• Journal of Korean Public Health Nursing
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• v.6 no.2
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• pp.58-69
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• 1992

The purposes of this study were 1) to assess the currunt documentation system 2) to identify the problems in communication regarding to documentation 3) to develop new documentation system 4) to suggest effective communication channel using new documentation system Research was conducted by direct observation, chart review, staffs interview and servey. Results were as follows: 1) nursing care plans were not used in ongoing care 2) documentation format was primarily narrative and charting was time consuming 3) documentation did not reflect the nursing process 4) patient records were not used as effective communication tool between case manager and part time nurse 5) difficult access to patient record for nurse manager created inefficiency in coordinating 6) documentation of patient education did not describe the precise contents of education, and the responses of the patients and evaluation To solve these problems, new documentation format was developed. With new formats nurses : 1) use standardized care plan which contains nursing diagnosis, ecpected outcome, time frame for evaluation, flow sheet for updating the plans 2) leave one copy of care plan at patient home for mutual agreement with patent and communication among nursing staffs 3) carry one copy of care plan for updating 4) document and evaluate the patient education using education check list keeping in patient's home 5) document nursing process in focus charting visit report 6) carry one copy of visit report 7) have one copy of visit report which was deligated to part time nurses 8) use documentation in direct communication with part time nurse 9) use beeper and memo to promote communication

• 대한상한금궤의학회지
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• v.13 no.1
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• pp.165-178
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• 2021

Objective: This study aimed to report the improvement of a patient with chronic insomnia who was treated with Baekho-tang based on the Shanghanlun disease pattern identification diagnostic system (DPIDS). Methods: The patient's symptoms were checked on days 19, 37, and 52 after taking Baekho-tang. Chronic insomnia was evaluated by the degree of insomnia, hours spent asleep, and the number of times the patient woke up during the night, which were all assessed by a visual analog scale (VAS) with the Leeds Sleep Evaluation Questionnaire. In addition, new clinical implications for the interpretation of the 350th Shanghanlun provision were reviewed. Results: After administering Baekho-tang for 52 days, based on the 350th Shanghanlun provision according to the DPIDS, the VAS score decreased from 10 to 1. Conclusions: The patient recovered from chronic insomnia. This case report suggests that the words "滑," "厥," and "裏" in the 350th provision of Shanghanlun mean physical and psychological causes of insomnia. In addition, Baekho-tang had a therapeutic effect in improving the chief complaint of the patient. Therefore, the interpretation of the 350th Shanghanlun provision requires a new definition that includes the patient's lifestyle, family conflict, and past history of the patient as a cause of chronic insomnia.

• Korean Journal of Clinical Pharmacy
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• v.31 no.1
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• pp.1-11
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• 2021

Objective: This study aimed to overview and assess the effectiveness of the policies and regulations that have governed new drug access in Korea, and to propose policies to enhance patient access to drugs, particularly for new innovative medicines. Methods: We approached drug access issues in two perspectives: approval lag (or availability) and reimbursement lag (or affordability). The issues were identified and evaluated through the review of literature, public documents, reports published by the government agencies and private organizations, and news articles. Results: To shorten approval lag, it is recommended to hire and train more reviewers at the Ministry of Food and Drug Safety. Increasing user fees to a realistic level can facilitate this process. To reduce reimbursement lag, flexible incremental cost-effectiveness ratio threshold, alternative cost-effectiveness evaluation, and establishment of funding source other than the national health insurance are identified as the areas to be improved. Conclusion: The current policies and regulations had to be supplemented by new systems to drastically promote patient accessibility to new drugs, consequently in order to promote national public health.

• Health Policy and Management
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• v.27 no.1
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• pp.39-46
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• 2017

Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.

• Health Policy and Management
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• v.25 no.4
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• pp.253-255
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• 2015

The concept of precision medicine-prevention and treatment strategies that take individual variability into account-is hot issue of US in the year 2015. Precision medicine is a new concept that approach patients individually by there characteristics, such as genome, life style, environmental exposure, etc. For developing the precision medicine, National Institute of Health of US has been prepared the Precision Medicine Initiative Cohort Program, at least 1 million people cohort. The US President Obama announced the Precision Medicine Initiative on 30th January 2015. He announced that he will pioneer a new model of patient-powered research that promises to accelerate biomedical discoveries and provide clinicians with new tools, knowledge, and therapies to select which treatments will work best for which patients. Most medical treatments have been designed for the 'average patient.' As a result of this 'one-size-fits-all-approach,' treatments can be very successful for some patients but not for others. This is changing with the emergence of precision medicine, an innovative approach to disease prevention and treatment that takes into account individual differences in people's genes, environments, and lifestyles. Precision medicine gives clinicians tools to better understand the complex mechanisms underlying a patient's health, disease, or condition, and to better predict which treatments will be most effective. The healthcare researcher should prepare the new medicine era such as bio-information technology convergence, big data study.

• Korean Journal of Clinical Pharmacy
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• v.30 no.3
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• pp.177-184
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• 2020

Background & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion: This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

• Journal of Medicine and Life Science
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• v.21 no.1
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• pp.15-19
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• 2024

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic necrotizing vasculitis that predominantly affects small vessels of the body. The two most common ANCAs are myeloperoxidase ANCA and proteinase 3 ANCA. Neurological manifestations are frequent in patients with AAV, including peripheral neuropathy, meningitis, and stroke. AAV-associated ischemic stroke usually affects small vessels supplying the white matter or brainstem. This case report details the presentation and treatment course of a 70-year-old man with rapidly progressive multiple intracranial large artery involvement attributed to myeloperoxidase ANCA-associated vasculitis. Despite treatment with high-dose steroids and a rituximab infusion, the patient developed new speech difficulties and respiratory distress, and brain imaging confirmed new stroke lesions with progressive multiple intracranial large cerebral artery involvement. The patient died from SARS-CoV-2 infection 4 months after the diagnosis. This case emphasized the rare presentation of rapidly progressive large vessel involvement in a patient with myeloperoxidase ANCA-associated vasculitis despite active immunotherapy.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.4
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• pp.494-505
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• 1999

In spite of the progress in techniques and materials of the prosthodontic rehabilitation of patients with complete edentulous arches, prosthodontists still face patients' complaints about dissatisfaction and discomfort from their dentures. In the past several decades, prosthodontists tried to find the factors that influence the patient's satisfaction with dentures. However the results are contraversial especially with the psychological factor. In this study using 'patient denture satisfaction questionnaire' and Hopkins Symptom Checklist, we tried to find the correlation between the patient's denture satisfaction and the patient's psychological aspects. 23 complete edentulous patients who have visited the Department of Prosthodontics, Yonsei University Dental Hospital from September 1998 to June 1999 for complete denture treatment were asked to complete the questionnaires 4 to 6 weeks after the upper and lower complete delivery. After the measurement of validity of the questionnaires, correlations between the patient's general satisfaction with their new upper and lower complete dentures and the other satisfaction questions including the satisfactions with esthetics, retention, mastication, speech, comfort and other people's opinion and between the patient's general satisfaction with their new upper and lower complete dentures and the 5 symptoms of Hopkins Symptoms Checklist including somatic, obsessive-compulsive, interpersonal sensitivity, depression and anxiety were analyzed. Among the several satisfaction questionnaire items, comfort with the lower denture showed highest relation to the patient's general satisfaction with dentures. However, only the anxiety scale of Hopkins Symptoms Checklist among the other symptom scales was related to the patient's general satisfaction with dentures. The two questionaires used in this study turned out to be valid means of analyzing patient's denture satisfaction and psychological status before and after the complete denture treatment.

• Korean Journal of Clinical Pharmacy
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• v.25 no.2
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• pp.68-73
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• 2015

With the changes in the pharmacy curriculum from a 4 year program to a 6 year program in 2009, a new subject called Pharmacy Practice Experience (PPE) has been launched into the curriculum. The purpose of introducing this subject is to increase the competency of new pharmacy graduates in providing quality healthcare to the community. This study has been done, via comparison among different pharmacy schools in Canada and Korea, to ensure that the competency of future Korean pharmacists can be increased with the introduction of this subject. In general, the Introductory Pharmacy Practice Experience (IPPE) in Korea consists of 60 hours while Canada consists of 320 hours (minimum). Furthermore, the Advanced Pharmacy Practice Experience (APPE) required in Korea is 1340 hours while Canada requires minimum of 960 hours. Specifically, comparing the Korean PPE curriculum to the PPE curriculums of University of Toronto (UT) and University of Waterloo (UW), UT and UW required a minimum of 75% and 89% direct clinical patient care experience respectively, either in hospital or community setting, compared to 45% in Korea; the remaining percentage in any of the universities can be fulfilled by taking other electives that may not require direct patient care experience. Observing these differences, it seems clear that the current PPE experience in Canada takes more of a patient focused approach than in Korea. Thus, with the recent movement in the Korean pharmacy community towards a more patient focused approach rather than a product focused approach, it would be beneficial to learn the differences between the PPE curriculums in Korea and Canada and apply any new understandings to the relatively newly introduced PPE program in Korea to further enhance the value of the new curriculum in helping to deliver quality patient care.

• Journal of Korean Clinical Nursing Research
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• v.28 no.3
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• pp.242-250
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• 2022

Purpose: This study was conducted to evaluate the performance following the application of the pilot program for the education nurse system of the Ministry of Health and Welfare in a medical institution. Methods: This study was employed a non-homogeneous comparative group design by comparing new nurses who entered the medical institution after the pilot project from December 2019 to April 2020 with new nurses who entered before the pilot project during the same period. Satisfaction, academic achievement, job adaptation, personal turnover within one year, and patient safety incident rate were investigated as performance indicators. Results: After the pilot project, the overall satisfaction among new nurses, preceptors, and fellow nurses increased, but there were no significant changes in academic achievement and job adaptation in new nurses. The personal turnover rate decreased from 15.6% to 9.1%, and the patient safety incident rate also decreased from 26.3% to 15.7%. Also, the preceptor overtime also decreased from 3.67 to 0.66 hours. Conclusion: The performance of the pilot project for the education nurse system was related to improvements in satisfaction, turnover rate of new nurses, patient safety incident rate, and preceptor overtime. Above all long-term monitoring of each performance indicator is necessary through the continuation of the education nurse system of the Ministry of Health and Welfare.