• 보건행정학회지
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• 제18권3호
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• pp.1-17
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• 2008

The measurement and management of patient satisfaction has become one of the key issues in the last two decades. Hospitals must thoroughly understand the needs of their customers and design products and health services that meet and exceed their expectations. The importance-performance analysis(IPA) is a widely used analytical technique that yields strategies for managing customer satisfaction in a variety of applications. IP A is a two-dimensional grid based on customer-perceived importance of quality attributes and attribute performance. Depending on the interplay of these two dimensions, four strategies can be derived. The aim of this study is to develop the management strategies for improving patient satisfaction in university hospitals using the I-P analysis. The attributes on inpatient service quality in 4 university hospitals was investigated using the Martilla and James(l977)' s a mean adjusted I-P grid where the axes of the grid cross at the average rating point of all items. The patient satisfaction questionnaires were completed by 600 hospital inpatients. The main statistical methods are path analysis and IPA with SPSS 12.0 and AMOS 4.0 statistical softwares. The two attributes, physician and medical service, administrative staff kindness attributes position in first quadrant(Keep Up the Good domain). The nurse and nursing service attributes position in second quadrant(Possible Overkill domain). The two attributes, convenience of check-in service, facilities and physical environment position in third quadrant(Low Priority domain). Finally the quality of inpatient service(food etc.) attributes position in fourth quadrant(Concentrate Here domain). These findings show various implications on the development of strategies in university hospitals in the future. It was determined that quality of inpatient service(food etc.) need to concentrate more on investments. These investments include a taste, price, proper provision of food service and quick response of pain management. A low priority was given to investment in streamlining the check-in process of inpatient and hospital facilities and physical environment in the long run.

• 대한한방내과학회지
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• 제34권3호
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• pp.231-239
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• 2013

Objectives : This study was performed to evaluate inter-rater and intra-rater reliability of interpretation and reproducibility of a pulse analyser (MAXMAC27-Plus). Methods : 38 of 40 volunteers completed the pulse analysis consecutively. Three Korean medical doctors who had at least 2 years of clinical experience interpreted the pulse waves for 3 aspects of size, depth and shape, then inter-rater reliability and crude agreement was obtained. Reinterpretation was done 2 weeks later and intra-rater reliability and crude agreement was obtained. Intra-rater reliability and crude agreement between 1st and 2nd measurement was calculated. Cohen's weighted kappa for size, Cohen's kappa for depth and shape were used as statistical analysis. Results : Inter-rater reliability of size, depth and shape among 3 raters was 0.598, 0.604, and 0.312, respectively, showing moderate to substantial agreement. Average intra-rater reliability between 1st and 2nd interpretation of size, depth and shape was 0.806, 0.705, and 0.638, respectively, showing substantial to almost perfect agreement. However, intra-rater reliability between consecutive measurements of size, depth and shape was 0.221, 0.121, and 0.194, respectively, which showed only poor to fair agreement. Conclusions : Intra-rater and inter-rater reliability of one pulse wave showed relatively high concordance. Training by a clinical expert may effect better concordance among raters. Test-retest reliability showed poor agreement. Improvement of measurement technique and device performance will be needed.

• 대한의용생체공학회:의공학회지
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• 제38권4호
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• pp.183-189
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• 2017

Electrosurgical Unit(ESU) is medical equipment that cut or coag tissues using electrical energy. It is used in hospitals' outpatient clinic room and operating room. Improper use of an ESU may cause fatal injuries to the patient, such as burns. So, before using an ESU, make sure that it is supplying enough energy for cut and coag by measuring the output power and checking the output power cable. In this study, we developed a simple ESU power measurement system PW100 that allows anyone to check the basic output power. And PW100 can check the state of the cable associated with the output power before using ESU. Then, we compared the measured output power of the PW100 with an ESU Analyzer which was commercialized, and compared the performance. In the experiment, the output power measured by the PW100 was lower value than an ESU Analyzer's that. However, the PW100's output power measured in the 5% error range and showed stable reproducibility by a low %RSD value.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권2호
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• pp.97-103
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• 2018

Background: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate ($RRa^{TM}$), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. Methods: We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. Results: Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were -0.03, -0.27, and -0.61 in each respective period (P < 0.001); limits of agreement were -4.84-4.45, -4.89-4.15, and -6.18-4.95 (P < 0.001). Conclusions: The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.

• Tuberculosis and Respiratory Diseases
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• 제86권4호
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• pp.272-283
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• 2023

Background: In patients with chronic obstructive pulmonary disease (COPD), decreased muscle mass is a frequently encountered comorbidity in clinical practice. However, the evaluation of muscle mass in patients with COPD in real-world practice is rare. Methods: We retrospectively reviewed the electronic medical records of all patients with COPD who underwent bioelectrical impedance analysis at least once between January 2011 and December 2021 in three hospitals. Then, we analyzed the performance rate of muscle mass measurement in the patients and the correlation between muscle mass, clinical parameters, and COPD prognosis. Results: Among the 24,502 patients with COPD, only 270 (1.1%) underwent muscle mass measurements. The total skeletal muscle mass index was significantly correlated with albumin, alanine transaminase, and creatinine to cystatin C ratio in patients with COPD (r=0.1614, p=0.011; r=0.2112, p=0.001; and r=0.3671, p=0.001, respectively). Acute exacerbation of COPD (AE COPD) was significantly correlated with muscle mass, especially the truncal skeletal muscle mass index (TSMI) in males (r=-0.196, p=0.007). In the multivariate analysis, TSMI and cystatin C were significant risk factors for AE COPD (hazard ratio, 0.200 [95% confidence interval, CI, 0.048 to 0.838] and 4.990 [95% CI, 1.070 to 23.278], respectively). Conclusion: Low muscle mass negatively affects the clinical outcomes in patients with COPD. Despite its clinical significance, muscle mass measurement is performed in a small proportion of patients with COPD. Therefore, protocols and guidelines for the screening of sarcopenia in patients with COPD should be established.

• 한국의학물리학회지:의학물리
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• 제33권4호
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• pp.150-157
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• 2022

Purpose: Elekta synergy^® was commissioned in the Seoul National University Veterinary Medical Teaching Hospital. Recently, Chung-Ang University Gwang Myeong Hospital commissioned Elekta Versa HD^TM. The beam characteristics of both machines are similar because of the same Agility^TM MLC Model. We compared measured beam data calculated using the Elekta treatment planning system, Monaco^®, for each institute. Methods: Beam of the commissioning Elekta linear accelerator were measured in two independent institutes. After installing the beam model based on the measured beam data into the Monaco^®, Monte Carlo (MC) simulation data were generated, mimicking the beam data in a virtual water phantom. Measured beam data were compared with the calculated data, and their similarity was quantitatively evaluated by the gamma analysis. Results: We compared the percent depth dose (PDD) and off-axis profiles of 6 MV photon and 6 MeV electron beams with MC calculation. With a 3%/3 mm gamma criterion, the photon PDD and profiles showed 100% gamma passing rates except for one inplane profile at 10 cm depth from VMTH. Gamma analysis of the measured photon beam off-axis profiles between the two institutes showed 100% agreement. The electron beams also indicated 100% agreement in PDD distributions. However, the gamma passing rates of the off-axis profiles were 91%-100% with a 3%/3 mm gamma criterion. Conclusions: The beam and their comparison with MC calculation for each institute showed good performance. Although the measuring tools were orthogonal, no significant difference was found.

• 대한방사선기술학회지:방사선기술과학
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• 제27권4호
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• pp.37-41
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• 2004

목 적 : 측정을 통한 장치의 성능관리 평가로 임상실무에서의 능력배양과 정확한 관전압, 조사시간, 출력선량을 측정하는 기술을 익히고 병원에서 사용 중인 간접촬영용 X-선 발생장치 성능현황을 파악하기 위함이다. 재료 및 방법 : 관전압, 조사시간, 출력선량 측정기를 이용하여 10개 대학병원 간접촬영용 X-선 발생장치(원내,외 각 10대)를 이용하였다. 결 과 : 관전압 정확도 시험 PAE 판정에 의해 부적합한 간접촬영기는 3대가 나왔으며, 조사시간의 정확도 시험에서는 2대, 또한 조사선량의 재현성 시험에서도 조사선량에 대한 변동계수를 계산한 결과 3대가 나왔다. 3가지 성능검사에서 원외(이동차량)의 부적합한 간접촬영기는 5대, 원내는 3대로 원외(이동차량)의 간접촬영기가 원내보다 부적합한 것이 높게 나타났다. 결 론 : 간접촬영기의 성능을 일정하게 유지함으로서 방사선 피폭경감, 화질관리, 재촬영 감소 등에 의해 환자에게 양질의 의료서비스를 제공할 수 있는 여건을 마련할 수 있을 것이다. 따라서 정기적인 성능검사가 필요하다고 사료된다.

• 대한디지털의료영상학회논문지
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• 제10권1호
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• pp.21-28
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• 2008

Diagnostic display monitor QA according to AAPM TG18 is usually performed by PACS administrator, product manager and reading doctor, and for acceptance testing and periodic quality control evaluation, a combination of visual and quantitative tests can be used, as outlined in sections 5 and 6 of 'assessment of display performance for medical imaging systems'. Although many display tests can be performed visually, a more objective and quantitative evaluation of display performance requires special test tools. The required instruments vary in their complexity and cost, depending on the context of the evaluation(research, acceptance testing, or quality control) and how thorough the evaluation needs to be. Objective and reliable assessment of many display characteristics can be performed with relatively inexpensive equipment, So, we made 'AAPM TG18 guiding instrument' to ues variable purpose of the evaluation of 'geometrical distortions(quantitative"', 'veiling glare(visual)' and 'sensor calibration'. The spatial measurements for the quantitative evaluation of geometric distortions, and the measurement of the veling-glare ring response function which provides information regarding the spatial extent of the luminance spread, can be performed using the TG18 guiding instrument can be used to sensor calibration to standardize the basic rate of 0% luminance when periodic calibration.

• 한국임상보건과학회지
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• 제5권3호
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• pp.973-980
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• 2017

Purpose. To understand the effectiveness of training programs to improve the daily living activities and social adaption abilities of stroke patients. Methods. The participant included 1 stroke patient in Jeonbuk, from March to August 2016. The test tools used was the Canadian occupational performance measurement, International classification of function, disability and health co-resets. After applying the training program, I compared the daily life satisfaction and social adaption abilities. Results. According to this study, both daily life satisfaction and social adaption abilities improved. Conclusion. In conclusion, after an exercise program, self- help program, and underwater exercise programs, daily life satisfaction and social adaptation levels were improved. Therefore, the programs that apply to stroke patients could be found to be effective.

• The Journal of Korean Physical Therapy
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• 제14권1호
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• pp.205-217
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• 2002

We performed the cross-cultural adaptation process directed at the translation into Korean of the Pain Visual Analogue Scale, the Self-Report of Improvement and the Beacke Physical Activity Questionnaire for Older Adults. This project will help ensure that the Korean versions of these measures retain their meaning and measurement properties when applied to the Korean language and culture. This will help reduce measurement error in the RCT. This research should be of value to other researchers who wish to study older adults with rheumatological conditions.