• 한국정보과학회논문지:데이타베이스
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• 제33권2호
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• pp.239-249
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• 2006

병원정보시스템(Hospital Information System)은 다른 병원정보시스템과 서로 독립적으로 운영되므로 상호운영성(Interoperability)이 배제되어 왔다. 이 연구는 HL7 표준임상문서구조(Health Level 7, Clinical Document Architecture)와 XML 스키마의 분석과 설계를 통하여 새로운 패러다임의 병원정보시스템을 제안한다. 퇴원요약지로부터 필수 항목을 규정하여 템플릿을 정의한 후 임상문서구조를 설계하여 자동적으로 임상문서를 생성되도록 하였다. XML 스키마는 HL7에서 정의한 참조정보모델(Reference Information Model)을 기반으로 분석하였고, 전송 프로토콜은 HL7 V2.4를 사용하였다. 본 연구가 가지는 의의는 첫째, 국제 표준인 HL7 표준임상문서구조를 사용하기 위한 확장과 정제과정의 연구를 했으며, 둘째, 표준임상문서구조를 사용할 수 있는 웹 기반의 차세대 병원정보시스템의 구조를 제안하였다. 결론적으로, 한국의 퇴원요약 표준임상문서구조에 대한 본 연구로 말미암아 평생전자의무기록(Electronic Health Record)과 임상데이타저장소(Clinical Data Repository)를 포함하여 다양한 보건의료기관 간 의료정보 공유의 기반이 될 것이다.

• Parasites, Hosts and Diseases
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• 제58권2호
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• pp.109-119
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• 2020

Soil-transmitted helminths and Schistosoma haematobium affect more than 3 billion people globally and mainly occur in sub-Saharan Africa. The present study assessed the overall infection status of a 1716-student cohort of schoolchildren in Zanzibar and applied mass drug administration (MDA) to the cohort from 2007 to 2009. Schools in Pemba, Zanzibar, had a much higher prevalence of soil-transmitted helminth infections than those in Unguja, and the Chaani, Ghana, and Machui schools of Unguja exhibited high S. haematobium infection rates. The MDA program only partially controlled parasite infections, owing to high rates of re-infection. The infection rate of S. haematobium across all 10 schools, for example, was only reduced by 1.8%, and even this change not significant, even though the S. haematobium infection rates of the Chaani and Mzambarauni schools were significantly reduced from 64.4 and 23.4%, respectively, at the first screening, to 7.3 and 2.3% at the last screening. The overall infection rate of Ascaris lumbricoides was reduced from 36.0% at the first screening to 22.6% at the last screening. However, the infection rates for both Trichuris trichiura and hookworm were generally unaffected by MDA. In the future, parasite control programs should involve strategically designed MDA schedules and holistic intervention (e.g., sanitation improvement, hygiene behavior changes, and control of intermediated hosts).

• Asian Pacific Journal of Cancer Prevention
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• 제17권12호
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• pp.5287-5294
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• 2016

Background: Breast cancer is a worldwide public health concern and is the most prevalent type of cancer in women in the United States. This study concerned the best fit of statistical probability models on the basis of survival times for nine state cancer registries: California, Connecticut, Georgia, Hawaii, Iowa, Michigan, New Mexico, Utah, and Washington. Materials and Methods: A probability random sampling method was applied to select and extract records of 2,000 breast cancer patients from the Surveillance Epidemiology and End Results (SEER) database for each of the nine state cancer registries used in this study. EasyFit software was utilized to identify the best probability models by using goodness of fit tests, and to estimate parameters for various statistical probability distributions that fit survival data. Results: Statistical analysis for the summary of statistics is reported for each of the states for the years 1973 to 2012. Kolmogorov-Smirnov, Anderson-Darling, and Chi-squared goodness of fit test values were used for survival data, the highest values of goodness of fit statistics being considered indicative of the best fit survival model for each state. Conclusions: It was found that California, Connecticut, Georgia, Iowa, New Mexico, and Washington followed the Burr probability distribution, while the Dagum probability distribution gave the best fit for Michigan and Utah, and Hawaii followed the Gamma probability distribution. These findings highlight differences between states through selected sociodemographic variables and also demonstrate probability modeling differences in breast cancer survival times. The results of this study can be used to guide healthcare providers and researchers for further investigations into social and environmental factors in order to reduce the occurrence of and mortality due to breast cancer.

• 대한방사선기술학회지:방사선기술과학
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• 제44권5호
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• pp.545-554
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• 2021

According to the changes of the medical environment of the times, it is necessary to discuss the issues of the doctor's medical guidance and to conduct continuous research so that alternatives can be prepared systematically. Furthermore, in order to enhance the professionalism of radiological technologists and to develop the medical technician system, the new Radiological Technologist Independent Act has been established, which contains the overall contents of the scope of work, professional qualifications, and specialized education of radiological technologists, and provides quality medical services to patients through professional procedures and treatment. In order to increase the level of medical care, the purpose, definition, mission, role, and scope of work specified in the Medical Act, Medical Service Technologists, etc. Act, the Enforcement Decree, and the Enforcement Rules were variously analyzed and new directions were presented. First, the definition of a medical technician should use a generic term so that the factors of conflict and prejudice could be resolved. Second, change the doctor's guide to doctor's prescription; and then legislate the authority to sign and write medical records after examination by radiological technologists, thereby prohibiting unlicensed technicians that seriously endanger patient safety. Third, an accurate definition of radiological technologists' roles should be established; not only selection and management of radiological technologists' work but also procedures and treatment for each radiology field should be specified to suit the current medical system. Fourth, a professional radiological technologists' qualification system and a specialized education system should be established in order to secure human resources that could provide patients trust in procedures and treatment based on professional knowledge and experience in the field of radiology. Fifth, the Education and Evaluation Institute should be operated in Korea education system to educate the professional knowledge and competency for students. In addition, it is necessary to in-depth analysis of foreign cases could be applied to the medical system and education system in Korea; it could strive to nurture systematic human resources.

• 대한방사선기술학회지:방사선기술과학
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• 제44권5호
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• pp.513-523
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• 2021

The purpose of this study was to discuss the required items and feasibility of medical records of radiological examinations performed by radiological technologists at medical institutions. An online survey was conducted to a total of 10,000 radiation-related workers, of which 1,026 (10.3%) responded. As a research method, self-made questionnaires were used. The online survey was conducted from September 10 to September 20, 2021 for the survey period. For response data, a Chi-square test was performed according to demographic characteristics using SPSS 27.0 version (IBM Inc., Chicago, Ill, USA), and it was judged to be significant when the P value was less than 0.05. The reliability of the questionnaire response was found to be Chronbach α=0.933. More than 90% of the medical records related to radiological examinations are necessary, and they answered that a curriculum, remuneration curriculum, and legal system for medical records should be prepared. More than 90% of the respondents agreed with the proposal of the Radiological Technologist Independent Act for legal preparation, and most of the information required for medical records is currently recorded in DICOM images. According to the demographic characteristics, the medical record requirement for radiological examination, curriculum, continuing education, and legislation were found to be higher with higher education and higher with longer working experience. In addition, most of the radiology departments showed a high demand for medical records, so most of them responded positively to the medical records requirements for radiological examinations. This study analyzed the medical record requirements for radiological examinations, and as shown in the results, medical record requirements for radiological examinations was found that most radiological technologists felt need for the new law and supported it. In addition, if the information recorded in the DICOM image is used, it is considered that medical records could be easily prepared without additional work by the radiological technologists.

• 대한방사선기술학회지:방사선기술과학
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• 제44권4호
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• pp.399-407
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• 2021

This study discussed the validity and necessity of compulsory recording of radiographic examination performed by radiological technologist on patients in medical institutions related to radiation exposure. Also, this study provided reasonable evidence of radiographic examination related medical records can contribute to the improvement of public health. Based on overseas cases of implementing a radiographic examination record system, the essential items to be included in medical record are the exposure date, exposure time, exposure method, exposure conditions that is tube voltage, tube current. Name and license number of the radiological technologist who performed the examination should be include in medical record. It is expected that the medical record of the total amount of radiation exposure per year would be in giving the maximum benefit with the minimum exposure to the medical radiation examination of the patient. In addition, interventional radiography medical record should also include exposure time, type and dose of the contrast medium.

• 디지털융복합연구
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• 제17권2호
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• pp.217-230
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• 2019

본 연구는 기존 동반질환을 이용한 중증도 보정 방법의 제한점을 보완하기 위해 급성심근경색증 환자의 맞춤형 중증도 보정방법을 개발하고, 이의 타당성을 평가하기 위해 수행되었다. 이를 위하여 질병관리본부에서 2006년부터 2015년까지 10년간 수집한 퇴원손상심층조사 자료 중 주진단이 급성심근경색증인 한국표준질병사인분류(KCD-7) 코드 I20.0~I20.9의 대상자를 추출하였고, 동반질환 중증도 보정 도구로는 기존 활용되고 있는 CCI(Charlson comorbidity index), ECI(Elixhauser comorbidity index)와 새로이 제안하는 CCS(Clinical Classification Software)를 사용하였다. 이에 대한 중증도 보정 사망예측모형 개발을 위하여 머신러닝 기법인 로지스틱 회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신기법을 활용하여 비교하였고 각각의 AUC(Area Under Curve)를 이용하여 개발된 모형을 평가하였다. 이를 평가한 결과 중증도 보정도구로는 CCS 가 가장 우수한 것으로 나타났으며, 머신러닝 기법 중에서는 서포트 벡터 머신을 이용한 모형의 예측력이 가장 우수한 것으로 확인되었다. 이에 향후 의료서비스 결과평가 등 중증도 보정을 위한 연구에서는 본 연구에서 제시한 맞춤형 중증도 보정방법과 머신러닝 기법을 활용하도록 하는 것을 제안한다.

• 한국산학기술학회논문지
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• 제19권11호
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• pp.126-136
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• 2018

본 연구는 머신러닝을 활용하여 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발을 목적으로 시행하였다. 전국 단위의 퇴원손상심층조사 2006~2015년 자료 중 한국표준질병사인분류(Korean standard classification of disease-KCD 7)에 따라 뇌졸중 코드 I60-I63에 해당하는 대상자를 추출하여 분석하였다. 동반질환 중증도 보정 도구로는 Charlson comorbidity index(CCI), Elixhauser comorbidity index(ECI), Clinical classification software(CCS)의 3가지 도구를 사용하였고 중증도 보정 모형 예측 개발은 로지스틱회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신 기법을 활용하여 비교해 보았다. 뇌졸중 환자의 동반질환으로는 ECI에서는 합병증을 동반하지 않은 고혈압(hypertension, uncomplicated)이 43.8%로, CCS에서는 본태성고혈압(essential hypertension)이 43.9%로 다른 질환에 비해 가장 월등하게 높은 것으로 나타났다. 동반질환 중중도 보정 도구를 비교해 본 결과 CCI, ECI, CCS 중 CCS가 가장 높은 AUC값으로 분석되어 가장 우수한 중증도 보정 도구인 것으로 확인되었다. 또한 CCS, 주진단, 성, 연령, 입원경로, 수술유무 변수를 포함한 중증도 보정 모형 개발 AUC값은 로지스틱 회귀분석의 경우 0.808, 의사결정나무 0.785, 신경망 0.809, 서포트 벡터 머신 0.830로 분석되어 가장 우수한 예측력을 보인 것은 서포트 벡터머신 기법인 것으로 최종 확인되었고 이러한 결과는 추후 보건의료정책 수립에 활용될 수 있을 것이다.

• 문화기술의 융합
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• 제5권2호
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• pp.23-30
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• 2019

본 연구는 상급종합병원의 간호 간병통합서비스 병동에서 근무하는 간호사의 직무스트레스, 직무만족도, 이직의도를 파악하기 위한 서술적조사연구로서 상급종합병원 두 곳을 편의추출하여 이 두 의료기관의 간호 간병통합서비스 병동에 근무하고 있는 간호사를 대상으로 설문조사를 실시하였다. 자료 분석은 대상자의 일반적 특성, 직무스트레스, 직무만족, 이직의도는 서술통계로, 대상자의 일반적 특성에 따른 직무스트레스, 직무만족, 이직의도의 비교는 Mann-Whitney U test를 이용하였다. 본 조사연구가 실시된 상급종합병원 두 곳의 간호 간병통합서비스 병동에서 근무하는 간호사는 모두 여성으로 30세 미만이며 미혼이 대부분이었다. 학력은 학사가 대부분이었다. 간호사 월수입은 93.8%가 150이상 300만원 미만으로 응답하였다. 직무스트레스가 높게 나타난 하위영역은 '의사와갈등', '보호자와 환자', '대인관계갈등'이었고, 직무만족이 가장 낮은 영역은 '보수및승진' '필수적직무'였다. 높은 이직의도를 보인 경우는 '본인이 원하지 않는 부서이동이 되었을때 이직하고 싶다', '부서이동을 인해 업무수행에 어려움이 심할 때 이직하고 싶다', '업무에 비해 월급이 적다고 느낄 때 이직하고 싶다' 등이었다. 간호 간병통합서비스 본래의 취지에 부합하도록 이 서비스를 정착하고 확대하기 위해서는 이 서비스를 제공하는 주요 의료인력인 간호사의 근무환경에 대한 체계적인 평가가 필요하다. 간호 간병통합서비스를 제공하는 간호사의 직무스트레스를 낮추고, 직무만족을 높이기 위해서는 적절한 보상, 명확한 업무에 대한 규정, 일반병동과 간호 간병통합서비스 병동 중에 선호하는 곳에서 근무할 수 있는 여건 등이 고려되어야 하며 이를 위해 정책적인 지원이 필요하다.

• Journal of Radiation Protection and Research
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• 제47권1호
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• pp.1-7
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• 2022

Background: In Japan, new regulations that revise the dose limit for the lens of the eye (hereafter the lens), operational quantities, and measurement positions for the lens dose were enforced in April 2021. Based on the international safety standards, national guidelines, the results of the Radiation Safety Research Promotion Fund of the Nuclear Regulation Authority, and other studies, the Working Group of Radiation Protection Standardization Committee, the Japan Health Physics Society (JHPS) developed a guideline for radiation dose monitoring for the lens. Materials and Methods: The Working Group of the JHPS discussed the criteria of non-uniform exposure and the management criteria set not to exceed the dose limit for the lens. Results and Discussion: In July 2020, the JHPS guideline was published. The guideline consists of three parts: main text, explanations, and 26 examples. In the questions, the corresponding answers were prepared, and specific examples were provided to enable similar cases to be addressed. Conclusion: With the development of the guideline on radiation dose monitoring of the lens, radiation managers and workers will be able to smoothly comply with revised regulations and optimize radiation protection.