• 대한한의학회지
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• 제42권3호
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• pp.1-8
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• 2021

Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

• Journal of Nutrition and Health
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• 제41권2호
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• pp.147-155
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• 2008

우리나라의 경제적 발달과 문화 수준의 향상으로 질병 양상과 사망 원인에 많은 변화가 있는데, 그 중에서도 최근 당뇨병의 유병률의 상승 현상이 두드러지게 나타나고 있으며, 사망 원인의 수위를 차지하고 있다. 그러므로 이를 예방하고 당뇨병 합병증을 예방하기 위한 구체적이고 근거중심인 영양치료 방법의 제시가 절실한 실정이다. 미국영양사협회에서는 지속적으로 증가하는 당뇨병 유병율을 낮추기 위하여 생활습관의 개선을 목표로 임상영양치료의 표준화 지침을 제시하고 이에 따른 치료 효과 연구가 활발히 진행되고 있으나, 아직 국내에서는 많은 연구가 진행되고 있지 않은 현실이다. 따라서 본 연구에서는 이미 국외에서 사용되고 있는 지침에 근거하여 심층영양교육 방법을 실시하여 그 효과를 1회 교육만으로 시행되는 기본교육 방법과 비교하여 다음과 같으나 결과를 얻었다. 심층 및 기본영양교육 즉, 두 가지 교육 방법을 비교하였을 때 심층영양치료 방법을 실시한 경우 기본영양교육을 실시한 경우보다 혈당, 혈압 및 체중 강하 효과 면에서 유의적으로 개선효과가 있는 것으로 나타났다. 비용효과 면에서 장기간의 혈당변화 상태를 알 수 있는 당화혈색소의 경우 1%를 낮추기 위하여 소요되는 비용은 심층영양교육군에서 더 적었으며, 교육의 잠재 효과를 고려하였을 경우, 모든 혈당 검사 지표의 영양치료 비용 대비 효과 면에서 심층영양교육 방법이 기본영양교육 방법보다 앞서는 것으로 나타났다. 저비용 고치료 효과를 보여주고 있는 임상영양치료는 당노병과 같은 만성질환의 중요한 기본치료로 주목되고 있는 현 시점에서 영양치료행위의 의료 보험 급여화는 국민의 건강을 증진시키고, 국가적으로는 의료비 지출을 감소시키며 국민의 건강을 증진시키는데 큰 기여를 하는 합리적인 방안이라 생각된다. 따라서 현 비급여 수가로 되어 있는 교육수가를 급여화하여 많은 환자들에게 의료 혜택을 주는 일이 필요하리라 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8371-8376
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• 2014

Background: The use of statistical methods has become an imperative tool in breast cancer survival data analysis. The purpose of this study was to develop the best statistical probability model using the Bayesian method to predict future survival times for the black non-Hispanic female breast cancer patients diagnosed during 1973-2009 in the U.S. Materials and Methods: We used a stratified random sample of black non-Hispanic female breast cancer patient data from the Surveillance Epidemiology and End Results (SEER) database. Survival analysis was performed using Kaplan-Meier and Cox proportional regression methods. Four advanced types of statistical models, Exponentiated Exponential (EE), Beta Generalized Exponential (BGE), Exponentiated Weibull (EW), and Beta Inverse Weibull (BIW) were utilized for data analysis. The statistical model building criteria, Akaike Information Criteria (AIC), Bayesian Information Criteria (BIC), and Deviance Information Criteria (DIC) were used to measure the goodness of fit tests. Furthermore, we used the Bayesian approach to obtain the predictive survival inferences from the best-fit data based on the exponentiated Weibull model. Results: We identified the highest number of black non-Hispanic female breast cancer patients in Michigan and the lowest in Hawaii. The mean (SD), of age at diagnosis (years) was 58.3 (14.43). The mean (SD), of survival time (months) for black non-Hispanic females was 66.8 (30.20). Non-Hispanic blacks had a significantly increased risk of death compared to Black Hispanics (Hazard ratio: 1.96, 95%CI: 1.51-2.54). Compared to other statistical probability models, we found that the exponentiated Weibull model better fits for the survival times. By making use of the Bayesian method predictive inferences for future survival times were obtained. Conclusions: These findings will be of great significance in determining appropriate treatment plans and health-care cost allocation. Furthermore, the same approach should contribute to build future predictive models for any health related diseases.

• 한국직업건강간호학회지
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• 제11권1호
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• pp.44-51
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• 2002

Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.4169-4172
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• 2012

Background: The majority of women in rural India have poor or no access to cervical cancer screening services, although one.quarter of all cervical cancers in the world occur there. Several large trials have proven the efficacy of low-tech cervical cancer screening methods in the Indian context but none have documented the necessary components and processes of implementing this evidence in a low-resource setting. Methods: This paper discusses a feasible model of implementation of cervical cancer screening programme in low-resource settings developed through a pilot research project carried out in rural Tamilnadu, India. The programme used visual inspection of cervix after acetic acid application (VIA) as a screening tool, nurses in the primary care centres as the primary screeners and peer educators within Self-Help Women groups to raise community awareness. Results: The uptake of screening was initially low despite the access to a screening programme. However, the programme witnessed an incremental increase in the number of women accessing screening with increasing community awareness. Conclusions: The investigators recommend 4 key components to programme implementation in low-resource setting: 1) Evidence-based, cost-effective test and treatment available within the reach of the community; 2) Appropriate referral pathways; 3) Skilled health workers and necessary equipment; and 4) Optimisation of health literacy, beliefs, attitudes of the community.

• 보건의료산업학회지
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• 제5권2호
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• pp.209-226
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• 2011

The purpose of this study is to analyze and find out key success factors and marketing strategies of Bumrungrad Hospital in Bangkok, Thailand. The major success factors of Bumrungrad Hospital are as follows; First, Bumrungrad Hospital had professional medical team and board of directors who had the international career. Second, Bumrungrad was supported by Thai government and they were in a cooperative relationship with each other for the development of the medical industry. Third, Bumrungrad appropriately handled the internal and external changes including Asia Financial Crises in 1997 and others. Fourth, Bumrungrad diversified and broaden its business field such as global medical investing and management, medical technology, anti-age medicine and wellness. Marketing strategies of Bumrungrad analyzed are the following four factors. First, Bumrungrad focused on the quality of services by employing professional medical staffs, who have the international certification, and by constructing IT system for hospital management. Second, Bumrungrad has maintained an equalized price policy to attract the customers bothin the domestic and foreign markets. The cost for care has appealed the foreign customers for its comparatively low price, but it focused mainly on the upper middle class in Thailand. Third, it established, managed, and consulted hospitals in the foreign countries including the Philippines and the Arab Emirates. Fourth, it adopted differentiated promotion strategies suitable for the special needs of domestic and foreign customers, and put emphasis on the buzz marketing.

• 보건행정학회지
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• 제17권4호
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• pp.113-133
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• 2007

The present study was conducted to measure health-related utility for post-menopausal symptoms among Korean woman. A survey questionnaire was developed to measure utility based on visual analogue scale(VAS) and time trade-off method (TTO). From January 29 to February 3, 2007, a face-to-face interview was conducted with 274 women aged 45 to 60 to ask about their subjective utility for hypothetical health status of mild or severe post-menopausal symptoms. Among the participants, 160 were recruited from outpatient departments of 3 hospitals and 114 from 2 sports centers located in Seoul. For mild symptom, the average utility score of the respondents was $0.63{\pm}0.14$ based on VAS and $0.61{\pm}0.26$ based on ITO. For severe symptoms, the average utility was $0.39{\pm}0.16$(VAS) and $0.44{\pm}0.27$ (TTO). For severe symptom, a higher utility score was observed for TTO than for VAS, which is consistent with earlier studies and thus supports the validity of the utility measurement in this study. Overall, the severity of post-menopausal symptoms of the respondents themselves was not significantly associated with the utility score that the respondents answered for hypothetical health status. Multiple regression analysis results showed that the utility score was significantly higher among respondents with older age, higher education, higher family income, and from hospitals. It is expected that the utility score measured in this study will enhance the understanding of the quality of life of women after menopause and will be used to conduct cost-utility analysis of health care interventions to treat post-menopausal symptoms.

• International Journal of Human Ecology
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• 제13권2호
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• pp.87-100
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• 2012

Smart wear integrates computing technology into fabric or a garment for additional functionality. This research explored the attitudes and opinions of the use of smart wear from the viewpoint of caregivers. Thirty two individuals including care providers of children and adult family members with health problems participated in focus group interviews. Participants reported being interested in smart wear because of the potential to detect the location (GPS) of a dependent (e.g., child, elderly) and to monitor vital signs. Participants indicated perceived advantages of smart wear such as identifying geographical location and effectiveness. Perceived concerns mentioned were privacy/security issues and accuracy of data. Participants taking care of dependents without a specific disease were hesitant to adopt and pay for smart wear. However, caregivers of elderly individuals expressed positive adoption intentions and willingness to reasonably pay for smart wear. They indicated expectations that potential insurance would provide coverage for cost savings. Caregivers expressed the need of specific requirements for future adoption such as customizability, and comfort/safety. Specific to smart wear clothing, most respondents preferred it be an undershirt or a jacket with a sensor located in the shoulder area. The findings from this study can be used in product development, promotion and marketing of smart wear.

• 한국의상디자인학회지
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• 제18권1호
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• pp.79-89
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• 2016

Middle-aged women, who are rising as the main consumers of modern society spare no cost in health care and enjoying cultural activities along with various changes in life styles. They are active in self-realization and taking care of their appearances, and the lifestyle changes of middle-aged women who prefer fashion of young and trendy sensibilities are becoming a important theme in the media such as dramas. The middle-aged women in dramas have social positions and economic power who contribute to the completion of the drama as a main character, and so their fashion styles are receiving attention. Also, they play the role of providing trend information and various fashion information, which even leads to sales of these fashion products. Hence, this study aims to derive design formative characteristics and fashion styles that current middle-aged consumers prefer and provide basic data for promoting the growth of the Korean fashion industry by analyzing the fashion styles in accordance with the life styles of middle-aged women in dramas who are becoming admired by middle-aged women. The analysis of the fashion of middle-aged female characters in dramas allows to examine the fashion styles per various situations in accordance with the life styles of middle-aged women, and furthermore in the domestic and foreign fashion industry, arranges an opportunity to form a new market for potential fashion exports aimed at foreign consumers who view Korean dramas.

• 한국응급구조학회지
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• 제7권1호
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• pp.235-246
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• 2003

Due to major disasters Korea has been damaged, and they caused lots of casualties: for last ten years natural disasters caused 1288 deaths including missing people; human disasters including industrial disasters brought as many as 4,512.148 casual ties (126,372 deaths with 4,385,400 injuries); and they cost 44.1 trillion property damage. However, even though major disasters have brought about tremendous human loss and property damage, Koreas National Disaster Medical System to rescue casualties is insufficient, and it has not been activated. Fortunately, through major disaster management process, the National Disaster Management System has been developed, increasing its own efficiency, and resulting in to organize an Office of Firefighting and Prevention of Disasters under the central government. Considering the value of human lives, the disaster medical part, in the U.S.A. as well as in Korea, must have an independent organization in the government, not as one sector of the government department. It will have its own organizational structure, such as disaster planning, operation, and logistics, and interact with central and local government or between local government agencies. So each agency will cooperate and supply resources interchangeably. Also, with the system of disaster management and restoration, the disaster medical system must be advanced in keeping step. Its role must be extended due to the possibility of biological terror or SARS around the world, resulting in severe casualties. Korea has the Emergency Medical Service System based on the regulation of emergency medical care, yet it is a part of the National Disaster Management System. It must be managed independently apart from it. As we see the emergency medical technicians playing as the backbone in disaster medical care in the US, we should have legal foundations for Koreas emergency medical technicians, emergency medical providers, to participate in rescue operation actively. At the same time, we need to have a national register system to classify disaster medical resources, and a total plan to place resources according to the impact of disaster, and how to organize teams. We also need to draw up a scheme to activate civil disaster medical resources, as integrating public and private or voluntary organizations.