• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.5125-5129
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• 2012

Economic decision models are being increasingly used to assess medical interventions. Advances in this field are mainly due to enhanced processing capacity of computers, availability of specific software to perform the necessary tasks, and refined mathematical techniques. We here estimated the incremental cost-effectiveness of ten strategies for colon cancer screening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and profit of chemotherapy in Iran. We used a Markov model to measure the costs and quality-adjusted life expectancy of a 50-year-old average-risk Iranian without screening and with screening by each test. In this paper, we tested the model with data from the Ministry of Health and published literature. We considered costs from the perspective of a health insurance organization, with inflation to 2011, the Iranian Rial being converted into US dollars. We focused on three tests for the 10 strategies considered currently being used for population screening in some Iranians provinces (Kerman, Golestan Mazandaran, Ardabil, and Tehran): low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 39%, 60% and 76%, and mortality by 50%, 69% and 78%, respectively, compared with no screening. These approaches generated ICER (incremental cost-effectiveness ratios) of $9067, $654 and $8700 per QALY (quality-adjusted life year), respectively. Sensitivity analyses were conducted to assess the influence of various scales on the economic evaluation of screening. The results were sensitive to probabilistic sensitivity analysis. Colonoscopy every ten years yielded the greatest net health value. Screening for colon cancer is economical and cost-effective over conventional levels of WTP8.

• Asian Pacific Journal of Cancer Prevention
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• 제13권10호
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• pp.4889-4895
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• 2012

Background and Aim: The incidence of extra nodal non Hodgkin lymphoma (ENL) is rising throughout the world. However, data regarding ENL as a group is limited. The aim was to study the epidemiological and histomorphological trends of primary ENL (pENL) in India. Material and Methods: The biopsy materials from sixty eight patients with pENL (45 male, 23 female, M:F= 1.9:1), diagnosed over a five year period (2005-2009), were analysed and pathologically reclassified according to the World Health Organization (WHO) classification, 2008 criteria. Results: Primary extra nodal non Hodgkin lymphomas constituted 22.0% (68/308) of all non Hodgkin lymphomas (NHL). The mean age at presentation for pENL and primary nodal NHL was 43 years and 58 years, respectively with a male predilection (M: F=2:1). Central nervous system (CNS) constituted the most common extranodal site (20/68, 29.5%) followed by gastrointestinal tract (17/68, 25%), and nose/nasopharynx (8/68, 11.8%). Diffuse large B-cell lymphoma (DLBCL, not otherwise specified), extranodal marginal lymphoma of mucosa associated lymphoid tissue (MALT) type, and B cell NHL unclassified (U) were the three most common histological types observed. T-cell phenotype was rarely noted (4%). Follicular lymphomas and anaplastic large cell lymphoma, seen among nodal NHL, were absent at extra nodal sites. Majority (41/68, 60%) of the patients with pENL were immunocompetent and 55% were in stage I-II with favorable prognosis. Conclusion: Central nervous system was the most common site of ENL, followed by gastrointestinal tract. Majority of pENL occurred in immunocompetent hosts with a favorable prognosis.

• 한국콘텐츠학회논문지
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• 제11권11호
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• pp.274-285
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• 2011

본 연구는 일개 시지역에 소재한 병원급 의료기관 2개에서 2009년 한 해 동안 교통사고로 입원진료를 받은 후 퇴원한 자동차보험 환자 중 1,583명을 대상으로 진료현황과 진료내역별 진료비, 진료비 비율의 특성을 분석하였다. 분석결과 자동차보험 입원환자는 남자가 많았고, 연령은 성인기 연령층이 많았으며, 재원일수는 4~7일이 가장 많았다. 진료현황과 진료내역별 진료비, 그리고 총진료비 중 진료내역별 진료비가 차지하는 비율은 성별, 연령, 재원일수에 따라 각각 통계적으로 유의한 차이를 보였다. 특히 진료내역별 진료비는 주로 여성의 진료비가 높았고, 60대 이상의 고연령층과 재원일수가 길수록 각 진료내역별 진료비가 높았다. 따라서 각 의료기관은 연령층에 따른 효율적 진료방안을 마련하여 재원일수의 단축을 위해 노력하고, 특히 고연령층에 대한 진료패턴 파악과 신체적 정신적 상태, 중증도 등을 고려한 적정진료를 제공함으로써 진료의 효율성을 제고해야 할 것이다.

• 한국병원경영학회지
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• 제13권2호
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• pp.36-63
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• 2008

This study carried out a covariance-structural analysis to verify formed causations between general variables and the influences of Medical Social Work Service of officers and NCOs in Korean Community Military Hospitals. The subjects were 7 hospitals, 337 military hospital executives in rear area, and the results of the survey are as below. First, about empowerment level, culture in the organization turned out to be the primary direct influential factor, and personal, organizational, and functional character were influential factor. There was no indirect influential factor present. Second, in Medical Social Work Service, empowerment level was significant on direct effect. In case of personal character indirect effect was important. It showed that the significant influence factor that affects Medical Social Work Service in total effectiveness is personal character and empowerment level. It's productive to suggest the possibility of application of furnish the outcome as a basic data for Military Medical Social Work Service revitalization plan. On the basis of the result, we propose several suggestions for Military Medical Social Work Service as follow. First, to educate empowerment increase program of officers and NCOs in Military Hospital, specific system which allows entrust education to a certain civil education institution or KAMTSW(Korean Academy of Military Social Welfare) is required. Second, need to provide the medical social work service that matches with Military Hospital and distinct from usual hospital. Last, for specific study we expect various follow-up researches on the basis of this study, which can develop concrete empowerment model by inquiring research, would come out.

• 한국병원경영학회지
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• 제7권1호
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• pp.121-130
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• 2002

As a hospital deals with people in their particular states, namely patients, computerization and automation in organization systems are very limited. Even though state-of-the-art medical systems such as the OCS, the HIS, the EMR, and the FACS are facilitating the computerization and informatization processes, they are for convenience and effectiveness. Ultimately, however, we should depend on specialists including doctors, nurses, pharmacists, and medical engineers. Therefore, a hospital is a representative labor-intensive body. Like other similar organizations, hospitals require a lot of manpower. But they are quite different in that hospital people hold variety and complexity in their qualifications and licenses. In personnel management, a hospital is twice controlled owing to the special characteristics that human life is at stake. First, the quota of medical manpower should be obeyed lest the quality of medical services should be lowered, and their roles and interrelations are even regulated. Second, in spite of the peculiarity of hospitals, the duties of obligatory employment and social insurances should not be neglected like other companies. In order that each hospital can preserve the proper level of medical services, securing the appropriate level of medical personnel has to be regulated. However, as the personnel cost is one of the important indices of hospital management, too much regulation in manpower supply can lead to poor hospital management and, in the end, the drop of the quality of medical services. In sum, as far as hospital personnel is concerned, some autonomy ought to be given to each hospital so that it can control the quality of hospital services. In addition to this minimum regulation of personnel, certain incentive and reward systems like the graded nursing system need to be prepared.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup1호
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• pp.17-23
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• 2016

The aim of this paper is to report the rate of current and ever cigarette smoking and explore correlates of current cigarette smoking among adolescents aged 13-15 in Viet Nam. This analysis was derived from GYTS survey, which comprised of 3,430 adolescents aged 13-15, conducted in 2014 in 13 cities and provinces of Viet Nam. We calculated the weighted rates of current and ever cigarette smoking and reported patterns of smoking behavior. We also performed logistic regression to explore correlates of current cigarette smoking behavior. The weighted rate of ever cigarette smoking was 9.5% (95% confidence interval (CI): 8.5 %-10.5%), in which the weighted rate among males (15.4%; 95% CI: 13.6%-17.0%) was higher than that among females (4.2%; 95% CI: 3.3%-5.1%). The weighted rate of current cigarette smoking was relatively low at 2.5% (95%CI: 2.0%-3.0%) with higher weighted rate among males (4.9%; 95% CI: 3.8%-5.9%) compared to the corresponding figure among females (0.2%; 95% CI: 0.0 %-0.5%). Current cigarette smoking was significantly higher among males than females, in students aged 15 versus 13 years old, and in students who had several or all close friends smoking and students with daily observation of smoking at school. For greater smoking reduction outcomes, we recommend that tobacco interventions for adolescents should consider targeting more male students at older ages, establish stricter adherence to school-based banning of cigarette smoking, engage both smoking and nonsmoking adolescents and empower adolescents to resist peer smoking influence as well as changing their norms or beliefs towards smoking benefits.

• Journal of Korean Medical Science
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• 제33권49호
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• pp.308.1-308.10
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• 2018

Background: The aim of this study was to describe the structure, organization, management, and staffing of pediatric critical care (PCC) in Korea. Methods: We directed a questionnaire survey for all Upper Grade General Hospitals (n = 43) in Korea in 2015. The first questionnaire was mainly about structure, organization, and staffing and responses were obtained from 32 hospitals. The second questionnaire was mainly about patients and management. Responses to second questionnaire were obtained from 18 hospitals. Results: Twelve from 32 Upper Grade General Hospitals had pediatric intensive care units (PICUs) and 11 of them had the PICU which was exclusive for children. Total number of PICU beds in Korea was 113. The ratio of the number of PICU beds to the number of children was 1:77,460 in Korea and this ratio is lower than that of other developed countries. The mean number of beds in the PICUs was $9.4{\pm}9.3$ (range, 2-30). There were 16 medical doctors who were assigned for PCC and only 5 of them were full time pediatric intensivists. In the 18 Upper Grade General Hospitals that responded to the second questionnaire survey, there were 97 patients in the PICUs with an average number of $5.7{\pm}7.2$ (range, 0-22) on the survey day. The mean age of the patients was $3.4{\pm}5.6$ years. The mean length of hospital stay was $82{\pm}271days$. The mean Pediatric Risk of Mortality score III was $9.4{\pm}7.8$ at the time of admission to the PICUs. Conclusion: There is a considerable shortage of PICU beds compared to those in developed countries. In addition, the proportion of PICUs with PCC specialists is much lower than those in the US and European countries.

• Genomics & Informatics
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• 제6권4호
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• pp.166-172
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• 2008

A multitude of protein-coding sequence variations (CVs) in the human genome have been revealed as a result of major initiatives, including the Human Variome Project, the 1000 Genomes Project, and the International Cancer Genome Consortium. This naturally has led to debate over how to accurately assess the functional consequences of CVs, because predicting the functional effects of CVs and their relevance to disease phenotypes is becoming increasingly important. This article surveys and compares variation databases and in silico prediction programs that assess the effects of CVs on protein function. We also introduce a combinatorial approach that uses machine learning algorithms to improve prediction performance.

• 한국실내디자인학회논문집
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• 제36호
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• pp.68-75
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• 2003

In Korea, even though many aspects of medical care system for the elderly have been considered. Until now, most people have realized that the conceptualization range of geriatric hospital is the same as recuperation hospital. However the recent geriatric hospital includes a short term treatment like general hospitals, together with that it has a tendency to increase the propotion of rehabilitationby the Introduction of the concept of active rehabilitation treatment for returning to society. Unlike the general hospitals, geriatric hospital has got different characteristics in a managing and patient. However this is not a concrete standard of faacilities by the law of health welfare and medical. So these kinds of research will have to keep continuing. What I want to say In this study is that the prominence of information, which is based on the existing data analysis, is what forms my latest projects that engage with a wider repertoire of strategies and approaches toward architectural problem.

• 경영과정보연구
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• 제1권
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• pp.413-443
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• 1997

In today's hospital-management, information system and the information by it will be a necessary administrative materials of organization with man-power, funds, equipment and resources. This study is for figuring out steps to utilize information-system, an important strategy to grow the hospital applying to the change of surroundings, improving the service for patients, accelerating medical examination, improving it in quality and suggesting a basis be able to manage it effectively by putting information system in practice such as economic effect by shorting time and the effect of medical study by computerizing clinical data. And the result of it is as follows: From the Nolan's 6 step - model about the degree using information system in hospital-management, the 1st group of hospital-size came to 1st and 2nd step, the 2nd group to the 3rd and 4th step and the 3rd group to the 5th and 6th step, which correspond to the survey- results that information system increases with the size of the hospital to propagation, regulation and integration step and that the number of the hospital developing to the step managing information is increasing.