• 제목/요약/키워드: Medical Services Value

검색결과 229건 처리시간 0.027초

119 구급대를 이용하여 야간에 응급실로 내원한 환자 현황 분석 - 전남대학교병원 응급의료센터를 중심으로 - (The present condition analysis of patients who transferred to the emergency room by 119 Rescue service at night - Focused on the Emergency Center of Chonnam National University Hospital -)

  • 윤종근;김건남;김경완;정용태
    • 한국응급구조학회지
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    • 제8권1호
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    • pp.117-126
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    • 2004
  • In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

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구급차량 내 전자파 방출에 관한 조사 (Research on the emission of electromagnetic waves in ambulance)

  • 윤종근
    • 한국응급구조학회지
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    • 제23권1호
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    • pp.61-69
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    • 2019
  • Purpose: The study aims to provide basic data to enhance the health of paramedics responsible for patient transport and treatment by analyzing the exposure level of paramedics to electromagnetic waves generated by electric devices used in ambulances. Methods: The study measured electromagnetic waves in ambulances in N region from July to December 2018. ME3030B produced by German Gigahertz Solutions was used to measure these waves and the maximum value was selected by moving it slowly in various directions. Each measurement part was selected and the mean value was calculated by repeatedly measuring at 10-minute intervals three times in total: $1^{st}$, $2^{nd}$, and $3^{rd}$ phase. Results: Among the electrical devices installed in the patient room of the ambulance measured at distances of 1 cm or 30 cm, results showed a high level of electric waves at the inverter ($26.25{\pm}39V/m$) and high level of electromagnetic waves ($564.00{\pm}31.75nT$) at the ozone sterilizer. According to measurements toward the front near the driver's seat, results indicated high levels of electric waves ($3.67{\pm}1.15V/m$) and electromagnetic waves ($450.00{\pm}19.52nT$) at the black box hard drive. Conclusion: Electromagnetic waves within the ambulance were stable and not beyond the range that might impact human health. However, in the case of the black box hard drive ($3.67{\pm}1.15V/m$, $450.00{\pm}19.52nT$) located under the passenger seat, it may have a direct effect on the human body and, thus it is necessary to move it to a storage area further away from the paramedics to minimized the impact.

응급통신관리 정보시스템 구축과 ASP 활용에 관한 연구 (A Study on the Development of Emergency Medical Dispatch Information System using ASP)

  • 최근명
    • 한국응급구조학회지
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    • 제6권1호
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    • pp.27-37
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    • 2002
  • The health and medical service attracts more public attention as the economy of Korea is rapidly growing up and the standard of living is elevated. Especially, the interest and demand on the prehospital emergency medical service that consists of the important part of primary medical service that is directly related to the life of patients are gradually increased. However, as compared with other advanced countries such as America in this area, Korea actually fell behind in the utilization of IT (Information Technology) to maximize the efficiency of emergency service system as well as has a problem in the general service system. This study suggested the necessity to introduce EMD (Emergency Medical Dispatch) system that takes a great role as the core part in the prehospital emergency medical service that is not systemized in Korea yet. In addition, this study proposed the implementation model of EMD ASP system using ASP (Application Service Provider) in EMD system to flexibly deal with the change of IT and efficient implementation and integration of information system as well as to significantly reduce cost through wire/wireless high speed Internet network that is politically promoted in Korea on the basis of EMD. The system analysis and design was executed by HIPO (Hierarchy Plus Input Process Output) analysis that was the conceptual design technology for EMD information system modeling based on ASP and DFD (Data Flow Diagram). This study proposed DB table configuration and data schema to implement the application of web browser interface in EMD system through ERD(ER-Diagram) of EMD ASP system. Finally, this study described how to implement and utilize EMD information system. This study aims to facilitate the qualitative development of emergency medical service in the future as suggesting the concrete models for the implementation of high value-added prehospital emergency medical information system as applying ASP concept to EMD system of prehospital emergency medical service area.

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구강악안면외과 의료행위 상대가치 개발에 대한 조사연구 (THE STUDY ON THE DEVELOPMENT OF RELATIVE VALUE IN MEDICAL TREATMENT OF THE ORAL AND MAXILLOFACIAL SURGERY)

  • 송진아;백경원;황종민;유순용;최진영
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제32권4호
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    • pp.334-347
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    • 2006
  • The aim of this study is to evaluate the reasonableness of the medical fee on oral and maxillofacial surgery field according to surgeon's opinions and actual conditions. The medical fee has significant influence on hospital income, the supply and distribution of medical manpower, quality and facilities of medical services. Questionnaire survey was sent to 86 oral and maxillofacial surgeons who worked more than 3 years in general hospital. Among them, 25 doctors replied the 109 answers survey and the average of treatment time and physician work relative value on each category was calculated. And the health insurance cost (that has been applied since 2003) was compared with the questionnaire results. And finally we investigated items that health insurance system did not include in oral and maxillofacial field but actually performed in oral and maxillofacial surgery clinic. The result was that the medical fee did not properly reflect physician work relative value of actual treatments. In case of complicated extraction, work relative value needed 3.5 times enhancement of present value. For simple impacted tooth extraction 1.8 times, for impacted tooth extraction including odontomy 1.7 times, and for fully impacted tooth more than 2/3 of it located into the alveolar bone, 1.8 times enhancement needed. In respect of the present physician work relative value, hemimandibulectomy with neck lymph node dissection for the malignancy is appropriated as 3.3 times of open reduction and internal fixation for the mandibular fracture, but the questionnaire result showed 25 times discrepancy. In conclusion, this research shows the need for intervention that health insurance included items and legal relative medical value must act in union with treatment in clinic to reduce the imbalance between them.

PACS 와 임상검사정보의 연동으로 인한 의사결정시스템; 크레아틴 수치정보전송으로 인한 조영제 부작용 예방 (A decision support system the interface between PACS and Laboratory Information)

  • 김선칠;조훈
    • 대한디지털의료영상학회논문지
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    • 제9권1호
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    • pp.17-19
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    • 2007
  • This study applies in case of operating an exam using by the contrast order or inputting an order of a contrast media the exam of Radiology Department. It is developed for helping decision making as regards a process of an exam from reading the creatinine value automatically linked with Laboratory Information System. It can be confirmed by real-time information; therefore, the creditability of the information is able to be improved. We will create the base for Patient Monitoring System with the data from the side effect of the creatinine value and allergies. Decision Support System minimize the inconvenience and the riskiness of the given contrast medium for CT tests. We would like to improve medical services by providing a standard circumstance where patients are able to run tests safely and comfortably.

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Immunohistochemical Profile of Breast Cancer Patients at a Tertiary Care Hospital in New Delhi, India

  • Doval, Dinesh Chandra;Sharma, Anila;Sinha, Rupal;Kumar, Kapil;Dewan, Ajay Kumar;Chaturvedi, Harit;Batra, Ullas;Talwar, Vineet;Gupta, Sunil Kumar;Singh, Shailendra;Bhole, Vidula;Mehta, Anurag
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권12호
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    • pp.4959-4964
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    • 2015
  • Background: To assess the immunohistochemical expression of estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor-2 (HER2) neu receptor in breast cancer and their associations with various clinicopathological characteristics. Materials and Methods: This is a retrospective analysis of women who presented with primary, unilateral breast cancer in the Department of Medical Oncology at Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India during the period from January 2008 to December 2011. Data were retrieved from the medical records of the hospital including both early and locally advanced cancer cases. ER, PgR and HER2neu expression in these patients was assessed and triple negative patients were identified. Associations of triple negative and non-triple negative groups with clinicopathological characteristics were also evaluated. Results: A total of 1,284 women (mean age 52.1 years, 41.9% premenopausal) were included in the analysis. Hormone receptor positivity (ER and/or PgR) was seen in 63.4% patients, while 23.8% of tumors were triple negative. Only 23.0% were HER2 positive. Around 10.0% of tumors were both ER and HER2 positive. ER and PgR positivity was significantly associated with negative HER2 status (p-value <0.0001). Younger age, premenopausal status, higher tumor grade, lymph node negativity, advanced cancer stage, and type of tumor were strongly associated with triple negativity. Significantly, a smaller proportion of women had ductal carcinoma in situ in the triple negative group compared with the non-triple negative group (35.6% versus 60.8%, p-value<0.01). Conclusions: The present analysis is one of the largest studies from India. The majority of the Indian breast cancer patients seen in our hospital present with ER and PgR positive tumors. The triple negative patients tended to be younger, premenopausal, and were associated with higher tumor grades, negative lymph nodes status and lower frequency of ductal carcinoma in situ.

Development of Patients Environmental Sustainability Performance in Healthcare Sector: A Conceptual Framework and Further Research Directions

  • KIM, Eunsung
    • 유통과학연구
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    • 제17권7호
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    • pp.99-109
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    • 2019
  • Purpose - The purpose of this development the business model of the healthcare sector in order to promote patents satisfaction towards medical sector services improvement for the medical business model innovation to possess a competitive advantage in the medical and pharmaceutical industry. Research design, data, and methodology - Safety standard protocol from existing multidisciplinary literature is a process of theorization, which uses grounded theory methodology rather than a description of the data and the targeted phenomenon by using Jabareen (2009). The first task is to map the spectrum of food safety literature regarding the phenomenon in safety management. This process includes developing the implementation factors and other sources such as existing business models and practices into the protocol design. Results - The study suggests the conceptual framework to improve the safety management for patients' environmental sustainability performance. Conclusion - The business model may support the beneficial aspect to healthcare government's policymakers, hospital employees, and medical specialist who can apply the practical perspective of its value regarding an educational protocol. Originality/value - This study contributes to and extends our understanding of environmental sustainability performance, identifying the rationale for safety standards performance in the healthcare industry with suggested hybrid safety standards market consumer interconnector.

관상동맥질환 치료를 위한 시롤리무스 방출 스텐트 ($CYPHER^{TM}$)의 경제성 분석 (Economic Value of the Sirolimus Eluting Stent($CYPHER^{TM}$) in Treating Acute Coronary Heart Disease)

  • 이후연;박은철;박기동;박지은;김영;이상수;강혜영
    • Journal of Preventive Medicine and Public Health
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    • 제36권4호
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    • pp.339-348
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    • 2003
  • Objective : To quantify the economic value of the Sirolimus fluting Stent ($CYPHER^{TM}$) in treating acute coronary heart disease (CMD), and to assist in determining an adequate level of reimbursement for $CYPHER^{TM}$ in Korea. Methods : A decision-analytical model, developed by the Belgium Health Economics Disease Management group, was used to investigate the incremental cost-effectiveness of $CYPHER^{TM}$ versus conventional stenting. The time horizon was five years. The probabilities for clinical events at each node of the decision model were obtained from the results of large, randomized, controlled clinical trials. The initial care and follow-up direct medical costs were analyzed. The initial costs consisted of those for the initial procedure and hospitalization, The follow-vp costs included those for routine follow-up treatments, adverse reactions, revascularization and death. Defending on the perspective of the analysis, the costs were defined as insurance covered or total medical costs (=sum of insurance covered and uncovered medical costs). The cost data were obtained from the administrative data of 449 patients that received conventional stenting from five participating Korean hospitals during June 2002. Sensitivity analyses were peformed for discount rates of 3, 5 and 7%. Since the major clinical advantage of $CYPHER^{TM}$ over conventional stenting was the reduction in the revascularization rates, the economic value of $CYPHER^{TM}$, in relation to the direct medical costs of revascularization, were evaluated. If the incremental cost of $CYPHER^{TM}$ per revascularization avoided, compared to conventional stenting, was no higher than that of a revascularization itself, $CYPHER^{TM}$ would be considered as being cost-effective. Therefore, the maximum acceptable level for the reimbursement price of $CYPHER^{TM}$ making the incremental cost-effectiveness ratio equal to the cost of a revascularization was identified. Results : The average weighted initial insurance covered and total medical costs of conventional stenting were about 6,275,000 and 8,058,000 Won, respectively. The average weighted sum of the initial and 5-year follow-up insurance covered and total medical costs of conventional stenting were about 13,659,000 and 17,353,000 Won, respectively. The estimated maximum level of reimbursement price of $CYPHER^{TM}$ from the perspectives of the insurer and society were $4,126,897{\sim}4,325,161$ and $4,939,939{\sim}5,078,181$ Won, respectively. Conclusion : By evaluating the economic value of $CYPHER^{TM}$, as an alternative to conventional stenting, the results of this study are expected to provide a scientific basis for determining the acceptable level of reimbursement for $CYPHER^{TM}$.

보건진료원 활동의 비용-편익 분석 (Cost-Benefit Analysis on Community Health Practitioner)

  • 이태화;고일선
    • 대한간호학회지
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    • 제32권4호
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    • pp.435-446
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    • 2002
  • Purpose : The purpose of the study were to describe outcomes of CHP activities, and to evaluate the economic validity of CHP through a cost-benefit analysis. Method : The sample size was 272. Data were collected using a researcher developed questionnaire from November 1999 to March, 2000. Result : The mean age of CHPs was 39.6 (SD-36). In regard to marital status, 90.8% of the respondents were married. 72% of the CHPs had associate degree. Among CHP activities, providing medical services was 50%, followed by home care visits 20% and health promotion services 20%, preventive services 10%. Total costs per month incurred to CHP activities was \3,053,437($2,442.7). Total benefits per month was \6,711,525($5,369.2). Hence, net benefit was calculated as \3,658,089($2,926). Conclusion : Cost-benefit ratio was 2.20, which provides the evidence of the economic viability of CHP program. The result of cost-benefit analysis, however, would more strongly support the economic value of CHP if intangible benefits of CHP activities such as decreases in pain and suffering and increased quality of life, could be counted.