• 보건행정학회지
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• 제25권3호
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• pp.197-206
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• 2015

Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

• 한국산업보건학회지
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• 제32권3호
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• pp.253-267
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• 2022

Objectives: This study was performed to check whether the CRS (Chemical Ranking and Scoring) system is appropriate as a method to determine substances as candidates for substances subject to permission and to apply this system to the selection of candidates for substances subject to permission. Methods: A risk score was obtained by multiplying the hazard score and the exposure score and then ranking them. The hazard sub-indicators are carcinogenicity, germ cell mutagenicity, reproductive toxicity, specific target organ toxicity-repeated exposure, respiratory sensitization and endocrine disrupting chemicals. Exposure sub-indicators are persistence, bioaccumulation and emission volume. Sensitivity analysis was performed for missing values. Correlation analysis and multivariable linear regression analysis were performed among hazard, exposure and risk in order to confirm that CRS was an appropriate method. Results: As a result of the sensitivity analysis on missing values, it was confirmed that the effect on the risk ranking was not sensitive. Correlation and regression analysis confirmed that exposure had a greater effect on risk than hazard. Conclusions: The CRS system, which derives a risk score using a hazard and exposure score, is judged to be appropriate as a method for the selection of preliminary of candidates for substances subject to permission. Benzene, cadmium, nickel, and cobalt were selected as priority candidates for substances subject to permission.

• 아동학회지
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• 제33권1호
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• pp.183-203
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• 2012

While efforts to measure and monitor children's well-being have gained increasing recognition across the OECD, there has been relatively little research on the subject of indicators of children's well-being in Korea. This study was undertaken in order to develop the domains and indicators which can be used to measure the quality of life of Korean children from birth to age 17 and to put forward a possible well-being index for Korean children. The 35 indicators of well-being were grouped into eight domains and were designed for this study, using previous research on key child indicators for Korea and the child well-being index in foreign countries, such as the FCD-Land Index, Kids Count, the index of child well-bing in the European Union and OECD area. These domains are composed of the following : economic well-being, health, education, spiritual/emotional well-being, children's relationships, civic participation, safety/risk behavior, and housing and environment. The establishment of a Korean children's well-being index requires access to and use of national statistical data analyzed annually by the government as well as a general consensus regarding such issues as scope and its indicators.

• 한국의료질향상학회지
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• 제24권2호
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• 대한지역사회영양학회지
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• 제5권3호
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• pp.475-483
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• 2000

The develop a simple screening test for identifying Korean elderly at risk of undernutrition, the data of the health-related habits, dietary behaviors and nutrient intakes of the elderly in Chongju were analyzed. Two risk indicators, mean adequacy ratio (MAR) and the respondents perceived health, were used to detect the undernutrition risk of the elderly. In order to select a list of questions for the test, factors a affecting nutritional status and items investigated in previous nutrition surveys of the elderly were considered, and 21 questions were primarily selected. A multiple regression and stepwise regression analysis were used to take out the weak predictors of poor nutrient intake, and to give item weights to the strong predictors, and a list of 17 questions was finally adopted. To determine the cut-point of the test score, sensitivity, and positive predictive values were calculated. The Simple Screening Test developed in this study is a brief, easily scored tool to predict poor nutrient intake and the perceived health status of the elderly. The test may provide a basis of further comprehensive nutritional assessment or intervention planning, if necessary, for those who are diagnosed ad "high risk". The test, however, needs to be independently validated by other groups of individuals.dividuals.

• Journal of Preventive Medicine and Public Health
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• 제57권3호
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• pp.298-303
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• 2024

Objectives: The aim of this study was to estimate drug prescription indicators in outpatient services provided at Iran Social Security Organization (SSO) healthcare facilities. Methods: Data on all prescribed drugs for outpatient visits from 2017 to 2018 were extracted from the SSO database. The data were categorized into 4 main subgroups: patient characteristics, provider characteristics, service characteristics, and type of healthcare facility. Logistic regression models were used to detect risk factors for inappropriate drug prescriptions. SPSS and IBM Modeler software were utilized for data analysis. Results: In 2017, approximately 150 981 752 drug items were issued to outpatients referred to SSO healthcare facilities in Iran. The average number of drug items per outpatient prescription was estimated at 3.33. The proportion of prescriptions that included an injection was 17.5%, and the rate of prescriptions that included an antibiotic was 37.5%. Factors such as patient sex and age, provider specialty, type of facility, and time of outpatient visit were associated with the risk of inappropriate prescriptions. Conclusions: In this study, all drug prescription criteria exceeded the recommended limits set by the World Health Organization. To improve the current prescription patterns throughout the country, it would be beneficial to provide providers with monthly and annual reports and to consider implementing some prescription policies for physicians.

• 여성건강간호학회지
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• 제27권1호
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• pp.14-26
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• 2021

Purpose: This study aimed to identify the effects of nursing intervention programs for women with gestational diabetes mellitus (GDM) through a critical review of recent studies. Methods: Studies related to effects of nursing intervention programs for women with GDM published in English or Korean between 2000 and 2019 were extracted from 10 electronic databases. The quality of the studies was evaluated and double-checked for accuracy by two reviewers using the Revised Cochrane Risk-of-Bias tool for randomized controlled trials. Results: Twenty studies were selected, of which 19 had a low risk of bias and one had a high risk of bias. Interventions fell into six main groups: (1) integrated interventions, (2) self-monitoring of blood glucose levels, (3) dietary interventions, (4) exercise, (5) psychotherapy, and (6) complementary therapy. This review found that nursing interventions for GDM were of many types, and integrated interventions were the most common. However, low-carbohydrate diets and blood glucose monitoring interventions did not show statistically significant results. Evidence shows that various nursing intervention programs applied to GDM improved diverse aspects of maternal, fetal, and neonatal health, including both physical and psychological aspects. Conclusion: The composition and delivery of integrated interventions continue to evolve, and these interventions affect physical and psychological indicators. Although interventions affecting physical health indicators (e.g., blood glucose levels, diet, and exercise) are important, many studies have shown that programs including psycho-emotional nursing interventions related to anxiety, depression, stress, self- efficacy, and self-management are also highly useful.

• 한국재난정보학회 논문집
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• 제19권3호
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• pp.719-728
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• 2023

연구목적: 이동식크레인은 높은 사망률에 기여하는 기계로 최근 6년간(2016~2021) 사고사망사례 중 건설업 2,574건을 분석한 고위험요인(SIF)정보에서 이동식크레인의 사고는 총 61건의 재해가 발생하였다. 현장의 안전대책에도 불구하고 제대로 활용이 안되고 있다. 본 연구에서는 표준 리스크 평가 지수를 제시하여 사고예방에 기여하고자 한다. 연구방법: 전문가 면담과 사망사고 사례분석, 현장실태분석, 문헌조사를 통해 위험성평가의 4M방식의 표준 리스크 평가 지수 방법을 제시하고자 한다. 연구결과: 현장 8개현장 위험성평가를 분석한 결과 재해예방에 실질적인 기여를 할 수 없다는 결론을 얻었으며, 표준 리스크 평가 지수 방식의 개선방안으로 적용하여야 한다. 결론: 건설현장에서 표준 리스크 평가 지수방식으로 전환함으로써 안전보건관계자 및 근로자가 쉽게 이용할 수 있고 재해감소에 기여할 수 있을 것으로 제안한다.

• International Journal of Human Ecology
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• 제10권1호
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• pp.61-74
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• 2009

This study identified the health, academic attainment, violence and abuse factors on predicting the conduct development and emotional symptoms in 'looked after children' placement. A sample of 1,543 children was interviewed regarding emotional and behavioral symptoms and risk factors. Logistic regression was used to assess whether selected variables predicted emotional and behavioral symptoms in 'looked after children'. All placement, health, academic, violence, and abuse factors differentiated behavioral and emotional symptom differences according to selected variables. Binary logistic regression indictors of conduct behavior symptom among 'looked after children', included gender, age, placement, health, violence, and abuse. Placement, health, reading ability, violence, and witnessing domestic violence further predicted emotional and behavioral symptoms. These findings highlight multidimensional approaches to address various vulnerability indicators that have a direct application to prevention and intervention efforts to designed for emotional and behavioral problems among children in public care.

• Safety and Health at Work
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• 제11권3호
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• pp.335-346
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• 2020

Background: Nursing service is a nonroutine work with an excessive physical load and diverse tasks. This study derived representative common tasks based on the frequently occurring tasks with a high physical load in the nursing workers' daily work and developed indicators to evaluate the work risk by reflecting the characteristics of nonroutine work. Methods: Common tasks were classified through the following stages: literature review, first focus group interview (FGI) with experts, first classification of common tasks, second FGI with hospital health managers, a survey of nursing service workers, and the final classification of common tasks for each task type. To develop an objective risk index for physical load assessment, we investigated the frequency and duration of the derived common tasks via survey. Results: Nursing common tasks were categorized into six task types and 56 subtasks. To evaluate the risks of various tasks in nonroutine works, three frequencies and three working time levels were defined by examining the task frequency and working hours. Exposure time was defined to reflect the characteristics of a nonroutine job. The final risk assessment was the product of the exposure time level and job intensity level. From this, four risk action levels were derived. Conclusion: This study has the advantage of solving the problem of focusing on some tasks in evaluating the physical load. It was meaningful in that a new risk assessment index based on exposure time was proposed based on the development of an evaluation scale for frequency and time by reflecting the characteristics of nonroutine work.