• Title/Summary/Keyword: 진료 지침

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A study of Simulations on the Changes of Physician's Practice Patterns in University Hospitals after the Introduction of DRG in Obstetrics and Gynecology (산부인과 포괄수가제 도입에 따른 일개 대학병원의 진료행태 변화 모의실험 연구)

  • Shin, Sam-Chul;Kim, Jong-Soo
    • Journal of Digital Convergence
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    • v.11 no.6
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    • pp.289-298
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    • 2013
  • The objective of this study was to predict the changes in the duration of hospital stay, hospital admission fee, costs of drugs, changes in laboratory cost, material cost, total medical cost, adjusted amount of treatment and the efficacy of obstetrics and gynecology DRG system. The cost of drugs showed the greatest change and was followed by materials for medical examinations and the change in methods of medical examinations. In the analysis of the quantity of medical service the profit of medical examinations were influenced mostly by the duration of hospital stay. The results and data in this study could be used as a basis of future DRG system protocols and will be utilized so that hospitals can build a efficient medical system.

A Survey on Treatment of Breast Cancer Patients with Korean Medicine: Preliminary Research for Clinical Practice Guidelines (한의표준임상진료지침 개발을 위한 유방암 보완치료 실태조사)

  • Kim, Nam-Hoon;Kang, Na-Hoon;Yoo, Eun-Sil;Park, Nam-Chun;Lee, Jin-Wook;Park, Kyoung-Sun;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock;Jang, Bo-Hyoung;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.165-178
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    • 2018
  • Objectives: To determine the current status of the treatment of breast cancer patients by Korean Medicine doctors (KMDs) and to examine the need for clinical practice guidelines (CPGs) for the supportive care of these patients. Methods: This cross-sectional study used a self-administered questionnaire. Participants were asked about their experience in treating breast cancer patients; the number of breast cancer patients they currently treat; the main complaints expressed by, diagnoses of, and treatments used for such patients; and their opinions about Korean Medicine (KM) as the basis for providing supportive care for breast cancer. Results: The data for this study were collected from 322 respondents. 84 of whom reported having ever treated patients with breast cancer. Most breast cancer patients who visited the KM clinic were classified as stage I or II, and their major complaints were fatigue, general weakness and musculoskeletal pain. The major diagnostic strategies were syndrome differentiation and pulse diagnosis. The major treatments administered were herbal medicine, acupuncture, and moxibustion. KMDs cited a need for medical information, such as CPGs, as their most important concern with regard to the treatment of breast cancer patients. Conclusions: This survey determined the prevalence of the use of KM for Korean breast cancer patients. Our results underscore the need for clinical practice guidelines for using of KM as the basis of supportive care for breast cancer and for informing clinicians and patients about this approach.

A study on the facial palsy patients' use of Western-Korean collaborative treatment: Using Health Insurance Review & Assessment Service-National Patients Sample (얼굴마비 환자의 의·한의 협진 의료이용 연구: 건강보험심사평가원 환자표본 데이터를 이용)

  • Park, Hyo Sung;Uhm, Tae Woong;Kim, Nam Kwen
    • Journal of the Korean Data and Information Science Society
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    • v.28 no.1
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    • pp.75-86
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    • 2017
  • The facial palsy is one of the most common illness in Western-Korean collaborative treatment (hereinafter "collaborative treatment"). The purpose of this study is to analyze facial palsy patients'collaborative treatment use patterns. By analysing the 2014 National Health Insurance Review and Assessment Patient Sample Data (NPS 2014) with the episode of care unit, we have found the following results. First, the collaborative treatment is preferred by patients over 50 years old and female. Second, western medicine mainly focuses on diagnosis and medical examination while korean medicine and collaborative treatment focus more on treatment activity. Third, western medicine showed the shortest treatment period, followed by korean medicine and collaborative treatment. However, the cost of medical treatment per day is highest in western medicine. The analysis of the use patterns of collaborative treatment shown in the study is expected to provide a direction for the development of clinical practice guidelines and the establishment of medical policies in the future.

Convergence effectiveness verification for developing practice guidelines for dementia patients cognitive programs (치매환자 인지프로그램 실무지침 개발을 위한 융합적 효과검증)

  • Ham, Min-Joo
    • Journal of the Korea Convergence Society
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    • v.12 no.5
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    • pp.85-91
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    • 2021
  • This study is a methodological study that explains the procedure for verifying effectiveness in developing practical guidelines for cognitive programs suitable for dementia patients. Based on the development of evidence-based new clinical practice guidelines, a preliminary recommendation for the domestic dementia patient care guidelines was developed. The practical guidelines consisted of the final four types, and the content validity score of the configuration items was 0.87 to 1 point. In the sub-categories of field applicability, appropriateness score was 3.95 to 4.34 points, applicability score was 3.57 to 4.27 points, and predicted effect score was 3.84 to 4.22 points. Through the examination of the content validity and field applicability of experts, it was confirmed that the practical guidelines developed in this study can be used as the basis for establishing an intervention plan for dementia cognitive program managers engaged in clinical practice. In future studies should further facilitate the development of evidence-based treatment guidelines to select appropriate treatment activities for dementia patients.

A Study on the Guidelines for Preventing Needlestick Injuries in Dental Offices (치과진료실에서 주사바늘 찔림 사고 예방을 위한 가이드라인 연구)

  • Jeon, Jeong-Mi;Lim, Soon-Ryun;Cho, Young-Sik
    • Journal of dental hygiene science
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    • v.15 no.3
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    • pp.247-253
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    • 2015
  • The purpose of this study is to investigate guidelines and safety and precautionary devices for prevention of needlestick injuries in dental offices. This study conducted comparative analysis on the domestic and overseas guidelines for infection control and surveyed safety and precautionary devices for prevention of needlestick injuries. Based on the result of analysis and survey, this study suggests safety and precautionary guidelines to prevent needlestick injuries. To prevent needlestick injuries, staff in dental offices should be well aware of the guidelines for infection control and how to use safety and precautionary devices.

Difference in Results according to Scorer and Test Date in Clinical Practice Test (진료수행 시험에서 채점자 및 시험 일자에 따른 결과 차이)

  • Kwon, So-Hee;Kim, Young-Jon
    • The Journal of the Korea Contents Association
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    • v.18 no.8
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    • pp.345-352
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    • 2018
  • The purpose of this study is to clarify the difference between the scoring results by scorer(doctors and standardization patients) and examination dates. A total of 101 students in the fourth grade of medical school participated in four clinical practice test. Students were randomly assigned to either day-1 or day-2, which was consisted of a standardized patient scoring set or a physician scoring set. Station checklists consisted of history taking, physical examination, patient education, physician-patient relationship and clinical courtesy. The achievement scores of each case and each domain were converted to the standard score, and the differences between groups were compared. Female students' achievement scores were significantly higher than male students' achievement scores in all domains. There was no significant difference between means by the standardized patients' group and doctors group. Day-2 group was significantly higher than day-1 group in both of history taking and physical examination domains. If the principles of checklist are clearly defined, the scorer status (either physician or standardized patients) does not determine the difference of students' practice test scores.

development of Decision Support System for the Management of hypertension using Datamining Technology (데이터마이닝 기법을 활용한 고혈압 관리를 위한 의사결정지원시스템의 개발)

  • 호승희;채영문;조승연;최동훈;송용욱;박충식;조경원;송지원
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2000.04a
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    • pp.271-282
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    • 2000
  • 본 연구의 목적은 데이터마이닝 기법을 임상적으로 중요한 위치를 차지하고 있는 고혈압 환자의 특성과 치료에 따른 예후를 예측할 수 있는 지식을 발굴하고 이의 임상적용의 타당성을 검증하여 의사결정지원시스템을 개발하고 이의 유용성을 평가하는데 있다. 이에 연세대학교 의과대학 부속 세브란스 병원의 환자를 대상으로 로지스틱 회귀분석을 이용하여 혈압조절상의 위험요인의 규명하고, 의사결정나무분석을 통해 치료약제별 혈압조절군과 비조절군의 특성을 도출하고 각 대상군을 결정짓는 규칙을 생성하였으며, 이를 활용한 의사결정지원시스템의 개발 및c 평가를 시행하였다. 그 결과 기존 임상이론만을 활용한 시스템의 처방에 의한 혈압조절군보다 데이터마이닝 기법을 활용한 시스템의 처방에 의한 혈압조절군의 비율이 전체적으로 더 높게 나타남을 알 수 있었다. 본 연구의 결과는 우리나라 현실에 부합되는 고혈압 진료지침을 개발하고 적용, 평가하는데 기여할 수 있을 것으로 판단되며, 이와 같은 의사결정지원 시스템을 운영을 통해 실제 임상 진료에 적용해 봄으로써 그 효과와 실증적 가치를 창출할 수 있을 것이다.

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Effects of a Standardized Critical Pathway for Laparoscopic Gastrectomy Patients in a General Hospital (일개 종합병원 복강경 위절제술 환자의 표준진료지침 적용효과)

  • Park, Hyo-Jin;Park, Jong;Ryu, So-Yeon;Choi, Seong-Woo
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.649-657
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    • 2016
  • This study is aim to investigate how applying a critical pathway(CP) to stomach cancer patients affects their recovery and treatment. The subjects were 165 patients over the age of 20 who were diagnosed with stomach cancer at the gastrointestinal clinic of C hospital and who underwent laparoscopic subtotal gastrectomy. The case group inclueded 102 patients who underwent laparoscopic subtotal gastrectomy with applying the CP from October 2008 to September 2009. The control group included 63 patients who underwent laparoscopic subtotal gastrectomy without applying the CP from September 2007 to September 2008. Pain at the time of discharge was significantly lower in the CP applicated group than in the non-applicated group (Odds ratio [OR], 0.07; 95% Confidence interval [CI], 0.03-0.21). The CP applied group was significantly lower than non-applied group in total hospitalization days (CP applied group: 8.95[1.33], non-applied group: 10.69[4.04], p<0.001) and in postoperative hospitalization days (CP applied group: 7.16[0.94], non-applied group: 8.79[3.90], p<0.001). In conclusion, application of a critical pathway to laparoscopic subtotal gastrectomy reduced pain at the time of discharge, total hospitalization days and postoperative hospitalization days.

A Case Series of Polycystic Ovary Syndrome with Improved Hyperandrogenism Treated with Korean Medicine (한방 치료로 고안드로겐혈증을 개선한 다낭성 난소 증후군 연속증례연구)

  • Shin, Haegue;Bae, Ji-Yong;Ji, Young-Geun;Ahn, Hae In;Yoon, Youngheum;Kim, Namkwen
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.3
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    • pp.175-191
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    • 2021
  • Objectives: This study aims to analyze the medical record of eight cases of polycystic ovary syndrome (PCOS) in a local Korean medicine clinic, in order to provide evidence on Korean medicine treatment of PCOS and to suggest the direction of future studies. Methods: The medical records of eight cases diagnosed with PCOS based on 2003 Rotterdam Criteria and whose total testosterone level was 0.53 ng/ml and over were retrospectively analyzed. The primary outcome was total testosterone level, and the secondary outcomes included luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels, LH/FSH ratio, weight, last mentrual period (LMP), numerical rating scale (NRS) score of dysmenorrhea, and other associated symptoms pre- and post-treatment. Korean medicine treatment consists of the complex herbal prescription consisting of Yukmijihwang-tang, Baekho-tang, Daesiho-tang, and Gyejibokryeong-hwan, modified according to symptoms; acupuncture and electroacupuncture on 中脘 (CV12), 下脘 (CV10), 關元 (CV4), 石門 (CV5), 合谷 (LI4), 太衝 (LR3), 三陰交 (SP6), and 懸鍾 (GB39); and indirect moxibustion on 神闕 (CV8). Results: The average total testosterone level lowered statistically significantly after the treatment. The average FSH and LH levels lowered with insignificance, while the average LH/FSH ratio and weight lowered statistically significantly. During the treatment period of three to six months, every patient had the menstrual cycle shortened except for one case; and two cases with infertility problem succeeded in being pregnant. There was no adverse event. Conclusions: The Korean medicine treatment was found effective in treating PCOS, especially regarding hyperandrogenism, amenorrhea or oligomenorrhea, and infertility.

Development of Clinical Practice Guideline for Hwabyung (2) - Tools for Development - (화병 임상진료지침 개발 연구 (2) - 지침 개발에 활용되는 도구 -)

  • Chung, Sun-Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.153-162
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    • 2009
  • Objectives : The approach to Hwabyung from all angles is needed to develop the clinical practice guideline. To achieve this approach, various tools should be used practically and systematically. Methods : We gather the tools based on multi aspects of Hwabyung's characteristics. The tools will be used to each steps of clinical practice guideline development. Results : For the clinical practice guideline, there should be applied many kinds of tools, such as for decision and assesment, survey with oriental medicine property, collecting individual stress information, mental and psychological trait, and related or following disease. Conclusions : Application of many objective tools provides the evidence-based medical approaches for development of clinical practice guideline for Hwabyung.

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