• Title/Summary/Keyword: Medical Procedures

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Comparative Analyses of the Clinical Characteristic and Medical Cost against Surgical Procedures for Intertrochanteric Fracture in the Elderly Patients (노인의 대퇴전자간 골절의 수술적 방법에 따른 임상적 특성 및 의료비용 비교)

  • Choi, Mi-Na
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.2
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    • pp.199-207
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    • 2007
  • Purpose: Clinical characteristics and medical cost were analyzed according to the surgical procedures for intertrochanteric fracture in aged patients to assess the appropriateness of treatment expense and to find possibility of reducing the medical cost. Method: Variable for the statistical analysis were; the clinical characteristics, medical cost according to the surgical procedures, the treatment success rate, the total medical expense, and the average expense per case. SAS Package Version 8.02. was used to analyze the relevant data. Results: Operative procedures differ significantly according to the gender and by the location of institution. Only significant clinical variables according to the operative procedure were duration of general anesthesia and amount of blood transfusion. Average cost per treatment was the highest in the bipolar hemiarthroplasty followed by the gamma nail and hip compressing screw. Average cost for bipolar hemiarthroplasty was significantly higher than other surgical procedures. Conclusions: The difference in hospital costs for treatment of intertrochanteric fracture originates from the utilized surgical procedures, mostly by the materials used. The method of surgical treatment should be carefully determined by the purpose of the surgery, in order to improve the quality of medical care and also to reduce the hospital cost.

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Benefits of the Various Pain Procedures as Therapeutic Option in Low Back Pain

  • Kim, Jung-Hee;Kong, Min-Ho;Hong, Hyun-Jong;Song, Kwan-Young;Kang, Dong-Soo
    • Journal of Korean Neurosurgical Society
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    • v.39 no.3
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    • pp.204-209
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    • 2006
  • Objective : The authors retrospectively evaluate the benefits of the various pain procedures for the treatment of low back pain unresponsive to conservative management. Methods : Over a period of 2 years from May 2002 and June 2004, the authors had performed various pain procedures on 106 patients with low back pain. Epidural block, facet joint block, sacroiliac joint block, and myofascial block were included among various pain procedures. The pain improvement, period of analgesic use, and degree of satisfaction were evaluated 1 day, 4 weeks, and 6 months after injections. The outcome of pain procedures was analyzed by using a modified Macnab criteria. Results : Sixty-four patients had a single procedure with no combination and 42 patients [39.6%] received the combination of the various pain procedure. Regardless of the single or combination cases of procedure, combination of appropriate spinal level on each procedure was conducted in 104 [98.1%]. Mean follow up period was 12.2 months. Eighty-two patients [77.4%] experienced significant pain relief and overall analgesic medication was reduced in 91 patients [85.8%] at 6 months after procedure. Unfavorable results were demonstrated in 10 patients. Permanent procedural complications did not occur. Conclusion : The various pain procedures are the possible therapeutic option for low back pain unresponsive to conservative management including medication or physical therapy.

Establish Selection Process of Performance Management Medical Devices and Test items Based on Risk Management (위험관리기반의 성능관리 의료기기 선정 절차 수립 및 시험 항목 도출)

  • Park, Ho Joon;Jang, Joong Soon
    • Journal of Biomedical Engineering Research
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    • v.40 no.1
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    • pp.20-31
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    • 2019
  • Medical device performance management is an activity that allows a device to be safely used and maintained even after it is put on the market. The purpose of this study is to provide procedures and criteria for selection of medical device items that should manage the safety and performance among medical devices in hospital. Investigate the performance management status of medical devices in hospitals and identify the performance management status by domestic and advanced regulatory agencies. Provides selection procedures and test methods for medical devices subject to performance management in hospitals based on medical device risk management and reliability. In addition, a case study on drug infusion pumps was conducted.

The Development of Classification System of Medical Procedures in Korea (한국표준의료행위 분류체계 개발)

  • Park, Hyoung-Wook;Sohn, Myong-Sei;Kim, Han-Joong;Park, Eun-Cheol;Yu, Seung-Hum
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.4 s.55
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    • pp.877-897
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    • 1996
  • In recent years, the Korean Medical Association has undertaken the feat of establishing the Korean Standard Terminology of Medical Procedures with the dedicated help of 32 medical academic societies. However, because the project is being conducted by several different circles, it has yet to see a clear system of classification. This thesis, therefore, proposes the three principles of scientific properties, usefulness and ideology as the basis for classification system and has developed the Classification System of Medical Procedures in Korea upon their foundation. The methodology and organization of this thesis as follows. First, by adopting scientific classification system of Feinstein(1988), an analysis of the classification systems of the medical procedures in the United States, Japan, Taiwan, WHO was carried out to reveal the framework and the basic principles in each system. Second, the direction of classification system has been constructed by applying the normative principle of medical field in order to show the future direction of the medical field and realize its ideology. Third, a finalized framework for the classification system will be presented as based on the direction of classification system. Of the three basis principles mentioned above, the analysis on the principles of usefulness was left out of this thesis due to the difficulty of establishing specific standards of analysis. The results of the study are as follows. The overall structure of the thesis is aimed at showing the 'Prevention-Therapy-Rehabilitation' quality of comprehensive health care and consists of six chapters; I. Prevention and Health Promotion II. Evaluation and Management III. Diagnostic Procedures IV. Endoscopy V. Therapeutic Procedures VI. Rehabilitation Chapter three Diagnostic Procedures is divided into four parts : Functional Diagnosis, Visual Diagnosis, Pathological Diagnosis, Biopsy and Sampling. Chapter five Therapeutic Procedures is divided into Psychiatry, Non-Invasive Therapy, Invasive Therapy, Anaesthesia and Radiation Oncology. Of these sub-divisions, Functional Diagnosis, Biopsy and Sampling, Endoscopy and Invasive Therapy employs the anatomical system of classification. On the other hand, Visual Diagnosis, Pathological Diagnosis, Anesthesia and Diagnostic Radiology, namely those divisions in which there is little or no overlapping in services with other divisions, used the classification system of its own division. The classification system introduced in this thesis can be further supplemented through the use of the cluster analysis by incorporating the advice and assistance of other specialists.

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A Study on the Indications for Various Types of Physical Procedures and the Prognoses for Fevers in "Maekgyeong(脈經)" Vol.VII ("맥경(脈經)"권제칠(卷第七) 온(溫).구(灸).자(刺).수(水).화법(火法)의 적응증(適應證)과 열병(熱病)의 예후(豫後에 대한(對) 연구(硏究))

  • Kwon, Mi-Ja;Du, Ja-Sung;Ahn, Jun-Mo;Jeong, Heon-Young;Keum, Kyung-Soo;Park, Kyung
    • Journal of Korean Medical classics
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    • v.21 no.3
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    • pp.307-355
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    • 2008
  • This thesis make a study on the sixteen chapters from 9 to 24 of "Maekgyeong(脈經)" Vol.Ⅶ. In this volume indications for several curative procedures, especially physical procedures, prognoses for fevers and symptoms hard to cure such as Eumyanggyo(陰陽交) are reviewed by Wang(王). The physical procedures include acupuncture, moxibustion, hydrotherapy, thermotherapy etc. The contents mainly quoted from "Sanghallon(傷寒論)", "Geumgweyoryak(金匱要略)", "Yeongchu(靈樞)" and "Somun(素問)".

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An Implementation of Intefrated Database for Electronic Medical Record System in East-West Medical Collabration (${\cdot}$양방 협진 전자의무기록 시스템 구축을 위한 통합 데이터베이스 구축)

  • Ahn, Yo-Chan;Oh, Sang-Bong
    • Journal of Information Technology Applications and Management
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    • v.12 no.2
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    • pp.129-143
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    • 2005
  • In recent years, two major streams in medical information systems are:1) system integration among OCS(Order Communication System), EMR(Electronic Medical Record), PACS(Picture Archiving and Communication System), and ERP(Enterprise Resource Planning) and 2) system integration through medical collaboration between East and West medical service providers. One of the characteristics which differentiate the Korean medical industry from the western medical industry is the East-West medical collaboration. In many respects there are many differences between East and West medical treatment. Although East and West medical treatment have developed from different medical philosophies and standards, we assume that the better medical care can be provided by integrating their medical procedures effectively. The two possible approaches to the integration of East and West medical information systems are suggested in this paper:One is loosely coupled model and the other is tightly coupled model. EMR improves the quality of medical record which reflects the quality of clinical practice. It provides more efficient and convenient way of input, retrieval, storage, communication and management of medical data. We abstracted the standard medical procedures from the two medical procedures performed in Daejeon Oriental Hospital and Hehwa Clinic at Daejeon University and also abstracted database schema by analyzing the characteristics of information needed in East-West medical collaboration. Our EMR is composed of two types of data:one is structured data and the other is unstructured data, which are formalized by SOAP(Subjective, Objective, Assessment, Plan) format. Currently the integrated system is implemented and operated successfully for six months.

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Evaluation of musculoskeletal disorders risk of 119 emergency medical technicians during emergency medical services procedures in firefighter combat challenge (119 구급대원의 근골격계 질환 위험성 평가 - 소방기술경연대회 구급종목을 대상으로 -)

  • Son, Jeong-Won;Park, Jae-Bum
    • The Korean Journal of Emergency Medical Services
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    • v.21 no.3
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    • pp.59-71
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    • 2017
  • Purpose: The purpose of the study was to evaluate the ergonomic risk factors of 119 emergency medical technicians (EMT) with musculoskeletal disorders, performing emergency medical services (EMS) procedures in a firefighter combat challenge. Methods: The evaluated EMT procedures were cardiopulmonary resuscitation (CPR) & intubation, trauma patient assessment, and intravenous (IV) injection. Measurement of working posture was done during training. Results: In CPR & intubation, OWAS-score was 2 (mean 1.9, maximum 4), requiring correction action, while REBA-score was 11 (mean 7.28, maximum 11), requiring immediate improvement. In trauma patient assessment & IV injection, OWAS-score was 4 (mean 2.9, maximum 4), requiring immediate correction action, while the REBA score was 7 (mean 7.5, maximum 11), requiring improvement. Conclusion: Both OWAS score and REBA-score showed improvement of posture and high-risk of musculoskeletal disorders. Occupational health management in EMS procedures during combat challenge and effective injury prevention program in fire stations are warranted.

Efficacy of Korean Medicine Combination Treatment on Recurrent Neck Pain After Medical Procedures: A Retrospective Study

  • Huh, Hyo-Seung;Jeong, Wu-Jin;Park, Ki-Tae;Lee, Sun-Ho;Kim, Sun-A;Kim, Min-Kyung;Kim, Hye-Gyeong
    • Journal of Acupuncture Research
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    • v.38 no.1
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    • pp.32-40
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    • 2021
  • Background: The aim of this study was to evaluate the efficacy of Korean medicine combination treatment on recurrent neck pain after medical procedures. Methods: This retrospective study included 158 inpatients of the Daejeon Jaseng Hospital of Korean Medicine who were diagnosed with "Cervical disc disorder with radiculopathy (M50.1)" between December 14th, 2017 and May 29th, 2019. The patients were assigned to 1 of 2 groups based on whether they received medical procedures on the cervical spine at least once. Korean medicine combination treatment was evaluated using EuroQol-5 dimensions index (EQ-5D), numeric rating scale (NRS), and neck disability index (NDI) scores. Results: Before and after treatment, the patients who received medical procedures on the cervical spine at least once before admission (Group A) showed a statistically significant difference in the NDI and NRS scores but not in the EQ-5D scores. This was similar to the patients who had not received medical procedures on the cervical spine before admission (Group B) they showed a statistically significant difference in the NDI and NRS scores but not in the EQ-5D scores. When comparing the results of Group A and Group B before and after treatment, no statistically significant differences were observed in the EQ-5D, NDI, and NRS scores. Conclusion: Korean medicine combination treatment improves the neck functional disability of patients who suffer from recurrent neck pain despite patients having undergone medical procedures.

Infantile Hepatic Hemangioma: Avoiding Unnecessary Invasive Procedures

  • Ernst, Lukas;Grabhorn, Enke;Brinkert, Florian;Reinshagen, Konrad;Konigs, Ingo;Trah, Julian
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.72-78
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    • 2020
  • Infantile hepatic hemangioma, the most common vascular tumor of the liver in infancy, can occur with acute postnatal liver and congestive heart failure. Nevertheless, its course is often benign, and many children can be diagnosed and treated without surgical intervention. The distinction from malignant diseases is not always easy and it not clear whether invasive procedures for diagnosis and therapy should be performed. Here we report our experiences in our Center for Pediatric Liver Disease and postulate that large studies are needed to avoid unnecessary invasive procedures for these patients in the future.

Is Diabetes a Contraindication to Lower Extremity Flap Reconstruction? An Analysis of Threatened Lower Extremities in the NSQIP Database (2010-2020)

  • Amy Chen;Shannon R. Garvey;Nimish Saxena;Valeria P. Bustos;Emmeline Jia;Monica Morgenstern;Asha D. Nanda;Arriyan S. Dowlatshahi;Ryan P. Cauley
    • Archives of Plastic Surgery
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    • v.51 no.2
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    • pp.234-250
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    • 2024
  • Background The impact of diabetes on complication rates following free flap (FF), pedicled flap (PF), and amputation (AMP) procedures on the lower extremity (LE) is examined. Methods Patients who underwent LE PF, FF, and AMP procedures were identified from the 2010 to 2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP®) database using Current Procedural Terminology and International Classification of Diseases-9/10 codes, excluding cases for non-LE pathologies. The cohort was divided into diabetics and nondiabetics. Univariate and adjusted multivariable logistic regression analyses were performed. Results Among 38,998 patients undergoing LE procedures, 58% were diabetic. Among diabetics, 95% underwent AMP, 5% underwent PF, and <1% underwent FF. Across all procedure types, noninsulin-dependent (NIDDM) and insulin-dependent diabetes mellitus (IDDM) were associated with significantly greater all-cause complication rates compared with absence of diabetes, and IDDM was generally higher risk than NIDDM. Among diabetics, complication rates were not significantly different across procedure types (IDDM: p = 0.5969; NIDDM: p = 0.1902). On adjusted subgroup analysis by diabetic status, flap procedures were not associated with higher odds of complications compared with amputation for IDDM and NIDDM patients. Length of stay > 30 days was statistically associated with IDDM, particularly those undergoing FF (AMP: 5%, PF: 7%, FF: 14%, p = 0.0004). Conclusion Our study highlights the importance of preoperative diabetic optimization prior to LE procedures. For diabetic patients, there were few significant differences in complication rates across procedure type, suggesting that diabetic patients are not at higher risk of complications when attempting limb salvage instead of amputation.