• Title/Summary/Keyword: Management Diagnosis Index

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A Study on the Three-Year Weight Changes of Workers at a Manufacturing Company and the Comparison of Metabolic Syndrome Diagnosis Components: Focused on the Data of Korean National Health Screening (2015~2017) (일개 제조업 근로자의 3년간 체중변화와 대사증후군 진단 구성요소의 비교 분석: 국가건강검진(2015~2017년) 자료를 중심으로)

  • Jung, Eunsook;Kim, Taeyeon
    • Korean Journal of Occupational Health Nursing
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    • v.28 no.4
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    • pp.262-270
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    • 2019
  • Purpose: This study aims to provide preliminary data for weight management, and prevention and management of cardiovascular and cerebrovascular diseases. We examined the effect of changes in the weight of workers at a manufacturing company over three years on their metabolic syndrome and metabolic syndrome diagnosis components. Methods: Necessary data were collected from the questionnaire and the results of the Korean National Health Screening of 2015 and 2017, which included 228 workers at a manufacturing company in G region. The collected data were analyzed using the SPSS/WIN 23.0 program. ANCOVA was used to examine the differences in the metabolic syndrome diagnosis components according to weight change. In addition, multiple logistic regression analysis was used to obtain the odds ratios of metabolic syndrome and metabolic syndrome analysis component, based on the weight changes in the normal weight group and the obesity group. Results: Waist measure, systolic blood pressure, and blood pressure were found to have significant effects based on participants' weight change over three years. These factors increased with a larger increase in weight at a statistically significant level. This study analyzed the weight changes of the normal weight group and the obesity group considering the data from the National Health Screening of 2015, and found that the risk of metabolic syndrome increased at a statistically significant level as body weight increased; thus, the obesity group showed a higher risk in this regard. It was also found that waist measure, fasting blood sugar, and high-density low cholesterol increased at a statistically significant level as body weight increased. Conclusion: Health administrators need to recognize the importance of workers' weight management, select an intensive management group based on a time series analysis of weight changes, and develop and implement programs to manage the metabolic syndrome diagnosis components.

Limitations and Improvement of Using a Costliness Index (진료비 고가도 지표의 한계와 개선 방향)

  • Jang, Ho Yeon;Kang, Min Seok;Jeong, Seo Hyun;Lee, Sang Ah;Kang, Gil Won
    • Health Policy and Management
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    • v.32 no.2
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    • pp.154-163
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    • 2022
  • Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

Changes in Quality of Care for Cesarean Section after Implementation of Diagnosis-Related Groups/Prospective Payment System (DRG 지불제도 도입 후 제왕절개술에서의 의료의 질 변화)

  • Kwon, Young-Hun;Hong, Du-Ho;Kim, Chang-Yup;Kim, Yong-Ik;Shin, Young-Soo;Yim, Jun
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.347-353
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    • 2001
  • Objectives : To determine the impacts of Diagnosis-Related Groups/Prospective Payment System (DRG/PPS) on the quality of care in cases of Cesarean section and to describe the policy implications for the early stabilization of DRG/PPS in Korea. Methods : Data was collected from the medical records of 380 patients who had undergone Cesarean sections in 40 hospitals participating in the DRG/PPS Demonstration Program since 1999. Cesarean sections were peformed in 122 patients of the FFS(Fee-For-Service) group and 258 patients of the DRG/PPS group. Measurements of quality used included essential tests of pre- and post-operation, and the PPI(Physician Performance Index) score. The PPI was developed by two obstetricians. Results : Univariate analysis demonstrated significant differences in PPI scores according to the payment systems. With respect to the mean of PPI scores, a higher score was found in the DRG/PPS group than in the FFS group. However, the adjusted effect did not show significant differences between the FFS group and the DRG/PPS group. Conclusion : This study suggested that the problem of poor quality may not be related to the implementation of DRG/PPS in Cesarean section. However, this study did not consider the validity and reliability of the process measurement, and it did not exclude the possibility of data emission in medical records.

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Update on polycystic ovary syndrome

  • Kim, Jin Ju
    • Clinical and Experimental Reproductive Medicine
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    • v.48 no.3
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    • pp.194-197
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    • 2021
  • Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4-6 based on a lower percentile of 85%-90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

Agricultural Drought Assessment and Diagnosis Based on Spatiotemporal Water Supply in Irrigated Area (필지단위 관개용수 공급에 따른 농업가뭄진단 평가)

  • Shin, Ji-Hyeon;Nam, Won-Ho;Kim, Ha-Young;Mun, Young-Sik;Bang, Na-Kyoung;Lee, Jueng-Chol;Lee, Kwang-Ya
    • Journal of The Korean Society of Agricultural Engineers
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    • v.63 no.4
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    • pp.1-12
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    • 2021
  • Agricultural drought is a natural phenomenon that is not easy to observe and predict and is difficult to quantify. In South Korea, the amount of agricultural water used is large and the types of use are varied, so even if an agricultural drought occurs due to insufficient precipitation, the drought actually felt in the irrigated area is it can be temporally and spatially different. In order to interpret the general drought in the past, drought disasters were evaluated using single indicators such as drought damage area, precipitation shortage status, and drought index, and a comprehensive drought management system is needed through drought diagnosis survey. Therefore, we intend to conduct research on agricultural drought assessment and diagnosis using re-evaluation of agricultural facilities and irrigation water supply network due to changes in various conditions such as climate change, irrigation canal network, and evaluation of water supply capacity of agricultural facilities. In this study, agricultural drought diagnosis was conducted on two agricultural reservoirs located in Sangju, Gyeongsangbuk-do, with structural or non-structural evaluations to increase spatiotemporal water supply and efficiency in terms of water shortages. The results of the agricultural drought diagnosis evaluation can be used to identify irrigated areas and canal network vulnerable to drought and to prioritize drought response.

Development of Personal Hypertension Management System Using PDA (PDA를 이용한 개인 심혈관리 시스템 개발)

  • Kwon, Seok-Young;Kwon, Mann-Jun;Park, Kyoung-Soon;Chun, Myung-Geun;Cha, Eun-Jong
    • Journal of the Korean Institute of Intelligent Systems
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    • v.17 no.5
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    • pp.718-723
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    • 2007
  • In this paper, we developed a personal hypertension management system (PHMS) having self-diagnosis function with PDA. The developed PHMS consists of five modules such as a personal information management, a life management, a food management, a sickness management, and network management modules. The personal information management module offers physical and fatness information as well as personal information. The life management module gives exercise and body mass index. The food management module includes caloric intake and the sickness management module renders a personal blood pressure and a subjective symptom. Finally, wireless networks are implemented for the network management. From these, it is possible to make a self diagnosis and be examined and treated remotely by sending the stored blood pressure related information to a medical doctor.

Myofascial Pain Syndrome in Chronic Back Pain Patients

  • Chen, Chee Kean;Nizar, Abd Jalil
    • The Korean Journal of Pain
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    • v.24 no.2
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    • pp.100-104
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    • 2011
  • Background: Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. Methods: This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. Results: The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS ($x^2$ = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P < 0.001) in Visual Analogue Score (VAS) and Modified Oswestry Disability Score (MODS) with standard management during three consecutive visits at six-month intervals. Conclusions: MPS prevalence among chronic back pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome.

The Corelation Analysis between Condition Evaluation Factors and Defect Index on the Concrete Retaining Wall (콘크리트 옹벽에 대한 상태평가 항목과 결함지수와의 상관관계 분석)

  • Seong, Joo Hyun;Byun, Yoseph;Lee, Dong Yul;Oh, Tae Keun
    • Journal of the Korean Society of Safety
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    • v.30 no.5
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    • pp.52-58
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    • 2015
  • Although lots of safety inspection and precision safety diagnosis have been conducted on concrete retaining wall, there is no comprehensive analysis on the basis of the accumulated data associated with the statistic. Especially, the concentrated management is necessary on the evaluation items that cause critical damages for the efficient performance. In this regard, this study conducted a correlation analysis between the 18 condition evaluation items and defect index for the concrete retaining wall as well as how each item affects the final defect index as much as in the manual. As a result, correlation coefficient between sliding and overturning was 0.601, which means that they have a strong correlation, and the most influential item on defect index is the condition of drainage that scored the 0.750 correlation coefficient. In addition, as a result of regression analysis, the condition of drainage with the 0.683 correlation coefficient has a strong correlation with the defect index. If the condition evaluation items are integrated or readjusted based on the results of the statistical analysis in this study, the more efficient and accurate maintenance will be possible.

Analysis of Factors Influencing Changes in Left Atrium and Left Ventricle Size in Adults (성인의 좌심방과 좌심실 크기변화에 미치는 영향 요인 분석)

  • Sun-Hwa Kim;Sung-Hee Yang
    • Journal of radiological science and technology
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    • v.47 no.2
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    • pp.125-135
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    • 2024
  • This study analysed the factors that predict and influence heart disease through key indicators related to changes in left atrial and left ventricular size. Measurements recommended by the American Society of Echocardiography were used, and the influence of variables was assessed using multiple regression analysis. The results showed that left atrial volume index(LAVI) was significantly different by age, obesity, diabetes, hypertension, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Left ventricular mass index(LVMI) was significantly different according to age, body mass index, hypertension, diabetes, dyslipidaemia, and left ventricular relaxation dysfunction(p<0.05). Increases in LVMI and relative ventricular wall thickness(RWT) were associated with changes in LAVI(p<0.05). Age, systolic blood pressure, increased LAVI, and RWT influenced changes in LVMI, and left ventricular dysfunction was analysed as an influencing factor for both changes in LAVI and LVMI. Therefore, changes in left atrial and left ventricular size are indicators for early diagnosis and prevention of heart disease, and it is necessary to carefully observe structural changes in the heart and actively manage risk factors for the prevention and management of heart disease.

Development and validation of an instrument to measure the health status of healthy but unsatisfied people : Mibyeong index(未病 index) (이상증상 기반 미병 분류도구의 신뢰도 및 타당도 연구)

  • Lee, Youngseop;Baek, Younghwa;Park, Kihyun;Jin, Hee-Jeong;Lee, Siwoo
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.3
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    • pp.45-53
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    • 2016
  • Objectives : The number of people in Mibyeong state that complain of physical and mental discomfort but without a clear medical diagnosis has rapidly increased, but the conventional medical system is insufficient to care for these people. By establishing an evaluation instrument for Mibyeong state, it will be possible to provide a research base for Mibyeong management system and expand the clinical area of integrative medicine. Methods : Mibyeong Index was designed to measure inconvenience and resilience of subject's complains including four physical symptoms (fatigue, pain, low sleep quality, indigestion) and mental distress include anxiety, anger, depression. A 21-item quality of healthy measure was developed and tested. We used results of a nation-wide stratified sampled adult data in Korea. Results and Conclusions : Mibyeong index had adequate internal consistency, Cronbach's alpha was 0.88 in general population(N=1,110). The correlation between establised quality of life questionnaires (including SF-12 and EQ-D5 VAS) and the Mibyeong index were from 0.468 to 0.493. The national promotion of advanced health for an aging society and original Mibyeong care technology based on traditional Korean medicine can be developed by a self-care system that enhancing health before suffering illness. We expect that this instrument could be contribute to health management of people in Mibyeong state.