• Title/Summary/Keyword: Integrated Health Care

Search Result 349, Processing Time 0.024 seconds

Changes in treatment behavior and cost according to the operation of preventive dentistry in university dental hospital (대학치과병원 예방치과운영 전·후의 환자진료행태와 진료비용 변화)

  • Hong, Hyo-Kyoung;Choi, Seong-Woo
    • Journal of Korean society of Dental Hygiene
    • /
    • v.20 no.5
    • /
    • pp.707-716
    • /
    • 2020
  • Objectives: This study aims to provide basic data for high-quality dental services. In addition, we will promote the operation of preventive dentistry that implements preventive measures. It was conducted to study the change of patient's treatment behavior and treatment cost due to the discontinuation of preventive dentistry in university dental hospitals. Methods: This study collected data using the integrated medical information system of the C University Dental Hospital. From September 1, 2017 to August 31, 2019, data were analyzed using frequency, percentage, mean, standard deviation, chi-square test using SPSS version 24.0 statistical program, and T-test. Results: There was a significant difference in the number of preventive dental treatment cases from 58.3% of preventive dental operation periods to 41.7% of preventive dental operation periods. As a result of comparing the medical expenses, the total medical expenses during the preventive dental operation period decreased from 521,308,872 won to 379,724,995 won during the discontinuation period, 141,583,877 won. The number of medical treatments by treatment behavior decreased 3,835 (28.4%) from a total of 13,520 preventive dental operation periods to 9,685. Conclusions: This study is meaningful as the first study to confirm the change in the treatment behavior and the change in the cost of treatment due to the discontinuation of the operation of preventive dentistry at university dental hospitals. In conclusion, it is thought that there is a possibility of the lack of accessibility and the limitation of professional preventive care due to the discontinuation of preventive dentistry.

Effects of Simulation Education on the Communication Competence, Academic Self-efficacy, and Attitude About the Elderly for Nursing Students: A learning approach based on an elderly-with-cognition-disorder scenario (인지장애 노인 시뮬레이션 교육이 간호대학생의 의사소통능력, 학업적 자기효능감, 노인에 대한 태도에 미치는 효과)

  • Kim, Jiyoung;Heo, Narae;Jeon, Hye Jin;Jung, Dukyoo
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.21 no.1
    • /
    • pp.54-64
    • /
    • 2015
  • Purpose: The purpose of this study was to investigate the effects of simulation in nursing education based on caring for elderly cognition disorder patients. The education consisted of a caring program for patients that included a process of assessment of a patient's mental status, diagnosis of the patient's health condition, and intervention to address the problems by using therapeutic communication. Methods: A nonequivalent control group pretest-posttest design was used. A total of 69 subjects (undergraduate students) participated in the education and they were assigned to two groups: the experimental group (n=32) and the control group (n=37). Data-gathering structured questionnaires that included communication competence, academic self-efficacy, and attitudes about the elderly. The data were collected from October 2013 to December 2013, and statistical analyses were conducted with-test and t-test using the SPSS 21.0 program. Results: With respect to education, there was significant improvement in communication competence in the experiment group (t=2.41, p=.022) compared with in the control group (t=.69, p=.494). However, there was no statistically significant difference in academic self-efficacy and attitude about the elderly. Conclusion: Simulation-based education should continue to be developed further for better elderly-patient care. Integrated education in particular using a high-fidelity simulator will contribute to improvements in nursing competence in this area.

A study on core competence of dental hygiene based on learning outcomes for establishing dental hygiene education evaluation and certification system (치위생학교육평가·인증체계 정립을 위한 학습성과기반 치위생 핵심역량에 관한 조사)

  • Lee, Sun-Mi;Jang, Kyeung-Ae;Lee, Jung-Hwa
    • Journal of the Korea Convergence Society
    • /
    • v.11 no.9
    • /
    • pp.65-72
    • /
    • 2020
  • This study conducted to investigate the core competency of dental hygiene based on learning outcomes for establishing an educational evaluation and certification system for dental hygiene. The sub-categories of core competencies, the overall score of professional behavior and ethical decision-making ability (category 1) and the ability to apply scientific and professional clinical hygiene and knowledge and skills of clinical dental work (category 2) was highest. and the level of communication skills (category 3) was 4.48 points, and the level of evidence-based integrated thinking and problem solving skills (category 5) was 4.35 points. Furthermore, there was a strong correlation between the core competency sub-categories, and it is necessary to identify the core competency between health care service occupations and to qualitatively study the core competency of dental hygienists working in clinical practice.

An Authentication Model based Fingerprint Recognition for Electronic Medical Records System (지문인식 기반의 전자의무기록 시스템 인증 모델)

  • Lee, Yong-Joon
    • The KIPS Transactions:PartC
    • /
    • v.18C no.6
    • /
    • pp.379-388
    • /
    • 2011
  • Ensuring the security of medical records is becoming an increasingly important problem as modern technology is integrated into existing medical services. As a consequence of the adoption of EMR(Electronic Medical Records) in the health care sector, it is becoming more and more common for a health professional to edit and view a patient's record. In order to protect the patient's privacy, a secure authentication model to access the electronic medical records system must be used. A traditional identity based digital certificate for the authenticity of EMR has private key management and key escrow of a user's private key. In order to protect the EMR, The traditional authentication system is based on the digital certificate. The identity based digital certificate has many disadvantages, for example, the private key can be forgotten or stolen, and can be easily escrow of the private key. Nowadays, authentication model using fingerprint recognition technology for EMR has become more prevalent because of the advantages over digital certificate -based authentication model. Because identity-based fingerprint recognition can eliminate disadvantages of identity-based digital certificate, the proposed authentication model provide high security for access control in EMR.

Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching

  • Hongjo Choi;Dawoon Jeong;Young Ae Kang;Doosoo Jeon;Hee-Yeon Kang;Hee Jin Kim;Hee-Sun Kim;Jeongha Mok
    • Tuberculosis and Respiratory Diseases
    • /
    • v.86 no.3
    • /
    • pp.234-244
    • /
    • 2023
  • Background: Effective treatment of fluoroquinolone-resistant multidrug-resistant tuberculosis (FQr-MDR-TB) is difficult because of the limited number of available core anti-TB drugs and high rates of resistance to anti-TB drugs other than FQs. However, few studies have examined anti-TB drugs that are effective in treating patients with FQr-MDR-TB in a real-world setting. Methods: The impact of anti-TB drug use on treatment outcomes in patients with pulmonary FQr-MDR-TB was retrospectively evaluated using a nationwide integrated TB database (Korean Tuberculosis and Post-Tuberculosis). Data from 2011 to 2017 were included. Results: The study population consisted of 1,082 patients with FQr-MDR-TB. The overall treatment outcomes were as follows: treatment success (69.7%), death (13.7%), lost to follow-up or not evaluated (12.8%), and treatment failure (3.9%). On a propensity-score-matched multivariate logistic regression analysis, the use of bedaquiline (BDQ), linezolid (LZD), levofloxacin (LFX), cycloserine (CS), ethambutol (EMB), pyrazinamide, kanamycin (KM), prothionamide (PTO), and para-aminosalicylic acid against susceptible strains increased the treatment success rate (vs. unfavorable outcomes). The use of LFX, CS, EMB, and PTO against susceptible strains decreased the mortality (vs. treatment success). Conclusion: A therapeutic regimen guided by drug-susceptibility testing can improve the treatment of patients with pulmonary FQr-MDR-TB. In addition to core anti-TB drugs, such as BDQ and LZD, treatment of susceptible strains with later-generation FQs and KM may be beneficial for FQr-MDR-TB patients with limited treatment options.

Factors Influencing Sexual Experiences in Adolescents Using a Random Forest Model: Secondary Data Analysis of the 2019~2021 Korea Youth Risk Behavior Web-based Survey Data (랜덤 포레스트 모델을 활용한 국내 청소년 성경험 영향요인 분석 연구: 2019~2021년 청소년건강행태조사 데이터)

  • Yang, Yoonseok;Kwon, Ju Won;Yang, Youngran
    • Journal of Korean Academy of Nursing
    • /
    • v.54 no.2
    • /
    • pp.193-210
    • /
    • 2024
  • Purpose: The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance." Methods: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ2 tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix. Results: The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol. Conclusion: Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.

Trends and Future Direction of the Clinical Decision Support System in Traditional Korean Medicine

  • Sung, Hyung-Kyung;Jung, Boyung;Kim, Kyeong Han;Sung, Soo-Hyun;Sung, Angela-Dong-Min;Park, Jang-Kyung
    • Journal of Pharmacopuncture
    • /
    • v.22 no.4
    • /
    • pp.260-268
    • /
    • 2019
  • Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.

Development of the Critical Pathway for Cesarean Section Patient (제왕절개술 환자를 위한 Critical Pathway 개발)

  • Chung Kyung-Hee;Jang Keum-Seung
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.4 no.1
    • /
    • pp.66-80
    • /
    • 1998
  • With the opening of healthcare market, the health care environment in Korea is anticipating a drastic change. In this Internationally open market environment, it is necessary to introduce a systematic health care plan and DRG system which offer qualitative medical services as well as reduced cost. Purpose of this study is to develop and test the critical pathway for Cesarean section patient in the way to be possible the integrated inpatient management. It was adopted the process of six phases to develop the critical pathway as the theoretical framework implemented by Johns Hopkins Hospital, Maryland, U.S.A. In the first phase, make a selection of diagnosis/procedures to develop. In the second phase, organize a development team consisted of eight expertises working in maternity nursing area. In the third phase, analyze the overall medical service offered to patient through review medical records and decided the service content and the implementation period for the Cesarean section patient. In the forth phase, make out a preliminary critical pathway after verification of expert group on content validity. In the fifth phase, validity operate to ten Cesarean section patients to test implementation in practice by using the preliminary critical pathway, In the sixth phase, defined the final critical pathway. The result of this study was as follows. 1. There were classified 8 categories as monitoring/assesment, treatment, medication, activity, diet, test, consult, education/discharge plan for vertical axis and showed hospital stayed from admission to discharge for horizontal axis of critical pathway through analysis 68 Cesarean section patients medical records. 2. After critical review 68 medical records to make out a preliminary critical pathway, hospital stays for horizontal axis were showed 6 days, mean hospital stays were 7.5 days, 2.1 days were to be taken operation after admission and 4.2 days were stayed until discharge after operation. 3. After making out a questionare in 90 items of a medical service content of eight categories and verifying the content validity of expertises, the 85 items of the preliminary critical pathway were selected by expertises agreement over 88% and modified or deleted 5 items showing agreement below 75%. 4. After verifying a validity to 10 patients for 4 weeks, hospital stays were 5.9 days. There were deleted 1 item and modified or supplemented the 9 items of the 10 items.

  • PDF

Factors Influencing the Safety Consciousness and Health status of the Young-old and Old-old elderly on Injury Occurrence Analysis (전기-후기노인의 안전의식 및 건강요인이 손상 및 손상기전에 미치는 영향)

  • Kim, Chang-Hwan
    • Journal of the Health Care and Life Science
    • /
    • v.8 no.2
    • /
    • pp.155-163
    • /
    • 2020
  • The purpose of this study is to examine the current status of the Injury based on the 7th National Data on the National Health and Nutrition Survey, identify the relationship between general characteristics, safety awareness, health status, injury, and identify the factors that affect the occurrence of injury. The subjects were selected for the final analysis of 1,608data. For the analysis, frequency analysis, cross analysis, and multiple logistic regression analysis were performed. the results of the study show that in the young-old elderly, gender(woman), marital status(separated of divorced), lower the awareness of safety, body discomfort, sickness, and in-outpatient, Annual unmet medical service experienced are higher the occurrence of injury. Therefore, as a prevention education that lowers the incidence of injury. selective education is required for the Young-old and Old-old elderly, and legal penalties for drunk driving on various means of transportation and an integrated approach to strengthening and education is required.

A Diagnostic Study on High School Students' Health and Quality of Life - Based on the PRECEDE model - (고등학생의 건강 및 삶의 질에 대한 진단적 연구 - PRECEDE 모형을 근간으로 -)

  • Yoo Jae-Soon;Hong Yeo-Shin
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.3
    • /
    • pp.78-98
    • /
    • 1997
  • Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

  • PDF