• Title/Summary/Keyword: Diagnosis-Related Group

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Factors Affecting of Relevance Index of the Regional Public Hospital: Focused on Refined Diagnosis-Related Group Impacts (지방의료원의 자체충족률에 영향을 미치는 요인: 수정 진단명기준환자군의 영향을 중심으로)

  • Yoon, Ari;Woo, Kyung-sook;Shin, Young-jeon
    • Health Policy and Management
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    • v.29 no.4
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    • pp.482-495
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    • 2019
  • Background: An important function of the regional public hospital is to satisfy the basic medical needs of the community through the stable provision of high-quality medical services. The purpose of this study was to identify the relevance index (RI) of the regional public hospital and to identify the factors that affect the RI. Methods: Data were obtained from the 2017 regional public hospital operation evaluation report and 2017 medical monitoring report for vulnerable area. RI of the regional public hospital was a dependent variable, and multiple regression analysis was performed with observed variables of medical supply-demand condition, medical supply, and medical supply structure. Direct effects and indirect effects were confirmed by the analysis of structural equation models (SEM) to see if there were mediating effects. Results: The RI was 13.1%, and the average of all percentage refined diagnosis-related group (RDRG) was 29.4%. Factors affecting RI were medical supply-demand conditions, medical supply, and medical supply structure. As a result of multiple regression analysis, RI was higher when high percentage RDRG of the regional public hospital (t=4.117, p<0.05), the size of regional public hospital location (t=-2.554, p<0.05), and the population of regional public hospital location (t =-2.415, p<0.05) were smaller. The results of the SEM analysis show that the higher the medical supply-demand conditions, the more direct effect of decreasing the RI and the indirect effect of decreasing the effect of reduction through the medical supply (direct effect=-1.322, total effect=-0.573, p<0.01). The higher the medical supply structure, the more direct effect on the RI (direct effect=1.047, p<0.05) and the higher the medical supply, the more indirect effect of RI through the medical supply structure (total effect=direct effect=0.619, p<0.05). Conclusion: It has been confirmed that the provision of medical services can affect the RI the regional public hospital which should be considered in carrying out future policies.

Clinical predictive diagnostic study on prognosis of Bell's palsy with the Digital Infrared Thermal Image (적외선 체열진단법을 이용한 Bell's palsy의 임상적 예후 진단 연구)

  • Song, Beom-Yong
    • Journal of Acupuncture Research
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    • v.18 no.1
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    • pp.1-13
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    • 2001
  • The Background and Purpose : Most diagnostic method for the facial palsy were invasive and complex. And we don't know very well prognosis for the recovery of facial palsy in the first stage after the onset. But the Digital Infrared Thermal Image(DITI) isn't invasive and complex diagnostic method for the facial palsy. So we should study on the clinical prognostic diagnosis of Bell's palsy among facial palsy with the DITI. Objective and Methods : This study researched into the clinical statistics for 89 case who are in Bell's palsy, and they are treated with oriental medical care at the Woosuk university during 2 years form November 1998 to October 2000. All objectives have the Grade 6(Zero state) of Bell's palsy in first week after the onset. It takes a patient's facial temperature after the onset. Group A is taken from 1 day to 4 days after the onset. Group B is taken from 5 day to 8 days after the onset. And group C is taken from 9 day to 12 days after the onset. Results and Conclusions : The Digital Infrared thermal image technique showed the more high temperature, the more rapid cure and short treatment period on TE23, B2, S3, S6 in abnormal site of Bell's palsy. But it showed the more low temperature, the more rapid cure and short treatment period on TE17 of abnormal site of Bell's palsy. As a conclusion, we could think that the prognostic diagnosis of Bell's palsy closely related with the thermal difference normal and abnormal site of Bell's palsy that were took picture after the onset.

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Breast and Cervical Cancer Related Practices of Female Doctors and Nurses Working at a University Hospital in Turkey

  • Kabacaoglu, Meryem;Oral, Belgin;Balci, Elcin;Gunay, Osman
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5869-5873
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    • 2015
  • Background: Breast and cervical cancers are among the most frequent and most fatal cancers in women. Life span of patients may be increased and quality of life improved through early diagnosis and treatment. This investigation was performed in order to determine knowledge and practices of female health personnel working at a university hospital regarding breast and cervical cancers. Materials and Methods: This descriptive investigation was performed in Erciyes University Hospitals in 2014. A total of 524 female health personnel were included in the study. Data were collected through a questionnaire of 36 questions prepared by the researchers. The Chi square test and logistic regression were used for statistical analyses. Results: The mean age of the study group was $32.8{\pm}6.9$ years, 18.3% being doctors and 81.7% nurses. Of the study group, 60.5% stated that they performed self breast-examination, 4.4% underwent HPV testing, 26.3% thought about taking an HPV test, 34.7% of those who are 40 years and over had mammography regularly and 19.5% of those who were married had a Pap smear conducted regularly. Most important causes of not performing the methods for early diagnosis of breast and cervical cancers are "forget and neglect". Conclusions: It was concluded that female doctors and nurses do not pay sufficient attention to screening programs for breast and cervical cancers. The importance of early diagnosis and treatment should be emphasized during the undergraduate education and in-service training programs. Health condition of personnel and their utilization of preventive health care should be followed by occupational physicians.

Association between Korean Medicine Hospital Utilization and Cardiovascular Risks in Patients with Hypertension: a National Korean Cohort Study (고혈압 환자에서 한방의료기관 이용과 심혈관 위험 요소와의 관계: 국민건강보험공단 표본코호트 DB)

  • Cho, Hyunjoo;Jung, Hyejin;Lim, Sabina
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.1-20
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    • 2019
  • Objectives: This study aims to investigate the effects of Korean Medicine Hospital Utilization (KMHU) on major adverse cardiovascular events (MACE), myocardial infarction (MI), stroke, and death in hypertensive patients taking antihypertensives. Methods: Using the Korean National Health Insurance Service-National Sample Cohort database, this study identified and diagnosed 68,457 hypertensive patients taking antihypertensives between 2003 and 2006. They were divided into KMHU and non-KMHU groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke, or death. After propensity score matching (PSM), there were 18,242 patients each in the non-KMHU and KMHU groups. We calculated the incidence rate, hazard ratio (HR), and 95% confidence interval (CI) for MACE, myocardial infarction, stroke, and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. Results: After PSM, the HRs for MACE (HR: 0.84, 95% CI: 0.81-0.87), all-cause mortality (HR: 0.75, 95% CI: 0.72-0.79), and myocardial infarction (HR: 0.90, 95% CI: 0.83-0.97) were significantly lower in the KMHU group than in the non-KMHU group. Moreover, the HRs for stroke-related mortality, haemorrhage and ischaemic stroke-related mortality, and ischaemic heart disease-related and circulatory system disease-related mortality were significantly lower in the KMHU group than in the non-KMHU group. Conclusions: On long-term follow-up observation, this study supported the effect of KMHU for managing hypertension and reducing the burden of cardiovascular diseases.

The Diagnostic Values of Ryodoraku and Pulse Analysis for Respiratory Disease Patients (호흡기계 환자에 대한 양도락 ${\cdot}$ 맥진검사의 진단적 가치)

  • Hwang, Joon-Ho;Jung, Seung-Yeon;Jung, Sung-Ki
    • The Journal of Internal Korean Medicine
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    • v.28 no.3
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    • pp.560-569
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    • 2007
  • Objectives : Ryodoraku is a physiological function test using electric current, and is closely related to skin sympathetic tone. Pulse analysis is known to reflect cardiovascular reactivity. There has been no report on the correlation between ryodoraku and pulse analysis in respiratory diseases. The present study examined the diagnostic values of ryodoraku and pulse analysis for respiratory disease patients Methods : For this study, we conducted ryodoraku and pulse analysis in 103 people including 79 respiratory disease outpatients who visited the $5^{th}$ Internal Department of the Oriental Medicine Hospital of Kyung Hee University during the period from January 1, 2003 to July 25, 2006, and 24 volunteers who did not have any respiratory symptoms or disease history. The respiratory disease patients were divided into five sub-groups according to their symptom: cough-sputum group, wheezing-dyspnea group ' nasal symptoms group. cold-prone group, and fatigue prone group. We compared the disease groups with the control group in six items as follows : mean ryodoraku, mean H1, mean elastic index, the percentage of those with mean ryodoraku below $40{\mu}A$, the percentage of those with HI beyond the physiological range, and the ratio of left : right of elastic index Results and Conclusions : Ryodoraku and pulse analysis were found to have a high value as quantitative diagnosis tools reflecting individuals' weakness and firmness. The results of this research suggest that ryodoraku and pulse analysis have value as tools for diagnosing respiratory diseases.

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A Survey on the Sasang Constitution Clinical Study;In the Journal of Sasang Constitutional Medicine (사상체질 임상 연구 현황에 대한 조사연구;사상체질의학회지를 중심으로)

  • Lee, Si-Woo;Hwang, Ji-Ho;Yu, Jong-Hyang;Oh, Seung-Yun;Joo, Jong-Cheon;Jang, Eun-Su
    • Journal of Sasang Constitutional Medicine
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    • v.20 no.2
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    • pp.21-29
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    • 2008
  • 1. Objectives and Methods It has been examined 703 papers of Sasang Constitution Society published from 1989 to 2007. Among them, the study methods have been classified focused on 332 papers related to clinical research and the method of constitution diagnosis and subjects have been researched to research the reality of the clinical research of Sasang Constitutional Medicine. 2. Results 1. The rest studies are the most which can not be classified by existing study method among 332 clinical studies. 2. The study of patient control group is 17 cases and the clinical experiment is one case, so highly well-grounded studies have not been performed. 3. The most method of constitution diagnosis is the constitution diagnosis by experts and by QSCC. 4. The number of constitution diagnosis method performed in the research institution is within 2. They are 254 cases(89.5%). 5. The studies which utilize more than 3 constitution methods are 22 cases and the studies that use medical rash are 7cases(31.8) 6. The 215 cases that subjects are less than 100 are the most and 100${\sim}$500 subjects are 71 cases. 500${\sim}$10000 subjects are 33 cases and more than 1000 subjects are 15 cases. 3. Conclusions Therefore, it is needed to increase the rate of highly well-grounded studies and set the standard criteria by providing constitution diagnosis guideline.

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Cross Mapping of Standardized Nursing Diagnoses and Problems with NANDA-I in 4 Tertiary Hospitals (표준화된 간호진단 및 문제와 NANDA-I 교차분석: 4개 상급종합병원 사례를 중심으로)

  • Song, Mi Ra;Shim, So Yun;Kim, Dae Sung;Lee, Kyung Soon;Lee, Yu Na;Won, Mi Suk
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.374-384
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    • 2020
  • Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion: It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

Age Differences in Signs and Symptoms of Patients with Temporomandibular Disorders

  • Jo, Jung Hwan;Park, Ji Woon;Kim, Ji Rak;Seo, Hyong Duk;Jang, Ji Hee;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • v.40 no.2
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    • pp.55-62
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    • 2015
  • Purpose: The aims of this study were to evaluate the differences in subjective symptoms, clinical characteristics, distribution according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) subgroup, psychological profile of TMD patients, and to identify the prevalence and trend according to age. Methods: A total of 1,052 patients (261 men and 791 women; mean age, $34.40{\pm}15.73$ years) who visited the Orofacial Pain Clinic of the Department of Oral Medicine, Seoul National University Dental Hospital complaining of TMD symptoms of were evaluated. All patients were questioned for medical history, clinical symptoms and contributing factors. Clinical examination and patient grouping based on RDC/TMD was conducted. Radiographies were taken. The Korean version of RDC/TMD axis II and Symptom Checklist-90-Revision (SCL-90-R) were administered to evaluate pain-related disability level and psychological status of the patients. Results: Prevalence peaked in the 20-year-old age group. There were more women than men in all groups. The highest T-score among SCL-90-R dimensions was somatization in each group, except for teenagers who showed the highest T-score in interpersonal sensitivity. The 30-year-old age group showed the highest distribution of high disability based on the graded chronic pain scale. Age was positively associated with pain intensity (r=0.100), number of positive muscles on palpation (r=0.137) and negatively associated with maximum mouth opening (r=-0.168). Conclusions: Subjective symptoms and clinical characteristics of TMD patients show distinct tendencies according to different age groups. Treatment should be customized and personalized according to age for efficient symptom resolution and patient satisfaction.

Effects of Copper Reduction on Angiogenesis-Related Factors in Recurrent Glioblastoma Cases

  • Jazayeri, Shima;Feli, Alireza;Bitaraf, Mohammad Ali;Dodaran, Masoud Solaymani;Alikhani, Mazdak;Hosseinzadeh-Attar, Mohammad Javad
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.10
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    • pp.4609-4614
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    • 2016
  • Purpose: To evaluate the therapeutic effects of copper reduction on angiogenesis-related factors in patients with glioblastoma multiforme treated by gamma knife radiosurgery. Materials and Methods: In the present block randomized, placebo-controlled trial, fifty eligible patients with a diagnosis of glioblastoma multiforme who were candidates for gamma knife radiosurgery were randomly assigned into two groups to receive daily either 1gr penicillamine and a low copper diet or placebo for three months. The intervention started on the same day as gamma knife radiosurgery. Serum interleukin-6 (IL-6), tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), vascular endothelial growth factor (VEGF) and copper levels were measured at baseline and after the intervention. The serum copper level was used as the final index of compliance with the diet. In order to control probable side effects of intervention, laboratory tests were conducted at the beginning, middle and end of the study. Results: The patients had a mean age and Karnofsky Performance Scale of 43.7 years and 75 respectively. Mean serum copper levels were significantly reduced in intervention group. Mean survival time was 18.5 months in intervention group vs. 14.9 in placebo group. VEGF and IL-6 levels in the intervention group were also significantly reduced compared to the placebo group and $TNF-{\alpha}$ increased less. Conclusions: It seems that reducing the level of copper in the diet and dosing with penicillamine leads to decline of angiogenesis-related factors such as VEGF, IL-6 and $TNF-{\alpha}$. Approaches targeting angiogenesis may improve survival and can be used as a future therapeutic strategy.

A study on the use of Alternative Therapies for Cancer Patients Undergoing Chemotherapy (항암화학요법제 투여 중인 암환자의 대체요법 이용실태 및 의사결정요인)

  • Oh, Hyo-Sook;Park, Hyeoun-Ae
    • Asian Oncology Nursing
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    • v.4 no.1
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    • pp.5-15
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    • 2004
  • Purpose: This study was conducted to examine utilization of alternative therapies and understand decisional criteria related to use of alternative therapies among chemotherapy patients. Method: Data were collected from 165 cancer patients through the use of questionnaire and interviews at the chemotherapy treatment rooms of two general hospitals located in Seoul. Result: Sixty point six percent of subjects after cancer diagnosis have experience of using alternative therapies and 39.4% were still using alternative therapies. On the average the patients used alternative therapies for 9.4 months and they paid 483,000 Won per month for alternative therapies. Decisional criteria related to use of alternative therapy were curability, social group influence about alternative therapy, confidence in alternative therapy, present symptoms, and who decide on the use of alternative therapy. These variables in the alternative therapy group were statistically different from those of the hospital treatment only group. Conclusion: Utilization rate of alternative therapy among chemotherapy patients is high and cost burden is heavy. Thus, they need to be educated about utilization of alternative therapy by nurse and medical personnel.

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