• 대한물리의학회지
• /
• 제12권2호
• /
• pp.129-136
• /
• 2017

PURPOSE: The purpose of this study was to compare the gait of elderly patients with and without dementia to investigate the possibility of an ambulation assessment test as a diagnostic tool for dementia. METHODS: A total of 96 subjects were included with 60 participants without dementia (control group) and 36 patients with dementia (dementia group). To compare the walking ability of the two groups, a 4-m walking test (4MWT) and Groningen Meander Walking Test (GMWT) were conducted. The GMWT is graded by amount of time in seconds and by number of oversteps outside the track. Mann-Whitney U test was used to compare the gait between the groups and the area under the curve (AUC) with Received Operating Characteristic (ROC) curve was analyzed. Statistical significance was considered at a p<.05, with a 95% confidence interval. RESULTS: There were statistically significant differences (p<.05) between the dementia group and the control group for the 4MWT, GMWTSEC, and GMWTSTEP scores. The AUC was .95 for 4MWT, .92 for GMWTSEC, and .96 for GMWTSTEP with the 95% confidence interval. The cut-off values of the ROC curve were 1.03m/s for 4MWT, 10.8 second for GMWTSEC, and 3.75 steps for GMSTEP. CONCLUSION: In our study, we investigated the utility of ambulatory assessment tools to predict dementia. The results of this study suggest that the 4MWT and the GMWT used in this study are appropriate assessment tools for dementia prediction.

• The Journal of Korean Physical Therapy
• /
• 제20권1호
• /
• pp.49-56
• /
• 2008

Purpose: Lack of a valid prognosis of gross motor development in children with cerebral palsy (CP) and the absence of longitudinal data on which to base an opinion in Korea have made it difficult to plan treatment and counsel prognosis issues accurately. The purposes of this study were to examine whether the Gross Motor Function Classification System (GMFCS) is valuable to prognostication about gross motor progress in children with CP in Korea. Methods: Medical records of 61 patients were retrospectively reviewed that visited outpatient department and were diagnosed as CP. Various information was surveyed including CP type, visual acuity, cognitive function, motor acquisition age, ambulatory status, development curves of Gross Motor Function Measure (GMFM) according to each of the 5 level of GMFCS. All of them were compared with other studies. Also the gross motor development curves and the maximum GMFM score derived from this study were compared with the Palisano's report and the Rosenbaum's report. Results: Based on a total of 494 GMFM assessments provided by this study, the 5 distinct motor development curves and the maximum GMFM score were created. These observations is corresponding with the Palisano's and the Rosenbaum`s Development curves. Conclusion: The 5 distinct motor development curves (GMFCS) that were created by Palisano's and Rosenbaum's study is useful in Korea, providing parents and clinicians with a means to plan interventions and to judge progress over time.

• 보건행정학회지
• /
• 제21권4호
• /
• pp.585-598
• /
• 2011

This study was conducted to examine the trend of national health insurance service use with relation to pregnancy, childbirth, and the puerperium among pregnant and postpartum women older than 35 over the last decade. A descriptive analysis was conducted, using the data which were drawn from the "nationwide claim database of Korean National Health Insurance Corporation(NHIC)". Data were composed of the total cases related to pregnancy, childbirth, and the puerperium (International Classification of Disease, $10^{th}$revision [ICD-10] codes O00-O99) from 2001 to 2008. During 2001-2008, the number of pregnant and postpartum women older than 35 had continuously increased and the percentage of them also had increased in both hospital and ambulatory care. There are similar trends in their total use of national health insurance service and total expenditure. According to demographic characteristics, there was the biggest increase of the percentage in residents in large cities, self-employed workers, ones in the highest income level. According to ICD-10 codes, there was the biggest increase of the percentage in O10-O16 (oedema, proteinuria and hypertensive disorders in pregnancy, childbirth and the puerperium). According to the major prevalent disease, there was the biggest increase of the percentage in O60 (preterm labor and delivery). Throughout the past decade, the necessity has been emphasized of supporting pregnant and postpartum women older than 35. But in maternal and child health care, they are in an early stage of development. The findings of this study would be helpful in developing the support programs for the aged pregnant and postpartum women.

• 보건행정학회지
• /
• 제22권1호
• /
• pp.129-144
• /
• 2012

Purpose : The purpose of this study was to investigate the level of emotional labor and to identify affecting factors on emotional labor among one university hospital employees. Material and Method : This study was based on cross-sectional, self-administered, and Internet-based survey. The survey was conducted from Mar. 2 to Mar. 28. 2011. Total subjects were 812 employees working in one university hospital. Total response rate was 61.5%. Modified evaluation tool was used, which was originally developed by Morris and Feldman, to measure the level of emotional labor among hospital personnel. In order to identify the affecting factors on high level of emotional labor, we conducted logistic regression. The SPSS statistical software package was used to perform the statistical analysis. All statistical tests were 2-sided and a p-value<0.05 was considered statistically significant. Results : Average score of emotional labor was 3.06. Employees(3.39) who are working at the emergency department and hemodialysis room indicated the highest level of emotional labor, followed by wards(3.14), department of administration(3.14), department of ambulatory cares(3.06). The factors affecting on the high level of emotional labor were the highest level of schooling, types of department, and types of personality(p<0.05). Conclusion : The survey results showed that there was significant level of emotional labors among hospital employees. Therefore, the efforts to reduce the level of emotional labors are needed.

• 보건행정학회지
• /
• 제30권2호
• /
• pp.164-177
• /
• 2020

This study aims to compare the experience of selected countries in operating separate payment system for new healthcare technology and to find implications for price setting in Korea. We analyzed the related reports, papers, laws, regulations, and related agencies' online materials from five selected countries including the United States, Japan, Taiwan, Germany, and France. Each country has its own additional payment system for new technologies: transitional pass-through payment and new technology ambulatory payment classification for outpatient care and new technology add-on payment for inpatient care (USA), an extra payment for materials with new functions or new treatment (C1, C2; Japan), an additional payment system for new special treatment materials (Taiwan), a short-term extra funding for new diagnosis and treatment (NUB; Germany), and list of additional payments for new medical devices (France). The technology should be proven safe and effective in order to get approval for an additional payment. The price is determined by considering the actual cost of providing the technology and the cost of existing similar technologies listed in the benefits package. The revision cycle of the additional payment is 1 to 4 years. The cost or usage is monitored during that period and then integrated into the existing fee schedule or removed from the list. We conclude that it is important to set the explicit criteria to select services eligible for additional payment, to collect and analyze data to assess eligibility and to set the payment, to monitor the usage or cost, and to make follow-up measures in price setting for new health technologies in Korea.

• 보건의료산업학회지
• /
• 제5권3호
• /
• pp.145-155
• /
• 2011

This study is Dental Hygiene Department of G University for comprehensive dental hygiene control and treatment weekly for four weeks from September 16 to October 20, 2010, excluding those who visited for ambulatory treatment of systemic diseases. For the 90 subjects, we performed oral examination, measured Simplified Oral Hygiene Index (S-OHI), Modified Patient Hygiene Performance (PHP-M), and O' Leary Index, and applied comprehensive dental hygiene control. First, as to the change of OHI according to age, the index in the 1st measurement was 3.43 in those under 35 and 3.17 in those aged 35 or older, so it was higher in the younger group, but in the 2nd measurement it was 1.89 in those under 35 and 2.14 in those aged 35 or older, and in the 3rd measurement it was 1.22 in those aged 35 or older, so it was higher in the older group. Second, as to the change of PHP-M according to age, the index in the 1st measurement was 50.35 in those under 35 and 43.16 in those aged 35 or older, soit was higher in the younger group, but in the 2nd measurement it was 31.97 in those under 35 and 28.88 in those aged 35 or older, and in the 3rd measurement it was 21.31 in those aged 35 or older, so it was higher in the older group.

• 보건행정학회지
• /
• 제21권1호
• /
• pp.23-43
• /
• 2011

Access to health care is complicated to define. It is a multidimensional process. In addition to the matters of quality of care, geographical accessibility and availability of the right type of care, finance, and acceptability are all involved. The purposes of this paper are to measure the geographic distances between patient residency locations and health service organizations in which the patients hadvisited, and to investigate the association between geographical distance measures and variables involved in health service utilization. The study used the first and the second wave of the 2008 Korea Health Panel Survey. The samples of analyses were patients who had visited outpatient or used ambulatory health services, and the total observations (visit numbers) analyzed were 229,128. We divided the samples into a frequent-visit illness group (Group 1) and a non-frequent visit illness group (Group 2) based on over 5,000 total visit numbers. We exploited three level analyses using xtmixed of STATA${\Box}$ 11.1 command with/without interaction terms among age, sex, and occupation. Geographical distances were measured using the Haversine method. Group 1 was tended to older and lower equivalent income than those of Group 2, but the geographic difference were not observed in terms of area deprivation index and standard mortality ratios. Amongst group 1, diabetes mellitus patients travelled far to visit health care organizations, and arthritis patients were more deprived in terms of the personal and areal characteristics. The study revealed that residents in rural areas traveled about 10 times more long distances than those whom lived in larger cities after adjusting for various variables, which we used for analyses. This study contributed to the practical understanding of health service utilizations using empirical analyses, and found that the types of diseases and socioeconomic characteristics of patients tended to define the amount of travel distance to healthcare organizations.

• 대한치과마취과학회지
• /
• 제7권2호
• /
• pp.120-125
• /
• 2007

Background: Propofol has been used extensively for short-acting intravenous sedative agent during monitored anesthesia care (MAC). This study was designed to evaluate the safety and availability of MAC using propofol in implant surgery of the one-day admission patients. Methods: In this study, subjects were divided into two groups according to ASA physical status. The heart rate, blood pressure, peripheral oxygen saturation and ECG of a patient were estimated under MAC by an anesthesiologist and the vital signs were recorded in recovery room periodically afterwards. The subjective satisfaction with regard to outpatient ambulatory surgery under MAC procedure was evaluated the next day. Results: Systolic and diastolic blood pressure were significantly decreased during MAC in ASA I group, but other remarkable changes in vital sign were not observed. There was no significant difference in pain and anxiety level between ASA I and ASA II, III group. Satisfaction rate was high in both groups. Conclusion: Monitored-Anesthesia Care using propofol during implant surgery of the one-day admission patients might be safe and available procedure because heart rate, blood pressure and oxygen saturation are stable before and during surgery, and adequate control of pain and anxiety is supported.

• 한국전문물리치료학회지
• /
• 제12권1호
• /
• pp.54-62
• /
• 2005

The purpose of this study was to find the effects of using aid in enhancing walking ability inpatients with spinal cord injury who have received rehabilitative care. The study population consisted of 24 spinal cord injury patients referred to the Department of Rehabilitation Medicine in the National Rehabilitation Center (NRC). All subjects were ambulatory with or without an assistive devices. All of the participants were assessed on SCIM II, WISCI II, FIM, MBI, gait speed (m/s), and walking endurance (120 min/m). The data were analyzed using a paired t-test, a one-way ANOVA, and a Duncan test. The results revealed that TSCIM II and all of the items of SCIM II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA A and C group patients (p<.05). The FIM, MBI, and WISCI II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA C group patients (p>.05). The walking velocities of the lumbar ASIA C group patients were higher than those of Thoracic ASIA A group patients (p<.05). The walking endurance of the lumbar ASIA C group patients was higher than that of the thoracic ASIA C group patients (p<.05). The ASIA D group patients used bilateral standard canes or crutches, but none used AFO. The ASIA A and C group patients used bilateral standard walkers with KAFO for standing and walking. The findings suggest that injury level as well as the functionality of walking aids should be considered when formulating a rehabilitative plan for patients with spinal cord injury.

• The Journal of Korean Physical Therapy
• /
• 제4권1호
• /
• pp.43-57
• /
• 1992

This study was conducted from August, 1980 to March, 9991 to the 40 subjects who were admitted to Kosin Medical Center and received rehabilitation treatment and discharged under the impression of stroke. The objectives are to evaluate the function of the activites of daily living and comprehensive function and find the status of rehabilitation treatment by Modified Barthel Index and PULSES Profile when first requested or rehabilitation treatment(T1), at 2 weeks after rehabilitation treatment(T2), at discharge(T3) and at the time of ambulatory treatment after 2 weeks(T4). The study materials were clinical charts and functional evaluation sheets, and the results are as follows : 21 subject$(52.5\%)$ were male, 19 subjects$(47.5\%)$ were female, and the age distribution was from 19 to 70 in age, the average age was 52.7. By the classification of diagnosis, 21 subjects$(52.5\%)$ were cerebral hemorrhage, 8 subjects$(20.2\%)$ were cerebral thrombosis, 6 subjects$(15.0\%)$ were cerebral embolism, and 5 subjects$(12.5\%)$ were cerebral infarction. The Barthel Index scores were 35.7, 54.5, 71.8, 88.7 on the average at T1, T2, T3, T4 respectively. The PULSES scores were 16.4, 13.7, 11.4, 8.7 on the average at T1, T2, T3, T4 respectively. Regarding the Pearson's correlation coefficient between the Barthel Index scores and the PULSES scores, it was -0.7991(P>0.001) at T1 and -0.8986(P>0.001) at T3, then beth of correlations were very high.