• 한국콘텐츠학회논문지
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• 제14권7호
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• pp.376-385
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• 2014

본 연구는 의료소비자들이 필요로 하는 병원정보를 확인하여 의료기관의 소비자 중심 마케팅 방향을 제시하고자 하였다. 이를 위하여 의료소비자들의 병원정보 이용목적, 알고 싶은 정보의 내용, 정보획득방법, 획득한 정보의 실용성에 대해 살펴보았다. 연구결과, 병원정보 이용목적은 실질적으로 의료기관을 이용하고자 하는 목적이 90% 이상으로, 특히 '가족 친지가 아플 경우 병원선택 시'에는 58.7%이었다. 알고 싶은 정보의 내용은 병원시설 전문분야 및 특수분야의 구체적 내용이라는 응답이 이용목적과 관계없이 과반수이상이었으며, 병원정보 이용목적에 따른 정보획득을 위해 가장 많이 이용하는 방법은 '주위사람'이 과반수 전후의 비율로 가장 높았고 '인터넷'을 이용한다는 비율이 24~28% 수준이었다. 그리고 획득한 병원정보의 실용성은 병원정보 이용목적이 '가족친지가 아플 경우 병원선택 시'에 4.8%, '건강상담 또는 종합검진 위한 병원선택 시'에는 0.5%로 상당히 낮았다.

• 보건행정학회지
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• 제17권3호
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• pp.87-105
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• 2007

The purpose of this study was to analyze whether nonemergency, isolated coronary artery bypass graft (CABG) surgery for high- or low-risk patients biases the assessment of the risk-adjusted mortality rates of hospitals. This study used 2002 National Health Insurance claims data for tertiary hospitals in Korea. The study sample consisted of 1,959 patients from 23 tertiary hospitals. The risk-adjustment model used the patients' biological, admission, and comorbidity data identified in the claims. The subjects were classified into high- and low-risk groups based on predicted surgical risk. The crude mortality rates and risk-adjusted mortality rates for low-risk, high-risk, and all patients in a hospital were compared based on the rank and the four intervals defined by quartile. Also, the crude mortality rates of the three groups were compared with their 95% confidence intervals of predicted mortality rates. The C-statistic (0.83) and Hosmer-Lemeshow test ($X^2$=11.47, p=0.18) indicated that the risk-adjustment model performed well. Presenting crude mortality rates with their 95% confidence intervals of predicted rates showed higher agreements among the three groups than using the rank or intervals of mortality rates defined by quartile in the hospital performance assessment. The crude mortality rates for the low-risk patients in 21 of the 23 hospitals were located on the same side of their 95% confidence intervals compared to that for all patients. High-risk patients and all patients differed at only one hospital. In conclusion, the impact of risk selection by hospital on the assessment results was the smallest when comparing the crude inpatient mortality rates of CABG patients with the 95% confidence intervals of predicted mortality rates. Given the increasing importance of quality improvements in Korean health policy, it will be necessary to use the appropriate method of releasing the hospital performance data to the public to minimize any unwanted impact such as risk-based hospital selection.

• 한국임상약학회지
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• 제32권3호
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• pp.215-225
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• 2022

Background: Patients with hematologic cancers have a risk of drug-related problems (DRPs) from medications associated with chemotherapy and supportive care. Although the role of oncology pharmacists has been widely documented in the literature, few studies have reported its impact on cost reduction. This study aimed to describe the activities of oncology pharmacists with respect to hematologic diseases and evaluate the associated cost avoidance. Methods: From January to July 2021, patients admitted to the department of hemato-oncology at Seoul National University, Bundang Hospital were studied. The activities of oncology pharmacists were reported by DRP type following the Pharmaceutical Care Network version 9.1 guidelines, and the acceptance rate was calculated. The avoided cost was estimated based on the cost of the pharmacy intervention, pharmacist manpower, and prescriptions associated with the intervention. Results: Pharmacists intervened in 584 prescriptions from 208 patients during the study period. The most prevalent DRP was "adverse drug event (possibly) occurring" (32.4%), followed by "effect of drug treatment not optimal" (28.6%). "Drug selection" (42.5%) and "dose selection" (30.3%) were the most common causes of DRPs. The acceptance rate of the interventions was 97.1%. The total avoidance cost was KRW 149,468,321; the net profit of the avoidance cost, excluding labor costs, was KRW 121,051,690; and the estimated cost saving was KRW 37,223,748. Conclusion: Oncology pharmacists identified and resolved various types of DRPs from prescriptions for patients with hematologic disease, by reviewing the prescriptions. Their clinical service contributed to enhanced patient safety and the avoidance of associated costs.

• The Korean journal of internal medicine
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• 제39권3호
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• pp.458-468
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• 2024

Background/Aims: The SAMe-TT₂R₂ score is used for assessing anticoagulation control (AC) quality with warfarin. However, it is hard to apply SAMe-TT₂R₂ score in Asian patients with atrial fibrillation (AF), because it has not been proven in those populations. This study aimed to validate the SAMe-TT₂R₂ score in Asian patients with AF and suggest a modified SAMe-TT₂R₂ score for this population. Methods: We analyzed 710 Korean patients with AF who were using warfarin. The AC quality was assessed as the mean time in therapeutic range (TTR). Each component of SAMe-TT₂R₂ score was evaluated for the relationship with AC. Further clinical factors that predict AC were analyzed. Identified factors were re-assorted and constructed as SA₂Me-TTR scoring system. Results: Of the components of the SAMe-TT₂R₂ score, female, age, and rhythm control were associated with AC. Heart failure and renal insufficiency were newly identified factors associated with AC. The modified SA₂Me-TTR score was reconstructed with the relevant risk factors (S, female gender, 1 point; A, age < 60 yr, 2 points; Me, medical history of heart failure, 1 point; T, treatment for rhythm control, 1 point; T, history of stroke or transient ischemic attack, 1 point; R, renal insufficiency, 1 point). The modified SA₂Me-TTR score demonstrated an excellent relationship with the grading of AC. The modified SA₂Me-TTR score ≤ 1 identified patients with good AC (hazard ratio 2.46, 95% CI 1.75-3.47). Conclusions: The modified SA₂Me-TTR score was useful for guiding oral anticoagulants selection in Asian patients with AF.

• Journal of the Korean Data and Information Science Society
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• 제27권2호
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• pp.499-510
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• 2016

생존분석 회귀모형에서 적절한 변수를 선택하는 것은 매우 중요하다. 본 논문에서는 "frailtyHL" R 패키지 (Ha 등, 2012)를 기반으로 하여 다수준 프레일티 모형 (multi-level frailty models)에서 벌점화 변수선택 방법 (penalized variable-selection method)의 절차를 소개한다. 여기서 모형 추정은 벌점화 다단계 가능도에 기초하며, 세 가지 벌점 함수 (LASSO, SCAD 및 HL)가 고려된다. 개발된 방법의 예증을 위해 벨기에 EORTC (European Organization for Research and Treatment of Cancer; 유럽 암 치료기구)에서 수행된 다국가/다기관 임상시험 자료를 이용하여 세 가지 변수 선택 방법의 결과를 비교하고, 그 결과들의 상대적 장 단점에 대해 토론한다. 특히, 자료 분석 결과에 의하면 SCAD와 HL방법이 LASSO보다 중요한 변수를 잘 선택하는 것으로 나타났다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제24권2호
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• pp.27-36
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• 2018

Purpose: In the case of mass disaster, the establishment of temporary medical facilities for the first aid and treatment is required for the stable accommodation of patients caused by the disaster. However, the criteria for decision making related to the deployment of field emergency medical facilities are not specified. So, The purpose of this study is to draw considerable factors needed for the deployment of field emergency medical facilities and to make proposal for site selection process of field emergency medical facilities on the basis of the factor. Methods: This study performs text mining of disaster-related laws, guidelines and documents to derive key factors affecting site selection, also proposes a decision making process and conducts virtual deployment to validate the process. Results: The key factors for the site selection derived as the size of the damage, the size of the DMAT inputs, the location of available place, and distance to the disaster base hospital. As a result of virtual deployment following proposed decision making process, It is confirmed that the site of field emergency medical facilities is changed depending on the type of disaster, even if the scope of the disaster damage was the same. Implications: The deployment of field emergency medical facilities requires a separate criteria for each type of disaster, not uniform, as a future research a quantitative approach of the criteria needs to be performed.

• 디지털융복합연구
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• 제18권8호
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• pp.263-270
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• 2020

본 연구는 응급구조(학)과 대학생을 대상으로 전공선택동기와 직업가치관이 취업준비행동에 미치는 영향을 파악하고, 이의 결과를 토대로 취업준비행동 향상을 위한 기초자료를 제공하고자 시행하였다. D광역시, J도 소재 3·4년제 대학 응급구조(학)과 대학생을 대상으로 2019년 11월 4일부터 8일까지 연구 참여에 대한 동의를 받은 후 자기기입식 설문조사를 하였다. 수집된 자료 중 응답이 미비한 9부을 제외한 341부를 SPSS ver. 12.0(Window)으로 최종 분석하였다. 본 연구결과, 취업준비행동에 전공선택동기의 개인적 동기, 직업가치관의 내재적 직업가치관, 외재적 직업가치관 순으로 영향을 미쳤다. 따라서, 성별 및 학년의 특성과 전공선택동기 및 직업가치관의 특성을 고려하여, 개별 및 집단 상담과 정규 또는 비정규 교육과정에서 직업가치관 강좌의 개설이 필요하다고 사료된다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제15권7호
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• pp.2455-2475
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• 2021

Patient Navigation Program (PNP) is considered as an important implementation of health care systems that can assist in patient's treatment. Due to the feasibility of PNP implementation, a systematic reuse is needed for a wide adoption of PNP computerized system. SPL is one of the promising systematic reuse approaches for creating a reusable architecture to enabled reuse in several similar applications of PNP systems which has its own variations with other applications. However, stakeholder decision making which result from the imprecise, uncertain, and subjective nature of architecture selection based on quality attributes (QA) further hinders the development of the product line architecture. Therefore, this study aims to propose a quality-driven approach using Multi-Criteria Decision Analysis (MCDA) techniques for Software Product Line Architecture (SPLA) to have an objective selection based on the QA of stakeholders in the domain of PNP. There are two steps proposed to this approach. First, a clear representation of quality is proposed by extending feature model (FM) with QA feature to determine the QA in the early phase of architecture selection. Second, MCDA techniques were applied for architecture selection based on objective preference for certain QA in the domain of PNP. The result of the proposed approach is the implementation of the PNP system with SPLA that had been selected using MCDA techniques. Evaluation for the approach is done by checking the approach's applicability in a case study and stakeholder validation. Evaluation on ease of use and usefulness of the approach with selected stakeholders have shown positive responses. The evaluation results proved that the proposed approach assisted in the implementation of PNP systems.

• 생물정신의학
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• 제19권4호
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• pp.172-178
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• 2012

Data from clinical studies are needed for psychiatrists to make quick and scientific decisions based on the best available evidence in clinical settings. Various methods of clinical studies are useful for clinicians to have reliable answers to unmet clinical needs. Although randomized controlled trials may provide high-quality information about major issues, well-designed, naturalistic and observational studies often give us unbiased explanation for real-world phenomena. Adequate selection of clinical variables and appropriate number of participants are key factors of well-designed clinical studies. Statistical methods can add an extra dimension to initial design of clinical studies. Given ethical issues in clinical studies on psychiatric disorders, special regards should be paid to participants' ability to provide informed consents. New strategies of clinical studies need to be developed to meet clinical needs and protect the rights and welfare of study participants.

• 대한한방내과학회지
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• 제39권4호
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• pp.645-661
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• 2018

Objectives: The aim of this paper was to aid Korean clinical practices for determining clinical and subclinical hypothyroidism and to identify further relevant studies by summarizing the present domestic clinical studies. Methods: The research consisted of a review of articles up to July, 2018 found by searching 'Hypothyroidism' and 'Hashimoto's thyroiditis' as keywords in five domestic electronic databases. Results: Only nine studies satisfied the selection criteria and were analyzed. These included six case reports, two controlled clinical trials, and one randomized controlled trial. Of these, Anjeonleejoong-tang was the most frequent herbal medicine used to treat hypothyroidism. Conclusions: Systematic and large-scale research studies are needed to standardize the guidelines for traditional Korean treatment of hypothyroidism.