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자료포락분석방법을 이용한 내원환자의 지역별 벤치마킹분석 : 일개 한방병원을 중심으로 (Benchmarking the Regional Patients Using DEA : Focused on A Oriental Medicine Hospital)

  • 문경준;이광수;권혁준
    • 한국전자거래학회지
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    • 제19권3호
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    • pp.91-105
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    • 2014
  • 본 논문의 목적은 지역을 대상으로 자료포락분석방법을 적용하여 한방병원에 내원한 환자의 지역적 특성 분석 및 성과개선규모를 파악하는 데 있다. 본 논문에서 사용된 자료는 대전광역시에서 운영 중인 일개 한방병원을 대상으로 수집되었다. 환자의 위치 정보는 행정구역의 가장 작은 단위인 '동'을 사용하였으며, 연구대상 병원의 의무기록 자료에서 환자 주소를 기준으로 수집하였다. 각 행정동의 인구사회학적 변수들은 통계청 자료를 사용하였다. 자료포락분석을 이용하여 행정동에서 내원한 환자의 규모를 비교 평가하였고, 그리고 Tobit 회귀분석을 이용하여 효율성 점수와 지역 특성 변수들 간의 관계를 분석하였다. DEA 분석결과 효율적인 동은 6개였으며, Tobit 회귀분석에서는 각 동별 기초생활수급자수와 총인구수 변수에서 통계적으로 유의하였다. 본 논문에서는 분석단위를 행정구역의 최소단위인 행정동 별로 세분화하여 자료포락분석방법이 가지는 벤치마킹의 개념을 이용하여 분석하였다는 점에서 의의가 있다. 그리고, 병원의 성과 개선을 위해 필요로 하는 각 지역별 환자수를 구체적으로 파악하여다는 점에서 의의가 있다.

한 대학병원 종합건강진단센터에서 시행한 복부 초음파검사의 유소견 연구 (A Study on Abdomen Ultrasonography Classified by Particular Disease Practiced in Health Promotion Center of a University Hospital)

  • 김남희;최종학
    • 대한방사선기술학회지:방사선기술과학
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    • 제24권1호
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    • pp.33-41
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    • 2001
  • This study is to get preliminary data for an effectiveness evaluation of abdominal examination and improvement of it. Abnormal cases of abdominal ultrasonography are classified by sex, frequency, diagnosis and age. 4,924 examinees were included at a university hospital of health promotion center from January to December in 1999. The results are as follows. 1. According to the distribution of sex, there are more male patients(55.0%) than females patients(48.0%). For men, 40's showed the highest percentage among examinees. For women, 50's were the highest. 2. The reason that they visited the health promotion center was that 'they wanted to check their health status'. This answers were reported the highest(59.3%). 3. Patients that had abnormal cases of abdominal ultrasonography were 48.3%. Liver, kidney, gallbladder showed the highest percentage of abnormal cases in order of organs. Additionally, abnormal cases were discovered in liver cases. 4. According to the frequency of abnormal cases among examinees, the slight fatty liver were the highest regardless of sex. Men had the slight fatty liver, kidney simple cyst, liver calcification and liver simple cyst in order of abnormal cases. Women showed the slight fatty liver kidney simple cyst, kidney calcification, liver simple cyst, and blood vessel tumor in order of abnormal cases. 5. For the abnormal cases of liver by sex and age, the 50's reported the highest number of abnormal cases in men(299 patients). In addition, 60's had the highest of disease rata 47.8%. For women, 50's reported the highest number of abnormal cases(361 patients). Over 70's patients had the highest of disease rata 52.6%. For kidney, men and women showed the highest number of abnormal cases -62 vs 44 respectively. Over 70's patients had the highest percentage of disease rata-23.2% vs 14.0% respectively. For gallbladder, the number of abnormal cases were the most in men's 60's (31 patients) and in women's in the same age group (32patients). Disease showed the highest percentage in men's 60's(7.6%) and in women's 70's (14.0%). 6. According to malignant tumor, 17patients were liver cancer, 2patients stomach ca and 1pt kidney cancer. 7. The relationship between the malignant tumor and the examination motive was that 'they wanted to check their health status(41.0%)' and 'regular checkup (24.0%)'.

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한의원 환경 및 경영 현황 변화에 대한 연구;한의원 시설 및 인력, 환자, 매출액을 중심으로 (Status of changes in the business environment of Oriental medicine clinics;With the focus on their facilities, staff, patients and service fee revenue)

  • 황대선;이경구;신현규
    • 대한한의학회지
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    • 제29권3호
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    • pp.100-112
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    • 2008
  • Objectives: The purpose of this survey is to monitor the changes that have occurred in the business environment surrounding Oriental medicine clinics, with the focus on their facilities, staff, patients, and service fee revenue. Method adopted: A questionnaire was sent in December 2006 to 1,000 Oriental medicine clinics nationwide, of which 122 (or 12 percent of them) replied. Previous questionnaires similar to this one in nature were checked for comparison. Results: As a result of analyzing the aforesaid replies, the average Oriental medicine clinic appears to have a floor size of 156 square meters (= 47.2 pyeong) and is equipped with 6.6 beds. The number of helpers and nurse's aids at each Oriental medicine clinics comes to 3.2 and 1.58, respectively. The number of patients coming to see a practitioner of Oriental medicine stands at 36.3 persons per day, of whom 32.06 come for acupuncture treatment. 50.2 percent of the Oriental medicine clinics' service fee revenue is paid from the health insurance. Each clinic spends on average 2.42 million won per month on the purchase of medicinal substances and so forth. The foregoing indicates a 27 percent increase from 1999 in terms of floor size, a 30 percent increase in the number of beds, a 47 percent increase in the number of helpers, a 45 percent increase in the number of nurse's aides, and an 11 percent increase in the number of patients who visit a practitioner of oriental medicine. As for the latter figure, there was an increase of 3.64 over a seven-year period. The number of patients coming for acupuncture treatment increased by 7.06 in the same period, whereas the number of those coming for medication treatment decreased by 4.28 percent. Health insurance payments as a proportion of Oriental medicine clinics' service fee revenues increased by 23.9 percentage points from 26.29 percent in 1997 to 50.2 percent in 2006. The amount that a clinic spends on the purchase of medicinal substances, etc, decreased by 250,000 won or by 9.3 percent from 1999. The estimated value of the domestic Oriental medical service market for 2006 stood at 2,422.2 billion won in total. Conclusion: Oriental medicine clinics in Korea appear to be getting larger, with an increase in the number of beds and helpers. Health insurance payments now account for a greater proportion of Oriental medicine clinics' service fee revenues, and management conditions at the clinics are deteriorating.

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근치 절제술을 시행한 위암에서 절제림프절 수의 임상적 의의 (The Prognostic Significance of the Number of Resected Lymph Nodes in Gastric Cancer Patients)

  • 김세진;장유진;김종한;박성수;박성흠;김승주;목영재;김종석;안형진
    • Journal of Gastric Cancer
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    • 제9권4호
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    • pp.246-255
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    • 2009
  • 목적: 위암의 근치 절제술에서 광범위 림프절 절제는 중요한 의미를 가지며 전이 림프절의 수가 종양의 침윤 정도와 함께 병기 결정의 기준이 되고 있다. 이에 저자들은 근치 절제술을 시행 받은 위암 환자에서 절제 림프절 수가 생존율에 미치는 영향을 분석하고 종양의 각 병기에 따라서 생존율 및 병기결정에 영향을 미치는 절제 림프절수의 최소 기준값을 구하고자 하였다. 대상 및 방법: 1992년부터 2002년까지 고려대학교병원에서 근치적 위절제술을 시행 받고 5년 이상 추적 관찰이 가능하였던 949명의 환자들을 대상으로 하였다. 조직검사결과에 따른 종양 침윤 정도에 따라 환자군을 분류하여 절제 림프절의 수를 조사하였다. 절제 림프절 수의 최소 기준값은 생존율에 유의한 차이를 보이는 최소값으로 정하였다. 결과: 종양의 크기, 위치, 림프절 병기, 전이 림프절의 수 및 절제 림프절의 수는 종양의 병기에 따라 유의한 차이를 보였다. Cox 비례위험모형을 통한 분석 결과 절제 림프절 수의 최소 기준값은 전체 환자에서는 14개였으며 각 병기별로 pT1군에서 15개, pT2군에서 28개, pT3군에서 37개의 값을 보였고 기준값 이상으로 절제된 경우 생존율이 유의하게 높았다. 결론: 근치적 위절제술을 받은 환자에서 기준값 이상의 림프절 절제가 생존을 향상시킬 수 있으며 이를 위해 외과의가 근치적 위절제술 시 기준값 이상의 림프절 절제술을 위해 노력해야 하며 병리의는 절제된 조직의 림프절 개수의 정확한 결과를 보고 하기 위해 더욱 노력해야 할 것이다.

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전이성 뇌종양의 1년간 추적 관찰연구-불량한 예후와의 연관성 (One Year Follow-up Evaluation of Metastatic Brain Tumors - with Relevant to the Poor Prognosis)

  • 이형중;김충현;김재민;백광흠;오석전
    • Journal of Korean Neurosurgical Society
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    • 제30권9호
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    • pp.1108-1114
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    • 2001
  • Objective : Prognostic factors of metastatic brain tumors have been widely reported and their operative indications also have been extended gradually even to the poor grade patients. Authors intended to analyze the causative factors for the clinical outcome of metastatic brain tumors, especially with relevant to the poor prognosis by one year follow-up evaluation. Patients and Methods : The authors retrospectively studied the clinical characteristics of 46 cases(35 patients) with metastatic brain tumors among 466 cases(437 patients) which were operated on due to the brain tumor, during the period between January 1994 to June 1999. Statistical analysis was performed by using SPSS 8.0$^{(R)}$. A p-value of less than 0.05 was considered clinically significant. Result : Among the variable clinical factors in patients with metastatic brain tumors, Karnofsky Performance Scale (KPS) score of less than 70(16 patients), uncontrolled primary tumor(8 patients), and surgical resection without further adjuvant therapy(9 patients) showed statistically significant poor prognosis ; p value of 0.002, 0.032, and 0.001, respectively. Other tested variables, such as old age(greater than 65 years ; 10 patients), gender(male ; 20 patients), type of primary cancer(primary undefined ; 6 patients, lung cancer ; 15 patients), location(infratentorial ; 9 patients, sellar ; 5 patients), number of lesion(multiple ; 12 patients), and number of operation(multiple craniotomy ; 7 patients) were not related to the poor prognosis. Conclusions : The most common primary site of distant metastasis was lung. The poorer prognosis was highly correlated with various factors including low KPS score(<70), no postoperative adjuvant therapy, and uncontrolled primary tumors.

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문서 라우팅 기법을 이용한 간호진단 과정에서의 정보접근 (Applying document routing mode of information access in nursing diagnosis process)

  • 백우진
    • 한국정보관리학회:학술대회논문집
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    • 한국정보관리학회 2006년도 제13회 학술대회 논문집
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    • pp.163-168
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    • 2006
  • Nursing diagnosis process is described as nurses assessing the patients' conditions by applying reasoning and looking for patterns, which fit the defining characteristics of one or more diagnoses. This process is similar to using a typical document retrieval system if we consider the patients' conditions as queries, nursing diagnoses as documents, and the defining characteristics as index terms of the documents. However, there is a small fixed number of nursing diagnoses and infinite number of patients' conditions in a typical hospital setting. This state is more suitable to applying document routing mode of information access, which is defined as a number of archived profiles, compared to individual documents. In this paper, we describe a ROUting-based Nursing Diagnosis (ROUND) system and its Natural Language Processing-based query processing component, which converts the defining characteristics of nursing diagnoses into query representations.

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Clinical Characteristics and Polysomnographic Features of Patients Visited a Snoring and Sleep Apnea Clinic of Dental Hospital in Korea

  • Kim, Ji-Rak;Chung, Jin Woo
    • Journal of Oral Medicine and Pain
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    • 제42권1호
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    • pp.1-7
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    • 2017
  • Purpose: The aims of this study were to evaluate the clinical characteristics and polysomnographic results of patients visited the Seoul National University Dental Hospital (SNUDH) and to suggest guidelines for the management of sleep disordered-breathing patients in a dental clinic. Methods: Five hundred sixty-two patients who visited the Snoring and Sleep Apnea Clinic of SNUDH were evaluated for clinical characteristics including associated comorbidities, age, gender, body mass index (BMI), neck circumference, and daytime sleepiness and among them 217 patients were performed nocturnal polysomnography for evaluating respiratory disturbance index, apnea-hypopnea index (AHI), oxygen saturation levels, and sleep stages. The associations among clinical characteristics, sleep parameters, and positional and rapid eye movement (REM) dependencies of the patients were analyzed. Results: The most common co-morbidities of the patients were cardiovascular (30.2%), endocrine (10.8%), and respiratory diseases (7.9%). Age (${\beta}=0.394$), total AHI (${\beta}=0.223$), and lowest $O_2$ saturation levels (${\beta}=0.205$) were significantly associated with the number of co-morbidities in patients with obstructive sleep apnea (OSA). Mean $O_2$ saturation was not significantly associated with number of co-morbidities. Non-positional OSA patients had higher BMI, longer neck circumferences, more severe AHI values, and lower mean and lowest $O_2$ saturation levels compared to positional OSA patients. Not-REM-related patients were older and had more severe AHI values compared to REM-related patients. Not-REM-related patients have longer duration of stage I sleep and shorter stage II, III, and REM sleep than REM-related patients. There were no significant differences in each sleep stage between positional and non-positional patients. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA. Conclusions: Age, total AHI, and lowest $O_2$ saturation level were significantly associated with the number of co-morbidities in patients with OSA. Neck circumference, positional dependency, REM dependency, and percentage of supine position were significantly associated with severity of OSA.

진료의뢰센터 경유환자의 진료비 영향요인에 관한 연구: 소화기내과 환자를 중심으로 (Study on the Medical Cost of Patients Visited by Referral Center: Focusing on the Patient in Gastroenterology)

  • 최영두;이광수;홍상진
    • 보건의료산업학회지
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    • 제6권2호
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    • pp.101-109
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    • 2012
  • This study purposed to analyze the differences of cost, length of stay, and number of visits between patients who referred from clinics to a general hospital and patients who directly visit a general hospital. Study sample included 402 patients (177 patients who were not referred from clinics, 225 patients who referred from clinics) who visited the Dept. of Gastroenterology in a university hospital in Daejeon from January to June in 2007. Cost and patients' information were collected from Hospital Information System and medical record. SPSS v.12.0 was used for the statistical analysis. Multiple regression analysis found that for inpatients, location variables and malignant tumors of digestive organs had a significant influence on cost variable. For outpatients, a referring hospital type and visiting month had significant influences on total cost, and sex and visiting month (February) had significant relationship with number of visit. The study results help to understand the differences of patient care depending on whether they were referred from clinics or not. Hospital managements could use the results for marketing purposes, and it could provide valuable information for increasing the competitiveness of hospital in a given market.

인공 슬관절 치환술 후 치료순응도와 경과기간에 따른 회복 양상 (Recovery According to Follow-up Period and Compliance in Osteoarthritic Patients after Knee Replacement Arthroplasty)

  • 박수아;강현숙;최진이
    • 동서간호학연구지
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    • 제16권2호
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    • pp.164-171
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    • 2010
  • Purpose: The aim of study was to investigate relationship between compliance and recovery of patients with osteoarthritis of the knee patients after knee arthroplasty. Methods: 193 patients living in Seoul were participated in this study. Data were collected using the Knee Society Clinical Rating System and Medical Outcomes Study Short Form 36(SF-36) and analyzed by ANCOVA, t-test, and repeated measure ANOVA. Results: There was a significant difference of physiological recovery based on the number of co-morbidity patients have. Physical recovery level was different according to age, religion, and the number of co-morbidity. Age and education level of patients were different in emotional recovery. The level of physiological and physical recovery were significantly different consistent with compliance. Compared to preoperative scores, physiological and physical scores showed significant improvement at six weeks, three months, and six months after surgery while emotional scores did not showed significant improvement. Conclusion: The results of this study suggest that nursing interventions to increase compliance are needed for better recovery of patients after knee arthroplasty.

Analysis of sedation and general anesthesia in patients with special needs in dentistry using the Korean healthcare big data

  • Kim, Jieun;Kim, Hyuk;Seo, Kwang-Suk;Kim, Hyun Jeong
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권3호
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    • pp.205-216
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    • 2022
  • Background: People with special needs tend to require diverse behavioral management in dentistry. They may feel anxious or uncomfortable or may not respond to any communication with the dentists. Patients with medical, physical, or psychological disorders may not cooperate and therefore require sedation (SED) or general anesthesia (GA) to receive dental treatment. Using the healthcare big data in Korea, this study aimed to analyze the trends of SED and GA in special needs patients undergoing dental treatment. It is believed that these data can be used as reference material for hospitals and for preparation of guidelines and related policy decisions of associations or governments for special needs patients in dentistry. Methods: The study used selected health information data provided by the Korean National Health Insurance Service. Patients with a record of use of one of the eight selected drugs used in dental SED between January 2007 and September 2019, those with International Classification of Diseases-10 codes for attention deficit hyperactivity disorder (ADHD), phobia, brain disease, cerebral palsy, epilepsy, genetic disease, autism, mental disorder, mental retardation, and dementia were selected. The insurance claims data were analyzed for age, sex, sedative use, GA, year, and institution. Results: The number of special needs patients who received dental treatment under SED or GA from January 2007 to September 2019 was 116,623. Number of SED cases was 136,018, performed on 69,265 patients, and the number of GA cases was 56,308, implemented on 47,257 patients. In 2007, 3100 special needs patients received dental treatment under SED while in 2018 the number of cases increased 6 times to 18,528 SED cases. In dentistry, ADHD was the most common disability for SED cases while phobia was the most common cause of disability for GA. The male-to-female ratio with respect to SED cases was higher for males (M : F = 64.36% : 35.64%). Conclusion: The application of the SED method and GA for patients with special needs in dentistry is increasing rapidly; thus, preparing guidelines and reinforcing the education and system are necessary.