• Title/Summary/Keyword: 중증

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The Selection of the Medical Institutions by Motivation of Medical Service Utilization (의료이용 동기에 따른 의료기관 선택요인)

  • Kim, Jeong-Yeon
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.217-230
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    • 2015
  • This study investigated the differences in how medical institutions are chosen according to the motivation of medical service utilization(minor disease, major disease, chronic disease management, cosmetic). Importance order of selection for the minor disease were medical skill, kindness, rapidness, proximity, importance order of selection for major disease and cosmetic were medical skill, facilities, reputation, medical fee, importance order of selection for chronic disease management were medical skill, facilities, kindness, medical fee. From this medical study skill was a more important factor in medical institutions irrespective of motivation, subjects with the major disease tend to consider the selection of the medical institutions more important, except proximity. Medical users select medical institutions according to the motivation of visiting, and there were differences in same motivation according to socioeconomic status and information searching behavior.

The effective management of length of stay for patients with acute myocardial infarction in the era of digital hospital (디지털 병원시대의 급성심근경색증 환자 재원일수의 효율적 관리 방안)

  • Choi, Hee-Sun;Lim, Ji-Hye;Kim, Won-Joong;Kang, Sung-Hong
    • Journal of Digital Convergence
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    • v.10 no.1
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    • pp.413-422
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    • 2012
  • In this study, we developed the severity-adjusted length of stay (LOS) model for acute myocardial infarction patients using data from the hospital discharge survey and proposed management of medical quality and development of policy. The dataset was taken from 2,309 database of the hospital discharge survey from 2004 to 2006. The severity-adjusted LOS model for the acute myocardial infarction (AMI) patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of AMI patients were CABG and comorbidity. The difference between severity-adjusted LOS from the ensemble model and real LOS was compared and it was confirmed that insurance type and location of hospital were statistically associated with LOS. And to conclude, hospitals should develop the severity-adjusted LOS model for frequent diseases to manage LOS variations efficiently and apply it into the medical information system.

Thymectomy for the Myasthemia Gravis Patient (중증 근무력증 환자의 흉선 절제술)

  • 정성운;박준호;김종원
    • Journal of Chest Surgery
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    • v.36 no.10
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    • pp.754-758
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    • 2003
  • Backgroun: Thymectomy was known as an effective treatment modality of myasthenia gravis. In this paper, we analyzed the result of thymectomy and the factors affecting the postoperative system improvement. Material and Method: We analyzed the medical records of 50 patients who received the thymectomy for myasthenia gravis from January 1997 to December 2001. Result: 39 patients showed sympton improvement. The effect of thymectomy as a treatment is 78%. There was no statistically significant correlation between postoperative improvement and Sex, Age, the Weight of thymic tissue, preoperative symptom duration, and preoperative mestinon dosage. However, the thymic pathology and low grade preoperative symptoms were affecting the postoperative prognosis. Conclusion: Thymic hyperplasia showed good prognosis compared to thymoma. Low grade preoperative symptoms (Group I or IIA) also showed good prognosis. So, early thymectomy is recommendable for the good treatment results of myasthenia gravis.

Reliability of the Emergency Severity Index Version 4 Performed by Trained Triage Nurse (중증도 분류 간호사에 의한 응급환자 중증도 분류 신뢰도 측정 연구: Emergency Severity Index Version 4를 중심으로)

  • Choi, Hee Kang;Choi, Min Jin;Kim, Ju Won;Lee, Ji Yeon;Shin, Sun Hwa;Lee, Hyun Jung
    • Journal of Korean Critical Care Nursing
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    • v.5 no.2
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    • pp.61-71
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    • 2012
  • Purpose: The aim of this study was to measure the inter-rater reliability of Emergency severity index (ESI) version 4 among triage nurse. Methods: This study was carried out from August 11, 2010 to September 7, 2010 in a regional emergency department. Data collection was done by ten triage nurses who trained ESI v.4. Two research nurses and ten triage nurses scored the ESI version 4 to the patients as references, independently. We calculated the weighted kappa between the triage nurses and research nurses to evaluate the consistency of the ESI v.4. Results: A total of 233 patients were enrolled in this study. Classification of ESI level was as follows - level 1 (0.4%), level 2 (21.0%), level 3 (67.8%), level 4 (9.4%), and level 5 (1.3%). Inter-rater reliability by weighted kappa was 0.79 (95% Confidence Interval= 0.74-0.83) and agreement rate was 87.1%. Under-triage rate by triage nurse was 6.0% and over-triage rate was 6.9%. Conclusion: For this study, inter-rater reliability was measured good level between triage nurses and research nurses in Korean single ED.

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Comparison of the Factors Affecting Smoking Quit Attempts in Adolescent Smokers according to Amount of Smoking (흡연 정도에 따른 청소년의 금연시도 영향요인 비교)

  • Yim, So-Youn;Park, Min Hee
    • The Journal of the Korea Contents Association
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    • v.17 no.7
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    • pp.622-633
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    • 2017
  • The study was conducted to compare the factors affecting smoking quit attempts according to the amounts of smoking in adolescent smoker. The data were derived from the 12th Korea youth risk behavior web-based survey 2016 in Korea and analyzed using the IBM SPSS statistics version 21.0 software package considering complex samples analysis. The subjects were 4,012 adolescents smokers, Of these, 78.4% of the general smoker who smoke less than 10 cigarettes a day and 21.6% of the heavy smoker who smoke more than 10 cigarettes a day. As a logistic regression, vigorous physical activity, depression, smoking initiation time, friends smoking, smoking cessation education, and non-smoking promotion were associated with significantly smoking quit attempts in general smoker, vigorous physical activity, friends smoking, smoking cessation education, and non-smoking promotion were associated with significantly smoking quit attempts in heavy smoker. Based on the results, they were taken a baseline data for developing adapted smoking quit education program which were succeed effectively in adolescent smokers.

A study on the variation of severity adjusted LOS on Injry inpatient in Korea (손상입원환자의 중증도 보정 재원일수의 변이에 관한 연구)

  • Kim, Sung-Soo;Kim, Won-Joong;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.6
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    • pp.2668-2676
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    • 2011
  • In order to analyze the variation in length of stay(LOS) of injury inpatients, we developed severity-adjusted LOS model using Korean National Discharge In-depth Injury Survey data of Center for Disease Control. Appling this model, we calculated predicted values and, after standardizing LOS using the differences from the actual values, analyzed the variation in LOS. Major factors affecting severity-adjusted LOS of injury inpatients were found to be severity, surgery(or no surgery), age, injury mechanism and channel of hospitalization. Result of analysis of the differences between the actual values and predicted values adjusted by decision tree model suggested that there were statistically significant differences by hospital size(number of beds), type of insurance and location of institution. In order to reduce the variation in LOS, efforts should be exerted in developing nationwide treatment protocol, inducing medical institutions to utilize it, and furthermore systematically evaluating it to reduce the variation continually.

Analysis of the Operation Efficiency and Influence Factors of Local Welfare Facilities for the Disabled -Focusing on Housing Facilities of the Severely Disabled in Jeolla Region- (지역 장애인복지시설의 운영효율성 및 영향요인 분석 -전라지역 중증장애인 거주시설을 중심으로-)

  • Lee, Hyeong-Bae
    • Journal of Digital Convergence
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    • v.12 no.12
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    • pp.611-620
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    • 2014
  • This research analyzed the operation efficiency and influence factors of housing facilities for the severely disabled in Jeolla region by using the DEA model. First, the analysis of efficiency for 2012 was carried out using the CCR model. As a result, 12 DMUs were proved to be efficient, and the average efficiency of CCR was 0.85, confirming that the efficiency of all DMUs were satisfactory. Second, regression analysis was carried out to analyze the factors affecting the efficiency of the DEA model by using the Tobit model. In this case, the inputs and calculated variables were set as independent variables whereas the efficiency as the dependent variable. As a result, the detailed variables had a low significance; the overall input variables showed a negative influence while the calculated variables tended to be a positive influence. In terms of operation efficiency, there was no meaningful result in input variables besides the number of workers. Instead of expanding the input variables, the following should be made for housing facilities of the severely disabled; more efforts should be put in to improve welfare service delivery system and operating environment and structure, and the program must be supplemented as well.

The Variation of Factors of severity-adjusted length of stay(LOS) in acute stroke patients (급성 뇌졸중 환자의 중증도 보정 재원일수 변이에 관한 연구)

  • Kang, Sung-Hong;Seok, Hyang-Sook;Kim, Won-Joong
    • Journal of Digital Convergence
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    • v.11 no.6
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    • pp.221-233
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    • 2013
  • This study aims to develop the severity-adjusted length of stay(LOS) model for acute stroke patients using data from the hospital discharge survey and propose management of length of stay(LOS) for acute stroke patients and using for Hospital management. The dataset was taken from 23,134 database of the hospital discharge survey from 2004 to 2009. The severity-adjusted LOS model for the acute stroke patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of acute stroke patients were acute stroke type. The difference between severity-adjusted LOS from the decision making tree model and real LOS was compared and it was confirmed that insurance type and bed number of hospital, location of hospital were statistically associated with LOS. And to conclude, hospitals should manage the LOS of acute stroke patients applying it into the medical information system.