• Title/Summary/Keyword: 의료이용률

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Comparing Risk-adjusted In-hospital Mortality for Craniotomies : Logistic Regression versus Multilevel Analysis (로지스틱 회귀분석과 다수준 분석을 이용한 Craniotomy 환자의 사망률 평가결과의 일치도 분석)

  • Kim, Sun-Hee;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.9 no.2
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    • pp.81-88
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    • 2015
  • The purpose of this study was to compare the risk-adjusted in-hospital mortality for craniotomies between logistic regression and multilevel analysis. By using patient sample data from the Health Insurance Review & Assessment Service, in-patients with a craniotomy were selected as the survey target. The sample data were collected from a total number of 2,335 patients from 90 hospitals. The sample data were analyzed with SAS 9.3. From the results of the existing logistic regression analysis and multilevel analysis, the values from the multilevel analysis represented a better model than that of logistic regression. The intra-class correlation (ICC) was 18.0%. It was found that risk-adjusted in-hospital mortality for craniotomies may vary in every hospital. The agreement by kappa coefficient between the two methods was good for the risk-adjusted in-hospital mortality for craniotomies, but the factors influencing the outcome for that were different.

Technical Trend of U-Healthcare Standardization (유헬스케어 표준화 기술 동향)

  • Park, C.Y.;Lim, J.H.;Park, S.J.;Kim, S.H.
    • Electronics and Telecommunications Trends
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    • v.25 no.4
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    • pp.48-59
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    • 2010
  • 한국 사회의 인구 고령화 속도는 세계 최고 수준으로 향후 보건, 의료, 복지 등에서 심각한 사회 문제를 발생시킬 것으로 예상되고, 고령화 사회로 인한 질병 발생률의 증가는 국민 의료비 부담의 증가로 이어져 이에 대한 대책이 필요하다. 이에 따라, 정보통신기술을 이용하여 시간과 공간에 구애받지 않고 언제 어디서나 건강과 생활을 관리하여 건강한 삶을 유지시키는 새로운 형태의 서비스인 유헬스케어(u-Healthcare)가 많은 주목을 받고 있다. 최근에는 일반인, 고령자, 만성질환자를 대상으로 하는 유헬스케어용 건강 개인 기기의 개발이 확산되고 있으나, 표준이 없이 업체별로 제품개발이 이루어지기 때문에 서비스간 호환성 등의 문제가 생기고, 이로 인해 유헬스케어 산업의 성장에 장애요소로 작용하고 있다. 이를 해결하기 위해, 최근 헬스케어 분야의 표준화가 활발하게 진행되고 있으며, 표준화를 통해 생체정보 데이터의 취합 및 전송, 분석 및 피드백이 표준적인 방법으로 운용이 될 수 있도록 하고 개인 건강 기기들과 유헬스케어 서비스간의 상호 운용성이 보장이 될 수 있도록 할 수 있다. 본 고에서는 최근 헬스케어 분야에서 가장 활발하게 표준화가 진행중인 IEEE 11073 PHD 표준화 동향과 HL7 CDA의 표준화 동향에 대해서 상세히 살펴보고, 본 연구원에서 개발한 국제 표준기반 유헬스케어 플랫폼에 대한 소개를 한다.

Analysis of Space Radiation Dose Rate using portable X-ray Generating Device for Abdomen (이동형 X-ray 발생장치를 이용한 복부 촬영 시 공간 선량률에 관한 연구)

  • Park, Chang-Hee
    • Korean Journal of Digital Imaging in Medicine
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    • v.12 no.2
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    • pp.97-101
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    • 2010
  • This experimental study is carried out one of the General Hospital in Kyungbok providence. Abdomen Phantom being located Anterior-posterior(AP) position on portable bed, and the portable X-ray generating device was placed the phantom at $-90^{\circ}$ direction. The experiment were set 65 kVp, 10 mAs, $10{\times}10\;cm^2$, 100 cm(FOD) for the measurement. Digital proportional counting tube survey meter was used for measuring the space scatter dose. Measurement points of horizontal distribution was set up at $30^{\circ}$ interval by increasing 50 cm radius of upside, downside, left and right. Vertical distribution of measurement points were set up for the vertical plane with a radius of at $30^{\circ}$ intervals with 50cm increments. It is concluded that longer distance from the soure of X-ray significantly decrease radiation dose to the patient and use of the radiation protection device should be applied in clinical practice to reduce dose to the patient.

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Study in vivo metabolism using nuclear medical examination of the dose rate reduction (체내대사를 이용한 핵의학적 검사의 선량률 저감에 관한 연구)

  • Kang, Yong-Gil;Na, Soo-Kyung;Hong, Jin-Woong;Lee, Gui-Won;Kim, Nak-Sang
    • Korean Journal of Digital Imaging in Medicine
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    • v.14 no.2
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    • pp.75-81
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    • 2012
  • The purpose of this study was administered to the body for examination and treatment, high-energy radioactive isotope(F-18, I-131) in vitro discharge experiments. Increasing exposed dose of radiation to health professionals is caused by the increase of PET/CT use and a radioactive isotope. Therefore, the high-energy isotope F-18 and I-131 after administration about using Metabolite excretion was studied. As a results of this study, patients had plenty of fluids for testing and treatment alone administered radiopharmaceuticals can be more than twice as fast excretion induced emissions. Also was able to get a better image space to reduce the dose rate.

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The Study for clinical application of The New Sasang Constitution Questionnaire (새로운 사상체질 설문지의 임상적 활용에 관한 연구)

  • Kim, Tae-gyun;Kim, Jong-weon
    • Journal of Sasang Constitutional Medicine
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    • v.12 no.1
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    • pp.173-185
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    • 2000
  • 1. The purpose of study The purpose of study is The New Sasang Constitution Questionnaire to improve clinical right, as the person takes off uncomfortable to must use both Questionnaire of Sasang Constitution Classification II (QSCC) and Questionnaire of Sasang Classification(I) 2. The method of study I made the judgmental equation, increasing ability of judgment to give thinking importance among each subject about a Clinical study of judgment and the method of using, I investigated which Equation is better by a Clinical Study of the judgment. I made Equation, 9 and examine the Accuracy rate of the judgment through patients, student of University formal peoples and peoples taking the drugs 304 member totally. 3. The result of study I made 9 Equation of the judgment. The Equation of the judgment(I-2) is the highest ability of the judgment, the diagnostic accuracy is 60.53% about Soeum, 52.78% about Taeum, 48.39 about Soyang.

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The Relationship between Cerebrovascular Mortality and Community Health Indicators in Gangwon-do (강원도의 뇌혈관질환 사망과 지역사회 건강 지표와 관련성)

  • Sim, Jeoung-Ha;Son, Mi-A
    • Journal of agricultural medicine and community health
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    • v.34 no.1
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    • pp.1-12
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    • 2009
  • Objectives: The aim of this study was to characterize the community health indicators affecting standardized mortality rate of cerebrovascular diseases(CVD) and to identify the relationship between CVD mortality and community health indicators in Gangwon-do. Methods: The community health indicators included material deprivation index, medical resource, rates of road pavement and local tax. CVD mortality and the material deprivation index were calculated in the registered death data and the 2000 census which were obtained from the Korean National Statistics Office. The community health indicators were measured using 2001 statistical year book of Ganwon-do. Data were analyzed by using Excel 2003, SAS 9.1. CVD mortality and material deprivation index were visualized by Arcview 9.1. Results: CVD mortality varied by region and sex in Gangwon-do. The highest CVD mortality in male and female were noted at Goseong-gun, the lowest CVD mortality in male was at Yangyang-gun as it of female at Pyeongchang-gun. In Taebaek city where material deprivation index was also the highest; in Pyeongchang-gun was the lowest. Also the higher material deprivation index in some regions was the higher CVD mortality was. CVD mortality was not related with community health indicators. Conclusions: The results showed the regional difference of mortality of CVD among counties and cities in Gangwon-do. It is recommended that other community health indicators besides material deprivation index, road pavement rate, medical resources and local tax affecting CVD mortality need to be considered to improve the preventive strategies.

PSNR Evaluation of P Company DSA System between Server Display Monitor and Client Display Monitor (P사 DSA 시스템의 Server Display Monitor와 Client Display Monitor의 PSNR 평가)

  • Lee, Junhaeng
    • Journal of the Korean Society of Radiology
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    • v.8 no.1
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    • pp.43-49
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    • 2014
  • PACS is needed medical imaging with large-capacity storage device. Slower transmission degrades the performance of the PACS. Thus, the image read by the reading of the long-term stored image without compromising the quality of the video, which does not affect future readings in the range will be compressed and stored. Compression and video storage, and video transport Noise generated during storage and transmission of medical images and the resulting loss of information that occurs when the monitor output from many problems. The study estimates server display monitor and client display monitor of philips DSA system, and suggests that the evaluation and improvement about PSNR, process from server display signal obtaining to client display monitor. P company DSA is used in the test. Two monitors that are $1280{\times}1024$ pixel monitor of P company and 1536x2048 pixel monitor of Wide are used displaying angiography picture. MARO-view is taken in PACS program, and Visual $C^{++}$ is taken as accomplishing PSNR measurement program. As a result of experiment, no change in No 1, 3 of PSNR appear that there is no error in telephotograph and display. In terms of compressibility, low compressibility has small change of definition, and there was not remarkable drawback of compressibility which has little change in definition.

Utilization Rate and Related Factors of Unified Health Sub-center Among Rural Residents (통합보건지소 설치 전후 주민들의 보건지소 이용율 변화 및 관련요인)

  • Hwang, Tae-Yoon;Kang, Pock-Soo;Kim, Seok-Beom;Lee, Kyeong-Soo;Kang, Young-Ah
    • Journal of agricultural medicine and community health
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    • v.27 no.2
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    • pp.107-126
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    • 2002
  • Health sub-centers(HSCs) have played an important role in primary health care in rural area in Korea. The unification of neighboring HSCs was a strategy to improve the role of HSCs. This study was conducted to reveal the efficacy of the unified HSC established in Yangbuk-myeon, Gyeongju-si in1997. The utilization patterns of HSC and its related factors, and satisfaction of consumer on HSC were compared before and after unification of two HSCs in Gampo-eup, Yangnam-myeon using questionnaire survey, and also the statistics of medical care services and public health services were compared. Four hundred forty nine subjects were questioned in survey, 156 from Gampo-eup, 147 from Yangbuk-myeon, and 146 from Yangnam-myeon. Following unification, the utilization rates and the frequency of visits in Gampo-eup declined. In all three areas, chronic illness was the common factor influencing the utilization and change in frequency of visits to the unified HSC. Following unification, aspects of consumer satisfaction, for example; accessibility and affordability decreased in Gampo-eup, but increased in both Yangbuk-myeon and Yangnam-myeon. The statistics relating to medical care, X-ray examination, home visiting service, vaccination, and health education showed an increase for the unified HSC when compared to the sum of the statistics for the previous two. The execution rates for other public health services were the same, or a little decreased. Clinical laboratory examinations and the issuing of civil affair documents were new services offered by the unified HSC. It is concluded, the overall consumer satisfaction with the unified HSC was improved. In Gampo-eup, where after unification there was no HSC, it seemed to be a barrier to accessing the unified HSC. The effect of the unified HSC, in the respect of medical care and public health services, was not as significant as expected at the time of being established. Therefore, the strategies to reenforce the unified HSC should be developed to provide all residents with comprehensive primary health care services.

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Study on Wireless Body Area Network System Design Based on Transmission Rate (전송률을 고려한 WBAN 시스템 설계에 관한 연구)

  • Park, Joo-Hee
    • Journal of the Korea Society of Computer and Information
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    • v.17 no.12
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    • pp.121-129
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    • 2012
  • In this paper, we proposed WBAN system model to management an application that requires low rate data transfer in IEEE 802.15.4. We have to use different wireless sensor network technology to transfer different date rate and emergency message in medical application service. A suitable system model for WBAN and a WBAN MAC protocol in order to solve these existing system problems are proposed. Firstly, the priority queuing was applied to contention access period, and the system model which could guarantee transmission of a MAC command frame was proposed. Secondly, the MAC frame was newly defined to use the system model which was proposed above. Thirdly, WBAN CSMA/CA back-off algorithm based on data transmission rate was proposed to enhance data throughput and transmission probability of the data frame which does not have priority in the proposed WBAN system. The proposed algorithm is designed to be variable CSMA/CA algorithm parameter, depending on data rate. For the evaluation of WBAN CSMA/CA algorithm, we used Castalia. As a result of the simulation, it is found that the proposed system model can not only relieve loads of data processing, but also probability of collision was decreased.

The Impact of Nurse Staffing Level on In-hospital Death and Infection in Cancer Patients Who Received Surgery (간호사 확보수준이 수술한 암환자의 원내 사망 및 감염에 미치는 영향)

  • Kim, Myo-Gyeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.408-417
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    • 2017
  • This study was conducted to examine the influence of the nurse staffing level on the level of in-hospital death and infection in cancer patients who received surgery. Secondary data were used and the subjects of this study were 24,510 patients who received surgery for six types of cancer with a high postoperative mortality rate in the first half of 2012 at 260 hospitals. Simple logistic and GEE multiple logistic regression analyses were used. After adjusting for the patient and hospital characteristics, a greater likelihood of dying was found in the nurse staffing level 2-3 group (odds ratio [OR], 1.46; 95% confidence interval [CI], 1.00-2.11) and in the level 6-7 group (OR, 3.28; 95% CI, 1.87-5.74) compared to the level 0-1 group. The likelihood of in-hospital infection increased with each additional bed per nurse, being 6.63 times higher (95% CI, 3.00-14.62) in the level 2-3 group, 5.79 times higher (95% CI, 1.88-17.78) in the level 4-5 group, and 8.4 times higher (95% CI, 1.82-38.84) in the level 6-7 group, as compared to the level 0-1 group. A lower nurse staffing level was associated with higher in-hospital death and infection levels. This shows that an appropriate nurse staffing level is associated with superior postoperative cancer patient outcomes. Policies for providing adequate nurse staffing should be maintained for the sake of ensuring improved care quality and patient safety.