• 제목/요약/키워드: Medical charge

검색결과 524건 처리시간 0.024초

소아병원의 정맥주사팀 활동에 대한 조사연구 (A Study on the Activities of IV Team In the Children's Hospital)

  • 황정해;황지인;김미란;신희영;안효섭
    • 한국의료질향상학회지
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    • 제6권1_2호
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    • pp.92-106
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    • 1999
  • Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

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예방의학을 위한 Smart-Telemedicine 시스템과 비즈니스 모델의 설계와 분석 (Smart-Telemedicine System Design and Business Model Analysis for Longitudinal Healthcare)

  • 김찬영;권두순;이재범;김진화
    • 경영정보학연구
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    • 제14권2호
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    • pp.1-19
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    • 2012
  • 최근 의료서비스 추세는 소비자의 교육과 생활수준의 향상으로 인해 의료기관이 추구하는 일방적인 형태의 의료서비스에서 벗어나 보다 차별화되고 지속적으로 자신의 건강관리가 가능한 능동형 의료서비스 형태로 변화하고 있다. 따라서 스마트 텔레메디슨 시스템은 기존의 단순한 혈압, 혈당, 심장박동, 체온 측정기 등에 블루투스와 이동통신 모듈의 결합을 통해서 의료서비스를 제공하며, 환자가 인식하지 못하는 사이에 환자의 건강 상태 패턴을 분석하여 예방적인 건강관리가 가능한 능동형 유비쿼터스 의료서비스를 제공하게 한다. 즉 온라인과 오프라인의 의료서비스 환경이 상호 연결되어 시간과 장소에 구애 받지 않고 스마트폰과 모바일 의료검진 디바이스를 통해서 양방향으로 의료서비스를 제공한다. 특히 정보통신 기술의 발전과 더불어 새롭게 등장하는 스마트 텔레메디슨 서비스 사업자를 통해 환자들이 효과적인 의료 검진을 위해 장시간 이동하고 대기하는 시간과 비용을 절감하고 환자의 종적 건강 데이터관리를 통해서 환자 스스로가 건강관리를 하게 한다. 또한 개인화된 맞춤형 예방 건강관리 의료서비스를 이용하게 함으로써 다양한 형태의 의료서비스 비즈니스 상거래를 가능하게 하고 있다. 본 연구는 예방의학적인 스마트 텔레메디슨 시스템을 정의하고 이를 기반으로 한 비즈니스 모델 설계와 분석 및 평가모델을 제시하고자 한다.

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수면치과치료가 치과환자 만족도 및 재이용에 미치는 영향 (A study on influence of sleep dental treatment on satisfaction degree and revisit to dental clinics)

  • 신연순;이종렬;민경진
    • 한국치위생학회지
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    • 제9권3호
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    • pp.415-425
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    • 2009
  • Objectives : In this study, the dental treatment satisfaction degree of the patients, who experienced the sleep dental treatment or non-sleep dental treatment, the revisit rate and the differences among the encouraging intention were compared and analyzed, and the primary factors through which the satisfaction degree of sleep dental treatment has influence on the revisits and the encouraging intention were analyzed, and the proposal was made on clinic management to raise qualitative medical service level on the basis of this study. Methods : The questionnaires filled out by the 202 users of a certain dental clinic located in Pohang-si, Gyeongbuk were analyzed. The frequency analysis and the crosstabulation analysis of the general characteristics of survey participants were carried out, and the satisfaction difference between the sleep dental treatment and the non-sleep dental treatment was identified with the t-test analysis. The multiple regression analysis were carried out to identify the factors through which the sleep dental treatment has influence on the through which the satisfaction degree of sleep dental treatment has influence on the satisfaction degree of the medical service and the revisited dentists. Results : In the medical service satisfaction degree in general, the sleep dental treatment had the higher meaningful value than the non-sleep dental treatment(p<0.05). In the case of the difference in satisfaction degree on each medical service factor, the satisfaction of the sleep treatment group was high in every case, but the meaningful difference showed up in the factors of waiting time, treatment procedure, revisit and the encouraging intention(p<0.01). The revisit to the sleep treatment dental clinic and the recommending dentist increased in proportion to the satisfaction degree of sleep dental treatment, and the Beta value appeared to be 0.337 at the influence of the subordinate variable(p<0.001). As for the influence on the sleep dental treatment satisfaction, the Beta value of the dental hygienist was the highest, marking the value at 0.375(p<0.01). As for the satisfaction of the patients who experienced the sleep dental treatment, the Beta value of the treatment fee was the highest, marking 0.352(p<0.001), in the multiple regression analysis of the revisit and the encouraging intention, and the 0.156 of dentist factor and the 0.152 of treatment procedure and waiting time showed lower regression coefficient(p<0.05). Conclusions : It is assumed that the satisfaction degree of sleep dental treatment, which is carried out as a new dental service has influence on the increase of revisit to the dental clinic as an important factor. But it was disclosed that the high level of treatment fee has the biggest influence on choice of revisit to the dental clinic. In the current medical charge system, the sleep dental treatment appeared to have a big influence on raising the quality of dentists, the satisfaction of patients, the revisit and encouraging intention, and also the roles of the dental hygienist was important. It is assumed that these facts are functioning as the factors that are linked to the increase of revisit and the encouraging intention.

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The Usefulness of a Wearable Device in Daily Physical Activity Monitoring for the Hospitalized Patients Undergoing Lumbar Surgery

  • Kim, Dong Hwan;Nam, Kyoung Hyup;Choi, Byung Kwan;Han, In Ho;Jeon, Tae Jin;Park, Se Young
    • Journal of Korean Neurosurgical Society
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    • 제62권5호
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    • pp.561-566
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    • 2019
  • Objective : Functional outcomes have traditionally been evaluated and compared using subjective surveys, such as visual analog scores (VAS), the Oswestry disability index (ODI), and Short Form-36 (SF-36), to assess symptoms and quality of life. However, these surveys are limited by their subjective natures and inherent bias caused by differences in patient perceptions of symptoms. The Fitbit $Charge^{(R)}$ (Fitbit Inc., San Francisco, CA, USA) provides accurate and objective measures of physical activity. The use of this device in patients after laminectomy would provide objective physical measures that define ambulatory function, activity level, and degree of recovery. Therefore, the present study was conducted to identify relationships between the number of steps taken by patients per day and VAS pain scores, prognoses, and postoperative functional outcomes. Methods : We prospectively investigated 22 consecutive patients that underwent laminectomy for spinal stenosis or a herniated lumbar disc between June 2015 and April 2016 by the same surgeon. When patients were admitted for surgery and first visited after surgery, preoperative and postoperative functional scores were recorded using VAS scores, ODI scores, and SF-36. The VAS scores and physical activities were recorded daily from postoperative day (POD) 1 to POD 7. The relationship between daily VAS scores and daily physical activities were investigated by simple correlation analysis and the relationship between mean number of steps taken and ODI scores after surgery was subjected to simple regression analysis. In addition, Wilcoxon's signed-rank test was used to investigate the significance of pre-to-postoperative differences in VAS, ODI, and SF-36 scores. Results : Pre-to-postoperative VAS (p<0.001), ODI (p<0.001), SF-36 mental composite scores (p=0.009), and SF-36 physical composite scores (p<0.001) scores were found to be significantly different. Numbers of steps taken from POD 1 to POD 7 were negatively correlated with daily VAS scores (r=-0.981, p<0.001). In addition, the mean number of steps from POD 3 to POD 7 and the decrease in ODI conducted one month after surgery were statistically significant (p=0.029). Conclusion : Wearable devices are not only being used increasingly by consumers as lifestyle devices, but are also progressively being used in the medical area. This is the first study to demonstrate the usefulness of a wearable device for checking patient physical activity and predicting pain and prognosis after laminectomy. Based on our experience, the wearable device used to provide measures of physical activity in the present study has the potential to provide objective information on pain severity and prognosis.

보험심사 근무직의 직무스트레스와 정신건강 (The Job Stress and Mental Health of the Insurance Reviewer)

  • 송경진;이정원
    • 서비스연구
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    • 제11권1호
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    • pp.31-44
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    • 2021
  • 국내의 의료보험 제도의 순기능은 높이 평가받지만 불완전한 보장성의 문제로 인해 국민들은 민영의료보험 가입을 통해 보장성을 확보하고자 한다. 이로 인해 최근 민영의료보험의 가입률이 높아지게 되었고, 청구율 또한 높아지게 되었다. 이처럼 민영의료보험을 찾는 사람이 늘어남에 따라 민영의료보험사의 근로자는 직무 부담이 가중되었으며, 특히 보험금 지급을 담당하는 보험심사 근무직의 경우 보험금을 고객과의 소통, 회사의 수익 상출에 기여 등 다양한 이유로 직무스트레스가 나날이 증가하고 있으며 그로 인한 부작용을 경험하고 있다. 이에 본 연구는 보험심사 근무직의 직무스트레스가 정신건강에 미치는 영향에 대해 분석하여 보험심사 근무직의 직무스트레스를 감소시키고 정신건강을 증진하고자 서술적 조사 연구를 실시하였다. 분석 결과, 보험심사 근무직의 직무스트레스는 정신건강에 유의한 정(+)의 영향을 미치는 것으로 나타났다. 세부적으로는 직무스트레스가 역할수행능력·자기신뢰도, 우울, 수면장애·불안, 일반건강·생명력의 정신건강 4가지 요인 모두에 유의한 영향을 미치는 것으로 나타났다. 본 연구를 통해 보험심사 근무직의 직무스트레스가 정신건강에 유의한 정(+)의 영향을 미친다는 사실을 알 수 있었다. 직무스트레스는 근로자로 하여금 직무수행에 대한 열의를 감소시키고 이직률, 퇴사율을 높이는 등 조직적인 측면에서의 부작용을 초래하기도 하지만 개인의 신체 건강을 악화시키고 우울, 불안 등과 같은 질환을 유발하여 정신건강을 피폐하게 만들기도 한다. 따라서 이를 예방하기 위하여 대상자의 특성에 맞는 적절한 직무스트레스 예방법과 대처법을 제공하여 직무스트레스를 감소시키고 정신건강을 증진할 수 있도록 지원하여야 할 것이다.

호흡명상기공테라피가 파킨슨병 환자의 후각 및 음성 기능장애 개선에 미치는 효과 (The Effect of Breathing Meditation Qigong Therapy on the Recovery of Olfactory Disorders and Voice Handicap Index in Parkinson's Disease Patients)

  • 안소정;안훈모
    • 대한의료기공학회지
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    • 제23권1호
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    • pp.10-29
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    • 2024
  • Objective : The purpose of this study is to determine whether An's breathing meditation qigong therapy (ABMQT) delivers bioenergy to the frontal lobe, prefrontal lobe, the olfactory tract in the mesolimbic pathway, olfactory bulb, CV22, CV21, olfactory area and vocal-related areas in Parkinson's disease (PD) patients to help improve olfactory disorders (anosmia) and vocal functions. Methods : The subjects of this study were 4 patients with idiopathic PD (3 males/1 female, 65.0±NA/68.7±10.2 years old). ABMQT was applied once a week, 120 minutes per session for 12 weeks in a non-invasive and noncontact manner, and the test before and after ABMQT application included olfactory impairment test the Korean version of Sniffin' stick test (KVSS), voice acoustic test, aerodynamic test, vocal handicap index (VHI-30), and auditory perception scale test tools. The results before and after the experiment were analyzed assuming a normal distribution, and a chi-square test was performed using a continuity correction, and the significance level was set to p<0.05. And the medical diagnosis and findings of the examiner (doctor in charge) before and after the experiment were described. Results : KVSS was significant as 0.2±0.5 and 9.0±0.0 before and after the experiment. There was no significant difference between the voice acoustic test FO and Jitter, the vocal aerodynamic test MPT, SP, AE, the vocal disorder index test, and the auditory perception test. However, the medical diagnosis findings of four study subjects showed that olfactory disorders, voice disorders, and laryngeal function were improved before and after the application of ABMQT. Conclusions : The breathing meditation qigong program showed significant effects on improving the olfactory disorders (anosmia) and speech function of each study subject. However, to produce meaningful results, it is thought that experiments involving a larger number of research participants are necessary, and additional blood and FMRI tests are conducted to verify metabolic activities and the olfactory neuron signal transmission system.

Cone-beam CT에서 웨이브렛 역치값을 이용한 x-ray 영상에서의 노이즈 제거 (Noise Reduction of medical X-ray Image using Wavelet Threshold in Cone-beam CT)

  • 박종덕;허영;진승오;전성채
    • 전자공학회논문지SC
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    • 제44권6호
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    • pp.42-48
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    • 2007
  • X-ray 영상 시스템에서는, 크게 2 종류의 noise 성분이 함유되어있다. 먼저 x-ray 방사선이 조사되어질 때, 검출기에서의 방사선의 상호작용으로부터 발생되어지는 것으로서 랜덤하게 발생되어지는 Poisson noise 성분이다. 다음으로 noise 성분은 readout electronics noise, pixel pattern noise 그리고 off-set noise 등으로부터 발생되어지는 Gaussian noise 성분이다. 그러나, x-ray 영상에서는 Gaussian noise가 아닌, Poisson noise로 모델링 되어진다. Gaussian noise에 의해서 발생되어지는 noise 성분은 위너필터 혹은 웨이브렛을 사용하여 쉽게 제거가 가능하지만, Poisson noise와 같은 랜덤 noise를 제거하기 위해서는 복잡한 분석기법이 필요하게 한다. 이 논문에서는 웨이브렛 영역에서 x-ray 영상의 Poisson noise를 제거하고자 하였으며, 적용된 분석 기법은 최적화된 웨이브렛 분석기법인 IBS(Improved BayesShrink)을 사용하였다. 적용된 IBS 기법은 cone-beam CT의 x-ray 영상에서의 기존의 방법에 비해 향상된 결과를 보여주었다.

Dosimetric Characteristic of Digital CCD Video Camera for Radiation Therapy

  • Young Woo. Vahc;Kim, Tae Hong.;Won Kyun. Chung;Ohyun Kwon;Park, Kyung Ran.;Lee, Yong Ha.
    • 한국의학물리학회지:의학물리
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    • 제11권2호
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    • pp.147-155
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    • 2000
  • Patient dose verification is one of the most important parts in quality assurance of the treatment delivery for radiation therapy. The dose distributions may be meaningfully improved by modulating two dimensional intensity profile of the individual high energy radiation beams In this study, a new method is presented for the pre-treatment dosimetric verification of these two dimensional distributions of beam intensity by means of a charge coupled device video camera-based fluoroscopic device (henceforth called as CCD-VCFD) as a radiation detecter with a custom-made software for dose calculation from fluorescence signals. This system of dosimeter (CCD-VCFD) could reproduce three dimensional (3D) relative dose distribution from the digitized fluoroscopic signals for small (1.0$\times$1.0 cm$^2$ square, ø 1.0 cm circular ) and large (30$\times$30cm$^2$) field sizes used in intensity modulated radiation therapy (IMRT). For the small beam sizes of photon and electron, the calculations are performed In absolute beam fluence profiles which are usually used for calculation of the patient dose distribution. The good linearity with respect to the absorbed dose, independence of dose rate, and three dimensional profiles of small beams using the CCD-VCFD were demonstrated by relative measurements in high energy Photon (15 MV) and electron (9 MeV) beams. These measurements of beam profiles with CCD-VCFD show good agreement with those with other dosimeters such as utramicro-cylindrical (UC) ionization chamber and radiographic film. The study of the radiation dosimetric technique using CCD-VCFD may provide a fast and accurate pre-treatment verification tool for the small beam used in stereotactic radiosurgery (SRS) and can be used for verification of dose distribution from dynamic multi-leaf collimation system (DMLC).

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미래산업에 적용가능한 점토 화합물: 식품포장 및 환경개선 (Engineered Clay Minerals for Future Industries: Food Packaging and Environmental Remediation)

  • 김형준;오제민
    • 한국광물학회지
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    • 제29권2호
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    • pp.35-45
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    • 2016
  • 점토광물은 자연에서 쉽게 얻을 수 있고, 환경친화적이며 다양한 물리화학적 특성을 갖고 있어 인류 역사상 여러 분야에 활용되어 왔다. 최근에는 몬모릴로나이트, 카올리나이트, 세피올라이트, 금속이중층수산화물과 같은 점토 화합물에 화학적 개질을 도입하여 산업분야에 활용하고자 하는 연구가 활발히 진행되고 있다. 넓은 비표면적과 높은 측면비율, 나노수준의 입자 두께, 그리고 조절가능한 표면전하를 갖는 점토화합물에 화학적 개질을 적용하면, 고분자의 기계적 성질과 기체차단성을 개선하고, 고분자 필름에 지속적 항균성을 부여하는 충전제로 사용할 수 있다. 또한, 개질된 점토화합물은 높은 흡착능과 화학적 선택성을 지니므로, 수질이나 토양을 오염시키는 화학적, 생물학적 오염원을 효과적으로 제거하는 물질로도 활용 가능하다. 본 논평에서는 이러한 점토화합물들이 미래의 주요산업군인 식품포장재 및 환경개선 분야에 활용될 가능성에 대해 최근 연구 결과를 소개하고자 한다.

$HgI_2$ 방사선 검출기의 누설전류 저감에 관한 연구 (Study on the dark current reduction of $HgI_2$ radiation detector)

  • 신정욱;강상식;김진영;김경진;박성광;조흥래;이형원;남상희
    • 한국전기전자재료학회:학술대회논문집
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    • 한국전기전자재료학회 2004년도 추계학술대회 논문집 Vol.17
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    • pp.456-459
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    • 2004
  • Analog film/screen systems have been being changed to a digital x-ray imaging device using direct conversion materials. Photocoductors for a direct detection flat-panel imager require high x-ray absorption, ionization and charge collection, low leakage current and large area deposition. In this work, $HgI_2$ films with excellent properties for x-ray detector were deposited by screen printing method. The thickness of $HgI_2$ film was about $150\;{\mu}m$. The passivation layer is fabricated using a-Se and parlyene, the both fabrication $HgI_2$ film were compared for analyzing the leakage current reduction. We measured electrical properties-leakage current, photosensitivity, SNR though I-V measurement, As the result, $HgI_2$ film using a-Se passivation layer had the greater

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