• Title/Summary/Keyword: 대체지표

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Does Process Quality of Inpatient Care Serve as a Guide to Reduce Potentially Preventable Readmission (PPR)? (의료서비스의 과정적 질과 잠재적으로 예방 가능한 재입원율과의 관계)

  • Choi, Jae-Young
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.87-106
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    • 2018
  • Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

Source Characteristics of the Recent Earthquakes for Seven Years in the Southwestern Region of the Korean Peninsula (최근 7년간 한반도 남서부 지역에서 발생한 지진의 진원 특성)

  • Jung, Mi Kyeong;Kyung, Jai Bok
    • Journal of the Korean earth science society
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    • v.34 no.1
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    • pp.59-68
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    • 2013
  • Focal mechanism solutions in the southwestern region of the Korean Peninsula ($34^{\circ}N-36^{\circ}N$, $126^{\circ}E-128^{\circ}E$) were obtained from the analysis of the recent 22 earthquakes ($M{\geq}2.0$) occurred from January, 2005 to March, 2011. The spatial differences between the epicenters recalculated by this study and those by KMA (Korea Meteorological Administration) and KIGAM (Korea Institute of Geoscience and Mineral Resources) are less than $0.05^{\circ}$, indicating a small deviation. However, they become a little bit larger in the coastal area due to a biased arrangement of seismic stations. Redetermined depths of hypocenters show a difference less than 12.7 km by comparison with the depth data announced by KIGAM. Most epicenters in inland area are located closely to the lineaments. Fault plane solutions were obtained from the analysis of P and SH wave polarities, and SH/P amplitude ratios. They show strike-slip faulting or strike-slip faulting with reverse components dominantly. The P-axes trends are mainly ENE-WSW or E-W directions. The direction of fault plane and auxiliary plane with 'NNE-SSW and WNW-ESE' or 'NE-SW and NW-SE' are dominant and almost parallel to the general trends of lineaments in the study area.

Evaluation of 358 Mandibular Poster ior Implants: A 3-year Retrospective Study (하악 구치부위에 식립한 358개 임플란트의 생존율에 대한 3년간 후향적 연구)

  • Yoon, I-Kwon;Lee, Gi;Lee, Dong-Un;Choi, Ju-Young;Yu, Jeong-A;Park, Pil-Gyu;Kim, Jeong-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.26 no.1
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    • pp.59-68
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    • 2010
  • Recently, dental implants extensively inserted on edentulous area show highly clinical success rate. However, clinicians cannot exclude the possibility of failure and it often unexpectively occures. Many possible factors associated with failure of dental implants have been reported but controversy exists over the extent to them. In this study, we collected 212 patients who had been inserted 358 dental implants on mandibular premolar and molar area from 2005 to 2006. The survival rate of fixtures was recorded according to age of patients, implantation site, implant system, diameter and length of fixtures. Multi-variable analysis using SPSS chi-square test was operated to verify relation of each factors and survival rates. Accumulative survival rate was 98.3% for 3 years. Only diameter of fixtures was related to the implant survival rate. This may be thought that wider fixtures had been chosen to rescue implants or used in sites of poor bone quality. Further continuous study will be needed for direct guidance associated with survival rate of implants.

Quality Characteristics and Antioxidant Properties of Cookies Supplemented with Taraxacum coreanum Powder (흰 민들레 분말을 첨가한 쿠키의 품질 및 산화방지 활성)

  • Lee, Yeong Mi;Shin, Hyeong Sik;Lee, Jun Ho
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.46 no.2
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    • pp.273-278
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    • 2017
  • This study was conducted to investigate the quality characteristics and antioxidant properties of cookies supplemented with 2~8% (w/w) Taraxacum coreanum powder (TCP). The pH and moisture content of cookie dough decreased significantly (P<0.05) while density was not influenced significantly by increasing levels of TCP. The spread ratio and loss rate of cookies increased significantly with increasing levels of TCP (P<0.05). Lightness, redness, and yellowness decreased significantly with higher amount of TCP (P<0.05). The use of TCP significantly increased hardness of cookies while 2,2-diphenyl-1-picrylhydrazyl and 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) radical scavenging activities were significantly elevated (P<0.05). The consumer acceptance test indicated that addition of 2% TCP had a favorable effect on consumer preferences in all attributes. Based on overall observations, cookies with 2% TCP can take advantage of the functional properties of TCP without sacrificing consumer acceptability.

The Relationship between FEV1 and PEFR in the Classification of the Severity in COPD Patients (만성 폐쇄성 폐질환 환자의 중증도 분류시 FEV1과 PEFR의 연관성)

  • Shin, Sang Youl;Ho, Yoon Jae;Kim, Sun Jong;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.507-514
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    • 2005
  • Background : Measurement of the $FEV_1$ and PEFR in COPD patients is a significant indicator of the disease severity, the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and $FEV_1$ in COPD patients is not well known. Methods : From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The $FEV_1$ and PEFR of each patient were measured and all the data was analyzed using SPSS. Results : The average predicted $FEV_1$ % and PEFR % was $56.98{\pm}18.21%$ and $70{\pm}27.60%$, respectively. There was linear correlation between the predicted $FEV_1$ % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. Conclusion : In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the $FEV_1$. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the $FEV_1$.

Impacts of ICT Development on Income Inequality (ICT 발전과 소득불평등 간의 관계 분석)

  • Cho, Wooje;Jung, Yoonhyuk;Kim, Sahangsoon
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.15 no.1
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    • pp.237-245
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    • 2020
  • The development of information and communication technology (ICT) provides many opportunities for businesses to increase productivity, to have better relationships with customers and suppliers, and to develop new products more efficiently and effectively. However, recently, there have been claims that ICT development in a country would increase income inequality of the country. In this debate, we examine the impact of ICT development on the income inequality at the country level. Data of 28 OECD countries were used for our study. According to results of the analysis, a country with a higher level of ICT development is likely to have a lower the level of income inequality. There have been many concerns that development of ICTs may result in a higher level of income inequality mainly because wealthy companies or individuals can more affordable to utilize advanced ICT and ICTs have replaced labor. However, there has been no such identified impact, at least in recent OECD countries. Rather, we can expect ICT development to play a role in lowering income inequality of a country.

Effects of Sea Tangle Extract on Formation of Collagen and Collagen Cross-link in Ovariectomized Rats (다시마 추출물이 갱년기 유도 흰쥐의 collagen 및 collagen 가교물질의 형성에 미치는 영향)

  • Lee, Young-Ae;Kim, Mi-Hyang
    • Journal of Life Science
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    • v.18 no.11
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    • pp.1578-1583
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    • 2008
  • The purpose of this study was to investigate the effects of sea tangle (ST) extracts on formation of collagen and collagen cross-link in ovariectomized rats. From day 3 until 42 after the ovariectomy, Sprague-Dawley female rats were randomly assigned to the following groups: sham-operated rats(Sham), ovariectomized control rats (OVX-control), ovariectomized rats supplemented with ST at 50 mg/kg bw/day (OVX-ST50), 200 mg/kg bw/day (OVX-ST200). The ethanol extraxcr of ST was orally administrated at 1 ml/day. The change of collagen content was investigated in bone, cartilage and skin of ovariectomized rats. Effects of ST extract on the amount of collagen was examined by measuring the hydroxyproline, which is a specific amino acid existing in collagen. The ovariectomy resulted in a decrease in the levels of collagen content in bone and cartilage tissues. However, the supplementation with the sea tangle extract prevented the decrease in the collagen level in bone and cartilage tissues. Pyridinoline is pyridinium cross-link formed in the mature form of collagen from lysine and hydroxylysine residues. Although the pyridinoline content in bone collagen declined after ovariectomy, it was recovered to a normal level of Sham group by the supplementation with the ST extracts. In addition, the deoxypyridinoline content in bone collagen, which was reduced after ovariectomy was enhanced to normal level by the supplementation with the ST extract. These results was consistent with the conclusions based on estrogenic activities of ST.

3-Dimensional numerical analysis on support performance of early-high-strength shotcrete (3차원 수치해석을 이용한 조기고강도 숏크리트 지보성능 분석)

  • Kim, Jong-Uk;Kim, Jung-Joo;Cho, Young-Jae;Yoo, Han-Kyu
    • Journal of Korean Tunnelling and Underground Space Association
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    • v.16 no.5
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    • pp.459-470
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    • 2014
  • Now-a-days, the trend in constructing tunnels is to build more deeper, more longer tunnels of greater cross-sections. That's why, the demand of "Early-high-strength shotcrete" is very high because of their advantage of attaining higher strength immediately after excavation, which controls the ground subsidence. So, this study reveals the supporting phenomena of early-high-strength shotcrete, using three-dimensional numerical analysis. The crux of this study can be applied practically in construction sites also. Support Performance of two different qualities of shotcrete was checked out, by keeping the general shotcrete's thickness constant and comparing it with early-high-strength shotcrete's thickness decreasing it gradually in five steps, and analysing/comparing the support performance in all cases. Effect of using early-high-strength shotcrete was analysed to save the cost of steel sets, which are widely used for supporting the ground before the hardening of general shotcrete. The results of numerical analysis on the performance of early-high-strength shotcrete show that, it behaves more effectively under worse ground conditions and it can support the ground more conveniently than steel sets, before the shotcrete is hardened.

A Study on Visitors' Characteristics and Cognition in Regard to Damage of Nature Environment in Different Types of Ecotourism Destination (생태관광지 유형별 탐방객 특성 및 자연환경 훼손에 대한 인식 비교 연구)

  • Lee, Ho-Young;Oh, Choong-Hyeon
    • Korean Journal of Environment and Ecology
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    • v.26 no.2
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    • pp.264-272
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    • 2012
  • For understanding the tourists' characteristics of several types of ecotourism sites, we surveyed and analyzed the demographic characteristics, travel motivations and cognition of damage in Bukhansan trail, Upo marshes, Jirisan trail and Uljin Keumgang pine tree trail. The field survey were conducted through face-to-face interviews. In the case of Bukhansan trail, many people came to build up their health, so the ratio of eco-tourists and the awareness of environmental damage was low. In Upo marshes, there were many group tourists who want to enhance friendship between the colleagues. And the ratio of eco-tourists, enjoying several activities such as observation or experience about the ecosystems of wetland and bird watching appeared high, but the cognition of tourists about the damage of natural environment was low because the flatland type tour site, Upo marshes has less damage factors comparing with mountain type tour sites. In Jirisan trail, eco-tourists, nature tourists and mass tourists appeared mixed and the cognition of damage was higher than that of flatland type. In the case of Uljin Keumgang pine tree trail, almost indices showed higher values than other sites because the tourists who visited there have high cognition of eco-tourism and nature conservation by limiting entrance. Tourists were generally accepted positively the control method such as collection of entrance fee and visitor reservation system when natural damages are expected.

An Interpretive Analysis of Magnetotelluric Response for a Three-dimensional Body Using FDM (FDM을 이용한 MT 탐사의 3차원 모형 반응 연구)

  • Han Nuree;Lee Seong Kon;Song Yoonho;Suh Jung Hee
    • Geophysics and Geophysical Exploration
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    • v.7 no.2
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    • pp.136-147
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    • 2004
  • In this study, the characteristics of magnetotelluric (MT) responses due to a three-dimensional (3-D) body are analyzed with 3-D numerical modeling. The first model for the analysis consists of a single isolated conductive body embedded in a resistive homogeneous half-space. The second model has an additional conductive overburden while the other conditions remain the same as the first one. The analysis of apparent resistivities shows well that the 3-D effects are dominant over some frequency range for the first model. Two mechanisms, current channeling and induction, for secondary electric fields due to the conductive body are analyzed at various frequencies: at high frequencies induction is more dominant than channeling, while at low frequencies channeling is more dominant than induction. Tippers have a strong relation to the position of anomalous body and the real and imaginary parts of induction vector also indicate the position of anomalous body. off-line conductive anomaly sometimes causes severe problem in 2-D interpretation. In such case, induction vector analysis can give information on the existence and location of the anomalous body. Each parameter of the second model shows similar responses as those of the first model. The only difference is that the magnitude of all parameters is decreased and that the domain showing the 3-D effects becomes narrower. As shown in this study, the analysis of 3-D effects provides a useful and effective means to understand the 3-D subsurface structure and to interpret MT survey data.