• Title/Summary/Keyword: 국립의료원

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Primary visit, transfer, and re-transfer to emergency department in patients with severe emergency diseases in Chungnam (충남에서 발생한 중증응급환자의 응급의료기관 일차 방문, 전원 및 재전원 현황)

  • Choi, Il Kug;Choi, Han Joo;Lee, Hae Jung
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.399-407
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    • 2018
  • Objective: Regionalization is one of the principal subjects for the advancement of rural emergency medical service systems in South Korea. This study shows the characteristics of interhospital transfer and status of the incidence of three major emergency disorders (acute myocardial infarction [AMI], acute stroke, and severe trauma) in one local province. Methods: A retrospective study was conducted for patients with three major emergency disorders who visited emergency medical facilities in one local province from January 2013 to December 2015, on the basis of the National Emergency Department Information System (NEDIS) data. Results: The incidence of three major emergency disorders had increased annually. Patients with each of these disorders tended to choose distinguishing methods of visiting emergency medical facilities. AMI patients tended to visited emergency medical facilities using private cars or on foot, while severe trauma patients usually visited by 119 ambulance, and acute stroke patients used 119 ambulance and private car in similar amounts. Overall, 65% of AMI patients were treated in intraregional medical facilities, but about 70% of acute stoke and severe trauma patients were transferred outside of the region. Conclusion: Because each of these disorders has an individual characteristic, it is difficult to expect a solution for the problems associated with emergency disorders just by assuring the availability of medical resources. Based on regionalization, a policy to provide the optimal treatment for those emergency disorders should be developed by planning public medical service systems based on the individual characteristics of emergency disorders, the standardized transfer plans of emergency patients and the assurance for mobilization and sharing of confined medical resources.

The Impact of Technology Utilization on Health Research and Development: Case Studies of the Development of Medical Device (합리적 기술 활용이 연구개발에 미치는 영향: 의료기기 개발 사례를 중심으로)

  • Min, Hye Sook;Park, Ji Eun;Kim, Chang-Yup
    • Health Policy and Management
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    • v.31 no.2
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    • pp.148-157
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    • 2021
  • Background: Based on that the key function of health technology is improving the quality of healthcare services, our study purports to explore the process of medical device development in detail and to discuss its policy implications. Methods: A total of 12 in-depth interviews were conducted with four groups of industry, hospital, academia, and civil society. All of the interviewees except those from civil society were involved in the new medical device development between 2009 and 2018. We performed a text network analysis and content analysis of the interview data. Results: The frequency and the degree centrality rankings suggested a close association between the utilization issue and the technology development. Similarly, the results of the content analysis showed that the appropriate intervention in the utilization of technology has a direct impact on the progress of development. Under the continuous industrial effort to boost profits by developing new technology, service providers and citizens should be knowledgeable of and make good use of the new technology for the provision of better services. Conclusion: As the development itself would not guarantee the improvement of service quality and better health outcomes, health technology policies should take a more comprehensive view to serve the unmet needs and even to facilitate the technology development.

Five Year Experience of Preexposure and Postexposure Rabies Prophylaxis in Korean Children at the National Medical Center (소아청소년에서 공수병 예방접종 및 교상 후 조치 현황: 최근 5년간 국립중앙의료원에서의 경험)

  • Noh, Jin Chul;Park, Hyang Mi;Park, Jong Hyun;Won, Youn Kyung;Lee, Chang Hyu;Kim, Jae Yoon
    • Pediatric Infection and Vaccine
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    • v.20 no.1
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    • pp.9-16
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    • 2013
  • Purpose : This study aims to investigate preexposure prophylaxis and postexposure prophylaxis of rabies that the National Medical Center (NMC) handled and to check whether appropriate measures were performed according to the recent domestic and overseas guidelines after animal bites. Methods : This study surveyed 41 people who were 18 years or under and received preexposure and postexposure prophylaxis of rabies at the NMC from November 2006 to December 2011. Their medical records were reviewed for their age, gender, the reason for preexposure prophylaxis, the body sites of animal bite, the kind of the animal that bit children, the region where the biting occurred and rabies vaccination and inoculation of immunoglobulin. Results : Eleven children took rabies vaccination for preexposure prophylaxis and 30 children received post exposure prophylaxis of rabies. Of patients who were bitten by unvaccinated animals including wild animals or by animals which were not certain to be vaccinated, 50% (13 of 26 children) received postexposure prophylaxis, while 75% (3 of 4 children) of patients who were bitten by vaccinated animals received postexposure prophylaxis of rabies. Ten of 30 bitten patients knew whether or not the biting animals had received rabies vaccination. Of them, four people (40%) were bitten by animals which had received rabies vaccination. Conclusion : To prevent the occurrence of rabies, people and health care providers need to correctly understand latest guideline for rabies preexposure and postexposure prophylaxis and the information for bitten patient, biting animal and area at bitten by animal should be accurately recorded.

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Survey of Foodservice Management Status according to Welfare Facility Type for Disabled Persons (장애인 복지시설 유형에 따른 급식관리 실태 조사)

  • Dayoung Oh;Woori Na;Seohyeon Hwang;Jung Joo Lee;Yu Jin Yang;Hyeok, Lee;Ji Hyeon Bang;Hae-Young Lee;Cheongmin Sohn
    • Journal of the Korean Dietetic Association
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    • v.29 no.3
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    • pp.173-189
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    • 2023
  • This study aimed to determine foodservice and hygiene management statuses at welfare facilities catering to disabled persons by facility type to provide basic data for foodservice management guidelines. An online survey was distributed to workers at 1,984 welfare facilities for disabled persons in Korea, and 531 facilities responded, which represented a response rate of 26.8%. The survey requested general information about the facilities, facility users, meals, hygiene, and management. Statistical analyses were performed, and frequency analysis and the chi-square test were used to investigate responses by facility type. The survey results revealed that daycare centers were most common and accounted for 27.4% of responses. Residential facilities for the severely disabled and sheltered workshops accounted for 16.9% and 16.4%, respectively, and residential facilities by disability type accounted for 13.0%. The presence of dietitians at welfare facilities varied by facility type. Welfare centers for the disabled (94.7%) had the highest percentage of dietitians, followed by residential facilities for the severely disabled (87.8%). On the other hand, sheltered workshops and daycare centers for disabled persons had the lowest percentages of dietitians (10.3% and 4.1%, respectively). This study highlights the variations that exist in foodservice management across different welfare facilities for disabled persons and emphasizes the challenges faced by those responsible for managing foodservices and maintaining hygiene, particularly in large facilities with no dietitians. Therefore, we recommend tailored meal management guidelines be developed for each type of welfare facility for disabled persons.

Comparison of sociodemographic characteristics, depression, quality of life, and unmet medical need between elders with and without limitation of activity by aging or dementia : Using seventh Korea national health and nutrition examination survey (노령 또는 치매로 활동제한이 있는 노인과 활동제한이 없는 노인의 사회인 구학적 특성, 우울, 삶의 질, 미충족 의료의 비교 : 제 7차 국민건강영양조사(2016) 원시자료를 이용하여)

  • Kang, So-La;Moon, Jong-Hoon
    • Journal of Society of Occupational Therapy for the Aged and Dementia
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    • v.12 no.2
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    • pp.1-11
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    • 2018
  • Objective : The aim of this study was to compare the sociodemographic characteristics, depression, quality of life, and unmet medical need in elders with and without limitation of activity by aging or dementia. Method : The data were used for raw data of seventh national health and nutrition examination survey (2016). We compared sociodemographic characteristics, depression, quality of life, and unmet medical needs between elders with limitation of activity by aging or dementia (n = 32) and elders without limitation of activity (n = 1201). Result : Elders with limitation of activity were significantly older than elders without limitation of activity (p<.001), income was lower (p<.05) and married status had more bereavement (p<.001). The elders with limitation of activity had higher depression (p<.001) and lower quality of life (p<.001) than elders without limitation of activity. Unmet medical need was greater than elders without limitation of activity (p<.001). Conclusion : Elders with limitation of activity showed that they did not receive enough medical services than elders without limitation of activity. These results suggest that the welfare system for the health care of population with aging or dementia needs to be improved.

Correlation of Quality Characteristics of Soybean Cultivars and Whole Soymilk Palatability (콩 품종별 품질특성과 전두유 식미의 상관관계)

  • Lee, Ji Hae;Lee, Yu Young;Son, Yurim;Yeum, Kyung-Jin;Lee, Yoon-Mi;Lee, Byong Won;Woo, Koan Sik;Kim, Hyun-Joo;Han, Sangik;Lee, Byoung Kyu
    • KOREAN JOURNAL OF CROP SCIENCE
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    • v.63 no.4
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    • pp.322-330
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    • 2018
  • The correlation between the nutritional composition of soybeans and whole soymilk palatability was investigated using nine soybean cultivars (Teagwangkong, Daewonkong, Saedanback, Jinpung, Daechan, Miso, Cheongmiin, Cheongja 3, and Socheongja). Physicochemical analysis of soybeans, showed that the protein and lipid contents were 37.7-46.0 and 15.2-20.9%, respectively. Unsaturated fatty acids were 81.1-84.8% of total fatty acids, of which linoleic acids was 49.7-56.8%. Total tocopherol was $243.5-361.3{\mu}g/g$ of extract, of which ${\gamma}$-tocopherol was $67.14-86.49{\mu}g/g$. Total isoflavone contents varied within cultivars from $495.4-1,443.8{\mu}g/g$ of extract. Daidzin and genistin were 252.1-556.0 and $241.8-730.7{\mu}g/g$, respectively, which were major isoflavones in soybeans. For the sensory evaluation, whole soymilk was made from nine soybean cultivars and 20 panels investigate its palatability. The Daechan cultivar had the highest (9.1), and Cheongmiin the lowest (5.6), overall palatability score. Interestingly, sensory results were strongly correlated with linoleic acid (0.746) and stearic acid (-0.716) content. In summary, the fatty acid composition of soybeans is the key factor in determining the palatability of whole soymilk. This study could be applied to determine the suitability of cultivars for soybean products, including whole soymilk.

Clinical study on C.V.A patients in Hospital attached to college of oriental medicine and N.M.C. department oriental medicine (대학부속한방병원 및 국립의료원 한방진료부 뇌졸증환자에 대한 한방치료 현황 분석)

  • Shin, Hyun-Kyoo
    • Korean Journal of Oriental Medicine
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    • v.1 no.1
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    • pp.1-14
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    • 1995
  • The clinical study was carried out on 1737 cases of inpatient and outpatient which have been diagnosed as C.V.A at hospital attached to 8 colleges of oriental medicine in Korea or National Medical Center from January 1st 1994 to December 31st 1994. The results were as follows; 1. In this study, the case of Occlusive C.V.D was 70.1%, Cerebral hemorrhage was 20.5%, Transient ischemic attack (T.I.A) was 5.3%, Subdural hemorrhage was 3.0%, Subarachnoid hemorrhage was 0.8% 2. It was confirmed by C.T (20%), E.K.G. (19%), X-ray (19%), Urinalysis (19%), Hematoscopy (20%). 3. The mean days of hospital treatment was 27.88 days, mean days of ambulation was 70.34 days. The mean days of hospital treatment of Occlusive C.V.D, Cerebral hemorrhage, T.I.A., Subdural hemorrhage, Subarachnoid hemorrhage were 25.79, 39.32, 12.49, 16.23, 23.40 days, respectively. The mean days of ambulation of Occlusive C.V.D, Cerbral hemorrhage, T.I.A., Subdural hemorrhage, Subarachnoid hemorrhage were 74.40, 93.68, 69.10, 29.75, 32.57 days, respectavely. 4. Oriental medical treatment of C.V.A was mainly Acupuncture (25%), Paper of Chinese herbs (22%), Chinese physiotherapy (14%), Extract of Chinese herbs (11%). 5. Oriental medical physiotherapy for C.V.A was mostly E.S.T., Kinesiatrics, electric negative therapy, others Aerohydrotherapy, interferential current therapy (I.C.T.), Carbon, Samhogi, T.E.N.S., Ultra-sound, Infra-red, Microwave, T.D.P., Ultraviolet, S.S.P., Chinese herbs beth, Prarffin bath, Magnetic treatment and tractions.

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A Case of Upper Thoracic Spinal Tuberculosis(T2-8) with T5,6 Compression Fracture in Pulmonary Tuberculosis Patient (폐결핵과 T5,6압박골절을 동반한 상부흉추(T2-8)결핵환자 1예)

  • Kim, Chong Kyung;Song, Ha Do;Cho, Dong Il;Yoo, Nam Soo
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.4
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    • pp.372-377
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    • 2007
  • Tuberculous spondylitis is the most common manifestation of musculoskeletal tuberculosis (TB). The progression of the disease is usually slow and insidious. The main symptom, back pain, is not specific, which frequently results in a delayed diagnosis resulting in neurologic deficits and more advanced vertebral destruction. It is more difficult to diagnose the disease if the involved area is an uncommon sites, such as the upper thoracic, cervical or sacral region. It is important to make an early diagnosis and treatment to achieve a better treatment outcome. We reported a 29 year old female with upper thoracic TB spondylitis(T2-8) and pulmonary TB complaining of back pain that persisted for 5 months and fever. TB spondylitis was not suspected to be due to upper thoracic involvement despite her pulmonary tuberculosis. Chest CT for the evaluation of pulmonary TB found T5 destruction and the paravertebral abscess that was consistent with TB spondylitis. Her spine was examined by MRI, which made an early diagnosis before the neurologic deficit had developed. She was treated with surgical intervention due to the spinal instability and anti-TB medication for 1 year with excellent results.

전염병정보화사업의 현황과 발전 방향

  • Lee Jong-Gu
    • 대한예방의학회:학술대회논문집
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    • 2001.04a
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    • pp.39-49
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    • 2001
  • 전염병 정보화사업은 1995년 콜레라의 집단 발병을 계기로 1996년부터 추진되었다. 교통의 발달과 국제교류의 증가는 전염병의 전파와 확산속도가 빨라져 국민건강을 위협하고 있으며 기존의 수작업만으로 정보수집 및 효율적인 전염병관리가 어려워 체계적이고 효율적인 전염병관리를 위하여 국가적 D/B 구축, 전염병관리의 의사결정지원자료 축적의 필요성 제기되었으나 독자적인 망 구축에는 막대한 예산이 들고 망의 운영과 유지관리를 위한 예산과 조직의 한계가 있는 상황에서 콜레라 발생을 계기로 보건복지부 방역과, 국립보건원, 국립서울 검역소, 경기도 6개 보건소 및 경기 및 인천 보건환경연구원을 실험적으로 연계하여 전염병 관리에 필요한 정보의 내용과 흐름, 자료 관리를 위한 기관별, 자치단체별 역할과 기능 등에 관한 개념 정립 둥 전산개발과 함께 제도정비 방안 등이 동시에 수행되었다. 이러한 실험과 연구 결과를 토대로 1998년부터 인터넷을 활용한 전염병의 신고 보고, 전염병관련 자료의 D/B를 통한 전염병의 발생 예측, GIS 등 전염병에 관한 모든 정보를 제공할 수 있는 portal site 구축을 위한 2단계 정보화사업이 정보통신부 지원 하에 시도되었다. 약 2년간의 작업 결과 전염병관리의 전산화 가능성이 확인된 후 전염병예방법을 개정하여 전산 보고의 제도적 틀을 만들고 2000년 8월부터 법정전염병은 전산 보고가 이루어 지고 있다. 일방적이 보고이외 전염병관리의 쌍방화를 위하여 각종 지령/정보의 전파, 각종 통계, 지침, 교육자료, 전염병관련 논문 등을 제공하고 있으며, 상담, 민원접수는 전염병 관련 정보의 전문화와 함께 국민과 호흡할 수 있는 시스템으로 운영될 수 있도록 설계하였다. 그러나 현재 사용하고 있는 WEB EDI가 가진 속도 문제, 응용프로그램의 문제로 신고 보고를 C/S 버전으로 전환하여 사용자의 편리성을 증진하고 있다. 또한 예방접종자료의 전산화를 통한 이상반응 관리, 접종주기 관리, 예방접종으로 관리할 수. 있는 전염병관리(Vaccine preventable disease), 학교에서 발생하는 전염병의 감시 등 전염병 포탈 사이트에 걸맞게 정보 내용을 한층 확대하고 있고 일선의료기관도 활용할 수 있는 시스템으로 발전시키고 있다. 이를 위하여 정보관리과도 신설하였다. 그러나 전염병관리의 전산화는 궁극적으로 전염병 자료의 지역화와 그를 통한 전염병관리의 분권화 및 지방자치화를 이루고자 하는 것이다. 기술적인 측면에서 전산망은 쉽게 만들 수 있으나 전염병관리의 개선과 그 정착은 1-2년간의 전산프로그램개발 작업만으로 달성되기는 어려우며 범국가적인 노력과 더불어 일선보건요원의 교육과 훈련 및 보건소장 등 보건관리자의 전산마인드 개발 등의 작업도 매우 중요할 것으로 사료된다.

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Curved Axillary Thoracotomy in Patent Ductus Arteriosus (동맥관개존증에 있어 굽은액와 개흉술의 적용)

  • Shin, Yong-Chul;Ahn, Jae-Bum;Kim, In-Sub;Chung, Sung-Chul;Kim, Woo-Sik;Kim, Byung-Yul
    • Journal of Chest Surgery
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    • v.39 no.12 s.269
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    • pp.957-959
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    • 2006
  • Muscle sparing thoracotomy is known as alternative of posterolateral thoracotomy because of less postoperative pain, preservation of muscle power and better cosmetic outcome. Curved axillary thoracotomy(CAT) is a type of muscle sparing thoracotomy. Between July 2003 and August 2004, 5 patients diagnosed as pure patent ductus arteriosus(PDA) treated by CAT and we reviewed results retrospectively by clinical record. The operative procedures were ligation of ductus in 4 cases and division of ductus in 1 case. There were no postoperative complication. Curved axillary thoracotomy is considerable alternative for surgical treatment of PDA with merits of muscle sparing effect and cosmetic benefit.