• Title/Summary/Keyword: 진료향상

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Oral Health-Related Quality of Life of the Elderly under Visiting Health Care (방문건강관리사업 대상 노인의 구강건강 관련 삶의 질과 관련 요인)

  • Lee, Keun-Yoo;Cho, Young-Sik;Lim, Soon-Ryun
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.325-332
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    • 2015
  • The aim of this study was to investigate the relationship between the oral health status of elderly under visiting health care and their oral health-related quality of life. The subjects were 300 elderly under visiting health care program over 65 years old in Asan city and they were interviewed. The result showed that average Geriatric Oral Health Assessment Index (GOHAI) score was 37.36 and the lowest scored question was 'never satisfied with the oral condition'. In GOHAI related to oral health behaviors, unmet dental treatment experience was statistically significant (p<0.001). In overall GOHAI, number of remaining teeth (p<0.001) and the age had statistical significance and men had higher score in pain and discomfort (p<0.05), under age of 74 limited function factors score was high (p<0.01). The number of remaining teeth had statistical significances in most factors except pain and discomfort (p<0.001). The factors affecting GOHAI were age (p<0.05), number of remaining teeth (p<0.001) and perceived health state (p<0.001). In order to improve oral health-related quality of life of elderly receiving visiting oral health care services, it is necessary to increase denture support by securing budgets and developing oral health promotion programs at the local government level.

Personal Health Record System for Efficient Monitoring of Cancer Therapy (효과적인 암환자 관리를 위한 개인건강기록 관리 시스템)

  • Song, Je-Min;Seo, Sung-Bo;Shin, Moon-Sun;Han, Hye-Sook;Park, Jeong-Seok;Ryu, Keun-Ho
    • Journal of Digital Convergence
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    • v.14 no.12
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    • pp.65-72
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    • 2016
  • Personal Health Record(PHR) service can be helpful to patients with diseases requiring strict everyday care and medical treatment, such as diabetes or cancer. In this paper, we propose a PHR system specialized in collecting and analyzing health record data of cancer patients, and present the process of how the system can improve the efficiency of cancer treatment process. Through the smart device application, cancer PHR system obtains daily PHR data which is highly related and critical to cancer therapy. The analysis report is provided to the medical staff with an available format suited for Electronic Medical Record used at medical institution. With the final result of PHR analysis which is easily merged with medical chart, most efficient Chemotherapy treatment can be provided for the patients. Also it is possible for the patients to give the information of side-effect and other pain experience during therapy to their doctors without loss of information. The proposed PHR system has the effect of improving the quality of patient care by allowing the medical staff to acquire the main objective data necessary for drug prescription and medical care benefits.

Psychogenic Dizziness for Psychiatrists in Korea (정신건강의학과 의사를 위한 심인성 어지럼)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.24 no.1
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    • pp.9-19
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    • 2016
  • Many patients with dizziness present with a symptom pattern that does not reveal the cause by neurotologic diagnostic approaches. In such cases, the physician frequently diagnoses psychogenic dizziness. Psychogenic dizziness is not characterized by true vertigo, and occurs in combination with other psychiatric symptom cluster. One out of two to four patients with dizziness are psychogenic dizziness. But there are few concern about this including clinical practice and study in Korea. I wrote this paper to increase concerning and attending to this for psychiatrists in Korea. I reviewed etiology including biological and psychological relations between dizziness and psychiatric disorder(especially anxiety), diagnostic approaches of, characteristics of dizziness of various psychiatric disorders related to, and the treatment of psychogenic dizziness. I also briefly reviewed the central and peripheral dizziness for psychiatrists. I suggest psychiatrists and clinicians in the psychosomatic field in Korea to acknowledge, concern, and attend to psychogenic dizziness. In turn, it will be helpful to well treat the patients with psychogenic dizziness.

A Study on the Health Information Management Practice Program Model for EMR Certification System Education -Focus on Patient Information Management- (EMR 인증제 교육을 위한 보건의료정보관리 실습 프로그램 모델 연구 -환자정보관리 중심-)

  • Choi, Joon-Young
    • Journal of the Health Care and Life Science
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    • v.9 no.1
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    • pp.1-9
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    • 2021
  • In this study, a model in which certification standards were added to the health information management practice program was studied and presented in order to understand the EMR certification standards implemented by the Korea Health and Medical Information Service. In the practice program, the certification standard function for patient information management was added to the health information management education system to practice and understand patient information management that corresponds to the functional standard of the EMR certification system. The EMR certification standard practice program for patient information management is composed of the following certification standards. registration number and personal information management, treatment reservation schedule management, personal information revision history management, identification of people with the same name, integrated management of multiple registration numbers, patient search by identification information, patient search by health care type, surgical procedure consent record and inquiry, record/inquiry of consent form for personal information use, display of life-sustaining medical decision information, registration/inquiry of external medical institution documents, registration and inquiry of external examination results. In this way, by operating and practicing the functions of the health information system according to the certification standards, it is possible to understand and practice the certification standards and details of patient information management in the functional area of the certification standards. In addition, since the function of the EMR certification standard can be checked, it will be possible to improve the management ability of the electronic medical record system of the health information manager in the medical institution.

An Efficient m-Healthcare Service Model using RFID Technique (RFID 기술을 이용한 효율적인 m-헬스케어 서비스 모델)

  • Jeong, Yoon-Su;Kim, Yong-Tae;Park, Gil-Cheol
    • Journal of Digital Convergence
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    • v.13 no.11
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    • pp.149-156
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    • 2015
  • Due to a change of food culture, many patients suffering from various diseases such as hypertension, heart disease, stroke, cancer. However, it takes a long time in the hospital for many patients due to the administration before the patient care process. In this paper, we propose a m-Healthcare service model that patients can receive medical services without the inconvenience offers by reducing the administrative hospital treatment that can automatically recognize through the hospital installed RFID readers when the patient patients with various diseases are foreign to the hospital. In particular, the proposed model improves the operational efficiency of the existing healthcare system by shortening the treatment time for medical personnel to help patients in emergency situations can determine automatically the patient's status does not give the disease type and condition of the patient to health care personnel. Test results, service latency, efficiency, etc. patient satisfaction, and evaluate the existing health care system model results, the proposed method was improved service delay existing techniques average 16.5% efficiency was higher 27% of patients service satisfaction was improved by 22.4% on average.

Activities to Reduce the number of No-Show Patients with Colonoscopy appointments (대장내시경 검사 부도관리를 위한 개선활동)

  • Kwon, Oh-Ryoun;Lee, Jung-Sun;Na, Eun-Shim;Kim, Hoon
    • Quality Improvement in Health Care
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    • v.15 no.1
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    • pp.89-100
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    • 2009
  • 문제: 소화기병검사실에서 대장내시경 검사의 부도건수가 최근 월 200명 정도로 예약인원의 16%에 달한다. 이는 본원 외래진료 부도율이 평균 10%인 것과 비교할 때 상당히 높은 결과이므로 대장내시경 예약환자를 대상으로 부도율 관리를 위한 활동이 필요하였다. 목적: 외래 및 입원환자의 부도건수 및 부도환자의 특성을 분석하고, 개선활동을 통하여 대장내시경 검사의 부도율을 줄인다. 의료기관: 서울 아산병원. 질 향상 활동: 부도관리를 위한 개선활동으로 SMS 횟수를 2주전, 4일전, 1일전 3회로 변경하고, 내용도 각 시기마다 차별화하였다. 대장내시경 검사 예약을 하고 기다리는 환자를 대상으로 처방일 순, 예약 날짜순서 등 필요한 항목 순으로 볼 수 있는 리스트가 필요하여 예약대기 프로그램을 개발하였고, 처방일로부터 2주 이내 자동예약을 금지하였다.(7월 10일부터 시작) 예약대기명단에 있는 환자를 대상으로 전화로 예약 변경을 하여 2주 이내에는 예약의 빈자리가 없도록 하였다. 미리 부도를 예측하여 추가로 예약하던 방법에서 정원조정을 하여 정원 외 추가 예약을 하지 않았다. 입원환자 일정관리를 위하여 일정관리 프로그램을 개발하여 타과의뢰 회신을 하는 전임의가 직접 날짜를 전산에 입력하여 회신과 동시에 검사실, 담당주치의, 담당 간호사가 모두 일정을 확인할 수 있도록 하였으나 프로그램이 늦어져 9월 12일부터 시행하였다. 개선효과: 부도건수가 개선 전 8주 동안 385건(예약인원 대비 16%) 에서 개선 후 6주의 평가기간 동안 256건(예약인원대비 14.1%)으로 129건이 감소하였으며, 검사 1-2일전 일정 변경 연락 환자 감소 및 검사 비용 수납 환자의 부도건수가 감소하였다. 대장내시경 검사 예약대기 프로그램 운영 및 예약 변경 전화 활동으로 2달씩 기다리던 환자의 예약일을 약 한 달 정도 단축하여 줄 수 있었다. 검사 정원 관리의 결과로 검사 예약 시 예약기준이 명확해지고, 부적절한 예약으로 인한 검사지연 등이 확실히 줄었다. 또한 입원환자 일정관리 프로그램 적용으로 입원환자의 검사일정과 관련된 전화업무는 확실히 줄어들 것으로 예상된다.

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The Effects of Self-Efficacy Promoting Pulmonary Rehabilitation Program in Out-Patients with Chronic Obstructive Pulmonary Disease (만성폐쇄성폐질환 외래환자에서 자기효능감증진 호흡재활프로그램의 효과)

  • Jung, Jang Hee;Kim, Jung Youp
    • Tuberculosis and Respiratory Diseases
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    • v.61 no.6
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    • pp.533-546
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    • 2006
  • Background: The aim of this study was to determine the effectiveness of self-efficacy promoting pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). Methods: thirty six patients, with clinically stable COPD were randomly assigned: 18 to a rehabilitation group and another 18 as a control group, The subjects participated in a the self-efficacy promoting pulmonary rehabilitation program for 8 weeks. This program consisted of education, breathing retraining, exercise training, relaxation and counseling. The control group received education only. The outcome variables were self-efficacy, dyspnea, exercise endurance, pulmonary function, and quality of life. Dyspnea was measured using the modified Borg scale. Exercise endurance was measured by the six minute walking distance. The quality of life was measured by the quality of life index for pulmonary disease patients. Results: In the rehabilitation group after performing the self-efficacy promoting pulmonary rehabilitation program, the self-efficacy score, exercise endurance, and quality of life score were higher than the control group (p=0.007, p=0.038, and p=0.039, respectively). and the exertional dyspnea score was significantly lower than controls(p=0.045). However, the dyspnea score and FEV1 were similar after performing the self-efficacy promoting pulmonary rehabilitation program. Conclusion: The self-efficacy promoting pulmonary rehabilitation program is effective to in improve self-efficacy, exertional dyspnea, exercise endurance and quality of life in patients with COPD.

Measuring Effects of Quality Improvement through the Development of Critical Pathway for Gamma Knife Radiosurgery (당일 감마나이프수술 환자의 표준진료지침 개발을 통한 질 향상 효과 측정)

  • Kim, Moo Seong;Ha, So Young;Bae, Yoon Hyuk;Jung, Yong Tae;Kim, Sung Tae;Lee, Won Hee;Go, Yeon Joo
    • Quality Improvement in Health Care
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    • v.18 no.1
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    • pp.27-36
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    • 2012
  • Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.

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A Study on Patient Satisfaction with Dental Medical Services in Some Areas (일부지역 치과의료서비스에 대한 환자 만족도 조사)

  • Song, Kwui-Sook;Kang, Eun-Ju;Lee, Heung-Soo
    • Journal of dental hygiene science
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    • v.5 no.4
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    • pp.191-198
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    • 2005
  • The present study was attempted to examine the patient satisfaction factors for dental services of several dental clinics to enhance their satisfaction and to provide information that will help dental clinics to have competitive edge over others. This study was conducted an on-site survey to the outpatients of a dentist at Jeollabuk-do, from March 23 to April 10, 2003. The results were as follows: 1. In the event of dental hygienists, their satisfaction with dental hygienists was statistically significantly different according to their occupation. The company employees(4.30) and self-employed people(4.36) were more satisfied with dental hygienists, and the government workers(3.86) were pleased with them the least. 2. Their satisfaction level with internal environments was statistically significantly different according to their age, educational background and occupation. Those who were in their 50s and up(4.23), who received middle-school or lower education(4.11), who were retired or unemployed (4.31), and who were self-employed(4.11) were most pleased with internal environments. 3. Their satisfaction level of external environments varied statistically significantly with their occupation. Those who were retired or jobless (3.57) expressed the most satisfaction, and the government workers(2.83) were pleased the least. 4. Their satisfaction level with treatment process differed statistically significantly with their occupation. Those who were self-employed(3.97) and who were retired or unemployed(3.89) were more pleased, and the public officials(3.34) and professionals(3.54) were satisfied the least. 5. As to satisfaction level with medical bills, those who were in their 50s and up(3.95), who received high-school education(3.80), who were self-employed(3.98), and whose monthly mean income was three million won or more(3.99) expressed the biggest satisfaction. 6. What factors affected their overall satisfaction level with treatment after receiving it was investigated, and it's found that their overall satisfaction level was under the statistically significant influence of dentists, dental hygienists, treatment process and medical bills.

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The Role of Inhaled Corticosteroid in the Management of Chronic Cough (만성 기침에서 스테로이드 흡입제의 역할)

  • Lee, Kyung-Hun;Jang, Seung Hun;Lee, Jung-Hwa;Eom, Kwang-Seok;Bahn, Joon-Woo;Kim, Dong-Gyu;Shin, Tae Rim;Park, Sang Myon;Lee, Myung-Gu;Kim, Chul-Hong;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.2
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    • pp.221-227
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    • 2006
  • Background : Cough may be a consequence of bronchial hyperresponsiveness or inflammation. Empirical treatment is important in this context because it difficult to verify the obvious cause of cough using laboratory tests, Corticosteroid has a nonspecific anti-inflammatory effect, and can be used for cough management. However, its response rate has not yet been fully elucidated. This study investigated the short- term effects of inhaled corticosteroid on chronic cough Methods : Patients with chronic cough with a normal chest radiograph and a pulmonary function test were enrolled. Cases with a prior respiratory infection within 8 weeks, a history of bronchial asthma, objective wheezing on examination, subjective symptoms of gastroesophageal reflux or taking an ACE inhibitor were excluded. On the first visit, a methacholine bronchial provocation test, spontaneous sputum eosinophil count performed twice and a paranasal sinus radiograph were checked, and the patients were treated with budesonide turbuhaler $800{\mu}g/day$ for ten days. The primary outcome measure was a decrease in the cough score after treatment. Results : Sixty nine chronic coughers were finally analyzed. The final diagnoses by the routine tests were as follows: bronchial asthma 13.0%, eosinophilic bronchitis 18.8%, paranasal sinusitis 23.2% and non-diagnostic cases 53.6%. The following responses to the inhaled corticosteroid were observed: definite responders, 76.8%, possible responders, 2.9% and non-responders, 20.3%. The response rate was not affected by the final diagnosis even in the non-diagnostic cases. There were minimal adverse drug related effects during the empirical treatment. Conclusion : Routine objective tests such as methacholine provocation, sputum eosinophil count and simple radiographs were notare not suitable for diagnosing chronic cough Therefore, empirical treatment is important. Short term inhaled corticosteroid is effective and can guide a further treatment plan for chronic cough.