Providing free primary care to everyone is an important goal pursued by many countries under universal health care programs. Countries like India need to efficiently utilize their limited capacities towards this purpose. Unfortunately, due to a variety of reasons, patients incur substantial travel and out-of-pocket expenses for getting primary care from publicly-funded facilities. We propose a set-covering optimization model to assist health policy-makers in managing existing capacity in a better way. Decision-making should consider upgrading centers with better potential to reduce patient expenses and reallocating capacities from less preferred facilities. A multinomial logit choice model is used to predict the preferences. In this article, a brief background and literature survey along with the mixed integer linear programming (MILP) optimization model are presented. The working of the model is illustrated with the help of numerical experiments.
Journal of Korea Entertainment Industry Association
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v.14
no.5
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pp.255-266
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2020
This study conducted a systematic literature review on nursing students to find out the types and composition of patient safety-related education programs. The research was conducted systematically using PRISMA. The patient was a nursing college student, and the intervention was patient safety education. The outcome was either numerical or descriptive reports of the results measured using the tool. The types of research were carried out including randomized design, quasi-experimental design, one-group design, survey and qualitative research. The paper was searched through Medline, Embases, CINAHL, DBpia, Riss and KISS. A total of 2,468 papers were searched in the search results, and nine papers were used for analysis as a result of extracting data according to PICO. The characteristics of patient safety education of nursing college students were classified according to the teaching method, period, result variables and measurement tools. As a result, patient safety education consisted of a variety of subjects, and was being taught through lectures, clinical practice, laboratories, and simulations. The period of education also varied. The resulting variables were mainly checked for knowledge, attitude, and skill, and the tools used to measure them varied. Patient safety education for nursing college students was conducted through various topics, methods and periods at home and abroad. Therefore, continuous research is needed to establish consistent and integrated patient safety education in educational institutions and working institutions to produce nursing personnel with patient safety capabilities.
This study was conducted to find out factors affecting patient safety management activities at nursing devisions of two university hospitals. The indicators of patient safety activities used in the study were selected from Hospital Survey on Patient Safety Culture which was developed by The Agency for Healthcare Research and Quality in the United States. Data were collected from 372 nurses working at inpatient wards at two university hospitals located in Seoul and Won-Ju cities through the self-administered questionnaires, and analyzed using frequency analysis, t-test, correlation, and regression analysis. The result of this study were as follows. First, The mean of patient safety management activities was 3.41 which was a little bit higher than the average level. The mean of communication within the ward was the highest, whereas that of patient safety management culture was the lowest. Second, there were significant differences in the perception of nurses on patient safety management activities in terms of the educational background, length of employment, and work hours per week. Third, three variables of communication within the unit, attitude of top management, and attitude of nurses have significant positive effects on patient safety management activities. Fourth, 37.4% of the variation in the patient safety management activities was explained by the study variables. In conclusion, hospital administration and nursing managers should make an effort to learn the knowledge of patient safety program, show their deep interest on the patient safety to the employees and motivate them to communicate effectively each other within the work unit to develop a good patient safety culture and system.
Uterine cervical cancer is the most common malignancy in korean women. In spite of recent development of early diagnostic and therapeutic modalities, about 40% of treated patient will develop relapse. So more aggressive local treatment such as more extensive surgery and higher radiation dose and administration of systemic chemotherapy will promote the curability but treatment related complications can not be avoidable. We used 22 cases of early cervical cancer, treated with surgery and post-operative radiotherapy, clinical data of these patients were analized to determine relationship between clinical parameters and final outcome. Three out of 22 cases revealed relapse and one patient showed rectovaginal fistula and another patient showed small bowel obstruction and the other patient showed rectal obstruction. Two out of three recurrence were stage IIa and the other one case was stage Ib adenocarcinoma with lymphovascular involvement. Nineteen out of 22 cases were followed without remarkable side effect or treatment related complication or sequelae. We concluded that our treatment policy was safe and effective to eradicate high risk postoperative cervical cancer with acceptable side effects or complication.
Kim, M.S.;Kim, Y.K.;Lee, Y.J.;Choi, Y.J.;Shin, H.Y.;Song, Y.C.
Quality Improvement in Health Care
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v.14
no.2
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pp.125-132
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2008
Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.
Kim, Hwa-Jung;Cho, Jin-Hee;Lyu, Yong-Man;Lee, Sun-Hye;Hwang, Kyeong-Ha;Lee, Moo-Song
Journal of Preventive Medicine and Public Health
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v.43
no.3
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pp.257-264
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2010
Objectives: An accurate estimation of cancer patients is the basis of epidemiological studies and health services. However in Korea, cancer patients visiting out-patient clinics are usually ruled out of such studies and so these studies are suspected of underestimating the cancer patient population. The purpose of this study is to construct a more complete, hospital-based cancer patient registry using multiple sources of medical information. Methods: We constructed a cancer patient detection algorithm using records from various sources that were obtained from both the in-patients and out-patients seen at Asan Medical Center (AMC) for any reason. The medical data from the potentially incident cancer patients was reviewed four months after first being detected by the algorithm to determine whether these patients actually did or did not have cancer. Results: Besides the traditional practice of reviewing the charts of in-patients upon their discharge, five more sources of information were added for this algorithm, i.e., pathology reports, the national severe disease registry, the reason for treatment, prescriptions of chemotherapeutic agents and radiation therapy reports. The constructed algorithm was observed to have a PPV of 87.04%. Compared to the results of traditional practice, 36.8% of registry failures were avoided using the AMC algorithm. Conclusions: To minimize loss in the cancer registry, various data sources should be utilized, and the AMC algorithm can be a successful model for this. Further research will be required in order to apply novel and innovative technology to the electronic medical records system in order to generate new signals from data that has not been previously used.
The Journal of the Society of Stroke on Korean Medicine
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v.14
no.1
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pp.61-70
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2013
■ Objectives The goal of this pilot study is to observe the change of gait pattern in a patient after peroneal nerve electrical stimulation(PNST). ■ Methods We analyzed the gait pattern of stroke patient using treadmill gait analysis system before and after PNST for seven weeks. The PNST was carried out for 20minutes every day except Sunday. In addition, the measurement was carried out every Saturday. At the fifth week, the PNST was not carried out to confirm whether the effect of PNST was disappeared immediately when PNST was not applied. ■ Results After PNST, while heel contact time and heel max force increased and forefoot and midfoot max force decreased, the gait parameters such as cadence, velocity, swing phase, stance phase, total double support, step length, stride length, step time, stride time and forefoot contact time, were not changed. ■ Conclusion Gait of a patient with cerebral stroke was changed positively after PNST.
Purpose: Music therapy helps alleviate anxiety, depression, and pain for cancer patients, contributing to stress relief. With such advantages, music therapy is applied across a broad spectrum of treatment areas, including mental disorders, developmental disabilities, and conditions affecting the elderly. It has been shown to enhance the quality of life for terminally ill cancer patients. Recent research has revealed its positive effects in boosting immune function and resilience. In light of these findings, the author conducted a study to investigate patient satisfaction with music listening. Materials and Methods: First, a survey was conducted with 30 individuals to inquire about the perceived necessity of listening to music in a waiting area. Next, participants were asked whether listening to music could contribute to psychological stability. Finally, preferences for music genres and satisfaction with music listening were assessed with a sample of 20 individuals. Results: In terms of the perceived necessity of listening to music in the waiting area, 28 out of 30 individuals, or 93%, expressed agreement. Regarding the belief that music listening could contribute to psychological stability, 28 out of 30 individuals, or 93%, believed that it would indeed help with stability. When it comes to preferred music genres, 4 individuals (13%) favored classical music, 2 individuals (6%) preferred traditional Korean music, 2 individuals (6%) enjoyed trot music, and 20 individuals (66%) had no specific genre preference. As for music listening satisfaction, 17 out of 20 individuals, or 85%, reported being satisfied. Conclusion: When patients visit the hospital, stress can increase due to concerns about their medical conditions. To address this, providing a variety of music genres at the hospital has been effective in reducing patient stress and promoting psychological stability.
Journal of the Korea Society of Computer and Information
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v.17
no.12
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pp.1-10
/
2012
In this paper, we propose an patient monitoring system which is suitable for mobile healthcare system. The mobile healthcare system is using portable device such as smartphone and it consists of small computing device. The mobile healthcare system is carry out same performance with desktop computer. We designed medical message structure based on TinyOS to transmit patient's biometric data on the smartphone of medical team, patient and family over the mobile carrier environment, and ported successfully in HBE-Ubi-ZigbeX using NesC. And We confirmed reliable transmission of biometric data on the smartphone by implementing the Android OS based patient information monitoring application to check the status of patient for medical team, patient and family.
AKOB, Muhammad;YANTAHIN, Munawar;ILYAS, Gunawan Bata;HALA, Yusriadi;PUTRA, Aditya Halim Perdana Kusuma
The Journal of Asian Finance, Economics and Business
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v.8
no.1
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pp.419-430
/
2021
The study aims to analyze the factors that shape patient loyalty, namely, by involving the service quality factor (SERVQUAL), hospital image, patient value, and patient satisfaction in private hospitals. This study was conducted in Makassar City, Indonesia, with a sample of 296 eligible samples from private hospitals. The sample criteria were patients with outpatient and hospitalization status. Then, this study developed 23 hypotheses to test the statistical relationship between direct, intervening and multiple-effect models. Problem-solving and research focus are carried out using a quantitative method approach with a PLS-SEM-based testing tool. The bootstrapping method is being used with the constant bootstrapping step to demonstrate the results of hypothesis testing; we find that the overall hypothesis has a positive and significant effect. The combination of testing models involving several variables shows that a patient's loyalty can be formed if a patient's satisfaction has been realized. Satisfaction can be realized if the value-customer has been felt by the patients. Therefore, the hospital image must be directly proportional to service quality. Service quality is the essence of service that directly affects customers; service quality is also the reason that shapes consumer perceptions in increasing rationalization and solid customer (patient's) decision-making.
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