• 제목/요약/키워드: Hospital choice factors

검색결과 129건 처리시간 0.027초

Scalp reconstruction: A 10-year experience

  • Jang, Hyeon Uk;Choi, Young Woong
    • 대한두개안면성형외과학회지
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    • 제21권4호
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    • pp.237-243
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    • 2020
  • Background: The scalp is an important functional and aesthetic structure that protects the cranial bone. Due to its inelastic characteristics, soft-tissue defects of the scalp make reconstruction surgery difficult. This study aims to provide an improved scalp reconstruction decision making algorithm for surgeons. Methods: This study examined patients who underwent scalp reconstruction within the last 10 years. The study evaluated several factors that surgeons use to select a given reconstruction method such as etiology, defect location, size, depth, and complications. An algorithmic approach was then suggested based on an analysis of these factors. Results: Ninety-four patients were selected in total and 98 cases, including revision surgery, were performed for scalp reconstruction. Scalp reconstruction was performed by primary closure (36.73%), skin graft (27.55%), local flap (17.34%), pedicled regional flap (15.30%), and free flap (3.06%). The ratio of primary closure to more complex procedure on loose scalps (51.11%) was significantly higher than on tight scalps (24.52%) (p=0.011). The choice of scalp reconstruction method was affected significantly by the defect size (R=0.479, p<0.001) and depth (p<0.001). There were five major complications which were three cases of flap necrosis and two cases of skin necrosis. Hematoma was the most common of the 29 minor complications reported, followed by skin necrosis. Conclusion: There are multiple factors affecting the choice of scalp reconstruction method. We suggest an algorithm based on 10 years of experience that will help surgeons establish successful surgical management for their patients.

뇌졸중 환자의 의료이용 경로에 관한 연구 (Pathway of stroke patients seeking medical care)

  • 변영순
    • 기본간호학회지
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    • 제7권2호
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    • pp.149-163
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    • 2000
  • The purposes of this study were to investigate the pathway which stroke patients take in seeking medical care and to identify factors which influence that pathway. This study was conducted by a survey. The subjects were 130 adults, who were diagnosed with a stroke between January and April of 2000. Data was collected by means of a interview, questionnaires, and an Activity Index. The result of this study are summarized as follows: 1. The mean age of subject was 61.58 years. Forty-nine percent were men and fifty percent were women. The majority of the subjects were married. For educational level, thirty-three percent finished elementary school, and twenty-three percent, high school. Most of the subjects reported 'middle' economic status. Ninety-two percent lived with their spouse and children. The diagnosis for seventy-two percent was ischemic stroke and for twenty-two percent, hemorrhagic stroke. 2 The most frequent early sign of stroke was hemiplegia(43.3%), loss of consciousness (36.7%), dysarthria(33.3%). The type of hospital first used was a herb hospital(40.8%), or a western hospital(59.2%). The factors in their choice were ; distance from the hospital to the place that the stroke occurred(47.5%), desire for a herb hospital(15.8%), and an invitation(12.9%). The ischemic stroke patients preferred herb hospitals, but hemorrhagic stroke patients preferred a western hospitals. 3. The pattern of stroke patients seeking medical care was that forty-three percent of stroke patients pass through step 1, forty-six percent, through step 2, and 8.5% through step 3. The more steps, the higher the use of herb hospitals. 4. The factors influencing the pathway of stroke patients seeking medical care were diagnosis, and level of consciousness. Ischemic stroke patients used herb hospitals, more frequently hemorrhagic stroke patients, who used western hospitals. The alert patient preferred a herb hospital, but stupor patients preferred a western hospital. 5. The Activity Index was not related to the pathway which stroke patients used in seeking medical care.

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쇄골 간부 불유합의 자가골 이식술 및 금속판 내고정술 (Internal Fixation with Plate and Bone Graft of Mid-shaft Clavicle Nonunion)

  • 고상훈;조성도;박문수;우종근;이채칠;정지영;정지영
    • Clinics in Shoulder and Elbow
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    • 제8권1호
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    • pp.19-22
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    • 2005
  • Purpose: The causes of twelve cases of the mid-shaft clavicle nonunion and the results of internal fixation with plate and bone graft were investigated. Materials and method: From August 1997 to March 2003, twelve cases of the mid-shaft clavicle nonunion were operated with internal fixation with plate and bone graft. The duration of follow-up was average 13 months. Results: The causes of the mid-shaft clavicle nonunion included severe associated injury, severe initial displacement of the fracture fragments and insecure fixation. All cases were operated with internal fixation with plate and bone graft. According to the factor for evaluations of results, using a rating scale of excellent (no apparent factors), good (one factor), fair (two factors), poor (more than three factors), the results showed 10 excellent, 1 good and 1 poor. Screw loosening was developed in only one case . Conclusion: The internal fixation with plate and bone graft of the mid-shaft clavicle nonunion after failed conservative treatment achieved excellent results and seemed to be the procedure of choice for mid-shaft clavicle nonunion.

질환에 따른 기능장애 요소의 이해와 물리치료 (Understanding and Physical therapy of Functional Disability Factors according to Disease)

  • 박승규;김상엽
    • 대한물리치료과학회지
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    • 제6권3호
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    • pp.83-89
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    • 1999
  • We are approaches various painful diseases in clinic. Although same disease, it is different to acute, subacute and chronic stage of disease. Therefore, to understanding of tissue anatomy, pathology and physiology is necessary to under-standing pattern of diseases. It is duty work that choice of hot or ice, electrotherapy, choice of adaptable frequency and mathod of exercise therapy etc. During treatment it is important method to choose to treat the client. As treating the client by exercising or treating when the client is resting and seeing if anything else is a problem etc. So what I have approached some of the treatment that a physical therapist could miss during treatment.

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Video-Assisted Thoracic Surgery Segmentectomy

  • Kim, Ha Eun;Yang, Young Ho;Lee, Chang Young
    • Journal of Chest Surgery
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    • 제54권4호
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    • pp.246-252
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    • 2021
  • Although lobectomy remains the gold-standard surgical treatment for non-small-cell lung cancer, the frequency of thoracoscopic segmentectomy is increasing. Multiple factors must be considered in the choice of the procedure, ranging from adequate surgical planning or simulation, tumor localization, and identification of the intersegmental plane to severing the intersegmental plane to achieve an oncologically safe surgical margin with no or minimal manual palpation and different landmarks. In this article, we present an overview of methods for each procedural step of thoracoscopic segmentectomy, from preoperative planning to division of the intersegmental plane.

Treatment of Femoral Neck Fractures in the Elderly: A Survey of the Korean Hip Society Surgeons

  • Hong Seok Kim;Je-Hyun Yoo;Young-Kyun Lee;Jong-Seok Park;Ye-Yeon Won
    • Hip & pelvis
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    • 제35권3호
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    • pp.157-163
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    • 2023
  • Purpose: This study examined the methods for treatment of femoral neck fracture (FNF) preferred by members of the Korean Hip Society (KHS) and identified factors that influence decisions regarding the surgical intervention of choice. Materials and Methods: A total of 97 members of the KHS responded to the 16-question survey which included questions about the mean number of surgeries performed each month for treatment of femoral neck fractures, the cut-off age for deciding between internal fixation and arthroplasty, the implant used most often, usage of cement, and factors influencing each decision. Results: The mean cut-off age used when deciding between internal fixation and arthroplasty was 64 years old. Hemiarthroplasty (HA) (70%) was the most preferred option for treatment of displaced FNFs in cases where arthroplasty was indicated (total hip arthroplasty [THA] 19% and dual mobility THA 11%). The main reasons for selection of arthroplasty over reduction with internal fixation were age and pre-fracture ambulatory status. Pre-trauma ambulatory status and/or sports activity were the main factors in selection of HA over THA. Cement was used by 33% of responders. Poor bone quality and a broad femoral canal were factors that influenced the usage of cement. Conclusion: Management of FNFs in the elderly is a major health problem worldwide; thus, remaining alert to current trends in treatment is essential for surgeons. The mean cut-off age used in deciding between internal fixation and arthroplasty was 64 years old. HA is the preferred method for treatment of displaced FNFs for members of the KHS.

2022학년도 작업치료(학)과 신입생의 학과 결정에 관한 연구 (A Study on Factors that Influence Department Selection for Freshmen Majoring in Occupational Therapy in 2022)

  • 배원진;조영석
    • 대한통합의학회지
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    • 제11권2호
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    • pp.37-47
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    • 2023
  • Purpose : This study aimed to identify factors that influence selection of occupational therapy as a college major by freshmen. Methods : A survey was conducted on 308 freshmen majoring in occupational therapy from March 2022 to September 2022. The questionnaire consisted of five items about general characteristics, two about the choice of college and major, three about the timing of major selection, three about information acquisition, and one about the university application process. Results : While choosing a university, 37% of the students primarily considered the available choice of majors, whereas 41% considered the college application period. Employment rate was another important factor that was considered when choosing a department. Most students learned about occupational therapy through research on physical therapy and primarily gathered information by searching on "Naver and blogs." Among the descriptions of occupational therapy, the most interesting keyword was "hospital" (54 %). Conclusion : This study investigated the factors that influenced the college major selection by new students in the department of occupational therapy. This study provides meaningful basic data that can be referred to when promoting the department of occupational therapy. A limitation of this study is that a high percentage of students from Gyeongnam were included, and hence, further research that investigates according to region is needed. Moreover, detailed investigations on factors related to university applications in each region are required. It is also necessary to investigate the relationship between the characteristics of freshmen and the determining factors of the department and the admission process.

한국여성의 제왕절개술 영향요인에 관한 생태학적 접근 (Impact Factors of Korean Women's Cesarean Section according to Ecological Approach)

  • 김현경
    • 여성건강간호학회지
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    • 제17권2호
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    • pp.109-117
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    • 2011
  • Purpose: This study examined the impact factors of cesarean section based on the ecological approach in Korea. Methods: Population-based data (Korea Institute for Health and Social Affairs) were used from 2,849 delivery cases during 2003~2009. Data were analyzed using geographic statistics with STATA 10.0 and hierarchical logistic regression with SPSS/WIN 12.0. Results: The range of cesarean section rate was 28.8~44.7% with geographic distribution. The proportion of mother's problem was increasing in choice of cesarean section. According to the ecological model, age of mother (OR=1.08), time of birth (OR=0.79), delivery in hospital (OR=1.83), delivery in clinic (OR=1.46), and education of mother (OR=2.61) had significant impact on cesarean section. Conclusion: This study contributes to provide the impact factors of the high cesarean rate in Korea ecologically. Policy maker and health care provider can consider these results to reduce cesarean section rate.

병원마케팅이 치과 의료기관 선택에 미치는 영향 : 의료소비자 만족도를 중심으로 (The influence of selecting dental hospital by hospital marketing : Focus on patient satisfaction)

  • 노한나;권초롱;황선희
    • 대한심미치과학회지
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    • 제23권2호
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    • pp.95-104
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    • 2014
  • This study is about the basis of satisfactions by patients : One is 'what factors of the marketing by dental medical service have an effect on consumers dental clinic' The other is 'what is the most important part when consumers choose the dental medical ser Seoul and Gyeonggi area unintentionally. Finally 446 people were analyzed. 6 general questions, 5 selective form questions when consumers choose the dental service, 11 satisfactions questions after treating and thought of reuse the dental service 6 (Likert scale) questions. Whether the choice of hospital dental marketing by dental analysis, both male and female hospital medical marketing and use of selected highly suggests that it does not respond. The resulting satisfaction analysis using the Hospital Dental Marketing consumer access to medical care, and then, a full explanation, comfort, quality and level, health care costs, treatment management, and symptom improvement were higher satisfaction with the item, select the dental healthcare after the analysis of the marketing of recycled doctors are otherwise subject the person selected from all entries equal to or higher than the average consumer satisfaction showed a higher medical doctor also higher reuse. Consequently, Through the use of marketing to choose the best dental healthcare need to providing quality care.

재활병원 입원 시 선택 및 전원 요인 조사 (An Investigation of Selection and Transfer Factors on the Admission of Rehabilitation Hospital)

  • 이재홍;권원안;이진환;민동기
    • 한국산학기술학회논문지
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    • 제14권6호
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    • pp.2819-2827
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    • 2013
  • 본 연구는 신경계 재활전문병원의 이탈환자에 대한 환경적 요인과 의료적 요인에 관해서 조사하는 것이다. 대상자는 107명의 입원환자를 대상으로 조사하였다. 수집된 자료는 SPSS Win 19.0을 이용하여 분석하였다. 그 결과 첫째, 일반적 병원선택에서는 추천이 35.5%, 환경적 불만족 요인에는 병원시설이 37.4%, 병원 선택인에는 지인이 23.4%로 장 높게 나타났다. 둘째, 전문성, 친절성 및 설명성에 대한 만족도 조사에서 만족도가 가장 낮은 그룹은 간병사 그룹이고 만족도가 가장 높은 그룹은 물리치료사와 작업치료사 그룹으로 나타났다. 셋째, 원무(행정)절차, 진료절차, 대기시간 및 의료비용에 관한 만족도는 모두 '보통'의 선택 안이 가장 높은 분포를 보였다. 결론적으로 환경적 불만족 요인에서 높은 비율을 차지한 병원시설은 신경계전문병원의 수가 적어서 환자의 밀집현상으로 인해 발생한 것으로 보여 환자이탈의 요소로 간주될 수 있고, 의료적 불만족 요인에서는 환자와 많은 시간을 할애하는 간병사(care worker)에 대한 만족도(전문성, 친절성, 설명성)가 가장 낮아서 환자 이탈의 중요한 요인이 됨을 알 수 있었다. 따라서 간병사에 대한 서비스 만족도와 불만족도에 미치는 요인을 조사하고 문제점을 해결하여 간병사의 서비스 질을 향상시킬 수 있는 방안을 모색해야 할 것으로 사료된다.