• 제목/요약/키워드: Health decision model

검색결과 371건 처리시간 0.026초

On Establishing a New Fee Schedule for General Surgical Procedure Using Fuzzy MCDM

  • Hung, Chih-Young;Huang, Yuan-Huei;Chang, Pei-Yeh;Wang, Kuei-Ing;Chang, King-Jen;Liu, Yi-Hsin
    • Industrial Engineering and Management Systems
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    • 제4권2호
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    • pp.218-227
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    • 2005
  • In this research a model for establishing a new, rational fee schedule for general surgical procedures in a national health insurance program is developed. A fuzzy multiple criteria decision-making (FMCDM) model is proposed. The relative values of eleven surgical procedures were obtained through an empirical study based on the FMCDM model. Consequently, a new fee schedule obtained from the FMCDM model. This new fee schedule is more convincing than previous schedule and more persuasive to the references for the policy setting.

의사결정나무분석법을 이용한 간호사의 대체수유교육요구 예측모형 (A Predictive Model using Decision Tree Method on Demand for Alternative Feeding Education by Nurses)

  • 오진아;윤채민;김병수
    • Child Health Nursing Research
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    • 제16권1호
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    • pp.84-92
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    • 2010
  • Purpose: One of the main reasons why mothers quit breast feeding is that the volume of breast milk is inadequate due to insufficiency in suckling. We believe suckling experience may be a factor affecting nipple confusion. So an alternative feeding method, namely cup, spoon, finger, or nasogastric tube feeding may be needed to prevent nipple confusion. The purpose of this study was to construct a predictive model for demand for alternative feeding education by nurses. Methods: A descriptive design with structured self-report questionnaires was used for this study. Data from 175 nurses working in hospitals in Busan were collected between April 1 and 15, 2009. Data were analyzed by decision tree method, one of the data mining techniques using SAS 9.1 and Enterprise Miner 4.3 program. Results: Of the nurses, 81.1% demanded alternative feeding education and 5 factors showed that most of them expressed intention to pay, desire to know about alternative feeding, age, and learning experience. From these results, the derived model is considered appropriative for explaining and predicting demand for alternative feeding education. Conclusion: This confirms that knowledge and compliance in alternative breast feeding for newborn babies should be correct and any inaccuracies or insufficient information should be supplemented.

의사결정나무분석을 이용한 성인의 알코올사용장애 위험요인 (Risk factors of alcohol use disorder in Korean adults based on the decision tree analysis)

  • 권미영;김지인
    • 한국학교ㆍ지역보건교육학회지
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    • 제24권1호
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    • pp.47-59
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    • 2023
  • Objectives: The aim of this study was to identify risk factors of alcohol use disorder among Korean adults. Methods: Cross-sectional exploratory study based on data collected from Data from the 6th Korea National Health and Nutrition Examination Survey in 2015 were performed in this study. There were 3,248 participants who were 2,558 normal drinkers while 690 had alcohol use disorder. Decision tree analysis were used to exam socio-demographic and health-related factors to predict alcohol use disorder. Results: As a result of decision tree analysis, the predictive model for factors related to alcohol use disorder in Korean adults presented with 8 pathways. The significant predictors of alcohol use disorder were age, gender, smoking, marital status, and house income. Male smokers whose household income is 'high' or 'low' are most vulnerable to alcohol use disorders. Conclusions: This study indicates that need to consider health behavior and house income when we practice prevention policies and health education of alcohol use disorder.

Migration and Economic Inequality in Indonesia: Longitudinal Data Analysis

  • YULIADI, Imamudin;RAHARJA, Sigit Satria
    • The Journal of Asian Finance, Economics and Business
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    • 제7권11호
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    • pp.541-548
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    • 2020
  • This study aimed to explain the factors that influenced an individual's decision to migrate. The method of analysis in this study was the estimation of the probit regression model with data from the Indonesian Family Life Survey (IFLS-5), which covered 30,000 individuals from 13 provinces in Indonesia. Data from IFLS-5 were longitudinal data, meaning that the study was looking for data consistently to get reliable data from respondents. The research variables to determine the individual's decision to migrate were education level, income level, employment status, marital status, land ownership status, health quality, gender, residence status, and poverty status. Individual decision to migrate as a dependent variable was placed as a dummy variable. The results showed that the level of education, income level, employment status, marital status, land ownership status, health quality, and poverty status significantly influenced an individual's decision to migrate. Meanwhile, gender and residence status did not significantly affect an individual's decision to migrate. This research recommends that it is necessary to pursue a policy of economic equality between regions because economic factors are the main trigger for an individual's decision to migrate. Policies to overcome economic disparities among regions will reduce the individual's decision to migrate.

일부 치과위생사의비판적 사고경향과 임상적 의사결정이 윤리적 딜레마에 미치는 영향 (The Effects of Critical Thinking and Clinical Decision-Making on Ethical Dilemmas by Some Dental Hygienists)

  • 강현경
    • 보건의료산업학회지
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    • 제9권1호
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    • pp.67-79
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    • 2015
  • The aim of this descriptive cross-sectional study was determine the effect of critical thinking and clinical decision-making on ethical dilemmas. A survey of dental hygienists residing in Busan and South Gyeongsang, Korea was conducted using convenience sampling between September and December, 2013. A total of 153 responses were used in the final analysis. Data analysis and structural equation modeling were performed with IBM SPSS Statistics(version 21.0) and AMOS(version 18.0) programs. A negative(-) correlation coefficient(-0.37) was observed between critical thinking and ethical dilemmas on statistical analysis, i.e., higher critical thinking led to less ethical dilemmas(p=0.024, CR=-2.264). The values from the structural equation model were ${\chi}^2=98.124$ df=66, GFI=0.919, AGFI=0.871, and RMSEA=0.057. This study proposed a theoretical model in which critical thinking, ethical values, and decision-making skills should be firmly established to effectively respond to specific situations, such as ethical dilemmas, and that greater tendencies for critical thinking led to less ethical dilemmas, thereby demonstrating a negative(-) correlation between the two parameters.

선택실험법을 이용한 의약품 급여결정기준에 대한 선호분석 (Eliciting stated preferences for drugs reimbursement decision criteria in South Korea)

  • 임민경;배은영
    • 보건행정학회지
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    • 제19권4호
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    • pp.98-120
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    • 2009
  • The purpose of this study is to elicit preference for drug listing decision criteria and to estimate the ICER threshold in South Korea using the discrete choice experiment (DCE) method. To collect the data, a DCE survey was administered to a subject sample either educated in the principle concepts of pharmacoeconomics or were decision makers within that field. Subjects chose between alternative drug profiles differing in four attributes: ICER, uncertainty, budget impact and severity of disease. The orthogonal and balanced designs were determined through computer algorithm to take the optimal set of drug profiles. The survey employed 15 hypothetical choice sets. A random effect probit model was used to analyze the relative importance of attributes and the probabilities of a recommendation response. Parameter estimates from the models indicated that three attributes (ICER, Impact, Severity of disease) influenced respondents' choice significantly(p${\pm}$0.001). In addition, each parameter displayed an expected sign. The Lower the ICER, the higher the probability of choosing that alternative. Respondents also preferred low levels of uncertainty and smaller impact on health service budget. They were also more likely to choose drugs for serious diseases rather than mild or moderate ones. Uncertainty however is not statistically significant. The ICER threshold, at which the probability of a recommendation was 0.5, was 29,000,000 KW/QALY in expert group and 46,500,000 KW/QALY in industry group. We also found that those in our sample were willing to accept high ICER to get medication for severe diseases. This study demonstrates that the cost-effectiveness, budget impact and severity of disease are the main reimbursement decision criteria in South Korea, and that DCE can be a useful tool in analyzing the decision making process where a variety of factors are considered and prioritized.

간호대학생의 윤리적 의사결정에 영향을 미치는 요인 (Factors Affecting Ethical decision-making of Nursing Students)

  • 유명숙;진주현
    • 가정간호학회지
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    • 제30권2호
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    • pp.163-173
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    • 2023
  • Purpose: The aim of this descriptive research study was to identify the factors affecting the ethical decision-making of nursing students. Methods: A convenience sample of 193 nursing students from three nursing colleges in D city who were engaged in clinical practice completed an online Google Forms questionnaire from September 9 to September 20, 2021. Using SPSS 23.0, data were analyzed with descriptive statistics, an independent t-test, a one-way ANOVA, Scheffé's test, Pearson's correlation coefficient, and a multiple regression analysis. Results: The influencing factors of ideal ethical decision-making were guilt (β=.38, p<.001), awareness of the nurses' Code of Ethics (β=.18, p=.023) and motivation for entering school, among general characteristics (β=-.18, p=.033). The explanatory power of the model was 22.2%. Further, the influencing factors of realistic ethical decision-making were ideal ethical decision-making (β=.26, p=.001) and grade (among general characteristics) (β=.15, p=.029); the explanatory power of the model was 17.9%. Conclusion: Various educational tools and programs pertaining to making ideal and ethical decisions must be enhanced to promote ethical choices in clinical areas and realistic ethical decision-making ability to actually make such choices. This focus may enable nurses to improve their nursing professionalism in the future.

간호학생이 경험한 간호윤리 문제와 윤리적 의사결정 모형의 적용 (Korean Nursing Students윤 Experience of Ethical Problems and Use of Ethical Decision-Making Models)

  • 한성숙;박현애;안성희;;오효숙;김경운
    • 대한간호학회지
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    • 제31권5호
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    • pp.846-857
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    • 2001
  • This study was conducted to study on 1) What is nursing students' experience of ethical problems involving nursing practice\ulcorner 2) What is nursing students' experience of using ethical decision-making models\ulcorner Method: In order to answer these two questions, we selected 97 senior baccalaureate nursing students from two Korean universities using a conceptual framework and method of content analysis. Result: From 97 ethical problems emerged five content categories, the largest being ethical problems involving health professionals (69%); the basic nature of the nursing students' experience of ethical problems consisted of conflict, resolution, and rationale; 94% of the students stated that using an ethical decision- making model was helpful. Conclusion: Although additional research is needed, these findings have important implications for nursing ethics education and practice.

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장기적 금연 지속기간 예측 모형: 스트레스 대처를 중심으로 (Decision-Tree Model of Long-term Abstention from Smoking: Focused on Coping Styles)

  • 서경현;유제민
    • 보건교육건강증진학회지
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    • 제22권4호
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    • pp.73-90
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    • 2005
  • Objectives: Smokers who had failed to quit smoking were frequently reported that life stress mostly interrupted their abstention. Stress vulnerability model for smoking cessation has been considered, and most of contemporary smoking cessation programs help smokers develop coping strategies for stressful situations. This study aims to investigate the appropriate coping styles for stress of abstention from smoking. The result of investigating the relationship between abstention following smoking cessation program and coping styles would suggest useful information for those who want to stop smoking and health practitioners who help them. Methods: Participants were 69 smokers (62 males, 7 females) participated in a hospitalized smoking cessation program, whose mean age was 44.89 (SD=9.61). Participants took medical test and completed questionnaires and psychological tests including: Fagerstrom Test for Nicotine Dependence and Multidimensional Coping Scale. To identify participants' abstention, researchers followed them for 2 years. To identify whether abstained or not and encourage them to abstain, researchers called them on the telephone once a week for 3 months. After 3 months, they were contacted every other week till 6 months passed since they left smoking cessation program. And they were contacted once a month for other 18months. Researchers also contacted their family to identify their abstention. Data Mining Decision Tree was performed with 37 variables (13 variables for the coping styles and 24 smoking-related variables) by Answer Tree 3.0v Results: Forty four (63.8%) out of sixty nine for 2 weeks, 34 (49.3%) for 6 months, 25 (36.2%) abstained for 1 year, and 22 (31.9%) abstained for 2 years. Participants of this study abstained average of 286.77 days from smoking. Included variables of a Decision Tree model for this study were positive interpretation, emotional expression, self-criticism, restraint and emotional social support seeking. Decision Tree model showed that those (n=9) who did not interpret positively (<=7.5) and criticized themselves (>6.5) abstained 23 days only, while those (n=9) who interpreted positively (>7.5), expressed their emotion freely (>6.5), and sought social support actively (>11.5) abstained 730 days, till last day of the investigation. Conclusion: The results of this study showed that certain coping styles such as positive interpretation, emotional expression, self-criticism, restraint and emotional social support seeking were important factors for long-term abstention from smoking. These findings reiterate the role of stress for abstention from smoking and suggest a model of coping styles for successful abstention from smoking. Despite of limitation of this study, it might help smokers who want to stop smoking and health practitioners who help them.