• 제목/요약/키워드: service of records center

검색결과 145건 처리시간 0.027초

예측 도구를 활용한 비외상성 거미막밑출혈 환자의 병원 전 기록 분석 (Analysis of pre-hospital records of patients with non-traumatic subarachnoid hemorrhage using prediction tools)

  • 김용준;심경율;이경열
    • 한국응급구조학회지
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    • 제26권2호
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    • pp.7-18
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    • 2022
  • Purpose: This study aimed to develop a pre-hospital subarachnoid hemorrhage (SAH) prediction tool by analyzing the extant predictive factors of patients with non-traumatic SAH who visited the hospital through the 119 emergency medical services. Methods: We retrospectively reviewed pre-hospital care reports (PCRs) and electronic medical records (EMRs) of 103 patients with non-traumatic SAH who were transported to the emergency department of two national hospitals via the 119 emergency medical service from January 1, 2017 to December 31, 2020. Variables required to apply the Ottawa SAH Rule and EMERALD SAH Rule, which are early prediction tools for SAH, were extracted and applied. Results: The most common symptoms-which were found in 94.1% and 97.0% of all patients according to PCRs and EMRs, respectively-appeared in the following order: headache, altered state of consciousness, and nausea/vomiting. When the variables used for the EMERALD Rule, namely systolic blood pressure (SBP), diastolic blood pressure (DBP), and blood sugar test (BST), were applied, the sensitivities of EMR and PCRs were 99.9% and 92.2%, respectively. Conclusion: For the timely prediction of SAH at the pre-hospital phase, patient age and symptoms should be assessed, and SBP, DBP, and BST should be measured to transport the patient to an appropriate hospital.

행정기관의 기록관리시스템 개선모델 분석 -2006년 기록관리시스템 혁신을 중심으로- (Analysis of Reform Model to Records Management System in Public Institution -from Reform to Records Management System in 2006-)

  • 곽정
    • 기록학연구
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    • 제14호
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    • pp.153-190
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    • 2006
  • 외부적으로 정책결정과정의 투명성을 위한 업무관리시스템이 도입되고 업무혁신을 위한 범정부 기능분류체계가 수립되어 행정기관의 업무환경이 변화하고 있다. 동시에 자료관시스템이 본격적으로 가동됨에 따라 미비한 기능에 대한 불만이 가중되고, 전자기록의 진본성 유지에 대한 문제가 제기되고 있다. 이러한 배경하에서 기록관리 혁신의 일환으로 '05년 9월부터 5개월간 국가기록원에서는 '기록관리시스템 혁신 정보화전략계획수립(ISP)' 용역사업을 수행하였다. 이 용역사업에서는 기존의 기록관리프로세스를 전자기록관리체계에 걸맞게 재설계하였고, 국제표준에 부합하는 시스템 모델을 제시하였다. 기록물관리법 제정이후, 행정기관의 기록관리는 종이기록을 전자적으로 관리하는 개념에서 추진되었다. 그러나 이번에 수립된 개선모델에서는 종이기록을 대체해 가고 있는 전자기록에 주목하고 전자기록의 속성을 고려한 관리방안을 모색하고 있다. 이것은 행정기관의 업무가 전산시스템을 통하여 수행되는 것이 보편화되어 감에 따라, 기록관리영역에서도 본격적으로 전자기록관리 문제가 이슈화되고 있다는 의미이다. 본 논문에서는 전자기록관리와 관련된 개선모델의 주요내용을 분석하고 그 의미와 한계를 살펴봄으로써, 전자기록관리시스템의 향후 방향을 이해하는데 목적이 있다. 개선모델 분석에 앞서, 변화된 행정환경과 그에 따른 기록관리상의 제문제를 검토하였다. 업무관리시스템과 정부의 기능분류체계는 업무측면에서 범정부의 실적을 온라인으로 관리하고 정부기능에 따라 체계적으로 분류하여 관리할 수 있는 공통기반을 마련했다는 점에서 혁신적이나, 기록관리측면에서는 기록관리대상의 재정의와 획득방법의 부재, 기록물분류기준표와의 이원화, 그리고 자료관시스템의 전자기록관리의 한계 등 많은 문제점을 발생시키고 있음을 확인하였다. 위와 같은 문제의 해결을 위하여, 기록관리시스템 개선모델에서는 확대된 기록관리대상을 포괄할 수 있는 범용적인 전자기록철의 구조를 설계하고, 업무분류에 기반한 기록분류체계를 도입하며, 전자기록관리를 강화하기 위한 기능을 추가해야 한다고 제안하고 있다. 이 모델은 다양한 생산시스템의 기록관리 대상에 대한 근본적인 관리방법을 모색하고 있고, 기록분류체계 및 보존기간 운영방식에 있어 기관별 기록관의 역할을 획기적으로 개선하고 있으며, 전자기록의 진본성 유지를 위한 시스템의 주요 기능이 구체적으로 설계되어 제시되고 있다는 점에서 국제표준과 선진사례의 추세와 부합하는 전자기록관리시스템의 기반을 마련하였다고 분석되었다. 그러나 이러한 혁신성에도 불구하고 본격적인 전자기록 시대의 기록관리시스템으로서는 걸음마 단계이다. 앞으로 행정정보시스템 등 상이한 기록구조의 획득방안, 기록분류체계의 질적수준의 확보, 기 개발된 보존기술의 검증 등이 보다 더 심도 있게 연구되고 실행될 때, 선진적인 전자기록관리시스템으로서의 전망을 가질 수 있을 것이다.

민간의료보험이 암 환자의 의료이용과 의료비에 미치는 영향: 일개 암전문의료기관의 우리나라 주요 암종을 중심으로 (Effects of Private Health Insurance on Health Care Utilization and Expenditures in Korean Cancer Patients: Focused on 5 Major Cancers in One Cancer Center)

  • 임진화;최귀선;김성경;박은철;박재현
    • Journal of Preventive Medicine and Public Health
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    • 제40권4호
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    • pp.329-335
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    • 2007
  • Objectives : To identify the effects of supplemental private health insurance on health care utilization and expenditure under the mandatory National Health Insurance(NHI) system in Korea. Methods : The data were collected by the National Cancer Center in Korea. Cancer patients who were newly diagnosed with stomach (ICD code, C16), lung(C33-C34), liver (C22), colorectal cancer(C18-C20) or breast(C50) cancer were included as study subjects. Data were gathered using a structured questionnaire from face-to-face interviews, the hospital Order Communication System (OCS) and medical records. Clinical, socio-demographic and private health insurance related factors were also gathered. The differences of health care utilization and expenditure were compared between those who have private health insurance and those who do not using t-test and multivariable regression analysis. Results : Individuals with private health insurance spent larger inpatient costs than those without, but no differences were found in utilization in other service such as hospital admissions, hospital days and physician visits. Conclusions : We found that private health insurance exerts a significant effect on the health care expenditure in inpatient service. These study results can provide a rational basis to plan a national health policy regarding private health insurance. Further studies are needed to investigate the impacts of private health insurance on cancer patients' outcomes and survival rates.

행정박물의 체계적 관리를 위한 프로세스 구축방안 (A Study on Process Model for Systematic Management of Archival Objects)

  • 이예경;김금이;이진희
    • 기록학연구
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    • 제17호
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    • pp.157-202
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    • 2008
  • 행정박물은 업무활동 과정에서 특정 목적을 지니고 생산되고 활용되었다는 기록으로써 가치를 지님과 동시에 역사성, 심미성, 예술성이라는 박물로써 가치를 지닌 물건(objects)이다. 이미 캐나다, 호주, 중국 등의 국가에서는 그 가치를 인정하여 별도의 관리대상으로 설정하여 보존 관리하고 있으며, 우리나라도 2006년 '기록관리혁신 종합실천계획'을 통하여 행정박물을 국가차원의 기록관리 대상으로 포함시키고 종합적인 관리방향을 제시하게 되었다. 더불어 2006년 기록물관리법을 개정하면서 행정박물의 가치에 대한 인식이 확산되었고, 국가의 적극적인 관리의지를 표명하였다. 지금까지는 행정박물의 정의 및 범주가 불명확하고 행정박물이 지니는 특성에 부합한 관리체계가 부재하여 각 기관에서 관리하던 박물들의 훼손가능성이 큰 것으로 나타났다. 비록 개정된 기록물관리법에서 행정박물의 정의를 나타내고 관리의무를 표명하고 있지만, 이것만으로는 다양한 형태와 재질로 이루어진 행정박물의 특성에 부합하는 관리체계가 설립되기는 부족한 감이 있다고 여겨진다. 이에 따라 본 연구에서는 간략하게나마 행정박물의 정의를 내려 보고 행정박물의 관리 실태를 파악하기 위한 기관표본조사를 실시하였다. 표본조사의 결과와 법령 및 현 기록관리시스템 분석을 바탕으로 행정박물 관리 문제점을 살펴보고 이를 개선하기 위한 행정박물 관리 프로세스를 입수${\rightarrow}$등록${\rightarrow}$기술${\rightarrow}$보존${\rightarrow}$활용${\rightarrow}$폐기의 각 단계별로 제언하였다. 본 연구는 체계적인 행정박물의 관리를 위한 기반을 제시한 것에 그치며, 더욱 심도 있는 연구들이 진행되어, 행정박물을 효과적으로 보존 관리하기 위한 방안을 모색해나가야 할 것이다.

미국의 기록(records) 및 아카이브즈(archives)의 역사적 기원과 관리·보존의 역사 17세기 초부터 20세기 중반까지를 중심으로 (The Origin of Records and Archives in the United States and the Formation of Archival System: Focusing on the Period from the Early 17th Century to the Mid 20th)

  • 이선옥
    • 기록학연구
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    • 제80호
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    • pp.43-88
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    • 2024
  • 미국의 국립문서보존소(현 국립문서기록관리청)는 서구의 전통적인 기록물보존소들 중에서도 후발주자로 조용히 등장했다. 미국의 공공기록물관리역사는 유럽에 비해 길지 않다. 그럼에도 미국은 20세기 격동의 세기를 지나며 생산되고 수집된 방대한 양의 현대기록물을 체계적으로 관리·보존하는 일에 집중하며 미국 역사적 상황에 최적화된 현대적인 기록물 관리체계를 확립해 왔다. 또한 미국은 국제적인 공공기록물 관리 발전을 견인하는 강력한 위상을 견지하고 있다. 미국의 공공기록물 관리체계의 중심에는 기록이 미국민의 공공재산이라는 공공소유권 개념이 확고하게 자리한다. 이는 기록을 통해 식민지 자치 시민으로서 그들의 권리를 보호받던 영국 식민지 시대로까지 거슬러 올라간다. 미국민에게 기록과 아카이브즈는 미국의 짧은 역사에서 '미국인'로서의 정체성은 물론 개인의 자유와 권리 더 나아가 민주주의를 지키기 위한 수단이자 국가의 상징 그 자체였다. 따라서 미국민의 삶과 역사는 기록되어야 하고 기록된 과거는 미국의 현재와 미래를 위해 관리·보존되는 것은 당연하고 자연스러운 것이었다. 미국의 공공기록물 관리체계는 미국의 역사와 함께 형성된 기록에 대한 그들의 철학과 가치관 그리고 미국 고유의 기록물관리 경험을 통해 정립된 이론과 실무, 교훈, 아이디어 등이 융합된 결과물이다. 본 논문에서는 미국의 기록(records)과 아카이브즈(archives)의 기원을 역사적 맥락에서 추적하여 미국민의 삶과 기록 간의 유기적 관계를 파악해 본다. 또한 미국 고유의 역사성이 반영된 두 형태의 기록물관리 전통(공공 기록·아카이브즈 관리 전통과 역사 메뉴스크립트 관리전통)을 살펴본다. 이에 더 나아가 미국의 역사적 현실에 부합하여 가장 미국적이면서도 세계적으로 보편적인 현대 공공기록물 관리체계가 형성되는 과정을 살펴보고자 한다. 역사적·개념적 연구 방법을 통해 미국 공공기록물 관리체계를 더욱 심층적이고 본질적으로 이해하고자 한다.

Clinical Features of Respiratory Syncytial Virus Infection in Neonates: A Single Center Study

  • Chang, Sung Hui;Jang, Gwang Cheon;Yoon, Shin Won
    • Neonatal Medicine
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    • 제25권4호
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    • pp.144-152
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    • 2018
  • Purpose: The aim of this study was to investigate the clinical characteristics of Respiratory syncytial virus (RSV) infection during the neonatal period to provide information that is useful in clinical practice and suggest extension of the palivizumab administration. Methods: Neonates admitted to the National Health Insurance Service Ilsan Hospital neonatal intensive care unit due to respiratory symptoms and for whom multiplex reverse transcription-polymerase chain reaction and multiplex real time-polymerase chain reaction tests were performed between October 2011 and May 2016 were included in this study. Medical records were retrospectively reviewed, and data was collected for 156 neonates. Results: Among the 156 neonates, RSV was detected in 114 (73.1%), non-RSV in 25 (16%), and no virus in 17 (10.9%). The majority were full term infants (92.4%) and peak incidence of RSV infection was in January. Post-natal care center infection was more common in the RSV group (46.6%) than that in the other virus groups (24%, P=0.0243). Clinical symptoms were severe in the RSV group in contrast to that in the non-RSV or others groups. The RSV group frequently needed oxygen therapy (P=0.0001) and the duration of hospital stays were longer (P=0.0001). Conclusion: RSV is a significant cause of respiratory infection in neonates and the severity is higher in contrast to that with other viral causes of infection. Infants in post-natal care centers have a high-risk of developing RSV infections; therefore, palivizumab administration may be considered in this group to prevent hospitalization and reduce the duration of hospital stay.

1930년대 중국 문서당안 행정개혁론의 이해 (The Records and Archives Administrative Reform in China in 1930s)

  • 이원규
    • 기록학연구
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    • 제10호
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    • pp.276-322
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    • 2004
  • Historical interest in China in 1930s has been mostly focused on political characteristic of the National Government(國民政府) which was established by the KMT(中國國民黨) as a result of national unification. It is certain that China had a chance to construct a modern country by the establishment of the very unified revolutionary government. But, it was the time of expanding national crises that threatened the existence of the country such as the Manchurian Incident and the Chinese-Japanese War as well as the chaos of the domestic situation, too. So it has a good reason to examine the characteristic and pattern of the response of the political powers of those days. But, as shown in the recent studies, the manifestation method of political power by the revolutionary regime catches our attention through the understanding of internal operating system. Though this writing started from the fact that the Nationalist Government executed the administrative reform which aimed at "administrative efficiency" in the middle of 1930s, but it put stress on the seriousness of the problem and its solution rather than political background or results. "Committee on Administrative Efficiency(行政效率委員會)", the center of administrative reform movement which was established in 1934, examined the plan to execute the reform through legislation by the Executive Council(行政院) on the basis of the results of relevant studies. They claimed that the construction of a modern country should be performed by not political revolution anymore but by gradual improvement and daily reform, and that the operation of the government should become modern, scientific and efficient. There were many fields of administrative reform subjects, but especially, the field of records and archives adminstration(文書檔案行政) was studied intensively from the initial stage because that subject had already been discussed intensively. They recognized that records and archives were the basic tool of work performance and general activity but an inefficient field in spite of many input staff members, and most of all, archival reform bring about less conflicts than the fields of finance, organization and personnel. When it comes to the field of records adminstration, the key subjects that records should be written simply, the process of record treatment should be clear and the delay of that should be prevented were already presented in a records administrative meeting in 1922. That is, the unified law about record management was not established, so each government organization followed a conventional custom or performed independent improvement. It was through the other records administrative workshop of the Nationalist Government in 1933 when the new trend was appeared as the unified system improvement. They decided to unify the format of official records, to use marker and section, to unify the registration of receipt records and dispatch records and to strengthen the examination of records treatment. But, the method of records treatment was not unified yet, so the key point of records administrative reform was to establish a unified and standard record management system for preventing repetition by simplifying the treatment procedure and for intensive treatment by exclusive organizations. From the foundation of the Republic of China to 1930s, there was not big change in the field of archives administration, and archives management methods were prescribed differently even in the same section as well as same department. Therefore, the point at issue was to centralize scattered management systems that were performed in each section, to establish unified standard about filing and retention period allowance and to improve searching system through classification and proper number allowance. Especially, the problem was that each number system and classification system bring about different result due to dual operation of record registration and archives registration, and that strict management through mutual contrast, searching and application are impossible. Besides, various problems such as filing tools, arrangement method, preservation facilities & equipment, lending service and use method were raised also. In the process this study for the system improvement of records and archives management, they recognized that records and archives are the identical thing and reached to create a successive management method of records and archives called "Records and Archives Chain Management Method(文書檔案連鎖法)" as a potential alternative. Several principles that records and archives management should be performed unitedly in each organization by the general record recipient section and the general archives section under the principle of task centralization, a consistent classification system should be used by classification method decided in advance according to organizational constitution and work functions and an identical number system should be used in the process of record management stage and archive management stage by using a card-type register were established. Though, this "Records and Archives Chain Management Method" was developed to the stage of test application in several organizations, but it was not adopted as a regular system and discontinued. That was because the administrative reform of the Nationalist Government was discontinued by the outbreak of the Chinese-Japanese War. Even though the administrative reform in the middle of 1930s didn't produce practical results but merely an experimentation, it was verified that the reform against tradition and custom conducted by the Nationalist Government that aimed for the construction of a modern country was not only a field of politics, but on the other hand, the weak basis of the government operation became the obstacle to the realization of the political power of the revolutionary regime. Though the subject of records and archives administrative reform was postponed to the future, it should be understood that the consciousness of modern records and archives administration and overall studies began through this examination of administrative reform.

당뇨병성 족부질환자의 직접의료비용 분석 (Analysis of Direct Service Costs about Diabetic Foot Patients)

  • 송종례;이진우;한승환
    • 대한족부족관절학회지
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    • 제15권3호
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    • pp.165-169
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    • 2011
  • Purpose: The objective of this study was to analyze diabetic foot patients' direct service costs until the cure of the disease. Materials Methods: The subjects of this study were randomly sampled 60 patients who had been treated for diabetic foot at one of two tertiary hospitals and cured of the disease during from January 2008 to December 2009, and whose diagnostic code was E11.5 or E14.5. Data were collected from medical records and direct service costs were analyzed using data on the payments of individual service charges. Direct service costs spent at other medical institutions for the same disease were excluded. Collected data were analyzed using descriptive statistics. Results: The subjects' mean hospital stay was 29 days, and mean period until cure was 132 days. The inpatient cost per patient was 10,844,648 won, outpatient cost was 715,751 won, and home care services cost was 641,854 won, so total direct service cost per patient was 11,913,419 won. The total direct service cost in patients who had their foot amputated was 12,769,822 won, 1.3 times higher than without amputation, who had vascular intervention was 16,219,477 won, 1.9 times higher than non-vascular intervention, who had both infection and artery occlusion was 17,522,435 won, 2.0 times higher than either infection or artery occlusion. Conclusion: In diabetic foot patients, the direct service cost was highest as 17,522,435 won in patients accompanied with both infection and occlusion of lower extremity artery.

교통사고 조사 및 재현에서 신형 전자식운행기록계의 신뢰성에 관한 연구 (Study on Reliability of New Digital Tachograph for Traffic Accident Investigation and Reconstruction)

  • 박종진;조건우;박종찬
    • 한국자동차공학회논문집
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    • 제23권6호
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    • pp.615-622
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    • 2015
  • Recently Digital-TachoGraph(DTG) was mounted mandatorily in commercial vehicles(Taxi, Bus, etc.). DTG records accurate and detailed information of the running state of vehicles related to traffic accident, such as Time, Distance, Velocity, RPM, Brake ON/OFF, GPS, Azimuth, Acceleration. Thus those standardized data can play an important role in traffic accident investigation and reconstruction. To develope the accurate and objective method using the DTG data for the reconstruction of traffic accident, we had conducted several tests such as driving test, high speed circuit test, braking test, slalom test at Korea Automobile Testing & Research Institute(KATRI), and collision test at Korea Automobile insurance repair Research and Training center(KART) with the vehicle equipped with several DTG. Development of the program which enables the reading and analysis of the DTG data was followed. In the experiments, we have found velocity error, RPM error, brake signal error and azimuth error in several products, and also non-continuous event data. The cause of these errors was deduced to be related to the correction factor, the durability of electronic parts and the algorithm.

Perspectives on Clinical Informatics: Integrating Large-Scale Clinical, Genomic, and Health Information for Clinical Care

  • Choi, In Young;Kim, Tae-Min;Kim, Myung Shin;Mun, Seong K.;Chung, Yeun-Jun
    • Genomics & Informatics
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    • 제11권4호
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    • pp.186-190
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    • 2013
  • The advances in electronic medical records (EMRs) and bioinformatics (BI) represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO) aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.