• Journal of Korean Academy of Nursing
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• v.10 no.1
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• pp.41-55
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• 1980

The medical care insurance system, being put into practice nearly for three years, seem to have brought about some considerable problems as serious for the government as to consider a revision of that system. As one of the most serious problems of present system, the treatment cost of insurance patients is so remarkably low in comparison with than of non-insurance cases that normal operation of hospitals is threatened and care services of low quality are induced. The researcher carried out this survey to analyze and bring to light several aspects of treatment cost of non-insurance patients as a material for a re-assessment of the cost of insurance cases which shows a a considerable difference in amount at the standpoint of hospitals with than of non-insurance cases and further, hoping the significant blind spot of present insurance system(that is, the absence of regulations' for cost assessment by patterns or types of health care treatment) will be mended in near future. The survey was carried out with the treatment invoice sheets of total 902 in-hospital Patients of a general hospital in Seoul during the period of the 2 nd quarter of the year(1979). Among total 902 patients, 694 cases were used for analysis, because those disease or syndromes shared by less than 10% of the patients were put aside before procession. The data were analyzed by kinds or types of diseases, demographic characteristics of patients, hospitalization patterns, types of nursing treatment, etc. The result of analysis was as follows 1. Among all the non-insurance cases, those who received one or more kinds of nursing treatment mounted up to 96. 7 ％. The invoice issue frequency per person was 7.2 times, while that frequency per day for a person was 0.8, : the treatment cosr per person was ￦22,650 while its daily average was ￦2,430, due to the average 9.3 in-hospital days per person. 2. As to the nursing treatment types by the demographic characteristics of patients and hospitalization patterns. a. The unit cost female patients was generally more expensive them that of males, and independent nursing service was more given than other types of treatment. As to age, higher age groups received independent nursing service most, while the youngest group received instrumental and integrated nursing services. b. As to room grade, the unit cost of I.C.U. cases was the highest : and the cast of private room patients was higher than that of public room patients. By in-hospital days, the curve of function showed L. type : that is, the longer stay, the lower function. 3. State of treatment types by kinds of disease were ; a. Dependent nursing service showed comparatively high availability in surgical and neurologic disease and independent nursing service was most received by medical, obstetrical and urological patients, while instrumental and integrated services were most available for respiratory disease and obstetrical and neurologic diseases next. b. The invoice issue frequency per day for a patient was highest in obstetrical disease 3.8 times, and the unit cost(per one invoice sheet) was also highest in obstertrical disease(￦10,880) and next in neurologic cases(￦ 4,690 ). 4. As to the pertained departments. a. Cost amount per person was highest in department of Psychiatries daily cost was highest in obstetrical cases : while the invoice issue frequency was highest in obstetrics and next in pediatrics. b. In departments in need of surgical operation, dependent nursing care was highly availabl : while in internal medicine and obstetrics, independent service was higher. Psychiatrics showed the highest the of integrate nursing while pediatrics and obstetrics higher of instrumental services. The variation co-efficien of treatment cost came out to be relatively in high in special surgery, opthalmology and internal medicine. 5. State of treatment cost by types of nursing behavior was. a. The average frequency of invoice issue was 3.5 (times). Among the type four types of treatment, instrumetal service (4.3) and independent nursing behavior(3.9) showed higher frequency than average respectively. But as to unit cost (per invoice). dependent (￦5,200) and integrated (￦5,340) nursing care services were higher than average and considerably higher than the other two types. b. In repect patient distribution. independent nursing behavior(80.3% ) was the highest and depend ent nursing (31.7% ) the lowest. The variation co-efficient of treatment cost appeared highest in dependent nursing be havior as a whole, and among that, doctor's diagnosis showed the highest coefficient value (100.7). In conclusion, the variaty of treatment cost(treatment itself ) by various characteristics and treatment types pro- that treatment various sort of patients and treatment cost of various types of nursing behavior cannot be uniform. Therefore, to attain the equalization of health care service and its cost both for insurant and non-insurant patients, a more specific provision for assessment of cost should be added to the present medical care insurance system and, in addition, the cost of nursing treatment is desired to be inserted into the treatment invoice.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.85-94
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• 1970

This is a study of 21 tuberculosis patients receiving medical treatment at the Public Health Center in Kyongi Do, Pu Chun Gun and at the General Hospital. The results cover the findings of the period from May, 1969 to November 1970. The information obtained is based on personal interviews with the patients, and symptomatic diagnosis made from observations. The following statistics when not equalling 100% contain only the responses of the two extremes in each case. The findings of the research are as follows: 1. 52.3% of the patients in the study are males and 47.7% are females. 28.6% of the subjects are between 20 and 29 years of age and an equal percent are between 30 and 39 years. 2. 47.5% of the subjects had graduated from primary school, while only 4.8% had graduated from high school. 3. 57.1% of the patients said they had no religions beliefs, while 4.8% professed to being Buddhists or believing in superstition. 4. 47.3% of the people said they were unemployed, while 4.8% classified themselves as labourers. 5. In response to how tuberculosis was first detected in their respective cases, 52.6% became aware of their disease through X-ray results, while 4.8% were discovered to have tuberculosis when being treated for other diseases at the hospital. 6. When asked how many of the patients knew anything about their disease when treated, 57.1% knew nothing about tuberculosis when they received treatment, while 42.9% had some knowledge of the disease. 7. Of those who knew something about tuberculosis, 61.9% learned about from doctors and nurses, while 4.8% learned from other people. 8. 57.1% of the patients knew that tuberculosis is a communicable disease, while 42.9% did not know. 9. 52.4% of the patients did not know the cause of tuberculosis while 4.9% believed the disease was caused by a curse. 10. When asked about the extent of treatment, 52.4% responded that they had undergone continuous treatment, while 4.8% had not received treatment. 11.The reasons given for not continuing treatment were the following: economic factors 55.6%; side reactions to the treatment, lack of knowledge of how to get treatment, of the need for treatment, or of the positive effects of treatment 11.1%. 12. 61.9% of the subjects usually took the medical treatment at home, 9.5% took it in the mountains or at the beach. 13. 42.9% of the patients received drugs for treatment at the local public health center, while 4.8% received them at the hospital 14. 33.3% of the patients received P.A.S＋I.N.H.＋S.M. for treatment of tuberculosis, while 4.8% received P.A.S.＋S.M.. and some secondary drug. 15. Of the patients who took some extra medicine for tuberculosis, 38.1% took a Chinese drug, while 9.5% took herb medicine. 16. 38.1% of the patients had continued treatment for three years, 4.8% had interrupted the treatment. 17. When asked about the development of the disease after treatment, the patients gave the following information: after one month, 90.5% thought the treatment helped, while 9.5% weren't sure; after one year, 55.6% thought it was good, while 5.5% thought it was not; after three years, 63.6% had a very bad condition. while 4.8% didn't know. 18. 61.9% of the patients were unconcerned about covering their mouths when they coughed, while 38.1% covered their mouths. 19. 57.2% were unconcerned they spit, while 23.8% spit into a waste basket. 20. 66.7% were unconcerned about sterilizing tableware, while 9.5% handled it separately. 21. 66.7% were unconcerned about ventilating their room, while 9.5% ventilated the room twice a week.

• Child Health Nursing Research
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• v.20 no.3
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• pp.168-175
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• 2014

Purpose: Study purposes were to exam effects of self-care education for children with type 1 diabetes on their diabetes management behaviors and to explore the relationship among diabetes management behaviors, knowledge, self-efficacy and clinical variables. Methods: This study was a one group quasi-experimental study. Study participants were children with type 1 diabetes and attended a four hour self-care education of a diabetes camp. Data were collected using structured questionnaires including Diabetes Management Behavior Scale (DMBS), Michigan Diabetes Research and Training Center's Brief Diabetes Knowledge Test and Self-Efficacy for Diabetes Self-Management. Results: The mean age of the participants was 12 (${\pm}2.3$) years. After the education, their DMBS and knowledge improved, but the improvement was not statistically significant (t=1.758, p=.101; t=0.528, p=.606). Two areas of DMBS, daily prevention behaviors and modification of care plan, were associated with study variables. Daily prevention behaviors were associated with duration of diabetes (r=.653, p=.008), HbA1c (r=.563, p=.038) and having a complication (r=-2.788, p=.015). Modification of care plan was associated with age at diagnosis (r=-.552, p=.033). Conclusion: Children with type 1 diabetes could improve some parts of their diabetes management behaviors even after a short diabetes camp.

• Journal of radiological science and technology
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• v.31 no.2
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• pp.115-121
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• 2008

Purpose: Aortic Dissection is very dangerous, prognostic disease, which the bloodstream flow out of the true lumen of the aorta by the bursting of aortic intima resulting in a rapid dissociation of inner and outer layer from the media. It is difficult to diagnose aortic dissection clinically by normal X-ray. This study was to investigate the occurrence frequency by age and number of patients who are identified to be aortic dissection by CT (Computed Tomography) scan. Materials and methods: We investigated the trend of yearly fluctuation, gender, age, and department of clinical research of the 112 patients who conducted CT scan in C- University Hospital for two years from January 2005 to December 2006. The MIP and SSD which reconstructed CT image and the VRT image were obtained for the accurate observation. The result was investigated by comparing normal X-ray and CT scan. Results and Conclusion: 1. The yearly check of 112 patients conducted CT scan showed 37 people (41.9%) in 2005, and it was increased to 65 (58.1%) in 2006 by 1.4 times. 2. The gender distribution of patients given a CT scan showed 45 males (40.1%), and female 67 (59.9 %). The aortic dissection patients were 9 (20%) out of 45 males, 21 (31.3%) out of 67 females and women were 1.6 times more than men. Women are also 1.5 times more than men in the number of examinee. 3. The age distribution of patient's who conducted CT scan revealed that there was no patient under 30 years old while 88.3% of all patients were through 41 to 80 years old. The higher the age was, the higher the occurrence of aortic dissection was. The difference in the occurrence frequency of age was statistically significant (p<0.01). 4. The departments that requested CT scan were the emergency department 46 (41.1%), circulatory internal medicine 37 (33.0%), chest surgery 13 (11.6%), and others 6 (14.3%). The combined ratio of emergency medicine and circulatory internal medicine was 74.1% of all. The results show that the aortic dissection is a very dangerous disease whose patients visit mainly via the emergency room. 5. The aortic dissection patients had normal X-ray readings in 22 (73.3%) out of 30, and only 8 (26.7 percent) are abnormal in the X-ray diagnosis. Therefore, the CT scan needs to be enforced in order to assess accurately the disease of aortic dissection.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.4
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• pp.378-387
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• 2016

This study sought to investigate interrelationships and differences of brachial-ankle pulse wave velocity (baPWV), body composition and cardiovascular variables between genders who have been exercised or not in elderly. One hundred fifty participants were classified four groups. Especially out of variables, in male elderly group who had participated in exercise program the PWV range were significantly correlated with muscle mass (r=0.357, p=0.026), SBP (r=0.468, p=0.003), right baPWV (r=0.406, p=0.010), and left baPWV (r=0.333, p=0.038). In male elderly group who had not participated in exercise program, the PWV range were significantly correlated with heart rate (r=0.395, p=0.014), right baPWV (r=0.598, p=0.000), and left baPWV (r=0.602, p=0.000). In female elderly group who had participated in exercise program, the PWV range were significantly correlated with name of diagnosis (r=0.321, p=0.044), SBP (r=0.399, p=0.011), DBP (r=0.545, p=0.000), right baPWV (r=0.648, p=0.000), and left baPWV (r=0.676, p=0.000). In female elderly group who had not participated in exercise program, the PWV range were significantly correlated with age (r=0.471, p=0.003), right baPWV (r=0.836, p=0.000), and left baPWV (r=0.801, p=0.000). The PWV among four groups were not significant different after experiment. However, there were significant differences in the waist/hip ratio (F=9.197, p=0.000), muscle mass (F=74.295, p=0.000), and %fat (F=35.045, p=0.000) from body composition. And there were significant differences in the SBP (F=3.525, p=0.017) after experiment. In conclusion, these data show that regular exercise is associated with arterial compliance (PWV range, right or left PWV) and differed from genders. In other words, this paper may support the concept that regular exercise program may exert a protective effect on arterial compliance, body composition and cardiovascular systems.

• Journal of Korean Ophthalmic Optics Society
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• v.18 no.2
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• pp.125-136
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• 2013

Purpose: The aim of this study was to investigate the effect of improving read speed with color filter or without color filter to improve reading disorder of teenager who were diagnosed as Meares-Irlen syndrome through survey inspection with Meares-Irlen syndrome visual stress (MISViS) score. Methods: MISViS subjects were selected from screening survey MISViS results given above 2.13 in the clinical criteria scores (MISViS score). Reading speed were measured quickly and efficiently the rate of reading via test in which randomly ordered common words are read aloud during a minute. Each of the subjects were worn a filter of the lowest concentration in each color filter group composed of 15 groups. Results: MISViS score of MISViS group and control group were 2.57 and 0.66, respectively. Results of reading speed with filter and without filter in MISViS group were $102.27{\pm}27.86$ wpm and $118.87{\pm}26.99$ wpm (p=0.001), respectively, as well as were $132.93{\pm}6.88$ wpm and $133.43{\pm}6.64$ wpm (p=0.131) in the normal group. Associated with error changes with filter and without filter between two groups, skipping in MISViS Group were from $0.25{\pm}0.62$ times to 0 times (p=0.191), Errors were from $1.83{\pm}1.69$ times to $0.17{\pm}0.38$ times (p = 0.004) and, repetitions were 0. skipping in control group were 0 times, errors were from $0.21{\pm}0.43$ times to $0.07{\pm}0.27$ times (p=0.336) and, repetitions were from $0.14{\pm}0.36$ times to 0 (p=0.165). The filter of blue series chosen in MISViS group had higher percentage (40%), whereas, subjects in normal group were more likely to prefer the filter of gray color (29%). Conclusions: This study showed that MISViS score have been used as a significant diagnosis for Irlen syndrome screening. This study found that wearing suitable color filter for MISViS patients were useful to improve learning with regard to reading. Unique color filter selection for MISViS subjects must be carefully considered since fit color filter are different personally.

• Journal of Korean Academy of Nursing
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• v.6 no.1
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• pp.60-71
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• 1976

The author reviewed the medical records of 96 typhoid fever patients who were diagnosed, admitted, and treated at Sea grave Memorial Hospital from January 1 , 1973 through August 31, 1975. Diagnosis was determined by clinical observation, aerology and bacteriology, eighty patients were treated medically, the remaining 16 patients required surgical intervention. The following results were obtained: 1) The age distribution of the patients revealed that 33.3% wert between 10 and 19 years old 21.9% were between 20 and 29, and 19.8% were between 30 and 39. The majority of patients were from these more active age groups. Male to female sex ratio was 1.3 : 1 2) Seasonal distribution was observed. Most illness occurred in the summer and autumn month 5. 3) 84. 3%of the patients came from farm families. 4) Duration between onset and admission averaged 16.0 days. The group without compilations was admitted after an average of 15. 1 days; The group with complications was ad-matted after an average of 19.4 days. 5) Methods of treatment before admission were as follows: 10.4% at medical clinics, 61, 5% at pharmacies (antibiotics 47.9%, other. drugs 13.5%), 7.3% by herb medications, 20.8% had no treatment. 6) Main clinical symptoms were as follows: fever 93.8%, headache 47.9%, abdominal pain 47.9%, chills 38.5%, cough 36.5%, general weakness 26.0%, nausea e vomiting 24.0% and generalized pain 21.9%. 7) Temperature of patients on admission: 22.9% were 39f or more, 67.6% were between 37℃ and 38℃, and 9.4% were 37℃ or less. 8) Occurrence of intensional bleeding after onset of disease averaged 9.3 days; perforation occurred at an average of 19. 1 days. 9) Interval between onset of major complication and surgical intervention averaged 2.8 days. 10) Among the 68 patients who underwent the bacteriological test the positive rate was 44.1% (30). The positive ,ales to, each separate culture method were as follows: 20.4% in the blood culture, 40.4% in the stool culture and 6.7% in the urine culture. Among these bacteriological positive patients 15 patients had a negative results or less than 160 titer of vidal reaction. 11) The initial vidal test of the total group showed a counts of 160 titer or more in 60.4% and less than 160 titer in 39.6%, 12) W. B. C. Counts in the uncomplicated group indicated that 32.5% were 6,000/㎣ or less, 47.5% were between 6,000 and 10,000, arid 20.0% were 10,000/㎣ or more. In the complicated group, 37.6% were 6,000/㎣ or less, 25,0% were 6,000-10,000/㎣ and 37.6% were 10,000/㎣ or more. 13) Duration of hospital stay of the patients averaged 6.4 days in the uncomplicated group and 12.7 days in the complicated group. 14) Subdiaphragmatic free air simple X-ray was found in 91.7% of the perforated cases. 15) Duration of antibiotic therapy until an febrile state was attained averaged 4.8 days in the uncomplicated group and 6.5 days in the complicated group. 16) Operative procedures were as follows: one layer simple closure of their perforation with or without debasement in 56.3%, drainage only in 6.3%, small bowel resection with primary anastomosis in 18.8% , externalization in 6.3%, cholecystectomy in 6.3%, The clinical findings of this study suggest the following recommendations. According to Top's report; 1% of typhoid fever patients treated with chlorarnphenicol and 2% of patients treated with other drugs become chronic carriers. Therefore, importance should be given to the strict control of these carriers. Immunization, improvement of sanitation and living standards are all needed for the prevention and treatment of disease, but a more serious problem is a lack of knowledge on the part of patients and their families. Thus it is most urgent to enlighten the citizens about the transmission and hygiene related to contagious disease. Legal restriction of sale of antibiotics at drug stores without a physician's prescription is an urgent matter for public health administrators. An even more important nursing responsibility is the reemphasis on health education both in the clinical setting and in the home.

• Tuberculosis and Respiratory Diseases
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• v.55 no.2
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• pp.154-164
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• 2003

Background : Until the early 1990's in Korea, treatment outcomes of patients with pulmonary tuberculosis in the private sector were reported to be inferior to those of the public health center under the National Tuberculosis Programme. The purpose of this study was to analyze the clinical characteristics and the treatment efficacy of the patients with pulmonary tuberculosis recently diagnosed at a private general hospital. Materials and Methods : The study included all pulmonary tuberculosis patients diagnosed at Samsung Medical Center and notified to the public health center from August 2000 to January 2001. Results : Of the 232 patients included in the study during a 6-month period, 188 were (81.0%) initial treatment cases and 44 (19.0%) were re-treatment cases. Eighty-three (35.8%) patients had smear-positive sputa, and 27 (11.6%) had smear-negative, culture-positive sputa. Initial sputum examinations were not performed in 47 (20.3%) patients. A six-month, short-course treatment using isoniazid, rifampin, ethambutol and pyrazinamide was prescribed for 31.4% of the patients under the initial treatment. The success rate (cured plus treatment completed) of the initial treatment for the smear-positive patients was 69.1%. Eleven (13.3%) of the 83 patients with smear-positive pulmonary tuberculosis discontinued their treatment without notice. Conclusions : To improve the treatment efficacy and decrease the default rates of the patients with pulmonary tuberculosis in the private sector, further efforts are required in line with the Korean Academy of Tuberculosis and Respiratory Disease Treatment Guidelines and in the implementation of an appropriate model of public-private mix for tuberculosis control in Korea.

• Journal of Radiation Protection and Research
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• v.35 no.3
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• pp.111-116
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• 2010

Ionizing radiation is most widely used for X-Ray examination among all artificial radiation exposure, it takes up the largest proportion. Even in Korea, the medical exposure by diagnostic X-Ray examination takes up 17.4% of all radiation exposure. It takes up 92% even in artificial radiation exposure. There were 111,567 cases X-Ray radiography for skull diagnosis in 2007, which is 3% annual increase since 2004. Thus, It is need to establish the diagnostic reference level and the medical facilities as a diagnostic reference level to optimize radiation protection of the patients and to reduce the doses of X-ray. In this paper, we survey patient dose on skull radiography - collected from 114 medical facilities nationwide by using human phantom and glass dosimeter. When the patient dose for the skull radiography was measured and evaluated to establish the diagnostic reference level, 2.23 mGy was established for posterior-anterior imaging and 1.87 mGy for lateral imaging was established. The posterior-anterior skull radiography entrance surface dose of 2.23 is less than the guidance level of 5 mGy from the global organizations such as World Health Organization (WHO) and International Atomic Energy Agency (IAEA), and 1.87 mGy for the lateral skull imaging is less than the guidance level of 3 mGy, which is guided by the global organizations such as World Health Organization (WHO) and International Atomic Energy Agency (IAEA).

• Investigative Magnetic Resonance Imaging
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• v.18 no.4
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• pp.341-351
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• 2014

Purpose : In this study, the medication effects of Milnacipran and Pregabalin, as well known as fibromyalgia treatment medicine, in fibromyalgia syndrome patients were compared through the change of BOLD signal in pain related functional MRI. Materials and Methods: Twenty fibromyalgia syndrome patients were enrolled in this study and they were separated into two groups according to the treatment medicine: 10 Milnacipran (MLN) treatment group and 7 Pregabalin (PGB) treatment group. For accurate diagnosis, all patients underwent several clinical tests. Pre-treated and post-treated fMRI image with block-designed pressure-pain stimulation for each group were obtained to conduct the statistical analysis of paired t-test and two sample t-test. All statistical significant level was less than 0.05. Results: In clinical tests, the clinical scores of the two groups were not significantly different at pre-treatment stage. But, PGB treatment group had lower Widespread Pain Index (WPI) and Brief Fatigue Inventory (BFI) score than those of MLN treatment group at post-treatment stage. In functional image analysis, BOLD signal of PGB treatment group was higher BOLD signal at several regions including anterior cingulate and insula than MLN treatment group at post-treatment stage. Also, paired t-test values of the BOLD signal in MLN group decreased in several regions including insula and thalamus as known as 'pain network'. In contrast, size and number of regions in which the BOLD signal decreased in PGB treatment group were smaller than those of MLN treatment group. Conclusion: This study showed that MLN group and PGB group have different medication effects. It is not surprising that MLN and PGB have not the same therapeutic effects since these two drugs have different medicinal mechanisms such as antidepressants and anti-seizure medication, respectively, and different detailed target of fibromyalgia syndrome treatment. Therefore, it is difficult to say which medicine will work better in this study.