• Title/Summary/Keyword: 진료향상

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The Analysis of Patients in Oral Medicine and the Evaluation of Oral Medicine as a Special Field (내원경로 분석을 통한 전문과목으로서의 구강내과의 역할)

  • Chung, Tae-Yong;Ryu, Ji-Won;Kang, Jin-Kyu;Ahn, Hyung-Joon;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.30 no.4
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    • pp.391-400
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    • 2005
  • Special Practitioner exists based on the need for special fields that are required to manage difficult patients with specialized skills distinguished from General practitioner. The purpose of dental specialist system is to manage patients who are not treatable by general practitioner by training doctors specializing in one specific field, thereby, enhancing health of the public. Oral Medicine deals with orofacial pain, oral soft tissue disease, forensic dentistry, oral diagnosis. In these days, living environments of city life bring about increase in stress which ultimately lead to increase in prevalence of temporomandibular disorder, oral soft tissue disease, neuropathies such as trigeminal neuralgia, and hence, the number of patients seeking help of those symptoms tend to increase. The purpose of this study was to analyze the rate of referrals and the routes of patients seeking help by investigating 3,707 patients who visited Department of Oral Medicine, College of Dentistry, Yonsei University, from August, 2004 to April, 2005. The results were as follows: 1. The types of disease referred to the Department of Oral Medicine were orofacial pain, oral soft tissue disease, forensic dentistry, oral diagnosis. 2. The rate of referrals was 58.51% which implies that more than half of the patients visiting the Department of Oral Medicine were referred. 3. The types of institution which made referrals were analyzed, and as a result, dental clinics made most of the referrals with the rate of 83.23%, while that from medical or oriental medical institutions was 16.78%. 4. Among the patients who visited the Department of Oral Medicine on their own, 30.52% gained the information about the Department of Oral Medicine from internet and mass media, and from neighbors. From the above results, most of the patients visiting the Department of Oral Medicine were found to be referred not only from the field of dentistry but also from the field of medicine. These suggest that Oral Medicine manages patients who are not treatable by general dental practitioners, and medical specialists tend to cooperate with the Department of Oral Medicine to manage diseases associated with Oral Medicine. Therefore, the role of Oral Medicine can be considered to be important as a special field, and the results of this study should be considered when working out a policy of Dental specialist system on demand and supply of residents in the future.

A Survey on Utilization of Health Center and Health Service Demand of Residents in a Urban and Rural Unified Community (일개 도시·농촌 통합지역 주민의 보건기관 이용경험과 보건서비스 요구도 조사)

  • Lim, Bu-Doll;Lee, Ju-Young
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.99-112
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    • 2000
  • This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.

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A Study on Public Health Doctors' Participation in District Public Health Program of Health Sub-centers in Korea (보건지소 공중보건의사의 지역보건사업 참여 실태)

  • Lee, Jae-Chun;Park, Yong-Moon;Ahn, Song-Vogue;Lee, Hae-Young;Hwang, Jin-Won
    • Journal of agricultural medicine and community health
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    • v.28 no.1
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    • pp.53-66
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    • 2003
  • Objectives: To investigate the state of medical care around health sub-centers, public health doctors' participation and opinion in the process of district public health programs. Methods: The study included 1,036 public health doctors who worked at health sub-center all over the country. The data were collected for Feb, 2002 using self-administered questionnaire by mail. Results: One or two doctors were working at health sub-center and 33.5% of health sub-centers was located in the region of the separation of prescription and dispensing. There were another medical facilities in 45.9% of the administrative district(eup or myon) where health sub-centers were located. The count of medical utilization went down to 14.8${\pm}$14.8 per a day in Nov, 2001 from 18.0${\pm}$15.6 in May, 2000, and the decline was much more in the region of the separation of prescription and dispensing. Among public health programs in health sub-centers, public health doctors participated mostly in preliminary medical examination for vaccination and least in health education. They participated in implementation rather than planning or evaluation of health program. Over a half of public health doctors were found to be positive that health programs implemented in their health sub-centers would promote the level of health in community people and they were willing to participate in district public health program if community people were in need. Conclusions: Recently health sub-centers are required to turn into health promotion facilities rather than medical practice facilities. Health program in health sub-centers will be advanced in both quality and quantity by turning the role of public health doctors who have provided medical services mainly into managing health program. Persistent education about managing health program and the policy to motivate participation in health program should be provided for public health doctors.

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An IT/Medical Converged Solution based on the Expert System for Enhancing U-Healthcare Services in Middle-sized Medical Environment (중소형 의료 환경에서 U-헬스케어 서비스 향상을 위한 전문가 시스템 기반 IT/의료 융합 솔루션)

  • Ryu, Dong-Woo;Kang, Kyung-Jin;Cho, Min-Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.4
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    • pp.1318-1324
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    • 2010
  • Recently, U-Healthcare is receiving attentions as a research for reducing the manpower, time in treatment, and etc. Although fundamental technologies, such as sensing, measuring, and etc. are sufficiently investigated. However, Technologies of IT/Medical convergence, which graft IT technologies to medical area, are still in germ. For this, we present a novel healthcare system, which can be applied to the middle sized medical environment, such as private hospital, home, or etc., by means of pre-verified technologies and the expert system. There exist IT element technologies are sufficiently developed in the fields, such as network, database or etc. due to the remarkable developments in IT technologies, and the healthcare is a mission-critical environment. Therefore, it is important not only to investigate novel approaches but also to utilize verified technologies for the U-Healthcare solution. Presented solution provisions automated medical services based on expert system by utilizing the measured data, such as body fat, blood pressure, blood glucose, and etc., in order to provide convenient treatment environment to doctors and nurses. In addition, since people, who do not have medical knowledge, can self-diagnose themselves, it is expected to cut medical costs in various areas. Especially, since each devices communicate with each other through standardized Bluetooth technology, Presented healthcare system is an extensible solution which can easily accept various medical devices. As a result of this, we can safely say that the self measurement and diagnosis services in U-Healthcare are now enhanced by reducing medical cost through our healthcare system.

An Audit Model for Information Security of Hospital Information System (병원정보시스템에서의 정보보호를 위한 감리모형)

  • Yu, Wan Hee;Han, Ki Joon;Kim, Dong Soo;Kim, Hee Wan
    • Journal of Digital Convergence
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    • v.12 no.7
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    • pp.133-145
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    • 2014
  • Recently, Hospital information systems have the large databases by wide range offices for hospital management, health care to improve the quality of care. However, hospital information systems for information security measures are insufficient. Therefore, when we construct the hospital information system, we have to audit the information security measures for them, and we have to manage the ISMS(Information Security Management System) to maintain the information protection level through the risk managements. In this paper, we suggested the hospital information security audit model for the protection of health information privacy by the current hospital information systems, information security management system(ISMS), and hospital information security requirements and threats. We derived the check items compared with ISO27799 reflected the characteristics of the hospital. We classified the security domains as the physical, technical, administrative domain, and derived the check items for information security. We also designed the check lists by mapping the ISO27799 risk management process to improve the security and efficiency simultaneously. Our model by the five-point scale survey of IT experts was verified the suitability with the average of 4.91 points.

Effect of practice guideline reminder and flow-sheet for improvement of quality in management of hypercholesterolemia (고콜레스테롤혈증 환자 진료의 질 향상을 위한 임상 지침 리마인더(Reminder)와 추적 관리지의 효과)

  • Cho, Han Kyu;Park, Hye Soon;Cho, Hong-Jun
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.230-240
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    • 1997
  • Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.

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Increasing Work Efficiency with Prevention of Reinspection for Bone Mineral Density (BMD) Exams (골밀도 검사의 재검사 방지에 따른 업무효율 향상)

  • Kim, Ho-Sung;Dong, Kyung-Rae
    • The Journal of the Korea Contents Association
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    • v.9 no.5
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    • pp.174-181
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    • 2009
  • Recently hospitals are implementing a One Stop Service as part of patient-care service. With the One Stop Service, medical treatment including consultation, inspection, and results are changing to be made available in one visit. Therefore most examinations are reserved for the same day; however, there are cases in which additional visits are necessary because of certain properties related to exams. This study compares and analyzes the number of reinspections before and after reforms. By designating the order of priority for BMD examinations and implementing education from information obtained in the OCS E-manual update, the number of reinspections for wards was reduced from 58 to 21, Outpatient departments were reduced from 51 to 12, and errors in reservations made by employees in the department of radiology were reduced from 98 to 11. Reinspections can be reduced with full understanding the factors related to reinspection and a background check prior to inspection in order to determine the order of priority for inspections. This will also reduce workers' stress and increase their efficiency and at the same time decease patient dissatisfaction and improve hospital reliability.

A Baseline Study on Quality Improvement Strategy for Appropriate Management of Medical Supplies and Goods at General Hospitals in Korea (우리 나라 종합병원 진료재료 구매와 재고관리 질 향상 방안에 관한 연구)

  • Lee, Yeon-Hee;Yoon, Seok-Jun
    • Quality Improvement in Health Care
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    • v.9 no.1
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    • pp.6-17
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    • 2002
  • Background : This study was conducted to investigate the current situation of medical supply purchasing and stock management at general hospitals having more than 150 beds in Korea and to find methods of effective purchasing and optimal stock management. Methods : Survey was done from staff at the purchasing departments of 229 general hospitals throughout Korea. Data collection was done using a structured questionnaire between January 3 to March 15, 2001. The survey form was returned from 88 hospitals (rate of return: 38.4%). Results : Firstly, 13.6% of the hospitals did not carry the optimal stock of medical supplies, the lead time optimal stock was 3 weeks or longer in 64.4% of the hospitals. Secondly, since 69.8% of the hospitals showed passive attitude toward training on purchasing management and stock management techniques. Thirdly, as for the question on the presence or absence of a deliberation committee for purchasing of new medical supplies, 60% of the hospitals with less than 300 beds did not have one, and 9.4% of the hospitals opened the deliberation committee less than twice a year. Conclusion : At the time of purchasing new medical supplies, purchasing should be done according to the decision by the deliberation committee so that no deduction is made at the time of claiming insurance, and by setting a certain period of time, purchasing of those medical supplies that were not purchased during this period needs to be done according to the decision by the deliberation committee.

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Patinets' Perception and Satisfaction with Nursing Care in Korea (일 종합병원의 간호행위에 대한 입원환자의 지각도와 만족도의 관계연구)

  • Eom, Ae-Yong
    • Korean Journal of Adult Nursing
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    • v.13 no.4
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    • pp.581-590
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    • 2001
  • 목적: 의료수준의 발전과 더불어 대중들의 건강요구와 건강증진에 대한 기대 수준도 점점 높아지므로 간호사는 대상자의 요구를 이해하고 양질의 간호를 제공하여 환자의 건강상태를 바람직한 방향으로 변화시켜야 한다. 따라서 이 연구는 환자가 인지한 간호에 대한 경험과 대상자가 경험한 간호에 대한 만족도를 파악하고, 그 관계를 규명함으로써 환자 간호의 질향상과 간호 만족도 향상을 위한 기초 자료를 제공하고자 한다. 연구방법: 본 연구는 일 종합병원의 127명의 입원 환자가 간호 경험정도와 제공받은 간호에 대한 환자 만족도 정도를 규명하기 위한 서술적 상관관계 연구이다. 연구결과: 첫째, 입원환자의 간호 행위에 대한 간호 지각도의 정도는 각 항목별 비교 분석한 결과 신체적 간호행위에 대한 지각도가 평균평점은 2.74로 가장 높았으며, 또한 환자가 지각한 간호행위에 대한 만족도는 기술-전문적 간호행위(M= 3.55)의 만족도가 가장 높았다. 둘째, 일반적 제특성과 전체 간호행위의 지각도와 차이가 있는지 분석한 결과 연령(p< 0.1)에 따라 유의한 차가 있는 것으로 나타났다. 즉 연령이 높을수록 간호행위에 대한 지각도가 높게 나타났다. 그리고, 간호행위에 대 한 지각도의 하부영역 분류중 신체적간호행위에 대한 지각도는 입원과(p< 0.05)에 따라 유의한 차가 있는 것으로 보였다. 또한 일반적 제특성과 전체 간호행위의 만족도와의 관계에서는 입원과(p< 0.05)에 따라 유의한 차가 있었다. 일반외과 환자가 내과 환자보다 만족도가 높은 것으로 나타났다. 셋째, 입원환자의 간호 행위에 대한 환자의 지각도와 만족도간의 관계(r= 0.39, p= 0.00)는 서로 상관성이 있는 것으로 나타났다. 결론: 본 연구의 대상은 1개 종합병원에 국한된 것이므로 연구결과를 일반화 할 때는 신중을 기해야 한다. 연구결과에서 보여주듯이 정신적 간호행위가 가장낮은 지각도로 나타났듯이 간호사는 환자들의 정신적 지지의 간호가 잘 이루어 지도록 노력해야 할 것이며, 또한 교육적 간호행위의 만족도가 가장 낮게 나타났으므로 보다 더 환자와 간호사간의 정보교환이 잘 이루어지도록 해야 한다. 연구결과를 기초로 하여 전 진료과 병동으로 확대 반복 연구를 제언하며, 환자의 간호 만족도를 향상시키기 위해 전문적 지식 및 긍정적 의사표현등을 포괄하여 간호사의 적극적 간호행위가 수행되어야 할 필요가 있다.

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Strategies and Experts in Other Countries for Patient Safety and Quality Improvement (환자안전과 질 향상을 위한 다른 나라의 개선 전략과 전담인력)

  • Kwak, Mi-Jeong;Park, Seong-Hi;Kim, Chul-Gyu;Park, TaeZoon;Lee, Sang-Il;Lee, Sun-Gyo;Choi, Yun-Kyoung;Hwang, Jeong-Hae
    • Quality Improvement in Health Care
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    • v.26 no.2
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    • pp.104-112
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    • 2020
  • This study was done to investigate the independent organizations established for patient safety, related policies, and the duties of experts in other countries. Australia established an organization called the Commission in 2006, the United Kingdom established the National Patients Safety Agency in 2001, and the United States assigned its work to the Agency for Healthcare Research and Quality in 2005. This was done by law in all three countries. The experts for patient safety were mainly called the "patent safety and quality coordinator", and although there was no qualification system for carrying out patient safety work, all three countries had licenses in the health care field or required more than 4-5 years of practical experience. The main duties were planning on patient safety and quality of healthcare service, data collection and analysis, and education, etc. and for this, competencies such as communication, leadership, and teamwork were required.