• Title/Summary/Keyword: Medical charts

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A Study of Hospital Infection in the Postoperative Patients (수술후 병원 감염 발생과 입원일수 및 수술 소요 시간과의 관계)

  • 박정호;윤혜상
    • Journal of Korean Academy of Nursing
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    • v.16 no.2
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    • pp.70-76
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    • 1986
  • This study was aimed to observe the incidences and types of hospital infections and to compare the length of hospitalization and of the operation between the infected Patients and those of non-infected after the operations. The subject of study were 465 patients who had been operated surgically in a University Hospital from March 1 to April 30, 1985. The data were collected by reviewing medical charts of subjects. The criteria to diagnose hospital infection for this study had been revised the one utilized at University of Virginia Hospital in the U.S. Summary of the results were as follows: 1. The incidence rate of hospital infection was 6 %. The type of infection with higher incidence rate in order were wound infection(28.5%)urinary infection(28.5%), fever of unknown origin (25%) and septicemia (18%). 2. There was a statistically significant difference in the duration of hospitalization between the patient group without it (t=265.2, p<0.005). 3. There was a statistically significant difference in the duration of operation between the patient group with it (t=75.0, p<0.005).

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Applications of Cause-Selecting Control Charts in Hospitals

  • Zhang, Gongxu;Zheng, Huiying;Park, Sung H.
    • Journal of Korean Society for Quality Management
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    • v.22 no.3
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    • pp.142-151
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    • 1994
  • In a hospital, there are many clinical departments. In general, the hospital management often uses the index of cure rate (i.e. the rate of patients recovered by the cure of this hospital) to evaluate the medical quality of each clinical department. But, since the cure rate varies significantly with the rate of patient with severe disease, the evaluation by cure rate is unreasonable and incomplete. This paper proposes a new evaluation method called the cause-selecting evaluation method proposed by Prof. Gongxu Zhang (1990). Besides, this method can also be used to diagnose the abnormality of cure rate. The practical case studies check with the theory very well.

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Medical Expenses for Trauma According to the Type of Medical Insurance (외상환자의 보험체계에 따른 진료비 분석)

  • Park, Heeseung;Jung, Yooun Joong;Kim, Young-Hwan;Kim, Tae-Hyun;Km, Min Ae;Kyoung, Kyu Hyouck;Kim, Jung Jae;Hong, Suk-Kyung
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.178-187
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    • 2012
  • Purpose: In Korea, the nation's medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital's emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient's insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system.

Adult Urological Soft Tissue Sarcomas: A Multicenter Study of the Anatolian Society of Medical Oncology (ASMO)

  • Unal, Olcun Umit;Oztop, Ilhan;Menekse, Serkan;Urakci, Zuhat;Bozkurt, Oktay;Ozcelik, Melike;Gunaydin, Yusuf;Yasar, Nurgul;Yazilitas, Dogan;Kodaz, Hilmi;Taskoylu, Burcu Yapar;Aksoy, Asude;Demirci, Umut;Araz, Murat;Tonyali, Onder;Sevinc, Alper;Yilmaz, Ahmet Ugur;Benekli, Mustafa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4777-4780
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    • 2015
  • Objective: To analyze clinicopathological characteristics, prognostic factors and survival rates of the patients with urological soft tissue sarcomas treated and followed up in Turkey. Materials and Methods: For overall survival analyses the Kaplan-Meier method was used. From medical records, nine prognostic factors on overall survival were analysed. Results: For the 53 patients (34 males, 19 females) whose charts were reviewed, the median age was 53 (range 22 to 83) years. Most frequently renal location (n=30; 56.6%) was evident and leiomyosarcoma (n=20, 37.7%) was the most frequently encountered histological type. Median survival time of all patients was 40.3 (95% CI, 14.2-66.3) months. In univariate analysis, male gender, advanced age (${\geq}50years$), metastatic stage, unresectability, grade 3, renal location were determined as worse prognostic factors. In multivariate analysis, metastatic stage, unresectability and grade 3 were determined as indicators of worse prognosis. Conclusions: Urological soft tissue sarcomas are rarely seen tumours in adults. The most important factors in survival are surgical resection, stage of the tumour at onset, grade and location of the tumour, gender and age of the patients.

Effect of practice guideline reminder and flow-sheet for improvement of quality in management of hypercholesterolemia (고콜레스테롤혈증 환자 진료의 질 향상을 위한 임상 지침 리마인더(Reminder)와 추적 관리지의 효과)

  • Cho, Han Kyu;Park, Hye Soon;Cho, Hong-Jun
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.230-240
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    • 1997
  • Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.

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A Survey of Drug Intoxication Patients Transferred by 119 Ambulance Service - Seocho area in Seoul - (일 지역 119구급대를 통한 약물중독 사례 고찰 - 서울시 서초지역 중심 -)

  • Cho Wonsun
    • Journal of Korean Public Health Nursing
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    • v.10 no.1
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    • pp.106-117
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    • 1996
  • This study aims to provide information about the acute poisoning patients transferred by 119 ambulance service for nurses and emergency medical technicians. The data is based on 119 ambulance services patients charts of Seocho area in Seoul. The results were as follows: 1. Total number of emergency patients all over the country has been nearly fourtimes in 1995 compared to 1991. Total number of emergency patients were 322.051 in 1994. 2. About $35\%$ of total E.R. patients were transferred by 119 ambulance services in Seoul in the last 5years. Acute drug intoxication patients occupied $2-3\%$ of E.R. patients in Seoul. 3. About $4\%$ of E.R. patients in Seoul were transferred by 119 E.R. services of Seocho area in Seoul in 1995. Among them $2.4\%$ patients were drug intoxication patients. 4. Data were collected from available patients of 119 ambulance services from Jan. 1993 to Dec. 1995 in Seocho area. Total poisoning patients were 184. - The female/male ratio was 69.7:30.4 and most of patients$(69.7\%)$ were in the age of 20th and 30th. - The busy time of calling 119 ambulance service was from 6P.M. to midnight$(37.5\%)$ - It took within 10 minutes for patients$(62.8\%)$ from notification to arrival in hospital. - Regarding poisoning substances. hypnotics $(22.8\%)$, tranquilizer$(14.7\%)$, agricultural agents$(6.0\%)$ rodenticide$(27\%)$ and others $(10.3\%)$ were in order and unknown were $43.5\%$. - Most of the patients or protector $(72.8\%)$ chose hospitals. Among them $(87.3\%)$ were general hospital. - The most predominant symptoms were coma$(22.3\%)$. dizziness$(6.5\%)$ and then allergy. vomiting. gastrointestinal cramps etc. - Airway management and oxygen administration together was the main medical control of prehospital emergency medical services$(33.7\%)$. It is proposed that first, a systematic survey of drug intoxication patients must be conducted to give an appropriate prehospital emergency care for the emergency medical technician and second, a wide and regular public education to improve understanding of first aids should be undertaken.

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Studies on Characteristics and Related Factors in Halitosis Patients (구취 환자의 특성 및 관련 인자에 대한 연구)

  • Yoon, Sang-Hyub;Ryu, Bong-Ha;Ryu, Ki-Won;Kim, Jin-Sung
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.252-259
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    • 2004
  • Objectives : Halitosis is a common human condition, exact pathophysiological mechanisms of which are unclear. This study, which investigates halitosis patients' characteristics and their related factors, was done with intent to establish a foundation for the Oriental Medical treatment of halitosis. Methods : 329 patients were surveyed by reviewing medical charts and questionnaires from the East-West Halitosis Clinic of Kyunghee Medical Center from May 1, 2001 to December 31, 2002. Sex, age, illness duration, coating on the tongue, postnasal drip, globus pharyngeus, indigestion, condition of feces, halimeter measurements and results of the salivary scans were analyzed. Results : The thick and yellowish coating on the tongue was not a major cause of halitosis in the patients studied. Among the halitosis patients, 21.6% complained of postnasal drip, 15.6% of globus pharyngeus, 37.4% of indigestion, and 23.8% of diarrhea or constipation, suggesting the possibility of extra-oral origin in oral malodor. Conclusions : This study suggests that, when treating halitosis patients, intra-oral causes of halitosis aside, Oriental Medical treatments such as solving qi-stasis(氣鬱), augmenting deficiency of the spleen qi(碑氣虛) and treating gastric fever(胃熱) constitute effective management for oral malodor patients.

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A Study of Functional Evaluation in Stroke Patients (뇌졸중 환자의 기능평가에 대한 연구 -Modified Barthel Index 및 PULSES Profile에 의한 평가성적을 중심으로-)

  • Ahn Jung-Kuk;Lim Hye-Hyun;Ahn So-Yoon
    • The Journal of Korean Physical Therapy
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    • v.4 no.1
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    • pp.43-57
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    • 1992
  • This study was conducted from August, 1980 to March, 9991 to the 40 subjects who were admitted to Kosin Medical Center and received rehabilitation treatment and discharged under the impression of stroke. The objectives are to evaluate the function of the activites of daily living and comprehensive function and find the status of rehabilitation treatment by Modified Barthel Index and PULSES Profile when first requested or rehabilitation treatment(T1), at 2 weeks after rehabilitation treatment(T2), at discharge(T3) and at the time of ambulatory treatment after 2 weeks(T4). The study materials were clinical charts and functional evaluation sheets, and the results are as follows : 21 subject$(52.5\%)$ were male, 19 subjects$(47.5\%)$ were female, and the age distribution was from 19 to 70 in age, the average age was 52.7. By the classification of diagnosis, 21 subjects$(52.5\%)$ were cerebral hemorrhage, 8 subjects$(20.2\%)$ were cerebral thrombosis, 6 subjects$(15.0\%)$ were cerebral embolism, and 5 subjects$(12.5\%)$ were cerebral infarction. The Barthel Index scores were 35.7, 54.5, 71.8, 88.7 on the average at T1, T2, T3, T4 respectively. The PULSES scores were 16.4, 13.7, 11.4, 8.7 on the average at T1, T2, T3, T4 respectively. Regarding the Pearson's correlation coefficient between the Barthel Index scores and the PULSES scores, it was -0.7991(P>0.001) at T1 and -0.8986(P>0.001) at T3, then beth of correlations were very high.

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The Clinical Analysis of Traffic Accident Patients Treated by Oriental Medicine (교통사고 후유증 환자의 임상적 분석과 한방치료효과)

  • Song, Young-Il;Jin, Kwang-Seon;Shin, Hye-Lan;Yoon, Il-Ji;Choi, Seung-Hoon;Oh, Min-Suck
    • Journal of Korean Medicine Rehabilitation
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    • v.15 no.2
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    • pp.77-89
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    • 2005
  • Objectives : This study was designed to find out the characteristic of patients who had admitted due to traffic accident and to promote the superiority of oriental medical treatment on the sequelae of traffic accident. Methods : We analyzed 332 traffic accident patients statistically according to medical charts, who had been hospitalized from January 1,20000 to October 30, 2004. Results and Conclusions : The analysis showed that there was no significant difference in sex(p<0.05), but the older group and the shorter group of interval time from onset to addmission had the better remedial result(p<0.05). The most common diagnosis that had the better remedial result was lumbar sprain, followed by multiple contusion, cervical sprain, herniated lumbar disc, herniated cervical disc(p<0.05), and the most effective oriental medical treatment was moxibusition, followed by blood cupping therapy, taping therapy, chuna therapy except acupuncture, herbal medication, oriental physical therapy(p<0.05). In using of TENS, ICT, U/S, complex therapy had better remedial result than single therapy(p<0.05). The longer period of treatment group had better remedial result generally(p<0.05).

A Single-Center Retrospective Study on the Effects of Korean Medicine in 342 Traffic Accident Cases

  • Jeong, Jin-Ho;Ku, Jaseung;Hwang, Ji Hye
    • Journal of Pharmacopuncture
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    • v.24 no.3
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    • pp.122-137
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    • 2021
  • Objectives: In South Korea, traffic accident victims can be treated under automobile insurance coverage. Korean medicine (KM) clinics have reported the largest number of automobile insurance fee claims among medical institutions. This study investigated the status of the KM automobile insurance system in a single KM clinic. Methods: We retrospectively surveyed the medical charts of 342 traffic accident patients treated at the Jisung KM clinic between January 2009 and June 2017. Results: Most of the patients were men and in their 30s. The most common method of locating the clinic was an internet search. The most common traffic accident type was collision between vehicles (83.63%), with 70.76% of patients visiting during the most acute phase. The major disease codes included S434, M4836, F072, S0600, and S3350. The most frequent treatment period was within 1 month of the accident, and most patients received 10 or fewer treatments. The mean treatment duration and number of treatments were 37.68 ± 45.11 days and 11.68 ± 10.63 treatments, respectively. The initial pain numerical rating scale (NRS), 7.32 ± 0.96, decreased to 3.57 ± 1.40 at the end of treatment, with a symptom improvement score of 1.87 ± 0.60. Regarding sex, age, disease duration, location at the time of the accident, presence of additional and psychological symptoms, and chuna, there were statistically significant differences in treatment duration and number of treatments. A higher number of treatments and the longer treatment duration was associated with a higher initial NRS, lower post-treatment NRS, and better improvement score. Since the introduction of traffic accident (TA) pharmacopuncture, the rate of use of a single type of pharmacopuncture increased; however, no significant differences in treatment duration and number, NRS before and after treatment, and improvement score were observed between treatment groups before and after TA pharmacopuncture. No adverse reactions were observed for any treatment. Conclusion: This study confirmed the previous findings of a high treatment effect of KM under automobile insurance. We also observed significant correlations based on a detailed medical status, which may explain the increasing use of KM in the automobile insurance system. Additional multi-center studies in different regions are needed.