• Title/Summary/Keyword: Health Indicator

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The Assessment of Severity Adjustment Measures for AMI Patients in Korea (급성심근경색증 환자를 대상으로 한 중증도 보정 방법의 평가)

  • Park, Hyeung-Keun
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.164-175
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    • 2003
  • Objectives: To evaluate the performance of models to predict AMI patients death using severity adjustment measures in Korea. Methods: Medical records of 861 patients treated by AMI in 7 general hospitals during 1996 and 1997 were reviewed by trained nurses. We measured the severity of patients by APACHE III, MedisGroups, CSI and DS. Using each severity method a predictive mortality for each patient was calculated from a logistic regression model including the severity score. The statistical performance of each severity method model was evaluated by using c-statistics and R2. For each hospital, z scores compared actual and expected mortality rates. Results: The overall in-hospital mortality was 14.5%, ranged from 10.0% to 22.2%. The distributions of severity scores for each method was significantly different by hospitals. The four severity-adjusted models to predict AMI patients death varied in their statistical performance for discrimination power of patients death. Order of Severity-adjusted mortality rates and z scores by four severity measures was different. Conclusion: Severity-adjusted mortality rates of AMI patients might be applied as an indicator for hospital performance evaluation in Korea. Because different severity methods frequently produce different impressions about relative hospital performance, more studies has to be done to use it as quality indicator and more attention should be paid to select appropriate severity measures.

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Improvement of inspection system for common crossings by track side monitoring and prognostics

  • Sysyn, Mykola;Nabochenko, Olga;Kovalchuk, Vitalii;Gruen, Dimitri;Pentsak, Andriy
    • Structural Monitoring and Maintenance
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    • v.6 no.3
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    • pp.219-235
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    • 2019
  • Scheduled inspections of common crossings are one of the main cost drivers of railway maintenance. Prognostics and health management (PHM) approach and modern monitoring means offer many possibilities in the optimization of inspections and maintenance. The present paper deals with data driven prognosis of the common crossing remaining useful life (RUL) that is based on an inertial monitoring system. The problem of scheduled inspections system for common crossings is outlined and analysed. The proposed analysis of inertial signals with the maximal overlap discrete wavelet packet transform (MODWPT) and Shannon entropy (SE) estimates enable to extract the spectral features. The relevant features for the acceleration components are selected with application of Lasso (Least absolute shrinkage and selection operator) regularization. The features are fused with time domain information about the longitudinal position of wheels impact and train velocities by multivariate regression. The fused structural health (SH) indicator has a significant correlation to the lifetime of crossing. The RUL prognosis is performed on the linear degradation stochastic model with recursive Bayesian update. Prognosis testing metrics show the promising results for common crossing inspection scheduling improvement.

The Impact of Weekend Admission and Patient Safety Indicator on 30-Day Mortality among Korean Long-Term Care Insurance Beneficiaries

  • Shin, Jaeyong;Kim, Jae-Hyun
    • Health Policy and Management
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    • v.29 no.2
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    • pp.228-236
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    • 2019
  • Background: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. Methods: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. Results: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI. Conclusion: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

The Relationship of Health Promoting Lifestyle, Health Risk Indicators, Activities of Daily Living, and Depression of the in-House Stroke Patients (재가뇌졸중환자의 건강증진 생활양식 수행정도와 건강위험지표, 일상생활 수행능력 및 우울과의 관계)

  • Bak, Hae-Kyoung
    • The Korean Journal of Rehabilitation Nursing
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    • v.9 no.2
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    • pp.134-144
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    • 2006
  • Purpose: This study was done to investigate correlations among Health Promoting Lifestyles, Health Risk Indicators, Activities of Daily Living, and Depression of the in-house stroke patients. Method: The subjects were 58 in-house stroke patients in a health center and two welfare centers. Data was collected using questionnaires and measuring health risk indicators such as blood pressure, total cholesterol, triglyceride, blood sugar, body fat rate. Data was analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients. Result: The health promoting lifestyle performance showed a significant negative correlation with health risk indicators and depression. There was a significant negative correlation between activities of daily living and depression. Conclusion: Health promoting lifestyle which focus on regular physical check-up, medication, diet management, exercise, smoking cessation, drinking abstinence, and stress management should be developed to improve health risk indicator and depression of the in-house stroke patients.

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A Time-series Study on Relationship between Visibility as an Indicator of Air Pollution and Daily Respiratory Mortality (대기오염 지표로서의 시정과 일별 호흡기계 사망간의 연관성에 관한 시계열적 연구)

  • Cho, Yong-Sung;Jung, Chang-Hoon;Son, Ji-Young;Chun, Young-Sin;Lee, Jong-Tae
    • Journal of Korean Society for Atmospheric Environment
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    • v.23 no.5
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    • pp.563-574
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    • 2007
  • There seems to be a consensus among most people that visibility impairment is the most obvious indicator of air pollution. While considerable evidence on the association between air pollution and health outcomes including death and disease have been established, based on industrial complex areas or huge urban cities, time-series, case-crossover and cohort studies, scarce literature exists on the direct evidence for the association between visibility and adverse health outcomes. Our study is assessed the effect of air pollution measured by visibility impairment on respiratory mortality over a period of six years. Relative risks in respiratory deaths were estimated by a Poisson regression model of daily deaths between $1999{\sim}2004$. Daily counts of respiratory deaths as dependent variable was modelled with daily 24-hr mean visibility measurements (kilometers) as independent variable by means of Poisson regression. This model is controlled for confounding factors such as day of weeks, weather variables, seasonal variables and $PM_{10}$. The results in this study is observed the statistically significant association between an inverse health effect and visibility during the study period for respiratory mortality (percentage change in the relative risk for all aged -0.57%, 95% Cl, $-1.01%{\sim}-0.12%$; for $0{\sim}15$ aged -7.12%, 95% Cl, $-13.29%{\sim}-0.51%$; for 65+ aged -0.43%, 95% Cl, $-0.93%{\sim}-0.06%$ per 1 km increased in visibility). The effect size was much reduced during warm season. Visibility impairment resulting from air pollution is strongly associated with respiratory mortality, especially for children may be spent at outdoor. Our result provides a quick and useful indicator for eliciting the contribution of air pollution to the excess risk of respiratory mortality in Seoul, Korea.

Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals (요양병원의 간호사와 간호조무사 확보수준과 이직률이 입원환자의 건강결과에 미치는 영향)

  • Kim, Yunmi;Lee, Ji Yun;Kang, Hyuncheol
    • Journal of Korean Academy of Nursing
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    • v.44 no.1
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    • pp.21-30
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    • 2014
  • Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

Estimation of Lead Exposure Intensity by Industry Using Nationwide Exposure Databases in Korea

  • Koh, Dong-Hee;Park, Ju-Hyun;Lee, Sang-Gil;Kim, Hwan-Cheol;Jung, Hyejung;Kim, Inah;Choi, Sangjun;Park, Donguk
    • Safety and Health at Work
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    • v.12 no.4
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    • pp.439-444
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    • 2021
  • Background: In a previous study, we estimated exposure prevalence and the number of workers exposed to carcinogens by industry in Korea. The present study aimed to evaluate the optimal exposure intensity indicators of airborne lead exposure by comparing to blood lead measurements for the future development of the carcinogen exposure intensity database. Methods: Data concerning airborne lead measurements and blood lead levels were collected from nationwide occupational exposure databases, compiled between 2015 and 2016. Summary statistics, including the arithmetic mean (AM), geometric mean (GM), and 95th percentile level (X95) were calculated by industry both for airborne lead and blood lead measurements. Since many measurements were below the limits of detection (LODs), the simple replacement with half of the LOD and maximum likelihood estimation (MLE) methods were used for statistical analysis. For examining the optimal exposure indicator of airborne lead exposure, blood lead levels were used as reference data for subsequent rank correlation analyses. Results: A total of 19,637 airborne lead measurements and 32,848 blood lead measurements were used. In general, simple replacement showed a higher correlation than MLE. The results showed that AM and X95 using simple replacement could be used as optimal exposure intensity indicators, while X95 showed better correlations than AM in industries with 20 or more measurements. Conclusion: Our results showed that AM or X95 could be potential candidates for exposure intensity indicators in the Korean carcinogen exposure database. Especially, X95 is an optimal indicator where there are enough measurements to compute X95 values.

Distribution and exposure assessment of indicator PCBs in Food (식품 중 indicator PCBs의 분포와 노출평가)

  • Oh, Keum-Soon;Suh, Jung-Hyuck;Paek, Ok-Jin;Park, Seong-Soo;Na, Young-Joon;An, Yeong-Sun;Kim, Mee-Hye;Lee, Kwang-Ho
    • Analytical Science and Technology
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    • v.23 no.3
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    • pp.312-321
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    • 2010
  • Seven indicator PCBs (IUPAC nos 28, 52, 101, 118, 138, 153, 180 congeners) concentrations were measured in food samples including cereal (polished rice), meats, eggs, milk and dairy products, and fisheries and products as representation for the general Korean populations during 2006-2007, and was analyzed using isotopic dilution method. Fishes had the highest average level as 39.8 ng/g, 1.4 ng/g for milk and dairy products, and 0.9 ng/g for meats. The hairtail out of fishes was contaminated at the level of 15.4 ng/g, 5.4 ng/g for pacific mackerel and spanish mackerel, and 4.5 ng/g for yellow croaker. The ratio for indicator PCBs in overall food was contributed as follows; 35.8% for PCB-153, 16.2% for PCB-138, 16.1% for PCB-101, 13.4% for PCB-118, 8.8% for PCB-180, 6.9% for PCB-52, and 2.9% for PCB-28. The hexa-CBs including PCB-153 and 138 were more predominated, and the next was penta-CBs including PCB-101 and 118 in food. For estimated daily intake (EDI) in average and $95^{th}$ percentile, fishes and products out of overall food were taken to represent over 50%. However, it was estimated that there was no adverse health effect for Korean.

Exploring Antecedents of Consumers' Willingness to Depend on E-Health Information

  • Oh, Su-Jin
    • International Journal of Contents
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    • v.8 no.1
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    • pp.61-68
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    • 2012
  • Previous research on online health (e-health) information was primarily focused on consumer information search behavior and information quality. Although studies addressing online information quality have flourished, they have yet to thoroughly examine whether consumers actually use the information they search. The purspose of this study suggests a conceptual framework that examines the potential antecedents of a consumers' willingness to depend on e-health information as an indicator of the consumer's trust of the provided e-health information. The proposed antecedents include healthcare product involvement, online skill level, perceived quality, and credibility of the source. Using structural equation modeling on online survey data, seven hypotheses, which describe the relationships between the variables of the model, were tested. The results indicate that consumer willingness to depend on provided e-health information was significantly influenced by the consumers' perceived quality and credibility of specific e-health information. Consumer involvement in healthcare and their online skill-level, respectively, also positively related to perceived quality and credibility regarding e-health information.

The Empirical Study for Well-Being and Healthy Living of the Korean Elderly

  • Kim, Kyung-Woo
    • Journal of the Korea Society of Computer and Information
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    • v.20 no.7
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    • pp.115-120
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    • 2015
  • The old people's feelings, emotions, and self-evaluative judgements fluctuate overtime. The purpose of this paper is to proof relations among well-being factors in social activity. Major results of this paper was as follows. First, the social activity participated elderly had higher health status, self-esteem, mental-health, and successful aging than the non-participated elderly. Second, self-esteem and mental health were exposed as important variable for all of the two groups to improve the successful aging. Thus, self-esteem and mental health can become significant indicator of self-empowering and psychological resilience. Third, the strongest total causal effect of successful aging was health status in social activity participated elderly, while self-esteem was the greatest total causal effect of it in the non-participated elderly. Health status had higher indirect effect of successful aging than direct effect of it in both of them.