• Title/Summary/Keyword: Diagnosis-Related Group

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A Study on the Police Organizational Health Diagnosis Index Development (경찰 조직건강 진단지표에 관한 시론적 논의)

  • Kwon, Hye-Rim;Joo, Jae-Jin
    • The Journal of the Korea Contents Association
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    • v.14 no.8
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    • pp.150-155
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    • 2014
  • This study explored the police organizational health diagnosis index development. and the ultimate purpose of this study is to suggest the ways for the police to develop the police organizational health diagnosis index and then to raise the organizational effectiveness. A police organizational health diagnosis index comprises three categories; Organizational Behavior, Group Behavior, and Individual Behavior. A Organizational Behavior questionnaire comprises five categories; Organizational Structure, Organizational atmosphere, Environmental Compliance, Transformational Leadership, and Communication & decision-making. Secondly, A Group Behavior questionnaire comprises five categories; How to manage the personnel, Conflict management style, Group cohesion, Vision and Strategy, and Community-oriented & shared responsibility. Thirdly, An Individual Behavior questionnaire comprises five categories; Job Motivation, work-related factors, Trust, Vitality, and Organizational Cynicism. This author expects this study to contribute to the development of an adequate measuring instrument of the police organizational health diagnosis index.

Study about Oriental Medical Diagnosis and Approach Related to Weighting According to Differentiation of Chronic Tension-type Headaches (만성 긴장성 두통의 한의학적 진단 및 변증의 가중치에 대한 접근방법 연구)

  • Lee, Ki-Su;Kim, Min-Jung;Park, Mi-Ra;Lee, Sang-Bong;Hong, Kwon-Eui
    • The Journal of Korean Medicine
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    • v.31 no.5
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    • pp.41-59
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    • 2010
  • Objective: Headache is one of the most common symptoms in primary medical care. The purpose of this study was to support medical treatment by consideration of a new CTTH (chronic tension-type headache) oriental medical diagnosis index. Methods: An Oriental medical diagnosis questionnaire was administered to a CTTH group, migraine group and normal group. The result was classified by using LDA, CART, factor diagnosis and tested in comparison with the original diagnosis. Also, weighting method based on expert opinions was done. Results: 1. The result analyzed by using LDA has an accuracy of 93.9% in comparison with the original diagnosis. 2. High accuracy showed when the test was performed with about 35 significant questions and four questions selected based on SPSS Wilks' lambda. 3. There was accuracy of 90.9% when differentiation was performed by using CART compared with original diagnosis. 4. 10 factors has a high initial value after factor analysis, consisting of questions to the similar differentiation. 5. Diagnosis formula of headache was made by using weighting method based on expert opinions. Conclusion: Oriental medical diagnosis questionnaires make it possible to classify headaches significantly. The study about weighting method of CTTH can make it possible to classify symptoms more accurately.

Cephalometric Characteristics of TMD Patients based on RDC/TMD Axis I Diagnosis (RDC/TMD Axis I 진단에 따른 측두하악장애 환자의 측두 두부방사선적 특징에 관한 연구)

  • Ahn, Ji-Yeon;Kim, Yong-Woo;Kim, Young-Ku;Lee, Jeong-Yun
    • Journal of Oral Medicine and Pain
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    • v.36 no.1
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    • pp.39-51
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    • 2011
  • The aims of this study were to investigate whether the facial skeletal patterns previously reported to be related to temporomandibular disorder (TMD) in other studies could be consistently observed in the TMD patients diagnosed according to Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD) Axis I and evaluate its usability in the orthodontic clinics to examine the patients with TMD related symptoms. The clinical records and radiographs of female patients who visited the TMD and Orofacial Pain Clinic of Seoul National University Dental Hospital and were diagnosed as TMD were consecutively filed for this study. Patients were clinically examined and diagnosed according to the revised diagnostic algorithms of RDC/TMD Axis I and the lateral cephalogram, panoramic orthopantomogram, temporomandibular joint (TMJ) orthopantomogram, and transcranial radiograph of each patient were taken and digitalized. The data of patients who were under 18 years of age or had any systemic disease, trauma history involving the TMJ, or skeletal deformity at the time of the first examination were excluded. The remaining data of 96 female patients were finally analyzed. The obtained results were as follows: 1. There are no significant differences of cephalometric measurements between RDC I (muscle disorders) diagnostic groups. 2. Only the articular angle of the RDC group IIc (disk displacement without reduction without limited opening) patients was larger than patients of the no diagnosis of RDC II group (disk displacement). 3. Larger articular angle and smaller facial height ratio were observed in RDC IIIc group (osteoarthrosis) compared to IIIa group (arthralgia). Larger articular angle, larger Bjork sum, smaller posterior facial height, and smaller facial height ratio were observed in RDC group IIIc compared to no diagnosis of RDC III group (arthralgia, arthritis, and arthrosis). 4. According to the results of cephalometric analysis in simplified RDC groups, smaller overjet was observed in muscle disorders (MD) group. Facial height ratio and IMPA were smaller and articular angle was larger in disk displacements (DD) group than in no diagnosis of DD group. In arthrosis (AR) group, posterior facial height, and facial height ratio were smaller, and articular angle, gonial angle, facial convexity, FMA, Bjork sum, and ANB were larger than in no diagnosis of AR group. In joint pain (JP) group, only posterior facial height was smaller than no diagnosis of JP group. In conclusion, Facial morphologic patterns showing posterior-rotated mandible and lower posterior facial height is related to RDC group II and III diagnosis of the TMJ in female TMD patients. RDC/TMD Axis I diagnosis can provide a good clinical diagnostic tool for the standardized examination of the TMJ in orthodontic clinics.

Lifestyle Behaviors in Patients With Gastric Cancer: Continuous Need for Alcohol Abstinence and Muscle Strength Training Education

  • Ji Won Seo;Kyu Na Lee;Kyung Do Han;Ki Bum Park
    • Journal of Gastric Cancer
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    • v.24 no.3
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    • pp.316-326
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    • 2024
  • Purpose: This study was performed to assess the lifestyle-related behaviors of patients with gastric cancer (GC) and to investigate the associations between the time since GC diagnosis and these behaviors. Materials and Methods: This study included 29,478 adults (including 338 patients with GC) aged ≥ 40 years who participated in the Korea National Health and Nutrition Examination Survey 2014-2021. Multiple logistic regression analysis explored the associations between the time since GC diagnosis (patients diagnosed with GC less than 5 years ago [<5 years group] and those diagnosed with GC 5 or more than years ago [≥5 years group]) and lifestyle factors. Subgroup analyses were conducted based on age and sex. Results: The current smoking rate was not lower in the GC group than in the healthy group, regardless of time since diagnosis. Compared to the healthy controls, monthly alcohol intake was lower in the <5 years group (odds ratio [OR], 0.450; 95% confidence interval [CI], 0.275-0.736). The ≥5 years group showed a lower rate of strength training (OR, 0.548; CI, 0.359-0.838), compared with the healthy control group. Subgroup analysis focusing on the ≥5 years group revealed a significantly lower rate of strength training, particularly in patients aged ≥65 years and male patients (OR, 0.519 and 0.553; CI, 0.302-0.890 and 0.340-0.901, respectively). Conclusions: Clinicians should continue educating patients on lifestyle behavior modifications, particularly alcohol abstinence, even beyond 5 years after GC diagnosis. Education on strength training is especially important for patients ≥65 years or male patients.

Personality Profiles of Patients Who Visit Oriental Neuropsychiatric Clinic : Analysis of Temperament and Character Inventory(TCI) (기질 및 성격검사(TCI)에 나타난 한방신경정신과 환자의 전반적 특성 및 화병 환자의 특성)

  • Kim, Sang-Young;Song, Seung-Yeon;Chung, Sun-Yong;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.4
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    • pp.107-122
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    • 2012
  • Objectives : The purpose of this study is to examine the general personality profiles of patients who visited an oriental neuropsychiatric clinic and to investigate the specific profiles of patients diagnosed with Hwa-byung. Methods : We analyzed the profiles of 122 patients who completed TCI-RS questionnaire for the purpose of counseling. Patients were divided by sex, age and diagnosis related groups. Scales and subscales of each group were compared by an independent t-test and ANCOVA with SPSS windows 16.0. Types of temperament and character were classified by percentile ranks of the total patients and diagnosis related groups. Results : 1. Total patients were classified as the high harm avoidance type of temperament and of low self-directedness type of character. 2. Male patients showed significantly higher scores on NS, all subscales of NS, P2 and P3 than female patients. HA4 and C5 scores were significantly higher in the female group. Younger patients showed significantly higher scores on NS, all subscales of NS, HA1 and P3. However, older patients had significantly higher scores on SD4, SD5, ST2 and ST3. 3. Between diagnosis related groups, Hwa-byung group had significantly higher scores on RD, ST, SD3 and ST2. However P3 score of non-hwa-byung patients was higher than hwa-byung patients. In typical classification, both hwa-byung and non-hwa-byung groups were classified as the same types as total patients. Conclusions : This study showed that the patients visited an oriental neuropsychiatric clinic and had similar personality with that of general psychiatric disorders. Hwa-byung patients exhibited higher RD and ST scores than other disorders, but they had no typical differences.

Policy Elites' Perception of Health Policy Governance: Findings from In-depth Interviews of Korean New Diagnosis Related Group Payment (정책 전문가의 인식을 통해 본 한국 보건의료정책 거버넌스: 신포괄수가제 사례에 관한 심층면접 결과)

  • Shon, Changwoo;Kwon, Soonman;You, Myoungsoon
    • Health Policy and Management
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    • v.23 no.4
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    • pp.326-342
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    • 2013
  • Background: Engaging and Involving stakeholders who have different interests in changing health care policies are difficult task. As the literature on the governance in Korean health care field is rare, this study aims to provide empirical evidence of 'governing health policy'-the ways health care policy is made, implemented, and evaluated from a political perspective. Methods: The authors of this study conducted interviews with elites in policy and clinical areas, which was considered to be the most effective approach to gather in-depth information about the background of changing payment policy as well as the barriers or contributors for making the policy sustainable. A total of 14 experts (3 government officials, 2 representatives from medical profession, 3 professors form academic field, and 6 healthcare providers from New DRG pilot program hospitals) participated in 2 hour long interviews. Results: There was a perception gap of the feasibility and substantiality of new payment system among elites. The score was higher in government officers than those in scholars or clinical experts. Next, the interviewees indicated that Korean New DRG might not sustain without significant efforts to improving democratic aspects of the governance. It is also notable that all interviewees except healthcare providers provided negative expectation of the contribution of new payment system to increase administration efficiency. For clinical efficiency, every stakeholders perceived there was no increased efficiency after introduction of New DRG payment. Like general perception, there was a wide gap between the perception of stakeholders in quality change after implementing the new payment system. Finally, interview participants negatively assumed about the likelihood of New DRG to remain a case of successful reforms. Conclusion: This study implied the importance of social consensus and the governance of health policy.

Changes in Public Hospital Employees' Perceptions Following the Introduction of the New Diagnosis-Related Groups (DRG)-Based Payment System in the Republic of Korea (공공병원 직원들의 신포괄수가제 참여 전후 인식변화)

  • Kim, Hyun Joo;Lee, Jin Yong
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.30-44
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    • 2021
  • Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.

The Characteristics of 7-zone-diagnosis on Postpartum Depression (산후우울군과 비우울군의 7구역 진단기 특성연구)

  • Bak, Ji-Young;Lee, Eun-Hee;Ban, Ji-Hye;Kim, Tae-Hee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.3
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    • pp.146-155
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    • 2011
  • Objectives: Since early developed measurement of Postpartum depression(PPD) doesn't reflect physical symptoms, we need to find out how PPD and related physical disorders are expressed in functional medical methods. The study was conducted to find out characteristics of 7 Zone diagnosis and postpartum physical symptoms on PPD. Methods: To 216 postpartum women who did normal delivery, we measured 7-zone-diagnosis Factor AA's height on 5th day and 15th day postpartum. And we surveyed EPDS and postpartum physical symptoms question on 15th day postpartum. Subjects were divided into normal and depression group by EPDS score. And we compared Factor AA's height between two groups and Factor AA's height change in each group. Results: In depression group, Factor AA's height was higher than normal group on 5th day and 15th day postpartum. In both groups Factor AA's height was decreased on 15th day compared to 5th day postpartum. In normal group 2, 6, 7 zone were significantly decreased and in depression group only 6 zone was significantly decreased. Conclusions: These results demonstrate that postpartum depression group has low recuperative power. And these can be judged by Factor AA's height change.

Are Accuracy Studies for Periprosthetic Joint Infection Diagnosis Inherently Flawed? And What to Do with Schrödinger's Hips? A Prospective Analysis of the Alpha Defensin Lateral-Flow Test in Chronic Painful Hip Arthroplasties

  • Jesse W.P. Kuiper;Steven J. Verberne;Pim W. van Egmond;Karin Slot;Olivier P.P. Temmerman;Constantijn J. Vos
    • Hip & pelvis
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    • v.34 no.4
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    • pp.236-244
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    • 2022
  • Purpose: The most recent diagnostic criteria for periprosthetic joint infection (PJI) include the use of the alpha-defensin (AD) lateral-flow (LF) test, but hip and knee arthroplasties were usually combined in previous studies. This prospective study was designed to examine the accuracy of the AD-LF test for diagnosis of PJI in chronic painful total hip arthroplasties (THA). Materials and Methods: Patients with chronic painful hip arthroplasties were prospectively enrolled between March 2018 and May 2020. Exclusion criteria included acute PJI or an insufficient amount of synovial fluid. The modified Musculoskeletal Infection Society (MSIS) criteria were primarily used for PJI diagnosis. Fifty-seven patients were included in the analysis group. Revision surgery was not performed in 38 patients, for different reasons (clinical group); these patients remain "Schrödinger's hips": in such cases PJI cannot be excluded nor confirmed until you "open the box". Results: The result of the AD-LF test was positive in nine patients and negative in 48 patients. Six patients were diagnosed with PJI. AD-LF sensitivity (MSIS criteria) was 83% (95% confidence interval [CI] 36-100%) and specificity was 92% (95% CI 81-98%). The positive and negative predictive value were 56% and 98%, respectively. Conclusion: The AD test is useful in addition to the existing arsenal of diagnostic tools, and can be helpful in the decision-making process. Not all patients with chronical painful THA will undergo revision surgery. Consequently, in order to determine the reliable diagnostic accuracy of this test, future PJI diagnostic studies should include a second arm of "Schrödinger's hips".

Patterns of the Diagnosis Prevalence of Psychiatric Disorders in the Population Aged 0-18 Years Based on the Nationwide Insurance Sample Data

  • Lee, Seung Yup;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.4
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    • pp.214-224
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    • 2020
  • Objectives: This study aimed to examine the trend in diagnostic prevalence of psychiatric disorders in children and adolescents. Methods: Individuals aged 0-18 years were included in the study based on the National Health Insurance Claims Data. To investigate the trends in diagnosis and diagnostic prevalence of psychiatric disorders reflecting the decrease in the birth rate, data were analyzed from 2010 as a reference year to 2015. Results: The number of patients diagnosed with psychiatric disorder decreased annually, from 23,412 on 2010 to 18,821 on 2015. The most common disorder was hyperkinetic disorder in male and depressive episode in female. Although there was no significant change in overall diagnostic prevalence rate of psychiatric disorders, age groups <10 years and some disorders had significant changes in prevalence rate. This study classified the diagnostic prevalence by age into two unique patterns: group in which the diagnosis rate increases with age and group in which the diagnosis rate peaks at a certain age and then decreases. Conclusion: Diagnostic prevalence of psychiatric disorders was different according to age and sex. These patterns should be reflected in the formulation of policies related to mental health and in medical practice for pediatric patients. It is urgent to identify how these patterns change in young adults.