• 대한예방의학회:학술대회논문집
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• 2002.10a
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• pp.332-333
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• 2002

• Health Policy and Management
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• v.15 no.4
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• pp.1-25
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• 2005

Legislation on pharmaceutical reimbursement decision using economic evaluation results was made in Korea in fm, but has yet to be fully implemented. We evaluated the quality of Korean economic evaluation studies of pharmaceuticals to understand gaps between legislation and implementation. From this evaluation, we propose policy options that might strengthen the research Infrastructure In order to support such studies. We reviewed 23 published studies for drugs conducted between 1996 and 2004. Evaluation criteria included methodological characteristics, healthcare system characteristics, population characteristics, and applicability of results. Large variation in study quality was observed, particularly with study design, outcome data, treatment patterns and interpretation. Korean clinical data used was mostly from observational studies of 1-2 hospitals. Foreign data was extracted from clinical trials that did not Include Asian population and their selection criterion was not clarified. With respect to treatment patterns, medical records and hospital bills were used without adjustment regarding area, hospital type, and others. And next frequent situation relied on expert opinion from academic physicians in specialty practice. preference measures, when used, were not elicited from the Korean population. $78.3\%$ of studies did not clarify the funding source. If the Korean economic evaluation policy is to provide meaningful data for decision makers, the quality of cost-effectiveness studies will need to improve dramatically. This may involve access to or creation of better data, more diverse funding, unproved training of researchers and evaluators, and partnerships with technology manufacturers.

• Journal of Korean Academy of Nursing
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• v.49 no.5
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• pp.575-585
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• 2019

Purpose: The purpose of this study was to develop predictive models for pressure ulcer incidence using electronic health record (EHR) data and to compare their predictive validity performance indicators with that of the Braden Scale used in the study hospital. Methods: A retrospective case-control study was conducted in a tertiary teaching hospital in Korea. Data of 202 pressure ulcer patients and 14,705 non-pressure ulcer patients admitted between January 2015 and May 2016 were extracted from the EHRs. Three predictive models for pressure ulcer incidence were developed using logistic regression, Cox proportional hazards regression, and decision tree modeling. The predictive validity performance indicators of the three models were compared with those of the Braden Scale. Results: The logistic regression model was most efficient with a high area under the receiver operating characteristics curve (AUC) estimate of 0.97, followed by the decision tree model (AUC 0.95), Cox proportional hazards regression model (AUC 0.95), and the Braden Scale (AUC 0.82). Decreased mobility was the most significant factor in the logistic regression and Cox proportional hazards models, and the endotracheal tube was the most important factor in the decision tree model. Conclusion: Predictive validity performance indicators of the Braden Scale were lower than those of the logistic regression, Cox proportional hazards regression, and decision tree models. The models developed in this study can be used to develop a clinical decision support system that automatically assesses risk for pressure ulcers to aid nurses.

• The Korean Society of Law and Medicine
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• v.14 no.1
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• pp.355-401
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• 2013

The first legislation for terminal health-care decision was California's Natural Death Act (NDA) of 1976 that permitted any adult person to execute a directive directing the withholding or withdrawal of life-sustaining procedures. Advance directive legislation has subsequently progressed on a state-by-state basis. By 1992, all 50 states, as well as the District of Columbia, had passed legislation to legalize some form of advance directive. This state legislation, however, has resulted in an often fragmented, incomplete, and sometimes inconsistent set of rules. Statutes enacted within a state often conflict and conflicts between statutes of different states are common. In an increasingly mobile society where an advance health-care directive given in one state must frequently be implemented in another, there is a need for greater uniformity. In 1993, the Uniform Law Commissioners approved the Uniform Health-Care Decisions Act (UHCDA) in order to bring order to the existing chaos. Unfortunately, the Commissioners waited too long to act. By the time the UHCDA was approved, nearly all states had passed legislation governing advance directives. Consequently, the UHCDA has achieved only a limited success, picking up but one or two enactments a year. The UHCDA is currently in effect in around 10 states: Alabama, Alaska, California, Delaware, Hawaii, Kansas, Maine, Mississippi, New Mexico, Tennessee, Wyoming. In these states the previous laws related to the subjects have been all repealed. The overall objective of the UHCDA is to encourage the making and enforcement of advance health care directives including living will or individual instruction, power of health-care attorney and to provide a means for making health care decisions for those who have failed to plan. The U. S. House of Representatives in 1991 enacted the Patient Self-Determination Act (PSDA). The Act stipulates that all hospitals receiving Medicaid or Medicare reimbursement must ascertain whether patients have or wish to have advance directives. The Patient Self- Determination Act does not create or legalize advance directives; rather it validates their existence in each of the states. Now in America, terminal health-care decision or advance directive for health care is common and universal system. The problem, however, is how to let more people use these good tools to make their lives more beautiful and honorable.

• The Korean Journal of Applied Statistics
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• v.21 no.4
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• pp.639-647
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• 2008

This study used the characteristics of the knowledge discovery and data mining algorithms to develop tailored hypertension follow up management model - hypertension care predictive model and hypertension care compliance segmentation model - for hypertension management using the Korea National Health Insurance Corporation database(the insureds’ screening and health care benefit data). This study validated the predictive power of data mining algorithms by comparing the performance of logistic regression, decision tree, and ensemble technique. On the basis of internal and external validation, it was found that the model performance of logistic regression method was the best among the above three techniques on hypertension care predictive model and hypertension care compliance segmentation model was developed by Decision tree analysis. This study produced several factors affecting the outbreak of hypertension using screening. It is considered to be a contributing factor towards the nation’s building of a Hypertension follow up Management System in the near future by bringing forth representative results on the rise and care of hypertension.

• Journal of the Korean Operations Research and Management Science Society
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• v.10 no.1
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• pp.54-64
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• 1985

This paper deals with analysis on complex and dynamic Primary Health Care (PHC) Systems in rural community to increase understanding of the nature of PHC feedback systems. Because Industrial Dynamics can be very useful for the analysis of such complex and dynamic systems. We used that as a basic tool of Modelling and simulation running. Even If PHC system-models require many assumptions, simulations based on these models can lead decision makers to a better way of problem solving.

• Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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• 2008.10a
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• pp.257-260
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• 2008

We build middleware architecture with J2EE and LiveGraph to process different ubiquitous healthcare application's data and process that data into useful information, which can play a most important role in decision making in ubiquitous Healthcare System. Application developers mostly rely on third party middleware, tools and libraries (i.e., webservers, distributed middleware such as CORBA, etc.) to respond the emerging trends of their target domain. With this middleware we tried to enhance the efficiency of application by decrease their memory uses, data processing and decision making on another web module which is independent of each application. For middleware system, we proposed an algorithm by which we can find some important conclusion about different health status likewise ECG, Accelerometer. etc., which can be used in various data processing and determine the current health status. In this paper we also analyze some different low level and high level middleware technology which were used to build different kind middleware likewise CAMUS, MiLAN and try to find the best solution in the form of middleware for Ubiquitous Healthcare Information System.

• 대한예방의학회:학술대회논문집
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• 2001.10a
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• pp.193-194
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• 2001

• Journal of Intelligence and Information Systems
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• v.3 no.2
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• pp.93-104
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• 1997

The major economic health problem of dairy cattle is mastitis which can affect 10 to 50% of cow-quarters. This health problem is difficult for many dairy farmers and health advisors to understand, diagnose and control. Without special laboratory testing, most mastitis is overlooked. Estimates of annual mastitis cast per cow vary from $50 to $200. For the nearly 9 million cows in the United States, annual loss to the dairy industry amounts to over one billion. A knowledge-based decision aid has been developed to evaluate mastitis data retrieved electronically from two of nine U. S. regional dairy records processing centers. Heuristic rules to diagnose herd mastitis problems were collected and incorporated into the system from various domain experts. This system information. It allows users to select mastitis control schemes with various degrees of aggressiveness and teaches commonly accepted mastitis control practices.

• Korean Journal of Health Education and Promotion
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• v.15 no.1
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• pp.49-66
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• 1998

The general objectives of this study were to develop a health education management information system to effectively deal with community health problems. This study aimed at 1) to development an health education management information system, and 2) to offer computer-based communication channels among the District Health System components such as health center, health subcenters, and community hospital, 3) lastly, to identify the key issues and effectiveness of health education. Major findings of the study were as follows: The major benefits and significances of this information system included: improvement of quality of health education statistics by reducing manual data processing, improvement of productivity of health educators by reducing paper works, improvement of decision-making capability of managers by providing more information for planning, organizing, and evaluating health education programes, and improvement of communication flow among health institutions. Based on the findings of the study, the following are recommended: (1) The health education information system will connect with computerized information systems of various health-related institutions in a district and computer-based communication channels among them, and of the superior agencies in the future. (2) The major functions of the computerized health education program are: to keep client medical records, to inquire about information on the client and his family's history. (3) The program will provide outputs in various forms, such as files for patient records, data on some chronic diseases, information on the patient and his family members, and various kinds of statistics.