• 제목/요약/키워드: Medical care services

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A Study of Evaluation Index Development of Healthcare Rehabilitation Device Design (헬스케어 재활훈련기 디자인 평가 요소 개발에 관한 연구)

  • Cho, Jae Sang;Kwon, Tae Kyu;Hong, Jung Pyo
    • Science of Emotion and Sensibility
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    • v.17 no.3
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    • pp.129-142
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    • 2014
  • Due to the increase of the aged population and population of the disabled today, there is a growing demand for rehabilitation medical instruments. Furthermore, there is a growing demand for evaluation indices for services that should be provided for uses of the rehabilitation medical instruments. In order to evaluate rehabilitation medical instrument designs in this study, the basic index for design evaluations shall be identified to search for assessment plans. Through this, new evaluation indices will be deduced through discussions and analysis of rehabilitation medical experts, biomedical engineers, and designers. The results of this study are summarized as follows. First, the existing design evaluation indices were collected and analyzed to construct 10 rehabilitation medical instrument design evaluation indices and 44 sub-evaluation items. These will be important evaluation standards for designing rehabilitation medical instruments in the future. Second, the design evaluation indices that must be taken into consideration when developing health care rehabilitation medical instruments are the 10 design evaluation indices of usability, cognition, safety, learning, motility, durability, economic feasibility, space, aesthetics and environmental aspects. Third, design evaluation indices of environment, space, cognition, usability, economic feasibility and aesthetics are indices that must be taken into consideration for product design, while learning, safety, motility and durability are factors that must be given special consideration for rehabilitation medical instrument design evaluation indices. Fourth, if existing product design evaluation indices placed importance on environment, space, cognition, usability, economic feasibility and aesthetics of products for design evaluation indices, rehabilitation medical instrument design evaluation indices placed importance on learning, safety, motility and durability on top of usability and economic feasibility, which are the differences between the design evaluation indices of rehabilitation medical instrument and other product designs. The 10 rehabilitation medical device design evaluation indices and 44 sub-evaluation items were carried out in this study. This research is only on the overall rehabilitation medical device design evaluation indices. In future research, the evaluation indices will be applied in the actual rehabilitation medical design device through production of prototypes, while making revisions and supplementations where necessary.

Clinical Characteristics and Prognosis of Elderly Patients Receiving Prolonged Mechanical Ventilation in the Medical Intensive Care Unit at a University Hospital (한 대학병원 내과계 중환자실에서 장기간 기계환기를 받은 노인 환자들의 특징 및 예후)

  • Han, Min Soo;Moon, Kyoung Min;Lee, Yang Deok;Cho, Yongseon;Na, Dong Jib
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.6
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    • pp.445-450
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    • 2008
  • Background: As the number of older-aged people increases, the number of elderly patients who receive critical care services is expected to increase substantially. The objective of this study was to examine the clinical characteristics and outcomes of elderly patients who receive mechanical ventilation for more than 30 days in the medical intensive care unit (MICU) at a university hospital. Methods: We retrospectively examined forty-one elderly patients (${\geq}65$ years old) who were receiving mechanical ventilation, from April 2004 to March 2007, for periods exceeding 30 days at the MICU at Eulji University Hospital. Results: The MICU and hospitalmortality rate were 60.9% and 65.9%, respectively. The mean length of the ICU stay was 57.5 days and the mean duration of mechanical ventilation was 49.3 days. The most common reason for MICU admission was acute respiratory failure (73.2%), followed by sepsis (12.2%), neurological problems (9.8%), and gastrointestinal bleeding (4.9%). The Acute Physiology and Chronic Health Evaluation (APACHE) II scores were higher for the nonsurvivors than for the survivors (28.0 vs. 25.0, respectively, p=0.03). The nonsurvivors received more red blood cell (RBC) transfusions during their ICU stay than did the survivors (84.0% vs. 43.8%, respectively p=0.007). The factors associated with hospital death were the APACHE II score and if the patient had received a RBC transfusion. Conclusion: The APACHE II score and a RBC transfusion were predictors of increased hospital mortality for the elderly patients who were on prolonged mechanical ventilation. These predictors may assist physicians to make clinical decisions for this patient population.

A Study on the Effects of Risk Factors and Protection Factors of Care givers on Job Change Intention: Focused on the Mediation Effect of Occupational Adaptation (요양보호사의 위험요인과 보호요인이 이직의도에 미치는 영향 연구: 직업적응의 매개효과 중심으로)

  • Park, Su Jan;Kim, Youn Jae
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.13 no.2
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    • pp.159-175
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    • 2018
  • The purpose of this study was to identify the factors that could overcome the crisis and adversity of the nursing care provider through understanding the effect of job adaptation on the turnover intention of the nursing care provider and to contribute to the various problems of the nursing care provider in the long term. In order to confirm this as an empirical research task, risk factors and protection factors, general characteristics of the survey subjects, job adaptation and turnover intention were selected, and the risk factors and protective factors of caregivers' As a mediator. So Seoul. The results of the questionnaire survey were as follows: 291 caregivers in the elderly medical welfare facilities in Gyeonggi area. First, as the relationship between the risk factors and protective factors of occupational caregivers and occupational adaptation were more severe, the higher the maladjustment of the workplace culture, the more the job satisfaction and organizational commitment were adversely affected. The emotional support, The higher the information support, the more satisfied and satisfied the job. Second, the relationship between the risk factors of the caregiver and the protective factors and the turnover intention, the higher the conflict of caregivers, the more unstable the workplace, the more difficult it is to adapt to work culture, Respectively. Finally, as a result of verifying the mediating effect of occupational adaptation on the relationship between risk factors and protective factors and turnover intention of caregivers, job satisfaction, which is a sub-factor of job adaptation, It is shown that they play mediating roles only in the relationship between stress and turnover intention, and do not play a mediating role in the relationship between protective factor self - efficacy and social support and turnover intention. In other words, if caregivers feel satisfaction about their job, they can be less stressed on their jobs, improve their self-efficacy, and have a positive attitude toward social support. Also, it was found that the more the caregiver 's immersion into the organization, the less job stress and turnover intention decreased, but the self - efficacy and social support perception were not influenced. Based on this, the director of the facility should strive to stabilize the operation of the facility and provide high-quality services by seeking ways to improve conflict resolution and adaptation to the workplace culture so that nursing care workers can adapt to their work. And it is required to develop active management strategies and institutional support for improving job satisfaction and organizational commitment of caregivers.

A Study on Current State of Web Content Accessibility on General Hospital Websites in Korea (국내 종합병원의 웹 접근성 실태에 관한 연구)

  • Kim, Yong-Seob;Oh, Kun-Seok
    • Journal of Internet Computing and Services
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    • v.11 no.3
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    • pp.87-103
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    • 2010
  • In the study, we introduce the trend in domestic and foreign web accessibility, as well as the legal system that ensures web accessibility. Based on Korean Web Content Accessibility Guidelines (KWCAG)1.0, we investigated the web content accessibility of 80 tertiary health-care hospitals and general hospitals in Korea. We evaluated accessibility by combining accessibility-based criteria (ABC) with usability-based criteria (UBC). ABC was limited to an alternative text for Guideline 1, using a small number of frames and keyboard accessibility for Guideline 2. UBC checked the voice service (TTS), resizing text, providing multi-lingual websites, and disclosing web accessibility policy. KADO-WAH2.0 was used for representing the compliance rate. The evaluation result was a considerable improvement from previous results, even though the rate of compliance with web accessibility was generally insufficient. There was a significant difference between those medical centers which did and did not comply with web accessibility. Incidentally, many hospitals were found to have attempted to confront and come to terms with web accessibility. In future, the following factors are advisable for medical centers with publicity or public interest: they must employ active and aggressive promotion of establishment of independent accessibility guidelines to secure web accessibility, they should effect an improvement of the realization of web accessibility, there can be constant education and promotion, and there can be an institutional supplementation, as well as others.

Significantly Low Effective Dose from 18FDG PET/CT Scans Using Dose Reducing Strategies: "Lesser is Better"

  • uz Zaman, Maseeh;Fatima, Nosheen;Zaman, Areeba;Zaman, Unaiza;Tahseen, Rabia
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3465-3468
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    • 2016
  • Background: Fluorodeoxyglucose ($^{18}FDG$) PET/CT imaging has become an important component of the management paradigm in oncology. However, the significant imparted radiation exposure is a matter of growing concern especially in younger populations who have better odds of survival. The aim of this study was to estimate the effective dose received by patients having whole body $^{18}F$-FDG PET/CT scanning as per recent dose reducing guidelines at a tertiary care hospital. Materials and Methods: This prospective study covered 63 patients with different cancers who were referred for PET/CT study for various indications. Patients were prepared as per departmental protocol and 18FDG was injected at 3 MBq/Kg and a low dose, non-enhanced CT protocol (LD-NECT) was used. Diagnostic CT studies of specific regions were subsequently performed if required. Effective dose imparted by 18FDG (internal exposure) was calculated by using multiplying injected dose in MBq with coefficient $1.9{\times}10^{-2}mSv/MBq$ according to ICRP publication 106. Effective dose imparted by CT was calculated by multiplying DLP (mGy.cm) with ICRP conversion coefficient "k" 0.015 [mSv / (mG. cm)]. Results: Mean age of patients was $49{\pm}18$ years with a male to female ratio of 35:28 (56%:44%). Median dose of 18FDG given was 194 MBq (range: 139-293). Median CTDIvol was 3.25 (2.4-6.2) and median DLP was 334.95 (246.70 - 576.70). Estimated median effective dose imparted by $^{18}FDG$ was 3.69 mSv (range: 2.85-5.57). Similarly the estimated median effective dose by low dose (non-diagnostic) CT examination was 4.93 mSv (range: 2.14 -10.49). Median total effective dose by whole body 18FDG PET plus low dose non-diagnostic CT study was 8.85 mSv (range: 5.56-13.00). Conclusions: We conclude that the median effective dose from a whole body 18FDG PET/CT in our patients was significantly low. We suggest adhering to recently published dose reducing strategies, use of ToF scanner with CT dose reducing option to achieve the lower if not the lowest effective dose. This would certainly reduce the risk of second primary malignancy in younger patients with higher odds of cure from first primary cancer.

Measure of Agreement between Prehospital EMS Personnel and Hospital Staffs using Guidelines for Field Triage of Injured Patients (외상환자의 병원 전 및 병원단계 중증도 평가의 일치도)

  • Kim, Dae Kon;Hong, Ki Jeong;Noh, Hyun;Hong, Won Pyo;Kim, Yu Jin;Shin, Sang Do;Park, Ju Ok
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.126-132
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    • 2014
  • Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

Financial performance analysis based on efficiency evaluation of Regional Public Hospital (지방의료원의 운영효율성 평가에 따른 재무성과 분석)

  • Lee, Jin-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.614-623
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    • 2017
  • The purpose of this study is to analyze the impact of the financial performance of regional public hospitals on their efficiency. In addition, the analysis of their efficiency using environmental factors, such as the market share, operating mode, and size of the regional public hospitals, as well as the factors influencing their efficiency, are selected by selecting the input and output factors of the hospitals and some differences were found between them. The DEA index and financial performance of the 31 regional public hospitals were calculated for the three years from 2012 to 2014. ANOVA and hierarchical regression analysis were used. As a result, there was a significant difference in their efficiency according to the environmental factors, such as the city scale of the regional public hospital, the number of hospital beds, and their business performance, productivity, and publicness. The medical profit margin (p<0.05), labor cost investment efficiency (p<0.05) and HHI (p<0.05) were found to affect the efficiency. In order to identify the inefficiencies of the regional public hospitals and increase their efficiency, it is necessary to measure the efficiency of the input resources and to reduce their cost. In addition, if the regional public hospitals were to provide specialized services, such as specialized functions of medical care that would give them a competitive advantage over private hospitals, their operational efficiency would be enhanced and they would be able to fulfill their role as public medical institutions.

A Study on the Analysis of China's Telemedicine Industry from the Perspective of the Industrial Innovation System and its Implications for Korea (산업혁신체제 관점에서의 중국의 원격의료 산업 분석과 국내로의 함의점 연구)

  • Kim, Mikyung;Zhang, Yi
    • The Journal of the Korea Contents Association
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    • v.21 no.3
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    • pp.441-453
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    • 2021
  • Recently, the untact healthcare industry due to COVID-19 has been attracting attention, and the telemedicine industry based on medical information has become a field of the healthcare industry receiving attention. However, in Korea, due to obstacles in the legal system, telemedicine is still illegal between doctors and patients. In the case of neighboring China, the reality is the opposite of the recent rapid growth of the telemedicine industry under the leadership of the government. This study looks at this from the perspective of the industrial innovation system on the grounds that telemedicine is an industry and innovative technology needs to be changed to clarify the difference between domestic and Chinese telemedicine industries. As a result of analyzing China's telemedicine industry on the seven sub-divisions of demand conditions, innovators, networks et al., Such as seizing appropriate opportunities for demand driving effects and appropriate communication between economic actors were identified as major success factors. This researcher proposes the following suggestions. first, it conforms to the current digital New Deal policy flow, and conducts a demand survey on the change in demand for medical services in the 4th Industrial Revolution and the Untact Era. For the introduction, a plan to conduct a demand survey for the public and second, second, a plan to grow and intensively foster digital high-tech medical care as a new industry was suggested.

Extended Adaptation Database Construction for Oriental Medicine Prescriptions Based on Academic Information (학술 정보 기반 한의학 처방을 위한 확장 적응증 데이터베이스 구축)

  • Lee, So-Min;Baek, Yeon-Hee;Song, Sang-Ho;CHRISTOPHER, RETITI DIOP EMANE;Han, Xuan-Zhong;Hong, Seong-Yeon;Kim, Ik-Su;Lim, Jong-Tea;Bok, Kyoung-Soo;TRAN, MINH NHAT;NGUYEN, QUYNH HOANG NGAN;Kim, So-Young;Kim, An-Na;Lee, Sang-Hun;Yoo, Jae-Soo
    • The Journal of the Korea Contents Association
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    • v.21 no.8
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    • pp.367-375
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    • 2021
  • The quality of medical care can be defined as four types such as effectiveness, efficiency, adequacy, and scientific-technical quality. For the management of scientific-technical aspects, medical institutions annually disseminate the latest knowledge in the form of conservative education. However, there is an obvious limit to the fact that the latest knowledge is distributed quickly enough to the clinical site with only one-time conservative education. If intelligent information processing technologies such as big data and artificial intelligence are applied to the medical field, they can overcome the limitations of having to conduct research with only a small amount of information. In this paper, we construct databases on which the existing medicine prescription adaptations can be extended. To do this, we collect, store, manage, and analyze information related to oriental medicine at domestic and abroad Journals. We design a processing and analysis technique for oriental medicine evidence research data for the construction of a database of oriental medicine prescription extended adaption. Results can be used as a basic content of evidence-based medicine prescription information in the oriental medicine-related decision support services.

The Awareness and Educational Needs of Some Health Major Students on The Forth Industrial Revolution (4차 산업혁명에 대한 일부 보건계열전공 학생들의 인식과 교육요구도 조사)

  • Lee, Mi-Lim;Lee, Hyo-Cheol
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.3
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    • pp.193-202
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    • 2021
  • The purpose of this study was to examine relation of awareness and education requirement of the 4th industrial revolution in health care students in attempt to provide basic data of determining the principle and education plan. The subject of study were 280 students of health department of H university in Gwangju and analyzed by gender and grade. The female students were positive awareness of the 4th industrial revolution and the level of influence on the major field was highest in lower grade students. The level of negative factors such as generation gap(p<0.05), gap between rich and poor (p<0.01), personal information infringement(p<0.05), decrease in existing jobs(p<0.05), and abuse of artificial intelligence(p<0.05) was highest in male students. In prepration for the 4th industrial revolution, education on bio and medical device(22.2%) was the most desired. The higher positive awareness, the higher educational demand(p<0.001). It is necessary to develop programs and various education to increase positive factors such as the creation of new jobs and improve the quality of life in the era of the 4th industrial revolution.