous bone flaps are the most ideal substitute for cranioplasty. Complications associated with cranioplasty are also variable, however, post-surgical infection is most common. Many new materials and techniques for cranioplasty are introduced. Cost-benefit analysis of these new materials and techniques can result in different outcomes from different healthcare systems.

Pediatric postintensive care syndrome: high burden and a gap in evaluation tools for limited-resource settings

  • Chaiyakulsil, Chanapai;Opasatian, Rapee;Tippayawong, Paweethida
    • Clinical and Experimental Pediatrics
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    • 제64권9호
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    • pp.436-442
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    • 2021
  • This article aimed to summarize the impact and burden of pediatric postintensive care syndrome (PICS-p) in the physical, mental, cognitive, and social health domains after a review of the current pediatric literature in MEDLINE and PubMed. We also aimed to elucidate the limitations of the current evaluation tools used in limited-resource settings. PICS-p can impact a child's life for decades. Most validated tools are time-consuming, require qualifications, and expertise, are often limited to older children, and can evaluate only one domain. A novel, simple, and comprehensive surveillance tool can aid healthcare providers in the early detection and intervention of PICS-p. Further studies should validate and refine the parameters that will enhance the outcomes of pediatric intensive care unit survivors.

Group Antenatal Care: A Paradigm Shift to Explore for Positive Impacts in Resource-poor Settings

  • Gaur, Bhanu Pratap Singh;Vasudevan, Jyothi;Pegu, Bhabani
    • Journal of Preventive Medicine and Public Health
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    • 제54권1호
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    • pp.81-84
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    • 2021
  • The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.

OMOP CDM 기반 의료 데이터 ETL 툴 개발 (Development of A HealthcareData ETL Tool Based on OMOP CDM)

  • 한만욱;이푸름;이호웅
    • 한국정보처리학회:학술대회논문집
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    • 한국정보처리학회 2023년도 추계학술발표대회
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    • pp.1224-1225
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    • 2023
  • 디지털 헬스케어 서비스 활성화에 따라 디지털 의료 데이터의 양은 매년 급속하게 증가하고 있으며, 의 데이터의 상호 교환과 연동을 위한 다양한 CDM(Common Data Model)이 개발되고 있다. 그러나, 의료 데이터 교류에 대한 요구가 증가하면서, 기존 레거시 시스템의 데이터를 CDM으로 변환하기 위한 추가적인 비용이 소요될 수 밖에 없다. 이에 본 연구에서는 OMOP CDM (Observational Medial Outcomes Partnership Common DataModel) 기반 의료 데이터 ETL (Extract, Transform, Load) 툴을 개발하였다. OMOP CDM ETL 툴은 기존의 레거시 데이터베이스 정보를 CDM으로 변환할 수 있는 효과적인 료인터페이스를 제공함으로써, 디지털 의료 데이터 공유와 관리 및 분석의 효율성을 증대할 수 있을 것이다.

Ultrasonography for Facial Nerve Palsy: A Systematic Review and Meta-Analysis Protocol

  • Seojung Ha;Bo-In Kwon;Joo-Hee Kim
    • Journal of Acupuncture Research
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    • 제41권1호
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    • pp.63-68
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    • 2024
  • Background: Facial nerve palsy presents a significant healthcare challenge, impacting daily life and social interactions. This systematic review investigates the potential utility of ultrasonography as a diagnostic tool for facial nerve palsy. Methods: Electronic searches will be conducted across various databases, including MEDLINE, EMBASE, CENTRAL (Cochrane Central register of Controlled Trials), CNKI (China National Knowledge Infrastructure), KMBASE (Korean Medical Database), ScienceON, and OASIS (Oriental Medicine Advanced Searching Integrated System), up to February 2024. The primary outcome will focus on ultrasonography-related parameters, such as facial nerve diameter and muscle thickness. Secondary outcomes will encompass clinical measurements, including facial nerve grading scales and electrodiagnostic studies. the risk of bias in individual study will be assessed using the Cochrane Risk of Bias assessment tool, while the grading of recommendations, assessment, development, and evaluations methodology will be utilized to evaluate the overall quality of evidence. Conclusion: This study aims to review existing evidence and evaluate the diagnostic and prognostic value of ultrasonography for peripheral facial nerve palsy.

Treatment Strategies of Improving Quality of Care in Patients With Heart Failure

  • Se-Eun Kim;Byung-Su Yoo
    • Korean Circulation Journal
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    • 제53권5호
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    • pp.294-312
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    • 2023
  • Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.