• 보건행정학회지
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• 제21권2호
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• pp.195-212
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• 2011

Objectives: This study investigates the relationship between nurse staffing levels and differences in patient outcomes in terms of average length of stay, in-hospital mortality rate and 30-day death rate in order to evaluate the effectiveness of a policy that differentiates fees for inpatients on the basis of nurse-to-bed ratios. Methods: We obtained information on inpatients from health insurance claims data published by the Health Insurance Review and Assessment Service(HIRA) in 2008, organizational factors(type of hospital, ownership) from the records of the hospital report system in 2008, and nurse staffing levels, which were graded on a scale of 1 to 7, from data compiled between December 15, 2007, and September 20, 2008. The data were segregated according to type of hospital and quarter and finally 3,517 records of 1,182 hospitals were analyzed using multi-level analysis. Results: The average length of stay in grade 1~6 hospitals was lower than that in grade 7 ones, but the difference was much below one day. No significant difference was found among different grades in tertiary hospitals. Further, variations in staffing levels did not result in any significant difference in the in-hospital mortality rate and 30-day death rate. Conclusions: High nurse staffing levels did not result in better patient outcomes compared with low staffing levels. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving patient outcomes.

• 한국컴퓨터정보학회논문지
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• 제15권2호
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• pp.27-34
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• 2010

최근 여러 인터넷 서비스 업체에서 온라인 의료 진단 서비스 시스템을 제공하고 있다. 대부분 의료 진단 서비스 시스템은 서양 의학을 기초로 질병에 대한 처방이나 식이요법 등을 제공하기 때문에 전문 지식이 부족한 일반인들은 이용하기에 큰 어려움이 있다. 본 논문에서는 퍼지 ART 알고리즘을 적용하여 한국인 고유의 신체적 특성에 맞는 한의학 기반의 한방 자가 진단 시스템을 제안한다. 제안된 한방 자가 진단 시스템은 사용자가 제시한 증상과 이전에 진단 받았던 진료 기록을 바탕으로 이미 학습되어진 질병의 증상과 비교하여 신경망을 통해 유사도가 높은 상위 3개의 질병을 도출한다. 또한 상위 3개의 질병에 대해 질병의 전체적인 증상과 한의학 서적에서 제시한 민간요법을 제시한다. 질병과 증상에 대한 데이터베이스는 여러 한의학 서적을 통해 구축한 후 한의학 전문의의 검증을 거쳐 구현하였다. 제안된 한방 자가 진단 시스템은 진료 기록을 바탕으로 학습함으로써 기존의 질병 진단 시스템 보다 정확하게 질병을 진단한 것을 확인하였다.

• Journal of Preventive Medicine and Public Health
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• 제34권4호
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• pp.347-353
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• 2001

Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

• 한국치위생학회지
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• 제19권2호
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• pp.277-286
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• 2019

Objectives: The purpose of this study was to evaluate the association between Internet use and oral health behaviors in Korean adolescents. Methods: This study used the 13th Korea Youth Risk Behavior Web-based Survey (2017) to find an association between Internet use and oral health behaviors. The total number of study subjects was 54,603. A chi-square test and multiple logistic regression analyses were used to estimate the association between Internet use and oral health behaviors. Results: Internet use was significantly increased among female, higher school grade, lower school records, and lower economic status participants (p<0.001). The rate of frequency of toothbrushing more than three times daily and use of oral hygiene devices was increased among female, higher school record, and higher economic status participants significantly (p<0.001). Oral symptoms experienced were significantly increased among female, higher school grade, lower school records, and lower economic status participants (p<0.001). The rate of the toothbrushing more than three times daily and toothbrushing after lunch groups was the highest in the group with less than one hour of Internet use, but the rate of oral symptoms experienced was the highest in the group with over five hours of Internet use. The risk of toothbrushing less than twice daily was 1.61 times higher in the group with over five hours of Internet use, and the risk of not brushing after lunch was significantly higher (1.52 times) in the over five hours group. The risk of not using oral hygiene devices was the highest (1.22 times) in the less than five hours group, and the risk of oral symptoms experiences was 1.40 times higher in the more than five hours group. Conclusions: Internet use was related to oral health behaviors in adolescents. Appropriate Internet use and awareness of oral health care are needed among adolescents.

• Asian Pacific Journal of Cancer Prevention
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• 제13권8호
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• pp.3617-3619
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• 2012

Background: The completeness of cancer registration is a major validity index of any reported cancer incidence. The present study aimed to evaluate the esophageal cancer incidence registered in the Tehran Metropolitan Area Cancer Registry. Materials and methods: The data on esophageal cancer abstracted from three sources of 1) pathology departments, 2) medical records, and 3) death certificates during 2003 till 2007 were utilized. The completeness of the data sources were evaluated using coverage (defined as the proportion of a community population with esophageal cancer identified by the source) and density (defined as the proportion of non-empty fields of the data by source). Results: A total 1,404 cases of esophageal cancer were reported for the duration of the study. Pathology provided 771, medical records 432, and death certificates 609. The coverage was 0.55 for pathology, 0.31 for medical records, and 0.43 for death certificates. The respective density values were 0.82, 0.96 and 0.98, respectively. Pathology (0.45) was the most complete source followed by medical records (0.42), and death certificates (0.29). Discussion: A low degree of completeness dictates putting more effort into case finding plus abstracting data more thoroughly.

• 한국학교보건학회지
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• 제23권2호
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• pp.181-191
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• 2010

Purpose: The purpose of this study is to analyze the drinking status and to identify the impacts of depression, temperament, characteristic on drinking status in the vocational high school students. Methods: By using stratified sampling, 416 vocational high school students in Gangwon Do were selected and surveyed through self -administered questionnaires. Data were analyzed by SPSS 12.0 using $x^2$-test, t-test, ANOVA, Pearson correlation coefficient and multiple regression. Results: 88% of students had experienced of drinking. Depression was observed 59.1% of students from light to severe depression score. There was a positive correlation among drinking, the school records, novelty seeking, reward dependence and persistence. Also, there was a negative correlation among drinking, economic status, harm avoidance. The significant predictors of drinking were school records, depression, novelty seeking and persistence. Conclusion: These results suggest that vocational high school students who have the factors identified in this study are regarded as having the potential to drink. The results of this study can provide the information for the development of the health promotion program.

• 여성건강간호학회지
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• 제12권4호
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• pp.316-325
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• 2006

Purpose: The purpose of this study was to develop a Critical Pathway for Uterine Artery Embolization patients. Method: There were 6 steps that were taken. Step 1 was selecting a diagnosis, and Step 2 was organizing a development team consisting of 7 experts. Step 3 analyzed the medical records, and Step 4 drew up a preliminary Critical Pathway. Step 5 tested the clinical validity of the preliminary Critical Pathway, and Step 6 developed the final Critical Pathway. Result: The contents of the medical practices observed in the medical records were investigated in seven areas: monitoring/assessment, treatment, medication, diet, activity, consults, and education/discharge plan; and a total of 73 items was identified. The validity of the 73 items was examined by a group of specialists. 68 items were adopted, 4 items revised, 1 item removed, and 1 item was added. Using the results, a preliminary Critical Pathway was drawn up. According to the results from examining the clinical validity of the preliminary Critical Pathway with five patients for five weeks, 3 items which showed discrepancy were revised and another 3 items were added. Then, the final Critical Pathway was completed. Conclusion: This Critical Pathway needs to be clinically applied and continuously to measure its effects in terms of the length of stay, cost.effectiveness, and the patients' and staffs' satisfaction.

• Genomics & Informatics
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• 제11권4호
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• pp.186-190
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• 2013

The advances in electronic medical records (EMRs) and bioinformatics (BI) represent two significant trends in healthcare. The widespread adoption of EMR systems and the completion of the Human Genome Project developed the technologies for data acquisition, analysis, and visualization in two different domains. The massive amount of data from both clinical and biology domains is expected to provide personalized, preventive, and predictive healthcare services in the near future. The integrated use of EMR and BI data needs to consider four key informatics areas: data modeling, analytics, standardization, and privacy. Bioclinical data warehouses integrating heterogeneous patient-related clinical or omics data should be considered. The representative standardization effort by the Clinical Bioinformatics Ontology (CBO) aims to provide uniquely identified concepts to include molecular pathology terminologies. Since individual genome data are easily used to predict current and future health status, different safeguards to ensure confidentiality should be considered. In this paper, we focused on the informatics aspects of integrating the EMR community and BI community by identifying opportunities, challenges, and approaches to provide the best possible care service for our patients and the population.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제18권3호
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• pp.685-703
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• 2024

Cloud computing provides each consumer with a large-scale computing tool. Different Cyber Attacks can potentially target cloud computing systems, as most cloud computing systems offer services to many people who are not known to be trustworthy. Therefore, to protect that Virtual Machine from threats, a cloud computing system must incorporate some security monitoring framework. There is a tradeoff between the security level of the security system and the performance of the system in this scenario. If strong security is needed, then the service of stronger security using more rules or patterns is provided, since it needs much more computing resources. A new way of security system is introduced in this work in cloud environments to the VM on account of resources allocated to customers are ease. The main spike of Fog computing is part of the cloud server's work in the ongoing study tells the step-by-step cloud server to change the tremendous measurement of information because the endeavor apps are relocated to the cloud to keep the framework cost. The cloud server is devouring and changing a huge measure of information step by step to reduce complications. The Medical Data Health-Care (MDHC) records are stored in Cloud datacenters and Fog layer based on the guard intensity and the key is provoked for ingress the file. The monitoring center sustains the Activity Log, Risk Table, and Health Records. Cloud computing and Fog computing were combined in this paper to review data movement and safe information about MDHC.

• 한국식생활문화학회지
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• 제12권2호
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• pp.137-147
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• 1997

The purpose of this study was to determine the influences on physical status and study achievement by the dietary behavior of the youth in Korea. The survey was carried from June to July, 1995 by way of questionnaire to 397 students. The students' study achievement records and physical status were analyzed by the factor of dietary behavior. The results were as follows: 1 The average physical status of male students was lean, but females were standard. 76ft of mothers of the subjects were working in specialty farming. The monthly income of their family was $1000{\sim}1500$ thousand Won and students' pocket money was $20{\sim}40$ thousand Won per month. 2. The aspects of meal behavior included the general idea that the meal was thought to relieve hunger, and preference of taste was spiciness The most important factor of the meals for the students was taste. Their bad meal habits were quick eating and irregularity of meals. 3. There was a significant difference in the comparison of the study achieving records with the frequency of supper However, there was no one meaningful difference between study achievement records and the attendance rate to school, health status, and living conditions. However, there was a significant difference between their study records and eating with family. The students, who had the breakfast and/or supper with family, remarked better study records than other groups. 4. Also, there was a significant difference of study records with physical status. The overweight or obese students had a lower degree of study score (p<0.1). Adolescence is considered a period of setting up dietary behavior, so it is necessary to educate good nutrition and dietary habits for students to keep in healthy physical condition and with high study achievements.