• Title/Summary/Keyword: Health care costs

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Big Data-based Medical Clinical Results Analysis (빅데이터 기반 의료 임상 결과 분석)

  • Hwang, Seung-Yeon;Park, Ji-Hun;Youn, Ha-Young;Kwak, Kwang-Jin;Park, Jeong-Min;Kim, Jeong-Joon
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.19 no.1
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    • pp.187-195
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    • 2019
  • Recently, it has become possible to collect, store, process, and analyze data generated in various fields by the development of the technology related to the big data. These big data technologies are used for clinical results analysis and the optimization of clinical trial design will reduce the costs associated with health care. Therefore, in this paper, we are going to analyze clinical results and present guidelines that can reduce the period and cost of clinical trials. First, we use Sqoop to collect clinical results data from relational databases and store in HDFS, and use Hive, a processing tool based on Hadoop, to process data. Finally we use R, a big data analysis tool that is widely used in various fields such as public sector or business, to analyze associations.

Outcomes of endoscopic retrograde cholangiopancreatography-guided gallbladder drainage compared to percutaneous cholecystostomy in acute cholecystitis

  • Hassam Ali;Sheena Shamoon;Nicole Leigh Bolick;Swethaa Manickam;Usama Sattar;Shiva Poola;Prashant Mudireddy
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.1
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    • pp.56-62
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    • 2023
  • Backgrounds/Aims: Endoscopic retrograde cholangiopancreatography-guided gallbladder drainage (ERGD) is an alternative to percutaneous cholecystostomy (PTC) for hospitalized acute cholecystitis (AC) patients. Methods: We retrospectively analyzed propensity score matched (PSM) AC hospitalizations using the National Inpatient Sample database between 2016 and 2019 to compare the outcomes of ERGD and PTC. Results: After PSM, there were 3,360 AC hospitalizations, with 48.8% undergoing PTC and 51.2% undergoing ERGD. There was no difference in median length of stay between the PTC and ERGD cohorts (p = 0.110). There was a higher median hospitalization cost in the ERGD cohort, $62,562 (interquartile range [IQR] $40,707-97,978) compared to PTC, $40,413 (IQR $25,244-65,608; p < 0.001). The 30-day inpatient mortality was significantly lower in hospitalizations with ERGD compared to PTC (adjusted hazard ratio 0.16, 95% confidence interval [CI]: 0.1-0.41; p < 0.001). There was no difference in association with blood transfusions, acute renal failure, ileus, small bowel obstruction, and open cholecystectomy conversion (p > 0.05) between hospitalizations with ERGD and PTC. There was lower association of acute hypoxic respiratory failure (adjusted ratio [AOR] 0.46, 95% CI: 0.29-0.72; p = 0.001), hypovolemia (AOR 0.66, 95% CI: 0.49-0.82; p = 0.009) and higher association of lower gastrointestinal bleed (AOR 1.94, 95% CI: 1.48-2.54; p < 0.001) with ERGD compared to PTC. Conclusions: ERGD is a safer alternative to PTC in patients with AC. The risk complications are lower in ERGD compared to PTC but no difference exists based on mortality or conversion to open cholecystectomy.

Smart-Coord: Enhancing Healthcare IoT-based Security by Blockchain Coordinate Systems

  • Talal Saad Albalawi
    • International Journal of Computer Science & Network Security
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    • v.24 no.8
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    • pp.32-42
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    • 2024
  • The Internet of Things (IoT) is set to transform patient care by enhancing data collection, analysis, and management through medical sensors and wearable devices. However, the convergence of IoT device vulnerabilities and the sensitivity of healthcare data raises significant data integrity and privacy concerns. In response, this research introduces the Smart-Coord system, a practical and affordable solution for securing healthcare IoT. Smart-Coord leverages blockchain technology and coordinate-based access management to fortify healthcare IoT. It employs IPFS for immutable data storage and intelligent Solidity Ethereum contracts for data integrity and confidentiality, creating a hierarchical, AES-CBC-secured data transmission protocol from IoT devices to blockchain repositories. Our technique uses a unique coordinate system to embed confidentiality and integrity regulations into a single access control model, dictating data access and transfer based on subject-object pairings in a coordinate plane. This dual enforcement technique governs and secures the flow of healthcare IoT information. With its implementation on the Matic network, the Smart-Coord system's computational efficiency and cost-effectiveness are unparalleled. Smart-Coord boasts significantly lower transaction costs and data operation processing times than other blockchain networks, making it a practical and affordable solution. Smart-Coord holds the promise of enhancing IoT-based healthcare system security by managing sensitive health data in a scalable, efficient, and secure manner. The Smart-Coord framework heralds a new era in healthcare IoT adoption, expertly managing data integrity, confidentiality, and accessibility to ensure a secure, reliable digital environment for patient data management.

The study of Health Care Utilization and Direct Medical Cost in the Diabetes Mellitus Client (당뇨병 질환자의 의료이용 및 직접의료비 연구)

  • Yoo, In Sook
    • The Journal of the Convergence on Culture Technology
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    • v.1 no.4
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    • pp.87-101
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    • 2015
  • This study was aimed to make data how much spent money of medical utilization and direct medical cost. In order to research we were using Korea Health panel 2012 Statistics which data contained Diabetes mellitus client 812 people in age 19. The method of this study was emergency cost, admission medical cost, out patient department cost(client own due, National Health insurance service due, not insurance fee). The result of this study, Diabete Mellitus client were using 198 times during 1 year per 100, total medical direct cost were 859,942 won, 447,359 won, 363,255,508. And admission times were 5.6 times per year, total direct cost was 772,240 won, 4,061,982 won, and 3,298,329,384 won, and out patient clinic using number was 10 times, medical cost total direct cost containing total direct cost was 11,978 won, 26,020 won, and 21,129,240 won. From this research we conclusion that the occurrence of diabetes mellitus can be increased medical cost and direct medical cost and it can be huge burden to client including their family and quality of life in the future. We suggest that in order to prevention and management of diabetes mellitus healthy diet, activity, blood sugar, and blood management should be encouragement.

Effects of Blood Factors on Coronary Artery Calcification Scores (혈액인자가 관상동맥 석회화 수치에 미치는 영향)

  • Park, Mi Jeong;Jang, Hyon Chol;Cho, Pyong Kon
    • Journal of the Korean Society of Radiology
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    • v.15 no.3
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    • pp.337-344
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    • 2021
  • Coronary artery calcification is associated with cardiovascular risk factors and metabolic syndrome, and several studies have already reported that coronary artery calcification score are closely related to the amount of atherosclerotic plaques. This study was conducted on 109 patients who underwent coronary calcium CT who visited the comprehensive health examination center in Daegu city during the period from December 2020 to February 2021. we would like to investigate the relationship between coronary artery calcification score and blood factors. As a result of the study, the abnormal group increased the risk of calcification by 1.113 times compared to the normal group in the waist circumference factor. In the fasting glucose factor, the abnormal group increased the risk of calcification by 1.036 times compared to the normal group, and in the triglyceride factor, the abnormal group was normal. As the risk of calcification increased 1.008 times compared to the group, the waist circumference factor, fasting glucose factor, and triglyceride factor were found to be factors affecting coronary artery calcification score. The risk of developing calcification is primarily associated with waist circumference, anemia and triglycerides, and health care and health checks are expected to help reduce the incidence of cardiovascular disease and reduce medical costs.

Role of Repeated Education to the Patients with Temporomandibular Disorders (측두하악장애 치료에 있어서 반복적 주의사항 교육의 효과)

  • Ok, Soo-Min;Heo, Jun-Young;Ko, Myung-Yun;Ahn, Yong-Woo;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.38 no.1
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    • pp.69-76
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    • 2013
  • Aim : The purpose of this study was to investigate the hypothesis that treatment with self-checking behavior management program was valuable in the management of temporomandibular disorders compared with a existing method treatment group. Methods : All participants who are diagnosed with temporomandibular disorders were treated with medication and physical therapy. They came into the clinic at intervals of two weeks, three times. The signs and symptoms were assessed investigating Pain NRS(Numerical Rating Scale), MCO(Maximum comfortable opening), Noise NRS, LOM(Limitation of Mouth opening) NRS at every visit. Experimental group received instructions repeatedly by using self evaluation questionnaire. Control group was educated once at the beginning of treatment. The difference Pain NRS, MCO, Noise NRS, LOM NRS between first and second visits, first and third visits were estimated.. Result :Experimental group showed greater improvement on MCO difference after stopping medication(p=0.001). This improvements were prominent in the male(p=0.001) and the first or second decade of the patients(p=0.004). Conclusion : The present study showed that there was better result when educating repeatedly with using self evaluation questionnaire than educating once at the beginning of the treatment.

Efficient Patient Information Transmission and Receiving Scheme Using Cloud Hospital IoT System (클라우드 병원 IoT 시스템을 활용한 효율적인 환자 정보 송·수신 기법)

  • Jeong, Yoon-Su
    • Journal of Convergence for Information Technology
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    • v.9 no.4
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    • pp.1-7
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    • 2019
  • The medical environment, combined with IT technology, is changing the paradigm for medical services from treatment to prevention. In particular, as ICT convergence digital healthcare technology is applied to hospital medical systems, infrastructure technologies such as big data, Internet of Things, and artificial intelligence are being used in conjunction with the cloud. In particular, as medical services are used with IT devices, the quality of medical services is increasingly improving to make them easier for users to access. Medical institutions seeking to incorporate IoT services into cloud health care environment services are trying to reduce hospital operating costs and improve service quality, but have not yet been fully supported. In this paper, a patient information collection model from hospital IoT system, which has established a cloud environment, is proposed. The proposed model prevents third parties from illegally eavesdropping and interfering with patients' biometric information through IoT devices attached to the patient's body at hospitals in cloud environments that have established hospital IoT systems. The proposed model allows clinicians to analyze patients' disease information so that they can collect and treat diseases associated with their eating habits through IoT devices. The analyzed disease information minimizes hospital work to facilitate the handling of prescriptions and care according to the patient's degree of illness.

Basic Study on the Development of Impact Protective Pants and Falls of Elderly Women (여성노인의 낙상실태 및 충격보호팬츠 개발을 위한 기초 연구)

  • Lee, Jin Suk;Park, Jung Hyun;Lee, Jeong Ran
    • Fashion & Textile Research Journal
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    • v.16 no.6
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    • pp.945-953
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    • 2014
  • This study aims to develop protective pants to relieve impact from falls and to present basic data for the development. The survey results are as follows; First, 45% of the respondents were in their 60s and 55% of them were in their over 70s and older. Also, 64% of them have fallen once for the past year and 36% of them have fallen twice or more. The older they were, the more there were those who have fallen twice or more. This indicated the older people has experienced more fall accidents again after a initial fall accident. Second, as per accident situations, the survey showed that fall accidents happened the most in the winter and in the afternoon (12-18 pm). Also, it happened on a street mostly and they were wearing sneakers or hiking boots when they got a hurt slipped in a front or side by missing their step in a walk. The injury areas are mostly knee and ankle. They had the bruises or a sprain in their knee and ankle mostly. The rate of bone fracture was 19.5%. Therefore, the protection area to falls in lower body is the knee. But hip and hip joint should be protected with knee as well because those are usually be broken when it is damaged. Third, approximately 80% of those who were hospitalized for treatment had surgery. Patients who had surgery were rather in their over 70s than in their 60s. The older they were, the more serious their fracture was. The period of hospital or outpatient treatment is more than three weeks in many cases. They responded their health got worse after falls. Aftereffects of accidents were physical discomfort, anxiety and medical costs. Falls to the old makes physical damage, psychological damage, which cause reduced physical activity and the increased cost of health care with economic losses. So it results on a negative impact on the life of the old. Fourth, elderly females were rarely aware of impact protective clothing and they have never purchased such clothing. For impact protective pants, the major consideration was suitable design for their body types. They liked casual style with front or side pockets and simple designs without any patterns or decorations. As per pants materials, they responded that they need functionality, activity and elasticity. Among the functional points, insulation of cloths are considered importantly, so the heat reservance of material in the impact protective pants should be considered carefully.

Study in Relation to Social Support, Compliance and Psychosocial Adjustment of Rheumatoid Arthritic Patient (류마티스 관절염환자의 사회적 지지, 치료지시 이행 및 사회심리적 적응과의 관계 연구)

  • Soh, In-Ae;Kwon, Young-Sook;Park, Chung-Ja
    • Journal of muscle and joint health
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    • v.6 no.2
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    • pp.211-225
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    • 1999
  • This descriptive correlational study was carried to identify the relationship among social support, compliance, and psychosocial adjustment of patients with rheumatoid arthritis. The study was done with 100 rheumatoid arthritic patients who were visited in Outpatient clinic of university hospital in Taegu, Korea from the 23rd of February to the 20th of March in 1998. The Data were collected through person to person interviews which were performed by five researchers. The instruments used for this study were Yu's social support scale(1996), Cho's compliance scale(1987), and Kim's psychosocial adjustment scale(1997). The data was analyzed by using a t-test, Pearson correlation coefficient, ANOVA, and Tukey test with the SAS Program. The results of this study were as follows ; 1. The mean score of social support was 2.76 for 4 full marks, compliance was 3.20 for 5 full marks, and psychosocial adjustment was 2.26 for 4 full marks. 2. Hypothesis 1 : "The higher the social support degree, the higher the compliance degree of the rheumatoid arthritis patient". It was supported(r=0.54, p<0.001). Hypothesis 2 : "The higher the compliance degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.34, p<0.001). Hypothesis 3 : "The higher the social support degree, the higher the psychosocial adjustment degree of the rheumatoid arthritis patient". It was supported(r=0.24, p<0.05). 3. In general, the spouse group compared to other groups was demonstrated as the most dependable group for patients to trust and expect support. And the sons and daughters group was shown higher than other groups in terms of social support(F=4.19, p=0.01). There was no difference in terms of compliance in degree. In the degree of psychosocial adjustment the highly educated group(more than high school) is a little higher than the lowly educated group(F=3.08, p=0.03). In the costs of medical care, the group that could afford was significant higher than the group which could not afford results in terms of the psychosocial adjustment degree(F=3.99, p=0.01). The outcome of this study is that the social support that related rheumatoid arthritic patients had an effect on the following compliance, and the following compliance helps psychosocial adjustment of patients. It also shows that social support related psychosocial adjustment. Therefore, to increase the level of psychosocial adjustment of rheumatoid arthritic patients, it will be effective in supportive nursing intervention to improve social support and compliance.

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Impact of antimicrobial resistance in the $21^{st}$ century

  • Song, Jae-Hoon
    • Proceedings of the Korean Society for Applied Microbiology Conference
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    • 2000.04a
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    • pp.3-6
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    • 2000
  • Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

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