• The Korean Journal of Health Service Management
• /
• v.6 no.4
• /
• pp.279-294
• /
• 2012

The study compared refractive surgery patients' hospital selection factors and satisfaction, through this to see the factors influencing patients' satisfaction, aiming at 235 patients visiting two Eye hospitals. The research results are followed. First, target group's hospital selection factors appeared facilities and environment factor, reliability factor, personal service factor, and accessibility factor in the order. Second, patients' satisfaction appeared reliability factor, facilities and environment factor, and personal factor in the order. Fourth, in the result comparing patients' expectation on hospital selection and satisfaction score, all factors of facilities and environment, personal service, and reliability had high satisfaction score than expectation. Third, in the result of factors influencing refractive surgery patients' satisfaction, in surgery determination period, surgery expenditure, and hospital selection factors among characteristics relating to refractive surgery, facilities and environment, personal service, and reliability appeared as satisfaction influencing factors. In conclusion, the study found that hospital selection factors and satisfaction influencing factors by refractive surgery patients' surgery type are considered to be able to be used to establish marketing strategy in the fields excluded from insurance application, the researches to improve patients' satisfaction in patient-oriented medical market should be continuously proceeded.

• Quality Improvement in Health Care
• /
• v.15 no.2
• /
• pp.107-120
• /
• 2009

Background : To estimate fall incidence rate and associated factors in inpatients from a general hospital. Method : The data were collected from 104 fall incident reports developed by the patient safety committee in a general hospital in Seoul from 01 January 2007 to 31 December 2008. Information included general characteristics of patients, factors related to fall, types, places, circumstances and outcomes of fall. Result : The incidence rate of fall, which was 4.4 per 1,000 total discharged patients and 0.5 per 1,000 patient-days, was much lower than that of several hospitals in the United States. The difference may reflect the different incidence reporting system of each hospital. Fall-prone patients were, in general, $$\geq_-$$65 years of age, had an alert mental status, were ambulatory with some assistance, and were dependent on and ambulatory device. High incidence of falls was associated with patients with circulatory disease. The majority of fall events usually occurred in bed or at the bedside in the patient's room, and occurred more often during the night than during the day or evening. Risk factors of fall were use of drugs (antihypertensive or neuropsychiatric drugs) and environmental factors (e.g., overly high bed height, surrounding objects, inadequate fitness shoes and slippery floor). Physical injury occurred in 43.3% of fall events, which typically required diagnosis of injury and treatment such as suturing. Risk factors for repeated falls were use of a neuropsychiatric drug (odds ratio=13.9) and gait disturbance (odds ratio=91.2). Risk factors for fall-related injury were alert mental status (odds ratio=3.3 times more likely to fall than those who were drowsy or in a stupor) and general weakness(odds ratio=3.3 times more likely to fall than those who were not generally weak). Conclusion : Medical and nursing staff should be aware of the fall risk factors of hospitalized patients and should intensively pursue preventative strategies. Development of fall prevention education based on these results is recommended.

• Parasites, Hosts and Diseases
• /
• v.48 no.1
• /
• pp.75-78
• /
• 2010

The present study investigated characteristics of 24 parasite infection cases detected during colonoscopy in a regional hospital from January 2001 to December 2008. Sixteen patients were confirmed with Trichuris trichiura infection, 6 patients were with Ascaris lumbricoides infection, 1 patient with Enterobius vermicularis infection, and 1 patient with Anisakis infection. Among them, 7 patients (43.8%) were asymptomatic. Colonoscopy findings were normal in 18 patients (75.0%). Among the patients with T. trichiura infection, colonoscopy showed several erosions in 2 patients (8.3%) and non-specific inflammation of the affected segment of the colon in 3 patients (12.5%). In 1 patient with anisakiasis, colonoscopy revealed a markedly swollen colonic wall. Stool examinations were performed before treatment in 7 patients (29.2%) and were all negative for parasite eggs or worms. These results suggest that colonoscopy is a useful diagnostic approach for parasitic infections even for asymptomatic patients and for patients with negative stool examinations.

• Journal of Chest Surgery
• /
• v.52 no.6
• /
• pp.420-424
• /
• 2019

Atypical thymic carcinoid is an extremely rare tumor with a poor prognosis. In addition to its known association with multiple endocrine neoplasia type 1, its hallmark characteristics include local invasion and early distant metastasis. In this report, we share our experience treating atypical thymic carcinoid in a patient with Zollinger-Ellison syndrome.

• Health Policy and Management
• /
• v.12 no.1
• /
• pp.21-53
• /
• 2002

The purpose of this study is to measure the resource use of the elderly in long-term care services and to examine the effects of patient and facility characteristics on their use of resources. The data were collected from 510 old people over sixty years of age, residing in five long-term care hospitals and two skilled nursing homes during the period between December 1, 2000 and February 28, 2001. For a full sample, when the first level of RUG(Resource Use Group)-III categories were employed as the proxy of patient severity, facility characteristics, such as location, size and ownership, have large effects on the resource use measured by service intensity, whereas patient characteristics such as severity have little or no effect. The resource use is significantly high if the facility: (1) is located in rural areas (gun): (2) has mare than 200 beds; (3) is a long-term care hospital; (4) is private; and (5) has a low percentage of medical aid patients. The analysis of the resource use in each RUG-III categories, for which ADL(Ability of Daily Living) were employed as the prosy of patient severity, shows a similar result. The loose relationship between the needs of residents and the resource use seems to be closely associated with the ineffective reimbursement system for providers. The current reimbursement system has no provision for quality improvement and reimburses facilities simply according to their types: fee-for-service for long-term care hospitals, and monthly-flat-rate or full-coverage-national-aid for skilled nursing facilities. It will be necessary to develop a more reasonable reimbursement system that takes patient's severity into account and gives incentives for long-term care providers to offer cost-effective services.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.45 no.1
• /
• pp.43-47
• /
• 2019

The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. The computed tomography scan revealed an "inhomogeneous solid lesion in the nasal fossa". With the patient under general anesthesia, the formation in the anterior portion of the right side of the nasal septum was removed up to its vascular base. Although electrical cauterization efficiently controlled the bleeding, we abraded the sub-perichondral area to prevent further bleeding as well as recurrence. The histological exam report confirmed the diagnosis of angiofibroma. As in our case, epistaxis is commonly the presenting sign of angiofibroma. Yet its onset was peculiar, given that the bleeding started with a low impact trauma. The nasal swelling was also a relevant feature as well as the breathing impairment. Although uncommon, nasal septal angiofibromas should considered in patients with epistaxis.

• Progress in Medical Physics
• /
• v.32 no.4
• /
• pp.153-158
• /
• 2021

Purpose: This study evaluated the features of a pressure mapping system for patient motion monitoring in radiation therapy. Methods: The pressure mapping system includes an MS 9802 force sensing resistor (FSR) sensor with 2,304 force sensing nodes using 48 columns and 48 rows, controller, and control PC (personal computer). Radiation beam attenuation caused by pressure mapping sensor and signal perturbation by 6 and 10 mega voltage (MV) photon beam was evaluated. The maximum relative pressure value (mRPV), average relative pressure value (aRPV), the center of pressure (COP), and area of pressure distribution were obtained with/without radiation using the upper body of an anthropomorphic phantom for 30 minutes with 15 MV. Results: It was confirmed that the differences in attenuation induced by the FSR sensor for 6 and 10 MV photon beams were small. The differences in mRPV, aRPV, area of pressure distribution with/without radiation are about 0.6%, 1.2%, and 0.5%, respectively. The COP values with/without radiation were also similar. Conclusions: The characteristics of a pressure mapping system during radiation treatment were evaluated on the basis of attenuation and signal perturbation using radiation. The pressure distribution measured using the FSR sensor with little attenuation and signal perturbation by the MV photon beam would be helpful for patient motion monitoring.

• Journal of Acupuncture Research
• /
• v.35 no.2
• /
• pp.69-74
• /
• 2018

Background: We conducted a cross-sectional study to analyze the pain characteristics and satisfaction scores in traffic accident (TA) patients seeking Korean medicine treatment. Methods: A survey was conducted in 845 outpatients who visited 10 Korean medicine institutions due to TA-associated symptoms from February 25th, 2016 to March 9th, 2016. The questionnaire included information about patient sociodemographic characteristics, accident circumstance details, pain levels, treatment methods, satisfaction and pre-existing musculoskeletal disorders. All statistical analyses were performed using STATA 14.0. Results: A total 754 of the 845 respondents had experienced acute pain of onset within 1-2 days. Pain in the neck or low back was most common, and low back pain (LBP) was more prevalent in pedestrian-vehicle accident cases. Patients showed highest satisfaction with pharmacopuncture treatment, followed by acupuncture and Chuna manual therapy. Although treatments were not completed at the time of the survey, the majority of patients were satisfied with the Korean medicine treatments they received and indicated their intent to reuse this treatment in the future. The degree of pain reduction after treatment was a factor that influenced patient satisfaction with and intention to reuse Korean medicine. Conclusion: This study determined the characteristics and status of TA patients using Korean medicine and suggests the need for further more inclusive studies.

• Korean Circulation Journal
• /
• v.52 no.11
• /
• pp.801-807
• /
• 2022

Percutaneous patent foramen ovale (PFO) closure in patients with a prior PFO-associated stroke showed a risk reduction of the stroke recurrence compared to the medical therapy alone in recent several studies. Nevertheless, optimal patient selection for PFO closure has not been clarified. In this paper, we discuss the characteristics of PFO-associated strokes and discuss the recently published evidence and patient selection for PFO closure in patients with ischemic stroke. The lesions characteristics of PFO-associated stroke are associated with multiple scattered lesion, small sized cerebral cortical lesion, or posterior circulation. Overcoming the failure of early studies in CLOSURE I, PC, and RESPECT trials, PFO closure showed a significant reduction in recurrent stroke in recently published REDUCE, CLOSE, DEFENSEPRO trials, and long-term follow-up data of RESPECT study. However, considering that PFO closure cannot completely prevent stroke recurrence and that complications including atrial fibrillation, we should be selectively performed in patients with high-risk PFO.

• Quality Improvement in Health Care
• /
• v.22 no.1
• /
• pp.71-90
• /
• 2016

Purpose: Objective of this study was to investigate how often nurses to perform patient safety activities. Methods: 521 observations were collected in 9 hospitals by 107 nursing students. Nurses' patient safety care activities were measured 0 (not at all) to 10 (all the time) scores. Descriptive statistics, independent t-test, one way ANOVA, correlation, multiple regression used to analyse data. Results: Items like 'Initial nursing assessment', 'drug management bring on', 'preparation for radiology test', 'falls assessment', 'nursing record' got high scores. But, scores of 'patient identification', 'verbal order management', 'hand hygiene' were lower than others. Each scores were different significantly according to institutions and departments. Within a same institution, the variance of scores, especially in 'patient identification', 'hand hygiene' were great. Scores of activities were different according to characteristics of institutions like type, location, number of beds, teaching hospital, number of accreditation, JCI accreditation. Predictors influencing nurses' patient safety activities were type, location and accreditation. These predictors account for 19.4% of variance. Conclusion: Performance of nurses' patient safety activities were different significantly according to characteristics of institutions. The important items like 'patient identification', 'hand hygiene' had achieved lowest performance. Further researches are needed to improve the basic safety activities.