• 제목/요약/키워드: Healthcare cost

검색결과 411건 처리시간 0.026초

Bayesian smoothing under structural measurement error model with multiple covariates

  • Hwang, Jinseub;Kim, Dal Ho
    • Journal of the Korean Data and Information Science Society
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    • 제28권3호
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    • pp.709-720
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    • 2017
  • In healthcare and medical research, many important variables have a measurement error such as body mass index and laboratory data. It is also not easy to collect samples of large size because of high cost and long time required to collect the target patient satisfied with inclusion and exclusion criteria. Beside, the demand for solving a complex scientific problem has highly increased so that a semiparametric regression approach could be of substantial value solving this problem. To address the issues of measurement error, small domain and a scientific complexity, we conduct a multivariable Bayesian smoothing under structural measurement error covariate in this article. Specifically we enhance our previous model by incorporating other useful auxiliary covariates free of measurement error. For the regression spline, we use a radial basis functions with fixed knots for the measurement error covariate. We organize a fully Bayesian approach to fit the model and estimate parameters using Markov chain Monte Carlo. Simulation results represent that the method performs well. We illustrate the results using a national survey data for application.

Use of a gesture user interface as a touchless image navigation system in dental surgery: Case series report

  • Rosa, Guillermo M.;Elizondo, Maria L.
    • Imaging Science in Dentistry
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    • 제44권2호
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    • pp.155-160
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    • 2014
  • Purpose: The purposes of this study were to develop a workstation computer that allowed intraoperative touchless control of diagnostic and surgical images by a surgeon, and to report the preliminary experience with the use of the system in a series of cases in which dental surgery was performed. Materials and Methods: A custom workstation with a new motion sensing input device (Leap Motion) was set up in order to use a natural user interface (NUI) to manipulate the imaging software by hand gestures. The system allowed intraoperative touchless control of the surgical images. Results: For the first time in the literature, an NUI system was used for a pilot study during 11 dental surgery procedures including tooth extractions, dental implant placements, and guided bone regeneration. No complications were reported. The system performed very well and was very useful. Conclusion: The proposed system fulfilled the objective of providing touchless access and control of the system of images and a three-dimensional surgical plan, thus allowing the maintenance of sterile conditions. The interaction between surgical staff, under sterile conditions, and computer equipment has been a key issue. The solution with an NUI with touchless control of the images seems to be closer to an ideal. The cost of the sensor system is quite low; this could facilitate its incorporation into the practice of routine dental surgery. This technology has enormous potential in dental surgery and other healthcare specialties.

폐렴원인균으로서 약제내성 폐렴사슬알균 ($Drug-resistant$ $Streptococcus$ $pneumoniae$)의 현황과 임상적 의미 (Clinical Implications of Drug-Resistant $Streptococcus$ $pneumoniae$ as a Cause of Community Acquired Pneumonia)

  • 신경철
    • Journal of Yeungnam Medical Science
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    • 제28권1호
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    • pp.13-19
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    • 2011
  • The emergence of antibiotic-resistant pathogens is a Serious clinical problem in the treatment of infectious diseases that increase mortality, morbidity, hospitalization length, and the cost of healthcare. In particular, $Streptococcus$ $pneumoniae$ is a major etiologic pathogen of pneumonia, sinusitis, otitis media, and meningitis. As the definition of penicillin resistance to $S.$ $pneumoniae$ was recently changed, macrolide-resistant $S.$ $pneumoniae$ is a major resistant pathogen in the community. Infections caused by antibiotic-resistant strains are associated with incorrect use of antibiotics and critical clinical outcomes. For the appropriate use of antibiotics to treat infections, physicians always should have up-to-date information on the current epidemiologic status of antibiotic resistance for common pathogens and their susceptibility to antimicrobials. Appropriate selection of antimicrobials, strict control of infection, vaccination, and development of a feasible national policy of infection control are important strategies for the control of antimicrobial resistance. This review article focuses on the current status of antibiotic-resistant $S.$ $pneumoniae$ in community-acquired pneumonia in Korea.

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Enzyme Replacement Therapy for Lysosomal Storage Disease in Indonesia

  • Sjarif, Damayanti Rusli;Hafifah, Cut Nurul
    • Journal of mucopolysaccharidosis and rare diseases
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    • 제4권1호
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    • pp.7-10
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    • 2018
  • Rare diseases are life threatening or chronically debilitating diseases with a low prevalence (less than 2,000 people in a population), which includes lysosomal storage diseases. These diseases are often seen as unimportant especially in developing countries, such as Indonesia, due to small number of patients. National Rare Disease Center in Indonesia was pioneered almost 20 years ago and officially established in 2017 by the Indonesian Minister of Health. Lysosomal storage disease become the most commonly found inborn errors of metabolism (IEM) in Indonesia due to easily accessible diagnostic facilities. Currently there are 7 patients receiving ERT in this mixed-donation scheme, one patient with Gaucher disease and 6 patients with MPS type II. Few challenges for ERT in Indonesia include importation through special access scheme, preparation of ERT infusion in intensive care settting, and cost of treatment. Even with limited resources, healthcare professionals in Indonesia have been giving the best care possible for rare disease patients, especially to provide diagnostic facilities through collaboration and treatment options for treatable rare diseases. Improvements in care for rare disease patients are still needed.

조산원 분만을 선택한 여성의 특성, 선택동기 및 출산경험 조사 (Characteristics, Motivation of Choice and Childbirth Experience of Women Who Selected Delivery at Midwifery Clinic)

  • 이선희;이미옥
    • 부모자녀건강학회지
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    • 제16권1호
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    • pp.1-10
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    • 2013
  • Purpose: This study is descriptive research to identify characteristics and childbirth experience of women who selected delivery with midwives. Methods: The research methods included structured questionnaires, open questions and charts and data were collected from March 2009 to May 2010 at one midwifery clinic. The 108 data of primipara and multipara were analyzed using descriptive statistics and grouping in same meaning. Results: The general characteristics of participants were age of 31~35, housewife, college or university graduate, religion 'yes', and economic state 'middle'. The obstetric characteristics of participants were abortion rate of 23.1%, none complication to pregnancy and delivery of 97.2%, and none postpartum complication. This study was analyzed using positive experiences of 3 categories, that is 'comfortable and natural childbirth', 'satisfaction and trust to personal care of midwives', and 'experience of baby-and-family-centered childbirth' and negative experiences of 3 categories, that is 'improvement of healthcare environment', 'insufficient facilities and nursing care', and'burden of cost'. Conclusion: This study is significant, since it investigates in the absence of domestic research on the characteristics of women who delivered at midwifery clinic. Thus, this study provided basic data on the characteristics of women who delivered at midwifery clinic.

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프리셉터 역할을 경험한 간호사의 근거기반실무에 대한 신념, 지식 및 수행 수준 (Level of Beliefs, Knowledge and Performance for Evidence-Based Practice among Nurses Experienced in Preceptor Role)

  • 유재용;오의금
    • 간호행정학회지
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    • 제18권2호
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    • pp.202-212
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    • 2012
  • Purpose: As Evidence-Based Practice (EBP) has increasingly been proven as a means of cost-effective and higher-quality healthcare, its successful implementing are challenging. This study done to identify EBP beliefs, knowledge and performance among nurses experienced as a preceptor. Method: A descriptive cross-sectional survey was conducted with a convenience sample of 249 preceptor nurses working in 9 general hospitals in Korea. Reliable and valid questionnaires (EBP beliefs scale, Evidence Based Practice Questionnaire, Research-related activities) were used and the data were analyzed using SPSS win 17.0. Result: Perceived beliefs on EBP were relatively positive (mean score 3.57 out of 5), and the level of knowledge was moderate (4.21 out of 7). However, performance of EBP was low (3.82 out of 7). Regularity in reading research journals and searching evidences using core web-database were rarely conducted. Statistically significant correlations were found between beliefs, knowledge and performance of EBP (all p<.05). Conclusions: This result indicates that education and training programs to facilitate EBP performance are needed among preceptor nurses.

의약품 보험급여 결정을 위한 경제성평가 연구의 평가 (Review of Economic Evaluation Studies for Drug Reimbursement Decision)

  • 최상은
    • 보건행정학회지
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    • 제15권4호
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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.

가치기반 체계에 근거한 의료기술평가: 영국 NICE의 신뢰 지향적 가치판단 과정을 중심으로 (Health Technology Assessment and Appraisal: Lessons from Reliability-Based Health Technology Appraisal in NICE, England)

  • 이현주;권영대
    • 보건의료산업학회지
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    • 제7권4호
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    • pp.273-288
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    • 2013
  • This paper is a general review contextualizing the state of the domestic health technology assessment. The aim of the paper is to present an overview of health technology assessment in Korea based on examining clinical efficacy as well as cost-benefit analysis, and to suggest the issue of appraisal based on social value. We have included a discussion of a major case study of the technology appraisal process of NICE (the National Institute for Clinical Excellence) in the UK. The review of the existing process of NICE shows that the appraisal both gives interest in health technology a sense of value perspective and raises methodological issues in terms of reliability. Details of the appraisal process and several guidelines for best practice have emerged. Suggestions are listed and their role in assessing is explained as a conclusion.

A Lightweight Integrity Authentication Scheme based on Reversible Watermark for Wireless Body Area Networks

  • Liu, Xiyao;Ge, Yu;Zhu, Yuesheng;Wu, Dajun
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제8권12호
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    • pp.4643-4660
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    • 2014
  • Integrity authentication of biometric data in Wireless Body Area Network (WBAN) is a critical issue because the sensitive data transmitted over broadcast wireless channels could be attacked easily. However, traditional cryptograph-based integrity authentication schemes are not suitable for WBAN as they consume much computational resource on the sensor nodes with limited memory, computational capability and power. To address this problem, a novel lightweight integrity authentication scheme based on reversible watermark is proposed for WBAN and implemented on a TinyOS-based WBAN test bed in this paper. In the proposed scheme, the data is divided into groups with a fixed size to improve grouping efficiency; the histogram shifting technique is adopted to avoid possible underflow or overflow; local maps are generated to restore the shifted data; and the watermarks are generated and embedded in a chaining way for integrity authentication. Our analytic and experimental results demonstrate that the integrity of biometric data can be reliably authenticated with low cost, and the data can be entirely recovered for healthcare applications by using our proposed scheme.

Design and Implementation of a USN Middleware for Context-Aware and Sensor Stream Mining

  • Jin, Cheng-Hao;Lee, Yang-Koo;Lee, Seong-Ho;Yun, Un-il;Ryu, Keun-Ho
    • Spatial Information Research
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    • 제19권1호
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    • pp.127-133
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    • 2011
  • Recently, with the advances in sensor techniques and net work computing, Ubiquitous Sensor Network (USN) has been received a lot of attentions from various communities. The sensor nodes distributed in the sensor network tend to continuously generate a large amount of data, which is called stream data. Sensor stream data arrives in an online manner so that it is characterized as high-speed, real-time and unbounded and it requires fast data processing to get the up-to-date results. The data stream has many application domains such as traffic analysis, physical distribution, U-healthcare and so on. Therefore, there is an overwhelming need of a USN middleware for processing such online stream data to provide corresponding services to diverse applications. In this paper, we propose a novel USN middleware which can provide users both context-aware service and meaningful sequential patterns. Our proposed USN middleware is mainly focused on location based applications which use stream location data. We also show the implementation of our proposed USN middleware. By using the proposed USN middleware, we can save the developing cost of providing context aware services and stream sequential patterns mainly in location based applications.