• 보건의료산업학회지
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• 제5권4호
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• pp.1-13
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• 2011

The purpose of this study is to analyze the medical care utilization behavior of patients to whom treatment (surgery) is recommended after they are diagnosed with abnormal findings on health screening and factors affecting the selection of the medical institute for treatment. The data was collected from 291 patients who need treatment or surgery, according to the abnormal findings on the additional examination such as cardiac CT, brain MRI, Gastroscopy and Colonoscopy since four diseases are suspected among of 2,752 people who receive health screening. The results are as follows. First, the most common disease of patients who have abnormal findings by the diagnosis through the results of first testing is colon disease based on through the additional examination. The most common disease of patients who will get treatment (surgery) based on final diagnosis by a doctor who determines the result of health screening on the basis of diagnosis from the first testing is cardiovascular disease. Second, in terms of diseases, patients with cardiovascular disease select the medical institute where they get the health screenings as a place for treatment. Patients with cerebrovascular disease select another medical institute for treatment. Finally, the affective factors of selectivity treatment facility on health screening satisfaction were human, facility, health screening and revisit factors.

• 농촌의학ㆍ지역보건
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• 제28권2호
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• pp.87-105
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• 2003

2002년도 군위군 내 30세 이상 저소득주민을 대상으로 건강검진을 실시한 결과 유소견자로 판정된 263명에 대하여 설문지를 이용하여 추후의료기관 이용여부와 관련요인을 조사 분석하였다. 대상자의 추후의료기관 이용률은 51.0%이었으며, 미이용률은 49.0%이었다. 단순분석결과, 추후의료기관 이용률은 소인성 요인에 있어서는 남자의 경우, 건강관심도가 높은 경우, 질병이 오는 이유가 팔자나 운명적이지 않다는 경우, 검진이 건강에 도움이 된다는 경우, 검진결과를 통보 받을 당시 느낌이 걱정된다는 경우가 의료기관 이용률이 높았다(P<0.05). 가능성 요인에서는 의료보장형태가 의료급여인 경우, 과거 2년간 건강검진 경험이 있는 경우, 단골의료기관이 있는 경우, 검진결과를 인지하는 가족이 있는 경우에 추후의료기관 이용률이 높았다(P<0.05). 필요성 요인에서는 검진결과를 본인이 인지한 경우, 판정결과가 건강에 심각하다는 경우, 검진결과를 통보받는 방법이 우편과 전화통보를 받은 경우, 검진결과에 대한 가족반응이 있는 경우, 보건지도가 있는 경우가 추후의료기관 이용률이 유의하게 높았다(P<0.01). 의료기관 이용여부를 종속변수로 하고 단순분석에서 유의한 관련이 있는 변수를 독립변수로 한 다중 로지스틱 회귀분석 결과, 판정결과를 받을 당시 느낌이 걱정이 된 경우, 의료보장형태가 의료급여의 경우 (P<0.05), 과거 2년간 검진경험이 있는 경우(P<0.05), 검진결과에 대한 가족의 반응이 있는 경우(P<0.01)가 의료기관을 더 이용하였다. 추후 의료기관을 이용한 방문시점은 통보 후 8-15일이 가장 높았고 그 다음이 16-30일 순이었다. 재검결과 당초와 같은 질환이 69.4%, 정상이 23.1%, 당초와 다른 질환이 7.5%이였으며, 정밀검사 후 치료유형에서는 규칙적 치료가 39.6%로 가장 높았으며, 치료하지 않은 경우가 34.4%, 치료중단이 11.8%이었다. 추후의료기관을 이용하지 않은 이유는 가벼운 질환인 것 같아서가 32.4%로 가장 높았으며, 일 때문에 시간이 없어서, 결과가 정상이라서, 이전부터 알고 있는 질병으로 치료 중이어서 순이었다. 이상의 결과, 저소득층의 건강검진 실시 후 의료이용 제고와 사후관리를 위해서는 국가와 검진기관, 보건기관, 가족 등이 연대가 되어야 하겠다. 국가에서는 차상위계층의 의료이용문제점을 해결하여 의료이용의 형평성과 효율성을 높이도록 하여야 하며, 검진기관과 보건기관에서는 건강검진 전에 검진의 필요성, 의의, 올바른 수검지도를 실시하고, 건강검진 통보 시에는 유소견자에 대해서는 방문 등을 통하여 추후관리를 하는 것이 의료기관 이용률을 높일 수 있을 것이다. 그리고 건강검진 결과에 대한 올바른 해석, 의료이용의 필요성, 해당 질환에 대한 정보에 대해 본인 뿐만 아니라 가족을 포함한 보건지도가 있어야 하겠다.

• 의학교육논단
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• 제20권1호
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• pp.20-31
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• 2018

Good assessment is crucial for feedback on curriculum and to motivate students to learn. This study was conducted to perform item analysis on the Medical Education Assessment Consortium clinical knowledge mock examination (MEAC CKME) (2011-2016) and to evaluate several effects to improve item quality using both classical test theory and item response theory. The estimated difficulty index (P) and discrimination index (D) were calculated according to each course, item type, A (single best answer)/R (extended matching) type, and grading of item quality. The cut-off values used to evaluate P were: >0.8 (easy); 0.6-0.8 (moderate); and <0.6 (difficult). The cut-off value for D was 0.3. The proportion of appropriate items was defined as those with P between 0.25-0.75 and D ${\geq}0.25$. Cronbach ${\alpha}$ was used to assess the reliability and was compared with those of the Korean Medical Licensing Examination (KMLE). The results showed the recent mean difficulty and decimation index was 0.62 and 0.20 for the first MEAC CKME and 0.71 and 0.19 for the second MEAC CKME, respectively. Higher grade items evaluated by a self-checklist system had better D values than lower grade items and higher grade items gradually increased. The preview and editing process by experts revealed maintained P, decreased recall items, increased appropriate items with better D values, and higher reliability. In conclusion, the MEAC CKME (2011-2016) is deemed appropriate as an assessment to evaluate students' competence and prepare year four medical students for the KMLE. In addition, the self-checklist system for writing good items was useful in improving item quality.

• Journal of Acupuncture Research
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• 제22권6호
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• pp.201-209
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• 2005

Objectives : We investicated correlation between Yangdorak and Meridian at Idiopathic facial nerve paralysis patients. Methods : For Yangdorak examination, We made a comparison between 21 patients who were diagnosticated to Idiopathic facial nerve paralysis and 22 persons who were not. Results : 1. The stress showed the highest frequency in premonitory cause at onset. 2. In comparing results on the Yangdorak general mean, they were not statistically significant between two group(p<0.05). 3. In comparing results on the Stomach(ST)-meridian Yangdorak mean, Idiopathic facial nerve paralysis group is stastically significant in comparison with non-facial paralysis group(p<0.05). 4. In comparing results on the Small Intestine(SI)-meridian Yangdorak mean, Idiopathic facial nerve paralysis group is not stastically significant in comparison with non-facial paralysis group(p<0.05). Conclusion : Yangdorak may be used for a method to objective clinical examination. But further studies are required for a use of practical indicator.

• 대한의료기공학회지
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• 제19권1호
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• pp.25-42
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• 2019

Objective : This study is a report on treatment effect of Korean medical treatment to ALS(Amyotrophic Lateral Sclerosis) patient. The purpose of this case study is to improvement of Korean medical treatment and evaluate prognosis and clinical course of ALS patients. Methods : The patient was treated by acupuncture, Su-Gi therapy, herbal medication, physical treatment. To determine the effects of Korean medical treatment, we evaluated every four days used by Korean version of Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (KALSFRS-R), Amyotrophic Lateral Sclerosis Severity Scale(ALSSS). Results : Before mental contraction caused by everyday life nursing management, symptoms such as lumbar pain, getting hoarse, lower limb powerless & spasticity, upper limbs powerless, neckache, tongue-tied etc. were improved after above treatment. K-ALSFRS-R and ALSSS scores were also increased till patient's mental contraction Conclusions : The Korean medical treatment is effective on local symptoms of ALS, and there is also functional improvement of ALS diagnosed by external examination. It is necessary to have more examination about ALS.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.120-127
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• 2024

Background: Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered. Methods: Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated. Results: Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14). Conclusion: The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.

• 대한예방한의학회지
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• 제10권1호
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• pp.109-121
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• 2006

The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.

• 여성건강간호학회지
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• 제20권1호
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• pp.92-104
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• 2014

Purpose: This study was to investigate factors that influence health examination for unmarried women. Methods: A correlation study was carried out with 144 unmarried women with an age range of 35~49 years through selfadministered questionnaires. This questionnaire included Health Belief Model modifying factors (demographic.sociological, structural, and cues to action variables). Data were analyzed using descriptive statistics, $x^2$-test, multiple logistic regression. Results: The mean age of participants was $37.2{\pm}2.67$ years. Rates for breast cancer, cervical cancer and comprehensive health examination were each 34.7%, 38.2% and 94%. In multiple logistic regression analysis, influencing factors on physical examination were age(OR=0.06, 95% CI: 0.02~0.26), personal medical insurance (OR=6.30, 95% CI: 1.60~24.82), housemate (OR=7.63, 95% CI: 2.58~22.52), exercise (OR=3.72, 95% CI: 1.37~10.12) in breast cancer examination, and age (OR=0.08, 95% CI: 0.02~0.34; OR=0.07, 95% CI: 0.01~0.85), personal medical insurance (OR=14.17, 95% CI: 2.94~68.23), sexual experiences (OR=3.38, 95% CI: 1.28~8.91), drinking (OR=2.92, 95% CI: 1.14~7.49) in cervical cancer examination. Conclusion: The results emphasize the necessity of preparing nursing education and intervention in consideration of associated factors which influence on the health examination in unmarried women.

• Asian Pacific Journal of Cancer Prevention
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• 제16권4호
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• pp.1535-1538
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• 2015

Background: The objectives of the study were to: 1) determine the frequency of incidental malignancy in unsuspected/grossly normal looking gall bladders; 2) determine the frequency of malignancy in suspected/grossly abnormal looking gall bladders. Materials and Methods: This prospective, cross sectional study was carried out at a tertiary care hospital in Pakistan, during a four year period (Jan 2009-dec2012). All the cholecystectomy cases performed for gallstone diseases were examined initially by a surgeon and later on by a pathologist for macroscopic abnormalities and accordingly assigned to one of the three categories i.e. grossly normal, suspicious, abnormal/malignant. Frequency of incidental carcinoma in these categories was observed after receiving the final histopathology report. Results: A total of 426 patients underwent cholecystectomy for cholelithiasis, with a 1:4 male: female ratio. Mean age of the patients was 45 years with a range of 17-80 years. The frequency of incidental gallbladder carcinoma was found to be 0.70 %(n=3). All the cases of gallbladder carcinoma were associated with some macroscopic abnormality. Not a single case of incidental carcinoma gallbladder was diagnosed in 383 'macroscopically normal looking' gallbladders. Conclusions: Incidental finding of gall bladder cancer was not observed in any of macroscopically normal looking gall bladders and all the cases reported as carcinoma gallbladder had some gross abnormality that made them suspicious. We suggest histopathologic examination of only those gall bladders with some gross abnormality.

• 자원ㆍ환경경제연구
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• 제17권4호
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• pp.845-873
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• 2008

이 연구에서는 회피행위의 다목적성(결합생산) 문제를 최소화할 수 있는 암 검진 행위라는 회피행위 자료에 대해 표본선택편의를 극복할 수 있는 모형을 적용하여, 사망위험 감소에 대한 지불의사금액의 도출과 더불어 확률적 인간생명가치(value of statistical life : VSL)를 추정하였다. 간암 사망위험을 감소시키기 위한 비용 및 시간 등과 관련된 자료를 이용하여 건강 및 안전에 대한 가계생산함수모형의 틀에서 사망위험 감소를 위한 한계편익을 추정하였다. 간암 검사를 받을 확률을 높아지도록 하는 변수는 남성인 경우, 연령이 많을수록, 교육받은 기간이 길수록, 유배우자인 경우, 현재 흡연자인 경우, 가구소득이 높을수록, 건강염려 정도가 높을 때인 것으로 나타났다. 간암 검진과 관련된 비용은 조기 검진으로 인하여 감소하는 사망위험의 크기 및 성별, 교육받은 기간, 유배우자 여부, 가구 소득에 의해서도 예상한 대로 유의한 영향을 받았다. 암 검진에 의한 사망위험 감소 크기(risk)의 한계효과는 321,097원이다. 교육년수(edu)의 경우 1년 증가하면 간암 검진비용이 905원, 가구 소득(hinc)이 100만 원 증가하면 간암 검진비용이 1,743원 증가한다. 한편 남성인 경우가 여성에 비해 간암 검진비용으로 12,310원을, 유배우자가 무배우자에 비해 7,969원을 더 부담하고 있다. 암 검진으로 인한 조기사망위험 감소로부터 도출된 확률적 인간생명가치는 평균 사망위험 감소 수준 및 평균 암 검진 비용 수준에서 3억 2,110만 원이다. 또한 암 검진 소요비용과 암 검진 효과에 대한 불확실성을 위해 민감도 분석의 결과에서는 확률적 인간생명가치가 1억 6,055만 원~6억 4,219만 원으로 추정되었다.