• Title/Summary/Keyword: Diagnostic study

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The Impact of Diagnostic Imaging Fee Changes to Medical Provider Behavior: Focused on the Number of Exams of Computed Tomograph (영상진단 수가 변화가 의료공급자 진료행태에 미치는 영향: 전산화단층영상진단 검사건수를 중심으로)

  • Cho, Su-Jin;Kim, Donghwan;Yun, Eun-Ji
    • Health Policy and Management
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    • v.28 no.2
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    • pp.138-144
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    • 2018
  • Background: Diagnostic imaging fee had been reduced in May 2011, but it was recovered after 6 months because of strong opposition of medical providers. This study aimed to analyze the behavior of medical providers according to fee changes. Methods: The National Health Insurance claims data between November 2010 and December 2012 were used. The number of exams per computed tomography was analyzed to verify that the fee changes increased or decreased the number of exams. Multivariate regression model were applied. Results: The monthly number of exams increased by 92.5% after fee reduction, so the diagnostic imaging spending were remained before it. But medical provider decreased the number of exams after fee return. After adjusting characteristic of hospitals, fee reduction increased the monthly number of exams by 48.0% in a regression model. Regardless type of hospitals and severity of disease, the monthly number of exams increased during period of fee reduction. The number of exams in large-scaled hospitals (tertiary and general hospital) were increased more than those of small-scaled hospitals. Conclusion: Fee-reduction increased unnecessary diagnostic exams under the fee-for-service system. It is needed to define appropriate exam and change reimbursement system on the basis of guideline.

Shanghanlun Diagnostic System : Exploring Value as Narrative Medicine by Analyzing Cases (사례분석을 통한 『상한론(傷寒論)』 변병진단체계(辨病診斷體系)의 서사의학적 가치의 탐색)

  • Kim, Jin-A;Lee, Sung-Jun
    • 대한상한금궤의학회지
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    • v.6 no.1
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    • pp.1-25
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    • 2014
  • Objective : The purpose of this study is exploring value of Shanghanlun six diagnostic system as Narrative Medicine by analyzing cases. Methods : In the article, we examined the theory of narrative medicine and current studies. And then key elements of narrative medicine was defined. On the basis of these, two medical cases were analyzed by reordering in accordance with time sequences and causality for confirming narrative factors. Results : The narrative approach to analyzing cases shows us that different diseases could be the result of same pathological patterns based on Shanghanlun. This tells us following four aspects. [1] Shanghanlun is the causes-oriented records and the text includes narrative factors. [2] Shanghanlun six diagnostic system is a process of constructing plot of medical case history through the clinical interpretation of contextual meaning of patient's life. [3] In the process of diagnosis, Schemata and script are engaged in assuming and confirming six patterns diseases. [4] The subjective factors of an individual can be applied universally through the provision of Shanghanlun. Conclusions : Narrative factors of Shanghanlun six diagnostic system suggest the possibility and value of Shanghan Medicine as Narrative Medicine in terms of Medical Humanities, essence of medical diagnosis and therapeutic action.

Diagnostic Distribution of Psychiatric Disorders among Korean Young Adults

  • Hwangbo, Ram;Chang, Hyejung;Bahn, Geon Ho
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.31 no.2
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    • pp.80-87
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    • 2020
  • Objectives: The prevalence of psychiatric disorders among young adults is different from that among younger or older age groups because of biological and environmental changes. The purpose of this study was to analyze the diagnostic distribution of psychiatric disorders in 19-30-year-old Koreans based on their age and gender using data from the Korean National Health Insurance Service (NHIS). Methods: From the 2011 medical claims sample data of NHIS of 1,375,842 people, we extracted the data of 221,038 people aged 19-30 years, including 106,232 (48.1%) men and 114,806 (51.9%) women. We evaluated the overall changes in the diagnostic distribution of psychiatric disorders over a 3-year period. Results: The diagnostic frequency in women was 13,627 (59.0%), which was significantly higher than that in men. "Other anxiety disorders" was the most common psychiatric disorder in both genders, followed by depressive episodes, somatoform disorders, "other neurotic disorders," and nonorganic sleep disorders. In men, attention-deficit/hyperactivity disorder or intellectual disabilities were not among the top 10 disorders. In women, no significant changes in major psychiatric disorders were seen over the 3-year period. Conclusion: These results reveal the trends of diagnostic distribution of mental illnesses depending on the development, particularly in young adulthood. It is necessary to identify whether such trends are due to biological or environmental factors, aging processes, or complex influences.

A Study of Diagnostic Algorithm for Quantitative Evaluation of the Stress Urinary Incontinence (복압성요실금의 정량적 평가를 위한 진단 알고리즘에 관한 연구)

  • Min, Hae-Ki;Noh, Si-Cheol;Choi, Heung-Ho
    • Journal of IKEEE
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    • v.12 no.2
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    • pp.87-94
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    • 2008
  • Pelvic floor muscle is the main subsystem that maintains urinary continence. It is possible to diagnose the degree of the stress urinary incontinence(SUI) by evaluating the contraction pressure of the pelvic floor muscle. Bio-signal measurement system was developed to measure the contraction pressure. Diagnostic parameters were drawn out by analyzing the measured data. Statistical evaluations were done to classify the all subjects with five groups each has similar characteristics. SUI diagnostic algorithm was implemented to each group separately. The accuracy of the algorithm was about 78.9% and utility was confirmed by clinical trial.

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DIAGNOSTIC ABILITY OF THE PERIAPICAL RADIOGRAPHS AND DIGITAL IMAGE IN THE DETECTION OF THE ARTIFICIAL PROXIMAL CARIES (인공적 인접면 치아우식증의 구내방사선사진과 디지털 영상의 진단능 평가)

  • Heo Min-Suk;You Dong-Soo
    • Journal of Korean Academy of Oral and Maxillofacial Radiology
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    • v.24 no.2
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    • pp.439-450
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    • 1994
  • Recently, the digital image was introduced into radiological image. The digital image has the power of contrast enhancement, histogram control, and other digitally enhancement. At the point of the resolution, periapical radiograph is superior to the digital image, but enhanced digital procedure improves the diagnostic ability of the digital image. The purpose of this study was to evaluate the diagnostic ability of artificial proximal caries in conventional radiographs, digital radiographs and enhanced digital radiographs (histogram specification). ROC (Receiver Operating Characteristic) analysis and paired t-test were used for the evaluation of detectability, and following results were acquired: 1. The mean ROC area of conventional radiographs was 0.9274. 2. The mean ROC area of unenhanced digital image was 0.9168. 3. The mean ROC area of enhanced digital image was 0.9339. 4. The diagnostic ability of three imaging methods was not significant difference(p>0.05). So, the digital images had similar diagnostic ability of artificial proximal caries to conventional radiographs. If properly enhanced digital image, it may be superior to conventional radiographs.

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Development of a Web-based Diagnostic Evaluation Program for Prevention of Nurse Malpractice Liability (간호과오책임 예방을 위한 웹기반 진단평가 프로그램 개발)

  • Kim, Ki-Kyong
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.1
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    • pp.33-43
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    • 2011
  • Purpose: This study was done to develop a web-based diagnostic evaluation program for nurses to prevent malpractice liability. Methods: A comprehensive review of the literature and 9 specialist interviews were used to search for learning goals and content for protection for nurses from malpractice. Data on needs for learning goals were collected from 56 hospital nurses who agreed to complete a self-report questionnaire. The diagnostic program was evaluated between September 2008 and August 2009 by 35 new hospital nurses using an application of the web-based program evaluation tools by Chung (2000). Results: A comprehensive review of the literature and interviews were used to search for learning goals and content. The evaluation program was composed of the 73 questions for diagnostic evaluation under 23 learning goals and 6 grand learning goals which included the principles of law, patient's rights, legal responsibility, patient's safety, regulation on nursing practice and patient's rights protection. Evaluation of the program showed that the mean for program evaluation was 3.43 (SD=.37). Conclusion: This diagnostic evaluation program could be an efficient method for teachers and learners to improve nurses' behavior in protecting the patient's rights and preventing malpractice claims.

Comparison among diagnostic tools used for differential diagnosis of blood stasis pattern in Korea, China and Japan (한중일 어혈증 감별진단을 위한 도구의 비교)

  • Kim, Jiwon;Nam, Dong-Hyun
    • The Journal of the Society of Korean Medicine Diagnostics
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    • v.22 no.1
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    • pp.1-10
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    • 2018
  • Objectives The purpose of this study is to compare the representative differential diagnosis methods of blood stasis pattern used in Korea, China and Japan, and then to characterize each diagnostic method. Methods Through the journal databases, we have selected representative tools that were developed for differential diagnosis of blood stasis pattern in Korea, China and Japan. In order to characterize the selected check-lists or questionnaires, we investigated the number of items, contents, score calculation method, internal consistency, and accuracy of each selected tool. Results A total of four diagnostic tools were finally selected; quantitative diagnosis scale of blood stasis syndrome (QDSBSS), diagnostic criteria for blood stasis (DCBS), blood stasis questionnaire (BSQ), and blood stasis syndrome questionnaire (BSSQ). The key points in the differential diagnosis for blood stasis were different for each of the diagnostic tool. The key point was oral mucosa (including tongue) status in the QDSBSS. Meanwhile it was abdominal pain/resistance in the DCBS, and general pain in the BSQ. Accuracy of the QDSBSS, the BSQ and the BSSQ were powerful but all of them was not generalized. Conclusions Therefore, it is desirable to select and apply a plurality of appropriate tools according to the characteristics of the blood stasis patients.

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Quantitative Evaluation of the Stress Urinary Incontinence using the Contraction pressure measurement at the Pelvic Floor Muscle (골반저근의 수축압력 측정을 이용한 복압성요실금의 정량적 평가)

  • Min, H.K.;Noh, S.C.;Kwon, J.W.;Min, K.S.;Choi, H.H.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.1 no.1
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    • pp.13-19
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    • 2007
  • In this study, diagnostic algorithm was suggested to diagnose quantitatively the degree of the stress urinary incontinence. The bio-signal measurement system was developed to measure the contraction pressure of the pelvic floor muscle and diagnostic parameters were drawn out by analyzing the contraction pressure data. Statistical evaluations were done to classify the diagnositc parameters by order that relationship is high. The diagnostic algorithm that was able to diagnose degree of the urinary incontinence as quantitatively was realized from the high relationship parameters.

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Accelerating Magnetic Resonance Fingerprinting Using Hybrid Deep Learning and Iterative Reconstruction

  • Cao, Peng;Cui, Di;Ming, Yanzhen;Vardhanabhuti, Varut;Lee, Elaine;Hui, Edward
    • Investigative Magnetic Resonance Imaging
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    • v.25 no.4
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    • pp.293-299
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    • 2021
  • Purpose: To accelerate magnetic resonance fingerprinting (MRF) by developing a flexible deep learning reconstruction method. Materials and Methods: Synthetic data were used to train a deep learning model. The trained model was then applied to MRF for different organs and diseases. Iterative reconstruction was performed outside the deep learning model, allowing a changeable encoding matrix, i.e., with flexibility of choice for image resolution, radiofrequency coil, k-space trajectory, and undersampling mask. In vivo experiments were performed on normal brain and prostate cancer volunteers to demonstrate the model performance and generalizability. Results: In 400-dynamics brain MRF, direct nonuniform Fourier transform caused a slight increase of random fluctuations on the T2 map. These fluctuations were reduced with the proposed method. In prostate MRF, the proposed method suppressed fluctuations on both T1 and T2 maps. Conclusion: The deep learning and iterative MRF reconstruction method described in this study was flexible with different acquisition settings such as radiofrequency coils. It is generalizable for different in vivo applications.

Current situation and control strategies of H9N2 avian influenza in South Korea

  • Mingeun Sagong;Kwang-Nyeong Lee;Eun-Kyoung Lee;Hyunmi Kang;Young Ki Choi;Youn-Jeong Lee
    • Journal of Veterinary Science
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    • v.24 no.1
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    • pp.5.1-5.16
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    • 2023
  • The H9N2 avian influenza (AI) has become endemic in poultry in many countries since the 1990s, which has caused considerable economic losses in the poultry industry. Considering the long history of the low pathogenicity H9N2 AI in many countries, once H9N2 AI is introduced, it is more difficult to eradicate than high pathogenicity AI. Various preventive measures and strategies, including vaccination and active national surveillance, have been used to control the Y439 lineage of H9N2 AI in South Korea, but it took a long time for the H9N2 virus to disappear from the fields. By contrast, the novel Y280 lineage of H9N2 AI was introduced in June 2020 and has spread nationwide. This study reviews the history, genetic and pathogenic characteristics, and control strategies for Korean H9N2 AI. This review may provide some clues for establishing control strategies for endemic AIV and a newly introduced Y280 lineage of H9N2 AI in South Korea.