• Title/Summary/Keyword: Medication Therapy Management

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Medical Expenses Structure on Hospitalized Patients of an Oriental Medical University Hospital (한방병원 입원환자의 진료비 구조 분석)

  • 서미경;이석구
    • Health Policy and Management
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    • v.6 no.2
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    • pp.115-130
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    • 1996
  • This study was performed to investigate the practical oriental medical expenses by the use of internal data of an oriental hospital due to the bias of medical insurance program data. The purpose of this study was to describe prevalent diseases of clinical department in the studied hospital, to analyze medical expenses structure and to verify the each cost share ration of expenses on insurer to insuree. Under this purpose, we analyzed actual medical expenses data of 1,611 hospitalized patients of the oriental medical university hospital with 150 beds that can be approached to internal data from Jan. 1, 1994 to Dec. 31, 1994. The major findings are as follows : 1. Upper five of most frequent diseases of admitted patients were Joul-Jung-Pung(55.5%), Yoo-Kak-Tong(7.3%), Yoo-/Tong(7.1%), Gu-An-Wa-Sa(2.7%) and sequale of Joul- Jung-Pung(2.4%) 2. In medical expenses structure, hospital ward fee was 47.1%, medication fee 41.3%, fee for procedure(acupuncture, moxibustion, negative therapy, physical therapy, etc) 11.1% and consultation fee 0.5%. In addition to the cost share ration of insuree & that of insurer was 75:25 respectly.

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CLINICAL STUDY OF BISPHOSPHONATE-INDUCED OSTEONECROSIS OF MANDIBULAR AND MAXILLARY BONE (비스포스포네이트로 인한 하악 및 상악골에 발생한 골괴사에 대한 임상적 연구)

  • Joeng, Hye-Rin;Kim, Tae-Wan;Lee, Jeong-Keun;Song, Seung-Il
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.35 no.5
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    • pp.353-360
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    • 2009
  • Bisphosphonates are compounds widely used in the treatment of various metabolic and malignant bone disease. Recently, an association between bisphosphonate use and a rare dental condition termed 'osteonecrosis of the jaw(ONJ)' has been reported. Bisphosphonate-related osteonecrosis of the jaw(BRONJ) is rare, but serious, side effect of bisphosphonate therapy in affected patients. It is characterized by poor wound healing and spontaneous intra-oral soft tissue break down, which lead to exposure of necrotic maxillary and mandibular bone. We reviewed 11 patients of BRONJ visited Ajou University Hospital Dental clinic from May 2007 to November 2008. The management of the patients included cessation of bisphosphonate therapy and various surgical restorative procedures and conservative care there after. Aggressive debridement is contraindicated. A new complication of bisphosphonate therapy administration, osteonecrosis of jaws, seems to be developing. The improved results after cessation of the medication should make clinicians reconsider the merits of the rampant use of bisphosphonates, while further investigation is needed to completely elucidate this complication.

Effect of Kynesio-Taping Therapy on Pain Among Community-Dwelling Older Adults (키네시오 테이핑 요법이 지역사회 거주 노인의 통증완화에 미치는 영향)

  • Lee, Ji-A;Park, Dal-A;Ji, Eun-Sun
    • Journal of East-West Nursing Research
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    • v.14 no.2
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    • pp.67-73
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    • 2008
  • Purpose: The purpose of this study was to examine the effect of Kynesio-taping therapy (KTT) on chronic joint pain among community-dwelling older adults. Methods: A pre-experimental design was used. KTT was employed on 23 consenting community older adults visiting a community center. KTT was applied on the painful joint for 3-4 days. Pain was evaluated using the visual analogue scale. Results: Frequent locations of pain were waist (43.8%), knee (28.1%), shoulder (12.4%), and head (9.4%). Time of severe pain during the day was mid-day (47.8%), early morning (21.7%), and evening (13.0%). Pain relief management included hospital visitation (65.2%), medication (17.4%), and application of a poultice (13.0%). Pain scores were significantly decreased after KTT compared to pretest scores acquired prior to taping (p<.001). Conclusions: KTT is a cost-effective, easy-to-use, and effective form of pain relief in older adults with chronic joint pain. Clinical practitioners can consider KTT as a complementary method of chronic pain control in older adults.

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A Case of Morbid Obese Patient with Comorbidities: Why a Lifestyle Modification is Important (동반 질환을 가진 고도 비만 환자의 증례: 생활습관 교정이 왜 중요한가?)

  • Eunjin Shin;Seon Yeong Lee
    • Archives of Obesity and Metabolism
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    • v.2 no.2
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    • pp.64-70
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    • 2023
  • Obesity is a complex multifactorial disease that is associated with various complications, including cardiovascular diseases. The prevalence of obesity among young adult males has increased, and this has increased the prevalence of several comorbidities. This trend was closely linked to lifestyle factors, including heavy drinking, smoking cigarettes, and an imbalanced diet. This emphasized the necessity of lifestyle improvements for effective obesity management. In this case, the comprehensive lifestyle changes and adjuvant medication resulted in weight loss and improvement in several comorbid conditions in a young adult male. The case highlighted the importance of a comprehensive approach to managing obesity. Furthermore, it emphasized the importance of a healthy lifestyle in addressing obesity and its complications.

The effect of Jeon-buk area daytime ward occupational therapy convergent activity on hand function, cognitive function and IADL in people with dementia (전북지역 낮 병동 작업치료 융복합활동프로그램이 치매환자의 손기능, 인지기능 및 수단적 일상생활활동에 미치는 영향)

  • Kim, Hyun-Gi;Lee, Min-Young;Kim, Ko-Un;Oh, Hye-Won
    • Journal of Digital Convergence
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    • v.15 no.4
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    • pp.511-519
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    • 2017
  • This study developed a occupational therapy convergent activity program to provide dementia patients admitted to the daytime ward, and investigated the program's effect on the hand and cognitive functions and instrumental activities of daily living. A total of 34 dementia patients were divided into two groups: a convergent occupational therapy program and medication were provided for 17 patients, and medication alone was provided for a control group of 17. The intervention was performed for 24 weeks, 8 times per week, 192 times in total. A handgrip strength test was performed to examine hand function before and after the intervention, and the MMSE-K and GDS were performed to evaluate cognitive function. In addition, the K-IADL was used to assess instrumental activities of daily living. With intervention, the experimental group showed significant improvements in hand and cognitive function and instrumental activities of daily living. In contrast, the control group did not show improvements in hand and cognitive function or instrumental activities of daily living. In conclusion, the study showed that a convergent/integrated activity program for occupational therapy has a positive effect on hand and cognitive function as well as instrumental activities of daily living.

Analysis of the Nursing Interventions done by MICU and SICU nurses using NIC (간호중재분류체계 (NIC)를 이용한 내외과계 중환자실 간호중재 분석)

  • 류은정;최경숙;권영미;주숙남;윤숙례;최화숙;권성복;이정희;김복자
    • Journal of Korean Academy of Nursing
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    • v.28 no.2
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    • pp.457-467
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    • 1998
  • The purpose of this research was to identify nursing interventions performed by MICU and SICU nurses. For data collection this study used the taxonomy of the Nursing Interventions Classification (NIC : 433 nursing interventions) which was modified by McCloskey and Bulecheck(1996). Each of the 433 interventions were identified as used by MICU and SICU nurses. More than 50% of the ICU nurses performed 280 nursing interventions at least monthly. Rarely used interventions included 26 nursing interventions in the childbearing care class. Overall, both MICU and SICU nurses used interventions in the Physiological : Complex domain most often on a daily basis and the interventions in the Family domain least often. The most frequently reported interventions as being used daily in the MICU were chest physiotherapy, airway suctioning and coughing enhancement and, in the SICU, documentation and airway suctioning. There were significant differences between MICU and SICU nurses in 17 nursing interventions childbearing care, cognitive therapy, communication enhancement, coping assistance, elimination management, lifespan care, health system mediation, immobility management, medication management, neurologic management, patient education, psychological comfort promotion, physical comfort promotion, respiratory management, risk management and information management. The SICU nurses performed there interventions more frequently than the MICU nurses. These findings will help in building of a standardized language for the MICU and SICU and enhance the quality of nursing care.

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Effect of Eye Drop Education on Adherence to Glaucoma Medication (점안 지도가 항녹내장 안약의 처방 순응도에 미치는 영향)

  • Park, Kyung-Ji;Song, Hyun Ju;Sohn, Uy Dong
    • YAKHAK HOEJI
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    • v.57 no.2
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    • pp.139-149
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    • 2013
  • Glaucoma is a potentially blinding chronic disease requiring life-long commitment to medical therapy. Failure to adhere to anti-glaucoma treatment may lead to disease progression and visual loss. This study surveyed the adherence to glaucoma eye drop and eye drop instillation technique of glaucoma patients and analyzed the improvement of the adherence and installation technique after patient education for eye drop instillation instructions. Collected responses were statistically analyzed using Kruskal-Wallis test, Mann-Whitney test, Chi-square test, Fisher's exact test, Spearman's correlation coefficient, or one sample proportion test. The survey after patient education for proper eye drop instillation revealed that, even if the patients experienced the adverse effect of their eyes getting dry, they used the eye drop more regularly. They were better at instillation techniques like putting the eye drop inside the eye, and also avoiding applying too much medication or touching their eye with the eye drop bottle. Also, when the patients were divided into groups based on etiologic division, there was difference among groups regarding which category they answered has improved. The result showed improvement in adherence to glaucoma eye drop and eye drop instillation technique after patient education, implicating that patient education is an important aspect of eye care for glaucoma patient and helps them participate in the proper management.

Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: Yes, in Considerable Cases (만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 긍정적인 입장에서)

  • Chang, Sang-Bum
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.3-6
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    • 2010
  • The British guideline for early management of persistent low back pain, published in 2009, indicated that physicians should offer exercise or medication, rather than radiological interventions or injections, as first choice of treatment in the patients with chronic low back pain (CLBP). However, there had been great controversies regarding the effectiveness of interventional treatment of patients with CLBP. Both somatic (discogenic, instability, etc) and psychosocial factors contribute to the pathophysiology of chronic low back pain (CLBP). Although it can be difficult in many occasions, thorough interview with the patients and specific diagnostic approaches can help us to identify which is the main etiology in individual patient. With the recent progress in medical radiology and development of new therapeutic modalities, some subgroups of patients of CLBP caused by somatic factors appear to be good candidates of interventional therapy. Interventional therapy can be considered in patients with CLBP caused by annulus rupture, facet joint degeneration, disc degeneration, and vertebral column instability. Among other subgroups of CLBP, carefully selected patients with disc degeneration show the most favorable result by interventional therapy. In this regard, discogenic pain, either as a form of CLBP or acute discogenic radiculopathy, seems to be a good indication of interventional therapy. Because many spine specialists generally consider those with radiculopathy are easier to be treated, patients with CLBP tend to be subjects of conventional conservative therapy. For these reasons, clinicians should make their best effort to identify every possible somatic cause in patients with CLBP before regarding them as hypochondriacs. In this review, some of the recent evidence on the role of interventional treatment in patients with CLBP will be discussed, and some of our cases who showed favorable results by interventional therapy will be presented.

Ultrasound-guided PENG block versus intraarticular corticosteroid injection in hip osteoarthritis: a randomised controlled study

  • Selin Guven Kose;Halil Cihan Kose;Feyza Celikel;Serkan Tulgar;Omer Taylan Akkaya
    • The Korean Journal of Pain
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    • v.36 no.2
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    • pp.195-207
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    • 2023
  • Background: This study aimed to compare the effectiveness of the pericapsular nerve group (PENG) block and intra-articular injection (IAI) of steroid-bupivacaine in the treatment of hip osteoarthritis (OA). Methods: After randomization, patients received either a PENG block or IAI under ultrasound-guidance. Clinical evaluations were recorded at baseline, day 1, and weeks 1, 4, and 8 post-intervention. The numerical rating scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC), Harris Hip Scale (HHS) scores, pain medication use determined by a quantitative analgesic questionnaire, and patient satisfaction were evaluated. Results: Sixty patients were included in this study. NRS scores improved significantly for both groups during the follow-up compared to pretreatment (P < 0.001), with better pain scores for the PENG group (P < 0.001) at day 1 with larger effect size (Cohen's d = 4.62), and IAI group at 4 (Cohen's d = 5.15) and 8 (Cohen's d = 4.33) weeks (P < 0.001). There was no significant difference in pain medication consumption (P = 0.499) and patient satisfaction (P = 0.138) between groups. Patients in the IAI group experienced significant improvement in HHS (Cohen's d = 2.16, P = 0.007) and WOMAC (Cohen's d = 1.02, P = 0.036) scores at 8 weeks compared to the PENG group. Conclusions: The ultrasound-guided PENG block provides effective pain relief which improves functionality and quality of life in hip OA patients up to 2 months. The PENG block can be considered an easy, safe, and useful alternative treatment modality for hip OA.

Clinical Outcomes of Spontaneous Spinal Epidural Hematoma : A Comparative Study between Conservative and Surgical Treatment

  • Kim, Tackeun;Lee, Chang-Hyun;Hyun, Seung-Jae;Yoon, Sang Hoon;Kim, Ki-Jeong;Kim, Hyun-Jib
    • Journal of Korean Neurosurgical Society
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    • v.52 no.6
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    • pp.523-527
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    • 2012
  • Objective : The incidence of spontaneous spinal epidural hematoma (SSEH) is rare. Patients with SSEH, however, present disabling neurologic deficits. Clinical outcomes are variable among patients. To evaluate the adequate treatment method according to initial patients' neurological status and clinical outcome with comparison of variables affecting the clinical outcome. Methods : We included 15 patients suffered from SSEH. Patients were divided into two groups by treatment method. Initial neurological status and clinical outcomes were assessed by the American Spinal Injury Association (ASIA) impairment scale. Also sagittal hematoma location and length of involved segment was analyzed with magnetic resonance images. Other factors such as age, sex, premorbid medication and duration of hospital stay were reviewed with medical records. Nonparametric statistical analysis and subgroup analysis were performed to overcome small sample size. Results : Among fifteen patients, ten patients underwent decompressive surgery, and remaining five were treated with conservative therapy. Patients showed no different initial neurologic status between treatment groups. Initial neurologic status was strongly associated with neurological recovery (p=0.030). Factors that did not seem to affect clinical outcomes included : age, sex, length of the involved spinal segment, sagittal location of hematoma, premorbid medication of antiplatelets or anticoagulants, and treatment methods. Conclusion : For the management of SSEH, early decompressive surgery is usually recommended. However, conservative management can also be feasible in selective patients who present neurologic status as ASIA scale E or in whom early recovery of function has initiated with ASIA scale C or D.