• Title/Summary/Keyword: Classified Records

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A Study on the Propriety of the Medical Insurance Fee Schedule of Surgical Operations - In Regard to the Relative Price System and the Classification of the Price Unit of Insurance Fee Schedule - (수술수가의 적정성에 관한 연구 - 상대가격체계와 항목분류를 중심으로 -)

  • Oh Jin Joo
    • Journal of Korean Public Health Nursing
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    • v.2 no.2
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    • pp.21-44
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    • 1988
  • In Korea, fee-for service reimbursement has been adopted from the begining of medical insurance system in 1977, and the importance of the relative value unit is currently being investigated. The purpose of this study was to find out the level of propriety of the difference in the fees for different surgical services, and the appropriateness of the classification of the insurance fee schedule. For the purpose of this study, specific subjects and the procedural methodology is shown as follows: 1. The propriety of the Relative Price System(RPS). 1) Choice of sample operations. In this study, sample operations were selected and classified by specialists in general surgery, and the number of items they classified were 32. For the same group of operations the Insurance Fee Schedule(IFS) classified the operations into 24 separate items. In order to investigate the propriety of the RPS, one of the purpose of this study, was to examine the 24 items classified by the IFS. 2) Evaluation of the complexity of surgery. The data used in this study was collected The data used in this study was collected from 94 specialists in general surgery by mail survey from November I to 15, 1986. Several independent variables (age, location, number of bed, university hospital, whether the medical institution adopt residents or not) were also investigated for analysis of the characteristics of surgical complexity. 3) Complexity and time calculations. Time data was collected from the records of the Seoul National University' Hospital, and the cost per operation was calculated through cost finding methods. 4) Analysis of the propriety of the Relative Price System of the Insurance Fee Schedule. The Relative Price System of the sample operation was regressed on the cost, time, comlexity relative ,value system (RVS) separately. The coefficient of determination indicates the degree of variation in the RPS of the Insurance Fee Schedule explained by the cost, time, complexity RVS separately. 2. The appropriateness of the classification of the Insurance Fee Schedule. 1) Choice of sample operations. The items which differed between the classification of the specialist and the classification of medical, Insurance Fee Schedule were chosen. 2) Comparisons of cost, time and complexity between the items were done to evaluate which classification was more appropriate. The findings of the study can be summarized as follows: 1. The coefficient of determination of the regression of the RPS on-cost RVS was 0.58, on time RVS was 0.65, and on complexity RVS was 0.72. This means that the RPS of Insurance Fee Schedule is improper with respect to the cost, time, complexity separately. Thus this indicates that RPS must be re-shaped according to the standard element. In this study, the correlation coefficients of cost, time, complexity Relative Value System were very high, and this suggests that RPS could be reshaped I according to anyone standard element. Considering of measurement, time was thought to be the most I appropriate. 2. The classifications of specialist and of the Insurance Fee Schedule were compared with respect to cost, time, and complexity separately. For complexity, ANOVA was done and the others were compared to the different values of different classifications. The result was that the classification of specialist was more reasonable and that the classification of Insurance Fee Schedule grouped inappropriately several into one price unit.

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An Archival Study on the Arrangement and Description of Old Document(Diploma) (고문서 정리(整理)에 대한 기록학적 연구 - 새로운 고문서 정리 방법의 모색을 위하여 -)

  • Cho, Kyung-Koo
    • The Korean Journal of Archival Studies
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    • no.7
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    • pp.37-74
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    • 2003
  • An Old document(Diploma) is a historical and unique record, so it must be collected, arranged, and preserved for research as soon as possible. Especially, for the effective use of the Old Document(Diploma), it is needed to arrange and describe the material systematically on the ground of modern archival theory. The Kyujanggak Archives in the Seoul National University has published 23 volumes of Old document(Diploma) material Old Document(Diploma). But they seem to cause the readers inconvenience, because the materials are classified and gathered only by genre, the titles or the orders of the materials are not standardized, and there is no description about the content of each Old document(Diploma). Jangseo-gak Library in The Academy of Korean Studies has also published the series of Old document(Diploma) material Old Document(Diploma) Collection. However the case is not different, since they are all mixed up with materials classified and gathered by genre, family, academy, or local school. And a great part of the materials have no titles and no description about the content of each Old document(Diploma), either. About the arrangement and description of the records, European and American archival science has established the theory of l)the principle of provenance, 2)the principle of original order, 3)levels of control, 4)collective description. These theories are valuable for the effective use of Old document(Diploma). On the viewpoint of the principle of provenance, Old document(Diploma) materials should not be classified by subject and genre, but by family and person. Then, the Old document(Diploma) materials, after collected by the unit of family or person on the viewpoint of the principle of provenance, should be arranged in their original order for more detailed arrangement and furthermore, for the work to find their relationship. This is so called the principle of original order. The hierarchical management of the Old document(Diploma) materials, for example, classifying by record group, sub-group, series, item and so on, is the concept of the levels of control, and comprehensive description of the each hierarchical structure is the concept of the collective description. Let's apply these archival theories to 34 pieces of the Chung, Man-Seok's material in the series of Old document(Diploma) material Old Document(Diploma). First, collect the Old document(Diploma) materials into Chung, Man-Seok's collection(the principle of provenance), which were scattered in the series classified by genre. Secondly, rearrange them chronologically(the principle of original order), and then we can find the comprehensive information about Chung, Man-Seok. For the hierarchical management of the Old document(Diploma) materials, we should establish a few concepts from the general, large group to specific, small item. The concepts can be organized as following; l)record group(Chung, Man-Seok record group) - 2)sub-group(personnel document, property document, family document, social activity document, political activity document, etc) - 3)series(gyoji-series, gyoseo-series, yuji-series etc. in the personnel document) - 4)folder(document with additions) - 5)item(one document). According to the the theory of the collective description, in the level of record group, there should be a collective description of Chung, Man-Seok's biography or a summary of record group. Similarly, there should be a collective description of a summary of sub-group in the level of sub-group and a summary of series in the level of series.

Statistical Study of the Patient of Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital in Daejeon - from September, 2019 to September, 2022 - (대전대 OO한방병원 침구의학과 환자들에 대한 통계적 분석 - 2019년 9월부터 2022년 9월까지 -)

  • So Jeong Kim;Hyun Jin Jang;Min Ju Kim;Hyeon Kyu Choi;Pil Je Park;Yeon Soo Kang;Hong Kyoung Kim;Jeong Kyo Jeong;Ju Hyun Jeon;Young Il Kim
    • The Journal of Korean Medicine
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    • v.44 no.2
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    • pp.20-33
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    • 2023
  • Objectives: This study is designed to statistically analyze the features of patients who visited to Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital for 3 years. Methods: This study retrospectively analyzed the medical records of patients at Department of Acupuncture and Moxibustion at OO Korean Medicine Hospital using IBM SPSS ver. 27.0 for Windows. Results: 1. In the analysis of the total number of patients, those in their 30s accounted for the highest percentage, male patients had a higher rate. 2. In the analysis of KCD-8 code, spinal stenosis and fractures in areas other than the spine were the most common in the 70s and older, and cervical sprains were the most common in other. 3. In the analysis of the number of hospitalizations, patients classified as illness or higher age had more re-hospitalization than patients classified as injury or lower age in first-time care. 4. In the analysis of hospitalization duration, patients classified as illness, female or higher age had longer hospitalization duration than patients classified as accident, male or lower age in first-time care. Conclusion: We expect that the results of this study would be used as reference materials for analyzing medical consumption condition of Department of Acupuncture and Moxibustion.

Prognostic Value of a Single Center Nutrition Screening Tool in Patients with Metastatic Cancer (전이암 환자에서 단일기관 영양검색 도구의 예후 가치)

  • Yoon, Sung Soo;Kim, Min Jin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.24 no.2
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    • pp.1-11
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    • 2019
  • Objectives : We investigated whether a single center nutrition screening tool (Kyunghee Neo Nutrition Risk Screening, KNNRS) can predict survival in patients with metastatic cancer. Methods : We retrospectively reviewed data of inpatients with metastatic cancer from April 2016 to August 2019. Data on demographic and clinical parameters were collected from electronic medical records, and overall survival was estimated using the Kaplan-Meier method. Stepwise Cox regression analysis was used to determine factors associated with survival. Patients with a KNNRS score of 0 to 3 were classified as "no-risk", 4 to 10 as "low-risk", and 11 to 20 as "high-risk". Results : Total 105 patients were included in the study. According to nutritional screening at baseline, 25 patients (23.8%, median age 57.0) were classified as ""no risk"" group; 80 patients (76.2%, median age 68.5) as "low risk" group; No patients as "high risk" group. Predictors of survival were Eastern Cooperative Oncology Group Performance Status score of 3 or 4 (hazard ratio [HR] = 1.93; 95% confidence interval [CI] = 1.21-3.10), hemoglobin less than 10 g/dL (HR = 1.97; 95% CI = 1.25-3.10) and C-reactive protein more than 1.0 mg/dL (HR = 1.95; 95% CI = 1.21-3.13). Kaplan-Meier survival analysis showed significant differences in the survival between KNNRS groups: ""no risk"" group: 6.1 ± 1.4 months (95% CI = 3.37-8.83); ""low risk"" group: 3.4 ± 0.9 months (95% CI = 1.5-5.37). Conclusions : Nutritional status according to KNNRS wasn't significant predictor of survival for patients with metastatic cancer. Improvement of KNNRS score thresholds is needed.

Urinary tract infections in pediatric oncology patients with febrile neutropenia (호중구 감소성 발열을 보이는 소아 암 환자에서의 요로감염에 대한 연구)

  • Suh, Kyoo Hyun;Park, Sun Young;Kim, Sae Yoon;Lee, Jae Min
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.105-111
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    • 2016
  • Background: Neutropenic fever is one of the most common and potentially severe complications of chemotherapy in pediatric oncology patients, while urinary tract infection (UTI) is one of the most prevalent bacterial infections in these patients. Therefore, this study was conducted to investigate features of UTI with neutropenic fever in pediatric oncology patients. Methods: We retrospectively reviewed and analyzed the medical records, laboratory results and image findings of cases of neutropenic fever in the Department of Pediatrics of Yeungnam University Medical Center, South Korea between November 2013 and May 2015. Episodes were divided into two groups, UTI vs. non-UTI group according to the results of urine culture. The results were then compared between groups. The analysis was performed using IBM SPSS 23.0. A p-value <0.05 was considered to indicate a significant difference between groups. Results: Overall, 112 episodes of neutropenic fever were analyzed, among which 22 episodes (19.6%) showed organisms on urine culture and were classified as UTI. The remaining 90 episodes were classified as non-UTI. Only four episodes (18.2%) of the UTI group showed pyuria on urine analysis. In the UTI group, 76.5% were sensitive to the first line antibiotics and showed higher clinical response than the non-UTI group. Among hematologic malignancy patients, the UTI group revealed higher serum ${\beta}2$-microglobulin levels than the non-UTI group ($1.56{\pm}0.43mg/L$ vs. $1.2{\pm}0.43mg/L$, p<0.028). Conclusion: UTI in pediatric neutropenic fever responds well to antibiotics. Hematologic malignancy cases with UTI reveal increased serum ${\beta}2$-microglobulin level. These results will be helpful to early phase diagnosis of UTI.

An Investigation of Ingredients and Hazardous Substances in Some Consumer Products - Focusing on Cleaners and Disinfectants - (일부 생활화학용품에 함유된 성분 및 유해물질 조사 - 세정제와 소독제를 중심으로 -)

  • Heo, Da-An;Huh, Eun-Hae;Park, Ji Young;Moon, Kyong Whan;Lee, Kiyoung
    • Journal of Environmental Health Sciences
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    • v.41 no.5
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    • pp.314-326
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    • 2015
  • Objectives: This study was conducted to identify the ingredients used in ten consumer product categories and determine hazardous substances among these ingredients. Methods: A total of 542 commercial products in ten consumer product categories were selected. The consumer products were sticker removers, washing machine cleaners, multi-purpose cleaners, mold removers, glass cleaners, chlorinated sanitizers, air conditioner cleaners, disposal cleaners, drain cleaners and disinfectant sprays. The company list was complied from governmental records and a market survey. The respective companies were contacted for a list of ingredients found in the 542 products. Results: The corresponding companies listed 163 ingredients. According to European Union (EU) Directive 67/548/EEC, 38 of the 163 ingredients were classified as dangerous substances. Among these substances, 28 ingredients were hazardous to the skin, 15 were hazardous to the eye, and nine were hazardous if inhaled. Three ingredients were classified as CMR (carcinogenic, mutagenic or toxic for reproduction) substances: liquefied petroleum gases (LPG) with carcinogenicity and mutagenicity, and VM&P naphtha and ligroine with carcinogenicity. Conclusion: Various chemicals, including hazardous substances, were used in consumer products. Risk assessment of consumer products is required in order to protect the population from health risks.

Outcomes of Acute Liver Injury from Accidental Mushroom Poisoning (급성 버섯중독으로 인한 간손상의 추적 조사)

  • Oh, Bum-Jin;Kim, Won;Lim, Kyoung-Soo
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.116-122
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    • 2004
  • Purpose: Several risk factors related with chronic complications and mortality related with liver injury of mushroom poisoning were reported. But, there were few reports about the long term outcomes. The aim was to evaluate the long term clinical outcomes in mushroom poisoning regarding the risk factors. Methods: Clinical data were reviewed and outcomes were evaluated with medical records and/or telephone interviews. The patients who had one or more risk factors such as markedly elevated aspartate aminotransferase (AST) or alanine aminotransferase (ALT), prolonged prothrombin time (PT) were classified into high risk group. Patients had no risk factor classified into low risk group. Results: From June 1989 to December 2003, nineteen mushroom poisoning patients admitted to Asan Medical Center, seven were male, and mean age was $58\pm9$ years old. All the patients accidentally ingested and the interval from ingestion to symptom onset was $9\pm4$ hours. There were four patients in high risk group, and fifteen in low risk group. In high risk group, peak AST was $2,263.3\pm1,303.0IU/L$most prolonged PT was $38.0\pm27.4\%$, and stuporous mental status was shown in one patient. In low risk group, laboratory values returned to the normal values but histological evaluation revealed specific features of toxic hepatitis on sixth hospital day. Chronic complications such as persistent or chronic hepatitis, mortality was not occurred during follow up period (from 10 months to 16 years) in both groups. Conclusion: Although the number of patients were small, there were no chronic complications or mortality related with liver injury after mushroom poisoning regardless risk factors of chronic complications and mortality.

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Accessory auricle: Classification according to location, protrusion pattern and body shape

  • Hwang, Jungil;Cho, Jaeyoung;Burm, Jin Sik
    • Archives of Plastic Surgery
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    • v.45 no.5
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    • pp.411-417
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    • 2018
  • Background Accessory auricles (AAs) are common congenital anomalies. We present a new classification according to location and shape, and propose a system for coding the classifications. Methods This study was conducted by reviewing the records of 502 patients who underwent surgery for AA. AAs were classified into three anatomical types: intraauricular, preauricular, and buccal. Intraauricular AAs were divided into three subtypes: intracrural, intratragal, and intralobal. Preauricular AAs were divided into five subtypes: precrural, superior pretragal, middle pretragal, inferior pretragal, and prelobal. Buccal AAs were divided into two subtypes: anterior buccal and posterior buccal. AAs were also classified according to their protrusion pattern above the surrounding surface: pedunculated, sessile, areolar, remnant, and depressed. Pedunculated and sessile AAs were subclassified as spherical, ovoid, lobed, and nodular, according to their body shape. Cartilage root presence and family history of AA were reviewed. A coding system for these classifications was also proposed. Results The total number of AAs in the 502 patients was 1,003. Among the locations, the superior pretragal subtype (27.6%) was the most common. Among the protrusion patterns and shapes, pedunculated ovoid AAs were the most common in the preauricular (27.8%) and buccal areas (28.0%), and sessile lobed AAs were the most common in the intraauricular area (48.7%). The proportion of AAs with a cartilage root was 78.4%, and 11% of patients had a family history. The most common type of preauricular AA was the superior pretragal pedunculated ovoid AA (13.2%) with a cartilage root. Conclusions This new system will serve as a guideline for classifying and coding AAs.

Medical review of Insurance claims for GIST and MALToma (기스트와 말토마의 보험의학적 악성도 판단)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.27 no.2
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    • pp.68-74
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    • 2008
  • Medical verification of cancer diagnosis in insurance claims is a very important procedure in insurance administrations. Claims staffs are in need of medical experts' opinions about claim administration. This procedure is called medical claim review (MCR) and is composed of verification and advice. MCR verification evaluates the insured’s physical condition by medical records and compares it with product coverage. It is divided into assessment of living assurance benefit, verification of cancer, and assessment of the cause of death. Actually cancer verification of MCR is applicable to coding because the risk ratio in product development is usually coded data. There are some confusing neoplastic diseases in assessing the verification of cancer. This article reviews gastrointestinal stromal tumors (GIST) and mucosa-associated lymphoid tissue tumors (MALToma) of the stomach. The second most common group of stromal or mesenchymal neoplasms affecting the gastrointestinal tract is GIST. Nowadays there are many articles about the pathophysiology of GIST. However there are few confirmative theories except molecular cell biology of KIT mutation and some tyrosine kinase. Therefore, coding the GIST, which has previously been classified as an intermediate risk group according to NIH2001 criteria, for cancer verification of MCR is suitable for D37.1; neoplasm of uncertain or unknown behavior of digestive organs and the stomach. The gastrointestinal tract is the predominant site of extranodal non-Hodgkin's lymphomas. B-cell lymphomas of the MALT type, now called extranodal marginal zone B-cell lymphoma of MALT type in the REAL/WHO classification, are the most common primary gastric lymphomas worldwide. Its characteristics are as follows. First, it is different from traditional stomach cancers such as gastric adenocarcinoma. Second, the primary therapy of MALToma is the eradication of H. pylori by antibiotics and the remission rate is over 80%. Third, it has a different clinical course compared to traditional malignant lymphoma. Someone insisted that cancer verification is not possible for the above reasons. However, there have been findings on pathologic mechanism, and according to WHO classification, MALToma is classified into malignant B-cell lymphoma and it must be verified as malignancy in MCR.

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Analysis of Crane Accidents by Using a Man-Machine System Model (인간-기계 시스템 모델에 의한 크레인 사망재해 분석)

  • Park, Jae-Hee;Park, Tae-Joo;Lim, Hyun-Kyo;Seo, Eun-Hong
    • Journal of the Korean Society of Safety
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    • v.22 no.2 s.80
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    • pp.59-66
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    • 2007
  • As the need of handling heavy materials increases, various cranes are used in industries. However, the effectiveness of crane also entails industrial accidents such as falling, constriction etc. In fact, the number of fatal accidents caused by crane is still high in Korea. To find out the causes of the accidents in terms of human error, we developed a man-machine system model that consists of two axes; human information processing and crane life cycle. In the human information processing dimension, we simplified it as five functions; sensing and perception, decision making and memory, response etc. In the crane life cycle dimension, we divided it into nine phases; design, production, operation etc. For the 152 fatal accident records during 1999-2006 years, we classified them into 45 cells made by two axes. Then we identified the preceding causes of the classified crane accident based on performance shaping factors. As the results of statistical analysis, the overall trend of crane fatal accidents was described. For the cause analysis, wrong decision making in work plan phase shows the highest frequency. Next, the poor information input in crane operation followed in accident frequency. In ergonomics view, the problems of interface design in displays and controls made 11.8% of fatal accidents. Following the analysis, several ergonomic design guidelines to prevent crane accidents were suggested.