• Title/Summary/Keyword: Health decision system

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Content Analysis of the Nursing Interventions and Telephone Calls to the Pediatric Nursing Unit (외래 및 퇴원환아 부모의 전화상담과 간호중재의 내용분석)

  • 한경자;최명애;강화자;박승현;김영미;권원경;안혜영
    • Journal of Korean Academy of Nursing
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    • v.26 no.3
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    • pp.515-530
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    • 1996
  • A descriptive study was conducted to describe the content of nursing interventions and incoming telephone calls from the parents whose child was discharged to home or who has planned immunization during the period from March 15, 1995 to November 30, 1995. Detailed notes on 145 telephone calls and 243 nursing interventions were recorded by head nurses on pediatiric nursing units were entered to data collection and content analysis. The results of the study are as follows : 1. Six analysis categories for the records on incoming telephone calls were identified judgement-dependence, dependent -coping, self-initiated coping, support, adjustment and intermediation need. 2. Five analytic categories for the records on telephone interventions were identified : guidance, mediation, facilitating self -care abilities, support, instrumental use. 3. Problems related to physical signs and symptoms, medication, immunization, and vital signs were most often cited as concerns by parents and caregivers. 4. Instruction, suggestion, provision knowledge and information, reassurance related to physical problems, medication, immunization and clinic visits were most often used as an nursing interventions by head nurses on pediatric nursing units. In spite of the fact that the telephone calls were initiated by the parents, dependency of parents during the telephone calls was remarkable. The dependency of parents on judgement and decision making of the pediatric nurses should be understood in terms of the psychosocial content as well as cultural characteristics. Therefore, it is suppested that telephone interventions focus on facilitating the self-care ability of the parents whose children have chronic conditions. The results of this study will be useful as an essential reference in providing effective for children and their families after discharged from the hospital. The results can also be used as reliable data for extended pediatric nursing service in the health care delivery system as well as for the development of telephone intervention service program in responding to the current health care environment.

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A Grounded Theory Approach of the Treatment Pattern of Patients with Arthritis (관절염 환자의 치료추구행위에 대한 근거이론적 접근)

  • Lee, Eun-Ok;Kang, Hyun-Sook;Lee, In-Sook;Eun, Young
    • Journal of muscle and joint health
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    • v.4 no.1
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    • pp.26-47
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    • 1997
  • The purpose of this study is to explore the treatment pattern of treatment of patients with arthritis. The grounded theory approach methodology was used in this study. The purposive sampling was conducted. 16 subjects who experienced RA, lived in middle sized city in Korea, and all women The results of this study were as follows : 1. The process of treatment was composed of the stage of symptom experience and the stage of sick role experience. The naming of the symptom was conducted in the stage of symptom experience through, the doctor shopping. The sick role experience was patterned by the choice of the treatment mode. 2. The treatment modes were roughly devided by western medicine and oriental or ethnic medicine. Several factors which affected the choice of the treatment mode were patient's economic state, educational level, religion, the acknowledgement of the cause of illness, duration of illness, lay referral system, the relationship of medical staff, and the acculturation of medical professionalism. The key component of the decision of the treatment was the level of the acculturation of medical professionalism. To enhance the acculturation of medical professionalism, we have to provide the information of cause and the prognosis of the disease to the patients and the variety of communication channel between medical staff and patients, and we should understand the medical culture according to the ages, gender, locations in Korea.

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Prerequisites on Smart Healthcare in the Perspective of Service Design : Focusing on the Elderly Experience Case (서비스 디자인 관점에서 본 스마트 헬스케어의 선행 조건 : 고령자 경험 사례를 중심으로)

  • Kim, Ho-Da;Joo, Ae-Ran
    • Journal of Information Technology Applications and Management
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    • v.28 no.3
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    • pp.49-58
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    • 2021
  • Due to the increasing interest in wellness aroused by the aging population and the pursuing feature of active old age, Korean elderly set importance on long life with their healthy condition. Following the change in the paradigm of the medical delivery system from hospital-oriented, treatment-oriented to personal-centered and self-care, Service design application of Smart Healthcare for the elderly became valuable. Smart Healthcare is a healthcare service provided through the fusion of ICT technologies including mobile/wearable devices, IoT, big data, and information technology, and it is utilized to prevent diseases managing abundant health information and living habits. As a methodology for delivering such Smart Healthcare to the elderly, Service design can be adopted. Therefore, this study would like to present the perquisites of Smart Healthcare design for the elderly through analyzing the results from in-depth interview methods between the elderly and medical staff. As a result of this study, guidelines for Service design application of health vulnerability management for the elderly utilizing smart phones were presented. Therefore, this study presented four prerequisites composed of 'high level of supplementation and ethical decision making', 'improvement of inequality in accessibility and experience', 'resolving problems in policy implementation' and 'user-friendliness' for the Smart Healthcare service design for the elderly. Overall, Service design is expected to play an innovative role in improving the quality of life for the elderly through the process of collecting and delivering information on Smart Healthcare centered on the experience of the elderly.

The Legal Effect of Criteria for the Medical Care Benefits and The Illegality Determination on Violation of Criteria for the Medical Care Benefits on Outpatient Prescription - A Commentary on Supreme Court Judgment 2009 Da 78214 Delivered on March 23, 2013 - (요양급여기준의 법적 성격과 요양급여기준을 벗어난 원외처방행위의 위법성 -대법원 2013. 3. 28. 선고 2009다78214 판결을 중심으로-)

  • Hyun, Dooyoun
    • The Korean Society of Law and Medicine
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    • v.15 no.1
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    • pp.123-164
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    • 2014
  • Under the new system of 'Separation of pharmaceutical prescription and dispensing' in Korea, which was implemented in 2000, physician could not dispense a medicine, and outpatient should have a physician's prescription filled at a drugstore. After pharmacist makes up outpatient's prescription, National Health Insurance Service(NHIS) pay for outpatient's medicine to pharmacist, except an outpatient's own medicine charge. And NHIS only pay for outpatient's prescription fee to physician and, physician doesn't derive profit from dispensing medicine in itself. Nevertheless, if physician writes out a prescription with violation of 'Criteria for the Medical Care Benefits', NHIS clawed back the payment of outpatient's prescription and medicine from the physician or the medical institution which the physician belongs to. In the past, NHIS's confiscation was in accordance with 'the National Health Care Insurance Act, Article 52, Clause 1'. But, since 2006 when the Supreme Court declared that there was no legal basis on the NHIS's confiscation of outpatient's medicine payment, NHIS had put in a claim for illegal prescriptions on the basis 'the Korean Civil law, Article 750(tort)'. So, Many medical institutions filed civil actions against NHIS. The key point of this actions was whether the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits constitute of the law of tort. On this point, the first trial and the second trial took different position. Finally the Supreme Court acknowledged the constitution of the law of tort in 2013. In this paper, the author will review critically the decision of the Supreme Court, and consider the relativeness between the legal effect of Criteria for the Medical Care Benefits and the constitution of the issuing outpatient prescriptions with violations of Criteria for the Medical Care Benefits as the law of tort.

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Health Risk Management using Feature Extraction and Cluster Analysis considering Time Flow (시간흐름을 고려한 특징 추출과 군집 분석을 이용한 헬스 리스크 관리)

  • Kang, Ji-Soo;Chung, Kyungyong;Jung, Hoill
    • Journal of the Korea Convergence Society
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    • v.12 no.1
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    • pp.99-104
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    • 2021
  • In this paper, we propose health risk management using feature extraction and cluster analysis considering time flow. The proposed method proceeds in three steps. The first is the pre-processing and feature extraction step. It collects user's lifelog using a wearable device, removes incomplete data, errors, noise, and contradictory data, and processes missing values. Then, for feature extraction, important variables are selected through principal component analysis, and data similar to the relationship between the data are classified through correlation coefficient and covariance. In order to analyze the features extracted from the lifelog, dynamic clustering is performed through the K-means algorithm in consideration of the passage of time. The new data is clustered through the similarity distance measurement method based on the increment of the sum of squared errors. Next is to extract information about the cluster by considering the passage of time. Therefore, using the health decision-making system through feature clusters, risks able to managed through factors such as physical characteristics, lifestyle habits, disease status, health care event occurrence risk, and predictability. The performance evaluation compares the proposed method using Precision, Recall, and F-measure with the fuzzy and kernel-based clustering. As a result of the evaluation, the proposed method is excellently evaluated. Therefore, through the proposed method, it is possible to accurately predict and appropriately manage the user's potential health risk by using the similarity with the patient.

Personality Type Test(MBTI) of the Korean Bruxism Patients (한국 이갈이 환자의 성격 유형 검사(MBTI))

  • Lee, Hyun-Ae;Auh, Q-Schick;Jung, Kee-Taig;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.33 no.1
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    • pp.41-48
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    • 2008
  • The focus of this study is to analyze the effect of stress on the health of bruxism patients using the MBTI system. The most common personality type will be identified among the bruxism patients and by understanding their personality & their handling of stress, more comprehesive and effective treatment plan can be constructed. The study will also conclude that the type of personality has big effect on the cause of bruxism, and that this will be considered in the treatment plan in this hospital. The result of the study is as follow. First, more bruxism patients were type I than type E. It can be suggested that this result is due to the introversive people maintaining their energy how within themselves, and private are less to likely to release there stress than the expressive people. Second, among the bruxism patients significantly more type T were found compared to type F. This implies the bruxism tend to follow principals, scientific and analysing during decision making rather than basing their decision an meanings, emotions and influences. Thirdly, more bruxism patients clarified into ST in comparison to non-bruxism patients. This is thought to be due to probable increased stress and anxiety following ST people's tendency to more strict and realistic thinking according to effectiveness, evidence-based and productivity. Fourth, the type IJ was the most of the bruxism patients. We can come to the conclusion that decision-oriented introversion people who have hard to change, a thoroughgoing preparation characters are likely to grind their teeth by their detailed characters. Fifth, the type IT was the most of the bruxism patients. Bruxism patients are usually influenced by spirit, easily hearted, awed of relationship and attention. So, their intensity of stress is much bigger because of their personality. The last, Type IS was the most of the bruxism patients. It means that introvert sensitive types who have characters of calm, passive but defence to other's emotion, also neutral, keep moderation, and have cold-heartedness are likely to grind their teeth frequently. In conclusion it is evident that bruxism patients have particular personality types. Precisive, analysing and introversive bruxism patients are expected to have higher sensitivities to stress.

Geographical Characteristics and Patients' Determinants of Online Referrals : A Case Study of Choongbook, Korea (온라인 협진에 대한 지리적 특성과 환자의 결정에 관한 연구 : 충청북도 사례를 중심으로)

  • Park, Soo-Kyung
    • Journal of the Korean association of regional geographers
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    • v.17 no.5
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    • pp.617-637
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    • 2011
  • This study employs qualitative approaches to examining geographical characteristics and patients' determinants of online referrals in terms of regionalization. In this light, I conducted interviews with 20 patients receiving online referrals in Choongbook, Korea, and investigated their behaviors regarding these referrals between July and August 2009. I found that many patients who suffered from various levels of illness preferred tertiary care centers outside of Choongbook and did not enjoy their experience with the local medical institutions as the online referral service sites. This result might be because patients choose online referrals for psychological considerations such as quality and level of health care services, personal stakes in online referral service sites, acceptability and credibility of good tertiary care centers, and easy access to and use of medical institutions. Meanwhile, immediate benefits with regard to the technological value of online referrals, such as convenience, utility, and original purpose associated with regionalization, did not influence patients' decision-making. Therefore, the social and public networks affiliated with online referrals plus the effect of Korean medical laws play hostage to private decisions made by citizens, who prefer high-level medical institutions. Accordingly, the technological contribution of online referrals does not halt the outflow of patients from local, tertiary care centers. Especially, the existing health care system and patients' behaviors are deeply related to referrals in the online system. To protect regionalization, the improvement of health care services from the present state of affairs is required.

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Mathematical Modeling of the Novel Influenza A (H1N1) Virus and Evaluation of the Epidemic Response Strategies in the Republic of Korea (수학적 모델을 이용한 신종인플루엔자 환자 예측 및 대응 전략 평가)

  • Suh, Min-A;Lee, Jee-Hyun;Chi, Hye-Jin;Kim, Young-Keun;Kang, Dae-Yong;Hur, Nam-Wook;Ha, Kyung-Hwa;Lee, Dong-Han;Kim, Chang-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.2
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    • pp.109-116
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    • 2010
  • Objectives: The pandemic of novel influenza A (H1N1) virus has required decision-makers to act in the face of the substantial uncertainties. In this study, we evaluated the potential impact of the pandemic response strategies in the Republic of Korea using a mathematical model. Methods: We developed a deterministic model of a pandemic (H1N1) 2009 in a structured population using the demographic data from the Korean population and the epidemiological feature of the pandemic (H1N1) 2009. To estimate the parameter values for the deterministic model, we used the available data from the previous studies on pandemic influenza. The pandemic response strategies of the Republic of Korea for novel influenza A (H1N1) virus such as school closure, mass vaccination (70% of population in 30 days), and a policy for anti-viral drug (treatment or prophylaxis) were applied to the deterministic model. Results: The effect of two-week school closure on the attack rate was low regardless of the timing of the intervention. The earlier vaccination showed the effect of greater delays in reaching the peak of outbreaks. When it was no vaccination, vaccination at initiation of outbreak, vaccination 90 days after the initiation of outbreak and vaccination at the epidemic peak point, the total number of clinical cases for 400 days were 20.8 million, 4.4 million, 4.7 million and 12.6 million, respectively. The pandemic response strategies of the Republic of Korea delayed the peak of outbreaks (about 40 days) and decreased the number of cumulative clinical cases (8 million). Conclusions: Rapid vaccination was the most important factor to control the spread of pandemic influenza, and the response strategies of the Republic of Korea were shown to delay the spread of pandemic influenza in this deterministic model.

Survey on Radiographic Works in Hospitals and Clinics (병(病)-의원(醫院)의 X선촬영업무(線撮影業務)에 관한 실태조사(實態調査))

  • Choi, Song-Hak;Jeon, Man-Jin;Park, Sung-Ock;Lim, Han-Young;Kim, Keon-Chung;Huh, Joon;Choi, Jong-Woon
    • Journal of radiological science and technology
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    • v.7 no.1
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    • pp.3-11
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    • 1984
  • The major findings of this investigation on radiographic works in 125 medical institutions around Seoul and Kyung-Ki area, from March 1983 to February 1984, are summarized as follows. 1. The number of references provided on radiographic techniques were 3 to 5 in general hospitals (52.1%), in hospitals (58.5%), and clinics (44.5%), and only the 10.4% of general hospitals had 11 or more. 2. The relatively high percentages of 75.0% of general hospitals and 68.3% of hospitals have established the standardized radiographic methods for regions examined, but most clinics (61.1%) have not. 3. As a log system for the radiographic request, the method of "routine study, or all the x-ray examinations are marked as 0 on a printed form" was most commonly used by general hospitals (62.5%) and hospitals (51.2%), and "the doctors employ their own methods" in most clinics (44.6%). 4. In the 85.4% of general hospitals, the 68.3% of hospitals and the 38.9% of clinics, the data such as diagnosis, clinic history, purpose of x-ray examination were recorded on a radiographic request at all times, or at least in part. 5. On a scale of hardness and easiness of order of doctors, the greatest response was "fairly easy to understand", and the 37.5% of general hospitals responded as "sometimes hard". 6. In determining the standards for radiographic factors, the general hospitals (62.5%) and hospitals (65.9%) adapted mostly "a departmental check list", and the clinics (61.1%) used mainly "a personal decision". 7. In using the immobilizing devices, angligner, and radiographic accessories, the Percentages were high in general hospitals and hospitals on the one hand, and were low in clinics on the other. 8. A consideration with regard to the devices for an improvement of examination of the same patients was totally ignored by the 50.0% of clinics, the 26.8% of hospitals and the 20.8% of general hospitals. 9. The causes of re-examination were due largely to patients (33.6%), and followed proportionately by incorrect exposure (22.8%), errors in positioning (22.0%), film processing faults (9.2%), conditions of x-ray equipments (8.8%), and quality of x-ray films (3.6%). 10. The conference on radiography was conducted regularly or irregularly by the 87.5% of general hospitals, the 56.1% of hospitals, and the 27.7% of clinics, and the meeting was proceeded only by radiologic technologists.

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A Study on the Regional Differences of Telemedicine and Digital Divide (원격진료의 지역적 차별성과 정보격차에 관한 연구)

  • Park, Sookyung
    • Journal of the Korean Geographical Society
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    • v.50 no.3
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    • pp.325-338
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    • 2015
  • Telemedicine, which gives or receives medical information via ICT (information and communication technology), is regarded as innovation in a medical field and its application is various according to offline conditions. For example, the utilization of telemedicine in Korea is unfair because of the administrative discretion, which is the basic unit of telemedicine for its practical operation, in spite of the same diagnostic area. With this mind, this study investigates the cause of regional differences of telemedicine through a case of Kangwon province. Furthermore, the crucial matter is that regional differences of telemedicine are associated with digital divide; therefore, this research considers digital divide triggered by telemedicine. The core results are as follows. First, there are little measures such as increase of the staff, economic compensation for public officials, education of telemedicine facilities; accordingly, only regions, where can accept these insufficient conditions, manage the telemedicine system. Second, the interesting of a mayor or a governor and a head of a health center as a highest decision maker has something to do with different utilization of telemedicine. Third, public health doctors play a role as practical operators in telemedicine, but their stance is skeptic about telemedicine somewhat because of the relationship with the medical association opposing the implementation of telemedicine, unimproved regional health care condition, etc. Forth, it seems that the digital divide caused by the regional differences of the present telemedicine utilization does not led to tangible results and is not turned to another disparity so far, the proper measures are required considering that various health care services based on telemedicine will be extended.

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