• Title/Summary/Keyword: Cost Score

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A COMPARISON OF PATIENT-CONTROLLED ANALGESIA (PCA) AND INTRAMUSCULAR ANALGESIA AFTER ORTHOGNATHIC SURGERY (악교정 수술후 근주와 자가통증조절장치(PCA)의 제통효과 비교)

  • Park, Mi-Hwa;Kim, Jae-Hyun;Baek, Sang-Heum;Cha, Duwon;Lee, Sang-Han
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.31 no.3
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    • pp.260-265
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    • 2005
  • Patient-controlled analgesia (PCA) has been widely used for postoperative pain control in medical surgery parts. Conventional intramuscular analgesia (IMA) is also effective in postoperative pain control, but it has some disadvantages that depend on patients' perception of pain and the anxiety that they endure caused by the delay of the injection time. This study was conducted to assess the efficacy and postoperative outcomes of intravenous PCA compared to IMA injections in 36 patients (BSSRO). Three factors were compared: amount of pain in PCA and IMA group ; amount of pain according to the sex in PCA and IMA group and the amount of pain according to the analgesia use. Results of this study did not demonstrate a statistically significant difference in any of these, using a p value of 0.05. The results of this study were as follows. : 1. There was no statistically significant difference in VAS pain score between IMA group and PCA group. 2. There was no statistically significant difference according to the sex. 3. There was no statistically significant difference according to the amount of PCA. The history of PCA is about 30 years and many literatures have reported about its effects, complications, methods, advantages and disadvantages. So, this study has some limitations of small sample size to conclude the effects of PCA. But when the decision about the method for postoperative pain control has to be made, it should be made based on patient or physician preference and cost factors rather than on the trend.

A Study on the Appropriateness of Health Insurance Fee in Main Nursing Practices (주요 간호활동의 건강보험 수가 적절성에 관한 연구)

  • Kim, Yunmi;Kim, Kyungsook;Park, Mi Mi;Kim, In Sook;Kim, Mi Young
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.236-247
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    • 2017
  • Purpose: This study was to present improvement strategy and the problems of the nursing fee in national health insurance system. Methods: A total of 23 nursing activities performed by nurses were selected. Data were collected the relative value score and criteria of the Health Insurance Review & Assessment Agency. Sixty clinical nursing experts panels were composed and nursing time surveyed self-reported method. The actual fee was calculated through the nursing time, relative value score and actual labor costs. Nextly, the labor costs analyzed was compared with that in the national health insurance. Results: Although the practices were mainly performed by the nurse, other occupations have been recorded as main practitioners and the time of the nursing activity is partially improperly reflected. Additionally, although the nurse practiced mainly in glucose (semi-quantitative) test, it was confirmed that the principal practitioner was described as a clinical pathologist. The the labor cost gap was estimated that is 9.3 times (median) and 11.9 times (average) in this analysis. Conclusion: This study suggests that it is necessary to legislate a policy that can improve the quality of clinical nursing by reinforcing the appropriateness and improving nursing fee through reflection of the actual time spent for nursing care.

Meat Quality Traits of Longissimus Muscle of Hanwoo Steers as a Function of Interaction between Slaughter Endpoint and Chiller Ageing

  • Dashdorj, Dashmaa;Oliveros, Maria Cynthia R.;Hwang, In-Ho
    • Food Science of Animal Resources
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    • v.32 no.4
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    • pp.414-427
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    • 2012
  • Carcass characteristics and meat quality traits as a function of endpoint months of slaughter age (26 vs 32 mon) and chiller ageing (1 vs 10 d) were evaluated for m. longissmus of 26 Hanwoo steers fed with commercial diets including whole crop barley silage. Totally twenty six Hanwoo steers for 6 mon of age that were fed until 26 mon of age constituted the short term-fed group and fed until 32 mon of age constituted long-term fed group. Carcasses were chilled for 24 h and were graded. Strip loin samples were divided into two age groups (1 d and 10 d). Long-term feeding increased carcass weight, rib-eye area, yield grade, marbling score, firmness and quality grade of the meat. The feeding for 32 mon produced tender, juicy meat (p<0.01) with lower cooking loss and higher rating score (p<0.05) than short term feeding, while other quality traits were not influenced by the length of feeding. Intramuscular fat content and oxidative stability (TBARS value) were significantly (p<0.05) higher in beef from long-term feeding however the length of feeding did not alter the fatty acid composition. Chiller aging reduced instrumental tenderness (WBSF value), improved color, sensory tenderness, acceptability and rating of beef. The results of the present study mirrors that Hanwoo steers until 32 mon of age overall improved carcass traits and palatability compared to that for 26 mon. However, from the viewpoints of economical and environmental aspects, cost of the additional feeding for 6 mon for value-adding of eating quality was relatively high and the effects in turn were limited.

Evaluation of the Relationships Between Kellgren-Lawrence Radiographic Score and Knee Osteoarthritis-related Pain, Function, and Muscle Strength

  • Kim, Si-hyun;Park, Kyue-nam
    • Physical Therapy Korea
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    • v.26 no.2
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    • pp.69-75
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    • 2019
  • Background: Knee osteoarthritis (OA) diagnosis using Kellgren-Lawrence scores is commonly used to help decision-making during assessment of the severity of OA with assessment of pain, function and muscle strength. The association between Kellgren-Lawrence scores and functional/clinical outcomes remains controversial in patients with knee OA. Objects: The purpose of this study was to examine the relationships between Kellgren-Lawrence scores and knee pain associated with OA, function during daily living and sports activities, quality of life, and knee muscle strength in patients with knee OA. Methods: We recruited 66 patients with tibiofemoral knee OA and determined knee joint Kellgren-Lawrence scores using standing anteroposterior radiographs. Self-reported knee pain, daily living function, sports/recreation function, and quality of life were measured using the knee injury and OA outcome score (KOOS). Knee extensors and flexors were assessed using a handheld dynamometer. We performed Spearman's rank correlation analyses to evaluate the relationships between Kellgren-Lawrence and KOOS scores or muscle strength. Results: Kellgren-Lawrence scores were significantly negatively correlated with KOOS scores for knee pain, daily living function, sports/recreation function, and quality of life. Statistically significant negative correlations were found between Kellgren-Lawrence scores and knee extensor strength but not flexor strength. Conclusion: Higher Kellgren-Lawrence scores were associated with more severe knee pain and lower levels of function in daily living and sports/recreation, quality of life, and knee extensor strength in patients with knee OA. Therefore, we conclude that knee OA assessment via self-reported KOOS and knee extensor strength may be a cost-effective alternative to radiological exams.

Factors associated with treatment outcomes of patients hospitalized with severe maxillofacial infections at a tertiary center

  • Kim, Hye-Won;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.3
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    • pp.197-208
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    • 2021
  • Objectives: The purpose of this retrospective study was to evaluate the variables associated with length of stay (LOS), hospital costs, intensive care unit (ICU) use, and treatment outcomes in patients hospitalized for maxillofacial infections at a tertiary medical center in South Korea. Materials and Methods: A retrospective chart review was conducted for patients admitted for treatment of maxillofacial infections at Dankook University Hospital from January 1, 2011 through September 30, 2020. A total of 390 patient charts were reviewed and included in the final statistical analyses. Results: Average LOS and hospital bill per patient of this study was 11.47 days, and ₩4,710,017.25 ($4,216.67), respectively. Of the 390 subjects, 97.3% were discharged routinely following complete recovery, 1.0% expired following treatment, and 0.8% were transferred to another hospital. In multivariate linear regression analyses to determine variables associated with LOS, admission year, infection side, Flynn score, deep neck infection, cardiovascular disease, admission C-reactive protein (CRP) and glucose levels, number and length of surgical interventions, tracheostomy, time elapsed from admission to first surgery, and length of ICU stay accounted for 85.8% of the variation. With regard to the total hospital bill, significantly associated variables were age, type of insurance, Flynn score, number of comorbidities, admission CRP, white blood cell, and glucose levels, admission temperature, peak temperature, surgical intervention, the length, type, and location of surgery, tracheostomy, time elapsed from admission to first surgery, and length of ICU use, which accounted for 90.4% of the variation. Age and ICU use were the only variables significantly associated with unfavorable discharge outcomes in multivariate logistic regression analysis. Conclusion: For successful and cost-effective management of maxillofacial infections, clinicians to be vigilant about the decision to admit patients with maxillofacial infections, perform appropriate surgery at an adequate time, and admit them to the ICU.

Role of suprascapular nerve block in idiopathic frozen shoulder treatment: a clinical trial survey

  • Mardani-Kivi, Mohsen;Nabi, Bahram Naderi;Mousavi, Mir-Hashem;Shirangi, Ardeshir;Leili, Ehsan Kazemnejad;Ghadim-Limudahi, Zahra Haghparast
    • Clinics in Shoulder and Elbow
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    • v.25 no.2
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    • pp.129-139
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    • 2022
  • Background: Several therapeutic methods have been proposed for frozen shoulder syndrome. These include suprascapular nerve block, a simple and cost-effective technique that eliminates the need for nonsteroidal anti-inflammatory drug therapy. Methods: This was a clinical trial that included patients with unilateral shoulder joint stiffness. Patients were divided into three groups: those treated with isolated physiotherapy for 12 weeks (PT group), those treated with a single dose intra-articular injection of corticosteroid together with physiotherapy (IACI group), and those treated with a suprascapular nerve block performed with a single indirect injection of 8-mL lidocaine HCL 1% and 2 mL (80 mg) methylprednisolone acetate together with physiotherapy (SSNB group). The variables assessed were age, sex, side of involvement, dominant limb, presence of diabetes, physical examination findings including erythema, swelling, and muscle wasting; palpation and movement findings; shoulder pain and disability index (SPADI) score; and the visual analog scale (VAS) score pre-intervention and at 2-, 4-, 6-, and 12-week post-intervention. Results: Ninety-seven patients were included in this survey (34 cases in the PT group, 32 cases in the IACI group, and 31 cases in the SSNB group). Mean age was 48.55±11.06 years. Fifty-seven cases were female (58.8%) and 40 were male (41.2%). Sixty-eight patients had a history of diabetes (70.1%). VAS and SPADI scores and range of mototion degrees dramatically improved in all cases (p<0.001). Results were best in the SSNB group (p<0.001), and the IACI group showed better results than the PT group (p<0.001). Conclusions: Suprascapular nerve block is an effective therapy with long-term pain relief and increased mobility of the shoulder joint in patients with adhesive capsulitis.

Bridge Life Cycle Cost Analysis of Preventive Maintenance (예방적 유지관리를 통한 교량의 생애주기비용 절감 효과 분석)

  • Jeong, Yo-Seok;Kim, Woo-Seok;Lee, Il-Keun;Lee, Jae-Ha
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.20 no.6
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    • pp.1-9
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    • 2016
  • The paper aims at evaluating effects of preventive maintenance on life cycle cost(LCC) reduction of bridges. The preventive maintenance activities capable to delay bridge deteriorations can reduce overall maintenance costs and extend service life of a bridge by regularly providing maintenance activities and avoiding larger maintenance(repairs or rehabilitations) costs. Couple of prediction models were proposed in order to calculate LCC of a typical bridge: a health score model and repair rehabilitation cost model. In addition, the maintenance activities such as wash and painting were also suggested in order to consider effects of preventive maintenance in the analysis based on literature reviews. According to analysis results, new maintenance strategy(reactive maintenance + preventive maintenance) can save \0.5 billion per bridge for future life-cycle costs over 100 year analysis or \184 billion for entire HBMS(Highway Bridge Management System) inventory over 20 years. Small investments for preventive maintenance in improved bridge management can have a very significant return when considering the large bridge inventory.

THE PATIENTS' SATISFACTION FOLLOWING IMPLANT TREATMENT

  • Heo, Yoon-Young;Heo, Seong-Joo;Chang, Myung-Woo;Park, Ji-Man
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.6
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    • pp.569-576
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    • 2008
  • STATEMENT OF PROBLEM: While patient-centered outcomes are usually not reported, these may represent major aspects of the implant success for the patient. Use of a well-designed patient survey form can be an invaluable asset to the implant practitioners. PURPOSE: The objective of this study was to investigate patient satisfaction after implant therapy by means of a questionnaire. MATERIAL AND METHODS: South Korean patients (n = 100), who visited the dental examination center of Soon Chun Hyang university hospital, were asked to fill out the satisfaction questionnaire regarding aspects of cost, comfort, esthetics, chewing, gingival health, food impaction, phonetic aspect, screw loosening, and general satisfaction. Responses to statements were given on the Likert response scale. Four experimental groups of patients were distinguished with various location ($A_1,\;A_2,\;A_3$), year ($B_1,\;B_2,\;B_3$), number of implant replacements ($C_1,\;C_2,\;C_3$), and treatment cost ($D_1,\;D_2,\;D_3$). The reliability of the response scales was measured by calculation of its internal consistency, expressed as Cronbach's ${\alpha}$. The scales were distinguished by means of factor analysis method. Possible differences in scale scores among the groups were assessed by One-way ANOVA (${\alpha}$= 0.05). RESULTS: Patients responded to most of the statements with high satisfaction. But the mean scale score of statement about cost was low. After the verification of internal consistency and factor analysis, five components, e.g. general satisfaction, comfort, chewing efficiency, esthetics, and phonetic aspect were grouped together. These components could be explained with common meaning and the first factor was named as 'general satisfaction'. Differences in patient satisfaction on the scale with esthetics were present between patients who have been wearing the implant prosthesis less than three years and those more than seven years ($B_1<B_3$). CONCLUSION: The patients were generally satisfied with the outcome of implant treatment. But the patients' major complaint was high cost and while the statistically significant difference was not shown, the satisfaction scale about food impaction and esthetics was low. So the continuing efforts to make improvements about these problems are needed for the implant practitioners.

Least Cost and Optimum Mixing Programming by Yulmu Mixture Noddle (율무국수를 이용한 최소가격/최적배합 프로그래밍)

  • Kim, Sang-Soo;Kim, Byung-Yong;Hahm, Young-Tae;Shin, Dong-Hoon
    • Korean Journal of Food Science and Technology
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    • v.31 no.2
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    • pp.385-390
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    • 1999
  • Noodle was made using a combination of yulmu, wheat and water through mixture design. Statistical models of yulmu noodle were shown by analysing tensile stress and color $(L^{*})$, and sensory evaluation with other constraints. Analysing the linear and non-linear model, the linearity in the values of tensile stress, lightness $(L^{*})$ and sensory evaluation showed that each component worked separately without interactions. In studying the component effect on the response by trace plot, the result indicated that the increase in the amount of yulmu enhanced tensile stress of noodle while degrading $L^{*}$ value and sensory evaluation score. In the range of satisfying the conditions of noodle in every tensile stress, $L^{*}$ value and sensory evaluation point, the optimum mixture ratio of yulmu : wheat : water was 2.27% : 66.28% : 28.45% based on least cost linear programming. In this calculation, the least cost was 9.924 and estimated potential results of the response for tensile stress was 2.234 N and those for $L^{*}$ was 82.39. Finally, the potential response results affected by mixture ratio of yulmu, wheat and water were screened using Excel.

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Seeking Alternative Models and Research Trends for Big Deals in the Electronic Journal Consortium (전자저널 빅딜 계약의 연구 동향과 대안 탐색)

  • Kim, Sang-Jun;Kim, Jeong-Hwan
    • Journal of Information Management
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    • v.42 no.1
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    • pp.85-111
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    • 2011
  • The purpose of this study was to seek a workable alternative to replace a big deal related to the journal budget for the maintenance of academic libraries with the largest issue on the E-journal consortium. The contents of this study was to present it. It had examined the current situation, strengths, weaknesses and corresponding to replace the big deal contract. After reviewing the literature, we looked into the alternative activities for the big deal such as open access-based, usage-based, consortium improvement-based, publishers lead, and other models. As a result, the 'consortium cost reapportion model' was an alternative for the KESLI. The alternative was in the short term for cost division format, but long-term oriented for a consortium single(bloc) payment type or national licence model. The model was based on the data from the last year. It had evaluated download the PDF and HTML documents, but the three times weighting more than others, and the rest of 14 factors of 0.5 to 5 out of 100 total score. The total amount negotiated by national units 10, 20 and 30 grades for the final step was allocated to the participating library on the KESLI consortium.