• 제목/요약/키워드: Diagnosis-Related Group

검색결과 471건 처리시간 0.023초

Prevalence and Related Risk Factors of Delirium in Intensive Care Units as Detected by the CAM-ICU (CAM-ICU로 평가한 중환자실의 섬망 발생률과 섬망 발생 위험요인)

  • Choi, Su Jung;Cho, Yong Ae
    • Journal of Korean Clinical Nursing Research
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    • 제20권3호
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    • pp.406-416
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    • 2014
  • Purpose: Screening of delirium using delirium assessment tools could promote delirium detection, however, there is lack of report about regular delirium assessment in Korea. This study was intended to describe the prevalence and related risk factors of delirium in intensive care unit (ICU). Methods: The Confusion Assessment Method for the ICU (CAM-ICU) data which were evaluated by nurses in ICUs was obtained through retrospective chart review. Data were analyzed using descriptive statistics, Chi-square test, t-test, Mann-Whitney U test, and stepwise logistic regression. Results: Delirium was evaluated in 125 patients. The incidence rate of delirium was 27.2% with a high prevalence of hypoactive delirium compared to hyperactive delirium (61.8 vs. 38.2%). Those with delirium were older, had hypertension, stayed longer in hospital, receiving ventilator support, had more number of catheters, had low serum protein and albumin level. Delirium incidence also varied according to diagnosis. Age, diagnosis of gastrointestinal disease, and application of ventilator were the significant risk factors for the incidence of delirium. Conclusion: Routine delirium screening is important for early detection of delirium. Identification of high-risk group and running delirium prevention programs could improve early recognition of delirium in ICU.

Inpatient care focused strategy and convergence performance in hospitals (병원의 입원 진료 집중화 전략과 융합적 운영 성과)

  • Yoo, Hai-Won
    • Journal of the Korea Convergence Society
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    • 제7권4호
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    • pp.59-66
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    • 2016
  • This study analyzed the relationship between the convergence performance in hospital. This study examined previous research and calculated centralized index using diagnosis related groups. In addition, multiple regression analysis was used based on LOS in order to understand the effect of focused strategy which quality of medical inpatient service. The centralized level was examined by analyzing national inpatient sample data using 'Internal Herfindahl-Hirshman index' This study is significant because it reviewed medical inpatient service quality by measuring hospital centralized level which has been rarely studied before Korea.

Refinement and Evaluation of Korean Diagnosis Related Groups (한국형진단명기준환자군의 개선과 평가)

  • 강길원;박하영;신영수
    • Health Policy and Management
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    • 제14권1호
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    • pp.121-147
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    • 2004
  • Since the pilot program for a DRG-based prospective payment system was introduced in 1997, the performance of KDRGs has been one of hotly debated issues. The objectives of this study are to refine the classification algorithm of the KDRGs and to assess the improvement achieved by the refinement. The U.S. Medicare DRGs version 17.0 and the Australian Refined DRGs version 4.1 were reviewed to identify areas of possible impro-vement. Refined changes in the classification and result of date analyses were submitted to a panel of 48 physicians for their reviews and suggestions. The refinement was evaluated by the variance reduction in resource utilization achieved by the KDRG The database of 2,182,168 claims submitted to the Health Insurance Review Agency during 2002 was used for evaluation. As the result of the refinement, three new MDCs were introduced and the number of ADEGs increased from 332 to 674. Various age splits and two to four levels of severity classification for secondary diagnoses were introduced as well. A total of 1,817 groups were defined in the refined KDRGs. The variance reduction for charges of all patients increased from 48.2% to 53.6% by the refinement, and from 65.6% to 73.1% for non-outlier patients. The r-square for length of stays of all patients was increased from 28.3% to 32.6%, and from 40.4% to 44.9% for non-outlier patients. These results indicated a significant improvement in the classification accuracy of the KDRG system.

Biomarkers for Evaluation of Prostate Cancer Prognosis

  • Esfahani, Maryam;Ataei, Negar;Panjehpour, Mojtaba
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권7호
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    • pp.2601-2611
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    • 2015
  • Prostate cancer, with a lifetime prevalence of one in six men, is the second cause of malignancy-related death and the most prevalent cancer in men in many countries. Nowadays, prostate cancer diagnosis is often based on the use of biomarkers, especially prostate-specific antigen (PSA) which can result in enhanced detection at earlier stage and decreasing in the number of metastatic patients. However, because of the low specificity of PSA, unnecessary biopsies and mistaken diagnoses frequently occur. Prostate cancer has various features so prognosis following diagnosis is greatly variable. There is a requirement for new prognostic biomarkers, particularly to differentiate between inactive and aggressive forms of disease, to improve clinical management of prostate cancer. Research continues into finding additional markers that may allow this goal to be attained. We here selected a group of candidate biomarkers including PSA, PSA velocity, percentage free PSA, $TGF{\beta}1$, AMACR, chromogranin A, IL-6, IGFBPs, PSCA, biomarkers related to cell cycle regulation, apoptosis, PTEN, androgen receptor, cellular adhesion and angiogenesis, and also prognostic biomarkers with Genomic tests for discussion. This provides an outline of biomarkers that are presently of prognostic interest in prostate cancer investigation.

Strategies for Deriving Strategic Products to Enter the Dementia Industry on SMEs-Focused on AHP Analysis

  • Yu, Tae Gyu
    • International Journal of Internet, Broadcasting and Communication
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    • 제12권1호
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    • pp.61-66
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    • 2020
  • Many SMEs are interested in entering the dementia industry as the national dementia responsibility system begins in earnest. However, it is ambiguous about which technology and field to enter, and accordingly, it is impossible to make a quick judgment and misses the time to enter the market. Therefore, the purpose of this study is to provide a simple but clear information to many SMEs in this situation, which products and related technologies will be able to help product development and market entry in the dementia prevention and diagnosis technology market more easily. In this regard, I would like to suggest the direction through hierarchical analysis (AHP) through conducting with a group of experts who can make professional judgments about the development of dementia medical technology, including the four-year university senior welfare department, nurses, directors and directors of long-term care institutions, medical device workers and experts' opinions on what sectors SMEs can most effectively apply to product development to enter the dementia market.

A Study on the Establishment of Impedance/Conductance Guide Line for Diagnosis of Lead-Acid Battery's State of Health(SOH) (납축전지 건전상태 진단을 위한 기준 임피던스/컨덕턴스 설정에 관한 연구)

  • Kim, Chong-Min;Bang, Sun-Bae;Shong, Kil- Mok
    • The Transactions of the Korean Institute of Electrical Engineers P
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    • 제58권2호
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    • pp.214-220
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    • 2009
  • Battery is one of the emergency power and its reliability is a very important to keep up the minimum of building capabilities in case of interruption of electric power. This paper, a comparison was made between three different types of instrument on 30 valve regulated lead acid(VRLA) TYPE 12[V]/100[AH] batteries, and then their indicated measured values(impedance/conductance) were compared with the measured capacity of the battery. As a result, Measured value of instrument is strongly related to battery's capacity in the same group battery and Impedance/Conductance guide line for diagnosis of lead-acid battery's state of health(SOH) is a different from each battery guoup.

A Case of Mucous Membrane Pemphigoid: From Diagnosis to Therapeutic Strategy

  • Kang, Kun-Hwa;Byun, Jin-Seok;Jung, Jae-Kwang;Choi, Jae-Kap
    • Journal of Oral Medicine and Pain
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    • 제46권2호
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    • pp.63-68
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    • 2021
  • Mucous membrane pemphigoid (MMP) is a heterogeneous group of chronic, autoimmune subepithelial blistering diseases, predominantly involving oral mucosal membrane. Because of its pathophysiology of autoimmune reaction, MMP-related gingivitis would not respond to conventional periodontal treatments. We present a case of a 65-year-old female with a chief complaint of chronic generalized buccal gingivitis, unimproved after periodontal treatment for four months. Based on the clinical findings, histological examination, and direct immunofluorescence microscopy, it was diagnosed as MMP. The symptoms were relieved with immunomodulatory therapy using corticosteroids and the supportive management of professional plaque control. MMP can cause pathological involvement throughout the oral and other mucosae of the body, thus leading to functional impairment through repeated inflammatory cascades. Therefore, accurate diagnosis is essential to properly manage local and possible systemic complications of MMP.

Considerations in the Diagnosis and Treatment of Temporomandibular Disorders in Children and Adolescents: A Review

  • Ji-Won Ryu
    • Journal of Oral Medicine and Pain
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    • 제48권3호
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    • pp.75-80
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    • 2023
  • Temporomandibular disorders (TMDs) are a group of musculoskeletal disorders that encompass symptoms caused by abnormalities of the craniofacial structures of the temporomandibular joint (TMJ), muscles involved in the masticatory system, and other related tissues or structures. Although TMDs can occur at any age, research on the prevalence, epidemiology, and treatment strategies of TMDs has been conducted in all age groups, but primarily in adults. Unlike adults, children and adolescents are in a period of cognitive and physical development. Because of this growth potential, children respond better to TMD treatment than adults do. However, clinicians must remember that chronic pain and growth abnormalities can occur if the patient's symptoms and signs are not accurately diagnosed and treated. This article reviews the growth and development of the craniofacial region, including the TMJ, and discusses considerations when diagnosing and treating TMDs in children and adolescents.

Relations between Clinical Findings and Treatment Results in Patients with Temporomandibular Disorders (측두하악장애환자의 임상양태와 치료결과와의 관계)

  • Hee-Young Oh;Kyung-Soo Han
    • Journal of Oral Medicine and Pain
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    • 제20권2호
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    • pp.407-420
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    • 1995
  • This study was performed to evaluate and compare conservative treatment results by several parameters such as age, sex, symptom duration, type and timing of joint sound, parafunctional habits, splint type, and diagnostic classification. There have been too many articles reporting long term results of conservative treatment but articles related to comparison of treatment results by patients' self-evaluation have been rarely reported. For this study 258 patients with temporomandibular disorders(TMDs) were selected and examined by routine diagnostic procedure for TMDs. The subjects were classified into 5 TMDs subgroups ad treated with conservative treatments involving splints, physical modalities, jaw exercises, and counseling. Visual analogue scale(VAS) about pain, joint sound, and mouth opening limitation was recorded respectively during treatment period. From the VAS data and treatment duration, VAS treatment index(VAS Ti) was calculated. The obtained results were as follows : 1. Pain was the most frequent main symptom in subjects with temporomandibular disorders, and main symptom for mouth opening limitation was comparatively less than for pain or sound in disk displacement with reduction group or in degenerative joint disease group. 2. Degenerative joint disease group had the most poor treatment results and highest occlusal index of Helkim's index. 3. Good prognosis for conservative treatment was observed in acute group, under 6 months than chronic group, 6months over in symptom duration, and subjects with 40 years over in age showed the most poor prognosis. 4. Subjects treated with anterior repositioning splint had better treatment results than subjects treated with centric relation splint, but statistical significance in VAS Ti and treatment duration was not observed. 5. Treatment results according to affected side, types and point of joint sound did not show consistent statistical results. 6. The result for conservative treatment was observed poor in subjects with bruxism and clenching. 7. In studying coincidence between preferred chewing and affected side, frequency of preferred chewing side, in unilateral affection, was higher in ipsilateral than in contralateral side.

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Neuroblastoma: Review of 20-year Experiences (신경모세포종: 20년 치료 경험의 분석)

  • Moon, Suk-Bae;Lee, Seong-Cheol;Park, Kwi-Won;Jung, Sung-Eun
    • Advances in pediatric surgery
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    • 제15권1호
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    • pp.27-37
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    • 2009
  • Neuroblastoma is the most common extracranial solid tumor in children. We retrospectively analyzed the results of neuroblastoma treatment of 191 patients (116 males and 75 females) treated between January 1986 and December 2005 at the Department of Pediatric Surgery and the Department of Pediatrics, Seoul National University Children's Hospital. The mean age at diagnosis was 3.1 years (0.1 yrs - 13.5 yrs). Forty-seven patients were under 1 year of age. The mean follow-up period was 57.3 months (24 days - 19.1 yrs). Patients were classified into two groups according to the completeness of resection of the primary tumor; (1) gross total resection (GTR) and (2) incomplete resection (IR). The number of patients in stages I, II, III, IV, IV-S were 17 (8.9 %), 12 (6.3 %), 43 (22.5 %), 114 (59.7 %), 4 (2.1 %), respectively. GTR was achieved in 120 patients and IR in 71 (22 stage III, 47 stage IV, 1 stage IV-S, 1 brain). Overall survival (OS) was 65.2 % and event-free survival (EFS) was 48.6 %. EFS were 100 %, 75 %, 66.8 %, 31.3 %, 75 % at stage I, II, III, IV, IV-S, respectively. There was no significant difference in EFS according to the completeness of resection. EFS was improved in GTR group (p=ns) of stage III, but by contrast, stage IV patients showed worse EFS in GTR group. EFS was improved significantly after the introduction of autologous stem cell transplantation (ASCT) (58.1% vs. 40.6%, p=.029). The EFS improved significantly after the introduction of ASCT in IR group (p=.009) rather than GTR group (p=ns). The EFS of the patients under 1 year of age (N=47) was better than the patients over 1 year of age (N=144) significantly (75.5 % vs. 39.4 %, p=.0034). The prognosis of neuroblastoma was related to the INSS stage and age at diagnosis. The survival of IR group significantly improved after ASCT.

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