• 제목/요약/키워드: High grade general hospital

검색결과 78건 처리시간 0.023초

입원환자 본인부담액에 영향을 미치는 요인 (Factors Affecting Cost-Sharing Charges for Inpatients)

  • 안병기
    • 보건행정학회지
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    • 제22권3호
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    • pp.451-465
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    • 2012
  • In order to strengthen assurance of National Health Insurance, co-payment should be reduced. This can happen with collaborative efforts of patients, medical institutes, and government altogether at the same time. This research applied Dutton(1986)'s medical service research model with high R-square, and analyzed 2008 Korea Health Panel Data (Beta Version 1), that was examined by Korea Institute for Health and Social Affairs and National Health Insurance, in order to figure out influential variables on co-payment. In result of Multiple Linear Regression Analysis, R-square was 46.7%, the older the age, the patients who had surgery, the longer days of hospital treatment are, the higher gross income of a household is, the more hospitalized in upper grade general hospitals, and the more upper grade rooms and selecting a doctor are used. The results have statistical significance. When conducting research applying medical service research model, there is a need to apply Dutton(1986)'s medical service research model with high R-square. In order to strengthen assurance of National Health Insurance, first conditions should be that patients are hospitalized in upper grade general hospital, and at the same time, are patients who had surgery with long stay of hospitalization. In addition, if proven that patients used upper grade rooms and selecting a doctor due to lack of regular treatment and rooms, for certain number of days of such hospitalization, it is suggested to be provided with health care insurance in upper grade rooms and selecting a doctor in calculating co-payment limit.

2013년 서울의 일개 고등학교에서 발생한 유행성 이하선염 집단발병 (An Outbreak of Mumps in a High School, Seoul, 2013)

  • 강하라;김성윤;차효현;안영민;박인아;강혜지;은병욱
    • Pediatric Infection and Vaccine
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    • 제22권1호
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    • pp.1-6
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    • 2015
  • 목적: 최근 일개 고등학교(S 고등학교)에서 유행성이하선염이 집단발병 하였기에 본 연구에서는 S 고등학교의 발생 현황을 알아보고 진단을 위해 시행한 PCR 검사의 역학적 유용성에 대해 알아보고자 한다. 방법: 2013년 4-7월 유행성이하선염이 의심되어 의료기관을 방문한 S 고등학교 학생들의 월별 분포와 학년별 수를 조사 하였고 이중 일부 학생에게 PCR 검사를 시행하였다. 결과: 총 77명이 의료기관을 방문하였고 월별로 4월 1명, 5월 17명, 6월 45명, 7월 5명, 학년별로 1학년 26명, 2학년 28명, 3학년 23명이었다. 볼점막도찰 PCR 검사를 받은 18명 중 15명은 증상 발생 3일 이내에 검체를 채취하여 그 중 5명(33.3%)이 양성이었고 나머지 3명은 3일 이후에 검체를 채취하여 모두 음성이었다(P=0.24). 결론: 본 저자들은 S 고등학교의 유행성이하선염의 집단발병 양상을 조사하였다. PCR 검사는 증상 발생 후 3일 이내 시행하면 역학 조사시 도움이 될 가능성이 있겠다.

S100A14 Promotes the Growth and Metastasis of Hepatocellular Carcinoma

  • Zhao, Fu-Tao;Jia, Zhan-Sheng;Yang, Qun;Song, Le;Jiang, Xiao-Jing
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권6호
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    • pp.3831-3836
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    • 2013
  • Background: S100A14 has recently been implicated in the progress of several types of cancers. This study aimed to investigate the clinical significance and possible mechanisms of action of S100A14 in the invasion and metastasis of hepatocellular carcinoma (HCC). Methods: S100A14 expression in HCC was detected at mRNA and protein levels and its prognostic significance was assessed. Functional roles of S100A14 in HCC were investigated using MTT, BrdU, wound healing, transwell invasion assay and HCC metastatic mouse model. Results: S100A14 was significantly elevated in HCC tissues, correlated with multiple tumor nodes, high Edmondson-Steiner grade and vascular invasion. Multivariate Cox analysis showed that the S100A14 expression level was a significant and independent prognostic factor for overall survival (OS) of HCC patients (hazard ratio=1.98, 95% confidence interval=1.14-3.46, P=0.013). S100A14 promoted cell proliferation, invasion and metastasis of HCC in vitro and in vivo. Conclusion: These results suggest S100A14 is a novel prognostic marker and therapeutic target for HCC.

The Bethesda System (TBS) - 자궁경부 세포진 검사의 새로운 보고양식 - (The Bethesda System (TBS) - A New Reporting System of Cervicovaginal Smear -)

  • 김희숙
    • 대한세포병리학회지
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    • 제6권2호
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    • pp.85-98
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    • 1995
  • In 1989, the Bethesda System (TBS) was introduced as an attempt to standardize cervical/vaginal reporting systems. TBS nomenclature was created for reporting cytologic diagnoses to replace the currently used Cervical Intraepithelial Neoplasia (CIN) and Papanicolaou Class System, which are deemed less reproducible. The name for preinvasive squamous lesions was changed to squamous intraepithelial lesion(SIL), subdivided into low-grade and high-grade types. TBS recommends a specific format for cytologic report, starling with explicit statement on the adequacy of the specimen, followed by general categorization and descriptive diagnosis. Pathologic and epidemiologic studios performed over last 10 years have provided evidence that human papillomavirus (HPV) plays a significant role in the development of cervical neoplasia, TBS corresponds not only to currently held views of the behavior of preinvasive lesions and their HPV distribution, but also to the current guidelines for clinical management.

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간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발 (Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process)

  • 조용애;은영;구미옥;김경숙;곽미경;김정혜;이선희;박동아;노화경
    • 임상간호연구
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    • 제21권2호
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    • pp.154-168
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    • 2015
  • Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

NOISH 직무스트레스 모형을 적용한 임상간호사의 직무스트레스 원인과 직무만족도 분석 (Job Stress Factor and Job Satisfaction in Clinical Nurse thorough of the NIOSH Job Stress Model)

  • 이준영;정혜선
    • 한국직업건강간호학회지
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    • 제13권1호
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    • pp.30-39
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    • 2004
  • Purpose: This study was performed to identify the factors of the job stress and to analysis affecting job satisfaction in clinical nurses, using the Job Stress Model by the National Institute for Occupational Safety and Health (NIOSH). Method: Data collection was done from July 21 to July 30, 2003. The study was involved in 203 nurses who work at the hospital. It was examined the self-recording questionnaire about general characteristics, work-related factors, non-work factors, instrument revised by NIOSH Job Stress questionnaire translated by the Korea Occupational Safety & Health Research Institute(1999). Instrument about shift work was the tool developed by Kim and Gu(1984). Result: Job satisfaction of subjects at an average level with $1.96{\pm}0.37$ score on the basis of 3 points. According to general characteristics, job satisfaction was high in those with older age and married group. According to work related general factors, job satisfaction was high with working career, an officer to higher grade. According to work characteristics factors, job satisfaction was low with much role conflict at work and much workload and much interpersonal conflict. As for the relationship between job satisfaction and non-work factor, job satisfaction was did not show statistically significant differences. As a result of Stepwise multiple regression analysis, job satisfaction was influenced by shift work, conflicts of between group and grade of office. Conclusion: Therefore, it suggests that the nurses need stress management related shift work for improvement of job satisfaction.

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위 신경내분비종양의 진단과 치료 (Diagnosis and Treatment of Gastric Neuroendocrine Tumors)

  • 최수인
    • Journal of Digestive Cancer Research
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    • 제10권1호
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    • pp.1-8
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    • 2022
  • The incidence of gastric neuroendocrine tumors (NET) has been increased with the improvement of endoscopy accessibility. The World Health Organization classified NET of low (G1), intermediate (G2), high (G3) grade and neuroendocrine carcinoma with poor differentiation by mitotic count and Ki-67 labeling index. Gastric NET are divided into three subtypes based on the pathophysiology, and treatment is determined according to the subtype and prognostic factors of tumor. For diagnosis, endoscopy with biopsy, endoscopic ultrasonography, abdominal pelvis computed tomography, and serum gastrin level measure are required. In general, type 3, size > 2 cm, deep submucosal infiltration, high histological grade, lymphovascular invasion and metastasis are poor prognostic factors. Type 1 or 2 without these factors are treated by endoscopic resection, and other tumors needs surgery. Endoscopic resection of early type 3 or type 1 and 2 tumors with poor prognostic factors still remains a challenge.

우리 나라 공무원의 표준화 사망비에 대한 연구 (A SMR study of Korean public servants)

  • 김현경;김용철;백도명
    • Journal of Preventive Medicine and Public Health
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    • 제30권2호
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    • pp.293-307
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    • 1997
  • In Korea, sudden deaths of middle-aged and older male workers who are the responsible persons at home as well as workplace, have aroused social concern. Besides, U. N. has reported recently that mortality of Korea male in 40-50's was one of the highest among newly developed countries in 1992. Not much is, however, known about the nature of the work contributing to the mortality of different groups of workers. Therefore, this study was done to examine mortality of public servants, comprising about 5% of all the employed in Korea, according to their job titles and grades. The datas of 1753 official deaths, comprised 323 (only disease-oriented deaths) applicants of survivors' compensation, were used to examine age-adjusted Standardized Mortality Ratios(SMRs) according to their job titles, grades, tenures and cause of deaths. Controlling age and sex difference was conducted using 26,950,481 general population, 95,340 general deaths and 864,560 working public servants. All the groups were aged 20-64, who were being observed January - December in 1993, at the same time. Results and discussions are as follows. 1. SMRs standardized by general population was significantly low (SMR 44.9 CI 42.8-52.7) for all job titlses. Of public servants, 90.0% was graduated from high school, although 17.5% in general population. The distinction of social status such a education may produce a strong healthy worker effect. Besides, SMRs for different tenure groups showed a steady increase as tenure increases. This suggests that the magnitude of healthy-worker effect may be greater with increasing tenures. 2. SMRs standardized by own public servants was significantly elevated for work-men(SMR 121.0, CI 110.2-132.6) in solitue. When SMRs for different grade, of work-men was examined, 9th(SMR 124.2, CI 104.4-146.7) and 10th(SMR 137.9 CI 120.8-156.8)grade, lower grade in workmen, showed significantly elevated SMRs. Of workmen, 57.0% were graduated from high school and 50.1% in 9th grade, as well. These mean that low economic states made up social class, education may increase mortality rate. 3. Of SMRs according to all causes of death, only policemen on 'cause of death related hypertensive disease'(SMR 282.5, CI 121.6-556.7) was significantly high except for' cause of death related other signs, symptoms and ill-defined conditions'. 4. When SMRs on cause of death related hypertensive disease for different grade of policemen was examined, senior policemen(SMR 241.9), in charge of the front service, showed elevated SMR, in spite of statistical no significance. Especially, the working hour of senior policemen is quite long and also the work schedule is even more irregular for policemen. The results of this study showed that mortality for different jobs differed, and it differed also for different grades in the same job. This difference in mortality may reflect the difference in the nature of job contents, and further studies are warranted to elucidate which job characteristics are responsible.

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Microvascular Myocardial Ischemia in Patients With Diabetes Without Obstructive Coronary Stenosis and Its Association With Angina

  • Yarong Yu;Wenli Yang;Xu Dai;Lihua Yu;Ziting Lan;Xiaoying Ding;Jiayin Zhang
    • Korean Journal of Radiology
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    • 제24권11호
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    • pp.1081-1092
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    • 2023
  • Objective: To investigate the incidence of microvascular myocardial ischemia in diabetic patients without obstructive coronary artery disease (CAD) and its relationship with angina. Materials and Methods: Diabetic patients and an intermediate-to-high pretest probability of CAD were prospectively enrolled. Non-diabetic patients but with an intermediate-to-high pretest probability of CAD were retrospectively included as controls. The patients underwent dynamic computed tomography-myocardial perfusion imaging (CT-MPI) and coronary computed tomography angiography (CCTA) to quantify coronary stenosis, myocardial blood flow (MBF), and extracellular volume (ECV). The proportion of patients with microvascular myocardial ischemia, defined as any myocardial segment with a mean MBF ≤ of 100 mL/min/100 mL, in patients without obstructive CAD (Coronary Artery Disease-Reporting and Data System [CAD-RADS] grade 0-2 on CCTA) was determined. Various quantitative parameters of the patients with and without diabetes without obstructive CAD were compared. Multivariable analysis was used to determine the association between microvascular myocardial ischemia and angina symptoms in diabetic patients without obstructive CAD. Results: One hundred and fifty-two diabetic patients (mean age: 59.7 ± 10.7; 77 males) and 266 non-diabetic patients (62.0 ± 12.3; 167 males) were enrolled; CCTA revealed 113 and 155 patients without obstructive CAD, respectively. For patients without obstructive CAD, the mean global MBF was significantly lower for those with diabetes than for those without (152.8 mL/min/100 mL vs. 170.4 mL/min/100 mL, P < 0.001). The mean ECV was significantly higher for diabetic patients (27.2% vs. 25.8%, P = 0.009). Among the patients without obstructive CAD, the incidence of microvascular myocardial ischemia (36.3% [41/113] vs. 10.3% [16/155], P < 0.001) and interstitial fibrosis (69.9% [79/113] vs. 33.3% [8/24], P = 0.001) were significantly higher in diabetic patients than in the controls. The presence of microvascular myocardial ischemia was independently associated with angina symptoms (adjusted odds ratio = 3.439, P = 0.037) in diabetic patients but without obstructive CAD. Conclusion: Dynamic CT-MPI + CCTA revealed a high incidence of microvascular myocardial ischemia in diabetic patients without obstructive CAD. Microvascular myocardial ischemia is strongly associated with angina.

Effects of Secondary Left-sided Portal Hypertension on the Radical Operation Rate and Prognosis in Patients with Pancreatic Cancer

  • Zhang, Shuo;Wen, Dong-Qing;Kong, Ya-Lin;Li, Ya-Li;Zhang, Hong-Yi
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권5호
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    • pp.2239-2244
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    • 2014
  • Objective: To investigate the effects of secondary left-sided portal hypertension (LSPH) on the radical operation rate of patients with pancreatic cancer and systemically evaluate the prognosis of patients with LSPH secondary to pancreatic cancer after radical surgery. Materials and Methods: The data of patients with pancreatic cancer who underwent laparotomy over a 15-year period in Department of Hepatobiliary Surgery of Chinese PLA Air Force General Hospital from Jan. 1, 1997, to Jun. 30, 2012 was retrospectively reviewed. Results: A total of 362 patients with pancreatic cancer after laparotomy were selected, including 73 with LSPH and 289 without LSPH. Thirty-five patients with LSPH (47.9%) and 147 without non-LSPH (50.9%) respectively underwent radical operations. No significant difference was found between these two groups regarding the total resection rate and stratified radical resection rate according to different pathological types and cancer locations. The mean and median survival time of patients after radical operation in LSPH group were $13.9{\pm}1.3$ months and 14.8 months, respectively, while those in non-LSPH group were $22.6{\pm}1.4$ months and 18.4 months, respectively(P<0.05). Conclusions: Radical operations for pancreatic cancer and secondary LSPH are safe and effective. Because high-grade malignancy and poor prognosis are closely associated, the decision for radical surgery should be made more meticulously for the patients with pancreatic cancer.