• 제목/요약/키워드: First-visit patient

검색결과 212건 처리시간 0.023초

노인환자에게 제공하는 개국약국 약료서비스의 경제적 가치 (Economic Value of Pharmaceutical Care for the Elderly Patients in Community Pharmacies)

  • 손현순;신현택
    • 약학회지
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    • 제51권5호
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    • pp.327-335
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    • 2007
  • This study was to evaluate economic impact of a comprehensive pharmaceutical care intervention provided by community pharmacists on drug-related morbidity and mortality in the elderly population, in a societal perspective. Clinical outcomes of pharmaceutical care included compliance increase, inappropriate medication discontinuation, and subsequent drug-related morbidity and mortality reduction. Economic outcomes included cost savings from direct medical costs reduction such as medication and healthcare resource utilization. Input costs for pharmaceutical care included pharmacist time and computerized prescription review supporting program costs. Model parameters of outcomes were derived from published literatures, and costs were from literatures and health insurance statistical data in Korea. Annual costs and benefits were estimated in the year 2005. Current usual care and standardized pharmaceutical care required 0.3 and 2.0 hours per year respectively, for elderly outpatient using average 4.4 prescription drugs per visit and average annual frequency of 17.8 pharmacy visits. Comprehensive pharmaceutical care provided to overall elderly outpatients at community pharmacies would have cost of \74,994 mil. and benefit of \357,002 mil. per year. Benefit:cost ratio was 4.8:1 and net benefit was \282,008 mil/year. It was corresponded to net benefit of \73,816/year for individual elderly patient. In addition, pharmaceutical care was estimated to reduce 1,531 drug-related deaths/year. Conclusively this study, a first attempt in Korea to evaluate an economic value of pharmaceutical care at community pharmacies, proved that it was a cost-effective intervention having significant economic benefit.

Clinical Observations on Treatment for Chinese Patients with Gastrointestinal Stromal Tumors

  • He, Zhan-De;Huang, Xin-En;Zhou, Jian-Nong
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.5111-5113
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    • 2015
  • Background: To investigate the diagnostic and treatment methods for Chinese patients with gastrointestinal stromal tumor (GIST). Materials and Methods: From January 2004 to June 2014, patients diagnosed with primary GIST and treated by a single medical team in the Department of Digestive Disease of XuYi Hospital of Traditional Chinese Medicine were retrospectively recruited. Re-examination and follow-up was conducted regularly and abdominal enhanced CT, blood biochemistry and responses to surgery or imatinib were recorded. Results: A total of 15 patients were enrolled, including 9 male and 6 female patients, with an average age of 54 years (ranging from 32-81 years). The primary symptoms were abdominal uncomfortable in 5 patients, abdominal pain in 6 patients as well as nausea and vomiting in 4 patients. One patient was diagnosed with bowl obstruction at the first visit. All patients were treated with surgery, and tumor site was confirmed 1 esophagus, 6 stomach, 4 small bowel, and 4 colorectal and all patients were pathologically diagnosed with GIST. Immunochemical test positive for CD 117 was found 12 patients, and positive for CD 34 in7 patients. The median follow-up time was 24 months (range of 3-63). Three metastasis were confirmed 1.5, 2 and 2.6 years postoperatively. Three patients were treatment by imatinib postoperatively. Conclusions: Surgery remains the main treatment method for Chinese patients with GIST and imatinib could be feasible and safe for treating Chinese patients with GIST.

청소년 측두하악장애 환자의 사이버여가활동과 신체활동 특성 (Cyber Leisure Activities and Physical Activities in Adolescents with Temporomandibular Disorder)

  • 김병수;허준영;옥수민;김경희;정성희;고명연;안용우
    • Journal of Oral Medicine and Pain
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    • 제38권2호
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    • pp.187-201
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    • 2013
  • 본 연구의 목적은 청소년 측두하악장애 환자의 개인 특성, 신체 활동 및 사이버여가활동과 턱관절증상과의 관계를 알아보기 위한 것이다. 부산대학병원 구강내과에 턱관절증상으로 내원한 11~19세 청소년 219명과 대조군 90명의 개인 특성, 사이버여가활동 및 신체활동과 측두하악장애 증상과의 관계를 조사하여 다음과 같은 결론을 얻었다. 환자군이 대조군에 비해 수면의 질이 더 낮았고, 사이버여가활동시간이 길고, 빈도가 더 잦았다. 환자군에서는 수면시간이 짧을수록 초진 시 느끼는 통증이 심했으며, 스트레스가 높을수록 신체활동이 더 적었고, 측두하악장애 증상이 심해질수록 사이버여가시간이 더 짧았다.

Bone-added osteotome sinus floor elevation with simultaneous placement of non-submerged sand blasted with large grit and acid etched implants: a 5-year radiographic evaluation

  • Jung, Jee-Hee;Choi, Seong-Ho;Cho, Kyoo-Sung;Kim, Chang-Sung
    • Journal of Periodontal and Implant Science
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    • 제40권2호
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    • pp.69-75
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    • 2010
  • Purpose: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. Methods: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. Results : All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. Conclusions: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.

조산 방지 및 자궁수축 관리의 한의학적 치료 (Prevention of Preterm Birth and Management of Uterine Contraction with Traditional Korean Medicine)

  • 김은섭;장은하;김남형;장새별
    • 대한한방부인과학회지
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    • 제29권4호
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    • pp.24-33
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    • 2016
  • Objectives: The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of Preterm Birth (PTB). Methods: It is a case report of a 38 year-old-woman hospitalized for irregular uterine contractions and cervical change at 33+3/7weeks of gestation. After 7 trials of IVF and artificial insemination, conception was successful via IVF with help of traditional Korean medicines. 2 TKMs were prescribed: Gami-danggui-san, and Antae-eum. 120 ml of Gami-danggui-san was given twice a day morning and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: As of 34+2/7 weeks of gestation, intermittent uterine contractions appeared (5-12 min) on cardiotocography and vaginal bleeding was also smeared at 34+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39+3/7 gestational weeks. Conclusions: Our report implies the potential of herbal medicine as a adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.

한국 치과병원내 진료과목의 공간배분계획에 관한 연구 (A Study on the Spatial Allocation Planning of Dental Care Departments in Dental Hospital in Korea)

  • 정태종;최재필
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제23권4호
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    • pp.27-36
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    • 2017
  • Purpose: The characteristics of spatial allocation planning in dentistry through examining the dental hospitals in Korea and comparison between them are necessary for the development of planning of the dental healthcare system. This study has been started to provide basic informations such as zoning, allocation distribution, and space configuration for the planning of dental hospital architecture. Methods: Literature review of dental care departments and investigation on current status of dental hospital in Korea have been conducted. The spatial allocation and space configuration of eleven dental hospitals have been analyzed. Results: The result of this study can be summarized in three points. The first one is that dental hospitals in Korea are consisted with eight to eleven dental care departments and they are divided with the horizontal allocation type with three to four departments in a floor for the spatial communication or the vertical allocation type with a department in each floor for the independent space. The second one is that oral medicine and oral maxillofacial radiology are located near the main entrance, orthodontics and pedodontic dentistry in lower level, prosthodontics in upper level, and conservative dentistry and periodontics have no specific spatial consideration. The third one is that the factors to consider the allocation planning are zoning for examination & diagnosis, basic practice, adolescence, surgery, circulations for patient, dentist, staff, different access for department like as easy access for reception and pedodontic dentistry, enclosure space for prosthodontics and surgery, frequency of visit and treatment care time, and change of treatment concept from treatment department to disease control corporative practice. Implications: This study is the starting point for the research of spatial configuration in dentistry and it is necessary to analyze the architectural planning to develop the dental healthcare system.

Longitudinal management of recurrent temporomandibular joint ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment

  • Lim, Seung-Weon;Choi, Jin-Young;Baek, Seung-Hak
    • 대한치과교정학회지
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    • 제49권6호
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    • pp.413-426
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    • 2019
  • This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

A Case Series of Symptomatic Distal Biceps Tendinopathy

  • Lee, Jung Hyun;Kim, Kyung Chul;Lee, Ji-Ho;Ahn, Kee Baek;Rhyou, In Hyeok
    • Clinics in Shoulder and Elbow
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    • 제21권4호
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    • pp.213-219
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    • 2018
  • Background: The study of conservative and surgical treatment of distal biceps tendinopathy and associated biceps tendon partial rupture. Methods: Twenty-one cases with distal biceps tendonitis and partial ruptures were studied who visited Pohang Semyeong Christianity Hospital from June 2010 to August 2017. The mean age was 57.1 years (39-69 years), 14 males and 7 females. The mean duration of symptom at the time of first visit was 4.9 months (0.2-14 months). Ultrasonography and magnetic resonance imaging were performed for patients with severe symptoms. According to the severity of the symptoms, splint immobilization, oral nonsteroidal anti-inflammatory drugs, and ultrasound-guided steroid injection were performed. Surgical treatment was performed if the patient did not respond to conservative treatment for 3 to 6 months or longer. Results: There were 9 cases of partial rupture of the distal biceps tendon associated with distal biceps tendinopathy on imaging studies. Conservative treatment showed symptomatic improvement in 16 of 21 cases. In 4 cases with a relatively mild symptom, anti-inflammatory analgesics and intermittent splinting showed good result. In 12 cases, symptoms improved after ultrasonography-guided steroid injection. Surgical treatment was performed on 5 cases that did not respond to conservative treatment. Conclusions: Conservative treatment of distal biceps tendinopathy may promise good results. However, in case of partial tear of the distal biceps tendon and refractory to conservative treatment, surgical treatment may be needed.

보건의료 빅데이터를 활용한 소아 감기 치료의 동향 조사 (A Study on the Trend of Childhood Common Cold Treatment Using Health Big Data)

  • 김태정;성현경;민상연
    • 대한한방소아과학회지
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    • 제36권2호
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    • pp.1-12
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    • 2022
  • Objectives We analyzed visiting patterns to medical institutions and cost per visit according to the common cold patients aged 0-19 years. We analyzed Korean medical treatment for common cold. Methods Using the Pediatric Patient Sample data of the Health Insurance Review and Assessment Service (HIRA-PPS), we analyzed the data on health insurance claims of approximately 1 million people from 2017 to 2019. The data included the number of patients who visited the hospital due to common cold for the first and second time, the ratio of second visits by type of medical institution, and the status of prescriptions in Korean medical institutions. Results The number of patients visiting healthcare providers for common cold was higher in Western medical institutions than in Korean medical institutions. However, the number of second visits was higher in Korean medical institutions. Acupuncture is the most commonly used medical treatment in Korean medical institutions for common cold. Herbal medicine for common cold was usually prescribed for 2-3 days for children and adolescents. Conclusions Although the average medical cost of Korean medical institutions was higher than that of Western medical institutions, the rate of second visits to Korean medical institutions was higher because of the demand for Korean medical treatment

척추 신경 차단술 환자 특성이 주사시술의 공포감과 방사선의 위험 인식에 미치는 영향 (Effect on Fear of Injection Procedures and Radiation Risk Recognition on Patients Characteristics Undergo Spinal Nerve Block)

  • 차진영;성열훈
    • 대한방사선기술학회지:방사선기술과학
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    • 제45권2호
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    • pp.171-177
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    • 2022
  • The purpose of this study was to investigate the effect of the characteristics of patients who underwent spinal nerve block on the fear of injection and the risk of radiation. Subjects were 137 patients (67 males, 70 females) who visited the Department of Anesthesiology and Pain Medicine in Cheongju. The method was conducted as a research study using a total of 28 questionnaires consisting of patient characteristics, experience characteristics of nerve block surgery, nerve block fear scale, and radiation risk perception scale. The reliability of the questionnaire response was secured with a Cronbach's alpha coefficient of 0.6 or higher. For statistical analysis, correlation was tested by descriptive statistics, frequency analysis, independent sample T-test, and Pearson and Spearman correlation coefficients by measurement scale and factor. As a result, the fear scale of nerve block was significantly higher in women than in men (p<0.05). The fear scale of nerve block injection was significantly higher in the first-visit patients than in the second-visited patients (p<0.05). However, there was no significant difference among all variables in radiation risk perception. In conclusion, patients undergoing spinal nerve block were more aware of the fear of injection than the risk of radiation exposure during the procedure.