• 한국치위생학회지
• /
• 제6권3호
• /
• pp.243-261
• /
• 2006

Priority setting in national health insurances in major advanced countries and the nation was investigated to draw the criteria for priority setting and suggest the most rational criteria for dental insurance so as to help secure the efficiency of medicare financing and individual's health right and also elevate medical consumers' satisfaction with health insurance. 1. Priorities in national health insurance are different from country to country, depending on the medical security systems, priority introducing conditions, and social environment, but have many common factors. 2. The priority setting criteria for national health insurance in those countries include the following in common: the efficiency, equity, and cost effect of treatment, emergency of treatment, consumption of expense, efficacy of treatment, patient's receptiveness, patient's demand, severity of disease, and patient's responsibility for the disease. 3. In oral diseases, severe diseases including oral cavity cancer are low in rate, and in-hospital treatments are few. From the above findings, it is suggested that dental insurance should establish discriminative criteria for priority setting by reflecting the aspects of dental diseases and system difference between dental and other health insurances and taking account of efficiency of treatment through prevention, cost effect, prevalence and incidence of generalized diseases, and individual's financing burden.

• 한국의료질향상학회지
• /
• 제28권1호
• /
• pp.45-54
• /
• 2022

Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

• 산업공학
• /
• 제24권4호
• /
• pp.274-280
• /
• 2011

Delayed access to surgery may lead to deterioration in the patient condition, poor clinical outcomes, increase in the probability of emergency admission, or even death. The purpose of this work is to decide the number of patients selected from a waiting list and to schedule them in accordance with the operating room capacity in the next period. We formulate the problem as an infinite horizon Markov Decision Process (MDP), which attempts to strike a balance between the patient waiting times and overtime works. Structural properties of the proposed model are investigated to facilitate the solution procedure. The proposed procedure modifies the conventional value iteration method along with the binary search technique. An example of the optimal policy is provided, and computational results are given to show that the proposed procedure improves computational efficiency.

• 중환자간호학회지
• /
• 제15권1호
• /
• pp.13-23
• /
• 2022

Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

• 성인간호학회지
• /
• 제21권3호
• /
• pp.349-354
• /
• 2009

Purpose: The purpose of this study was to determine core nursing intervention in nursing records and to compare perceived nursing intervention priority and nursing intervention frequency of general surgery department. Methods: Subjects were 70 nurses who work in the general surgery department. Data was collected using a nursing intervention classification and analyzed by frequency and mean. Results: The most frequent nursing interventions of nursing records were orderly risk management, coping assistance, tissue perfusion management, skin/wound management and nutrition support. Important nursing interventions were tissue perfusion management, respiratory management, electrolyte acid-base management, elimination, peri-operative care. The most frequent nursing interventions were drug management, peri-operative care, risk management, tissue perfusion management, patient education. Conclusion: This study found that nursing records were different from intervention priority and nursing frequency. So further study is needed for finding focused intervention of specific subjects and differences with priority of nursing and frequency of nursing.

• 대한간호학회지
• /
• 제41권1호
• /
• pp.1-8
• /
• 2011

This study was conducted to investigate the clear concept of patient safety and obtain theoretical evidences. Methods Research was conducted using Walker & Avant's conceptual analysis process. Results: Patient safety was defined as a activity that minimizes and removes possible errors and injuries to patients. It includes a basic desire to secure the patient's right to safety, and the legal regulations and duties of medical teams. The results of the establishment of a safety culture are patient-centered medical treatment and caring. Antecedents were found to be open and clear communications, continuous education and training for health care personnel, sufficient allocation of qualified personnel, cooperation among departments, improvements in the recognition of patient safety. Consequences were found to be the provision of high quality medical care and treatment, and increase in patient satisfaction. Conclusion: Patient safety as defined by the results of this study will contribute to the foundation of institutionalization of the pursuit of patient safety and creation of a hospital culture focusing on patient safety as a first priority.

• 대한장애인치과학회지
• /
• 제12권1호
• /
• pp.20-26
• /
• 2016

저자 들은 뺑소니 차량에 다발성 손상을 입고 응급실로 내원된 정신지체 장애환자에서, 초기 평가와 관리의 단계에서부터 다발성 외상환자 진료우선 순위에 따라 먼저 경척수를 안정시키고, 구강출혈부 지혈위한 구개횡단 강선결찰술과 비강출혈부 바셀린 거즈 전색 압박술 및 구강주위 개방 창상내 습윤거즈 전색 압박술 등을 신속하게 시행하여 기도폐쇄를 방지하고서, 임상 병리검사와 방사선 사진검사를 시행한 다음에, 기관내 삽관술, 비위장관 삽입술, 전신상태 모니터링 장비 활용, 수액 약물요법 등을 시행하였고, 보호자와 뒤늦게 연락이 되어서 체계적인 관련의학과적 관리를 장기간 시행해서, 비교적 양호한 예후를 관찰할 수 있었다.

• 한국중재학회지:중재연구
• /
• 제32권4호
• /
• pp.3-31
• /
• 2022

In the past, there has not been a law with the main purpose of preventing or preventing a risk in advance in order to protect the safety of patients in relation to medical services. It is evaluated that the enactment of the Patient Safety Act has a very important meaning in protecting patient safety as the top priority and further improving the quality of medical care. However, looking at the status of patient safety accidents reported to the Patient Safety Reporting System after the Patient Safety Act was enacted and implemented, various types of risk factors for patient safety still exist in the medical field. Meanwhile, Korea Consumer Agency and Korea Medical Dispute Mediation and Arbitration Agency, the existing domestic ADR specialized agencies, have been operating reasonable damage relief procedures such as recommendation of settlement, mediation, and arbitration according to the purpose of their establishment. Therefore, with the aimof broadening the choice of compensation system for patients, we propose the establishment and revision of ADR-related laws to apply the damage relief procedures of both institutions.

• Journal of Trauma and Injury
• /
• 제33권3호
• /
• pp.181-185
• /
• 2020

Damage control surgery (DCS) is an abbreviated laparotomy procedure that focuses on controlling bleeding to limit the surgical insult. It has become the primary treatment modality for patients with exsanguinating truncal trauma. Herein, we present the case of a 47-year-old woman with liver, kidney, and superior mesenteric vein (SMV) injuries caused by a motor vehicle collision. The patient underwent DCS following resuscitative endovascular balloon occlusion of the aorta (REBOA). In this case report, we discuss the importance of priority setting in DCS for the treatment of multisystem damage of several abdominal organs, particularly when the patient has incurred a combination of major vascular injuries. We also discuss the implications of damage control of the SMV, perihepatic packing, and right-sided medial visceral rotation. Further understanding of DCS, along with REBOA as a novel resuscitation strategy, can facilitate the conversion of uniformly lethal abdominal injuries into rescuable injuries.

• 산업공학
• /
• 제23권1호
• /
• pp.1-11
• /
• 2010

There are various ways to manage the patient flow of the hospital outpatient system. However, it is difficult to apply many implementation solutions to the real outpatient system at once. Because first, the expected effects of each different solution are very much depend on the real situation of the system and applied other solutions, and second, owing to the limited resources, each solution should be implemented according to the priority. In order to overcome these difficulties, this paper focuses on proposing the comprehensive subset of implementation solutions, which is one of the most effective among various kinds of subsets, and verifying the effects of it. The comprehensive subset of solutions is derived from conducting design of experiments and simulation which determine the optimum set of different solutions and analyze the particular interactions and priority order among them. This implementation strategy can solve the difficulties of applying different kinds of various solutions to the hospital outpatient system.