• Title/Summary/Keyword: Operating Method

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A Technique of Forecasting Market Share of Transportation Modes after Introducing New Lines of Urban Rail Transit with Observed Mode Share Data (관측 교통수단 분담률 자료를 활용한 도시철도 신설 후 수단분담률 예측분석 기법)

  • Seo, Dong-Jeong;Kim, Ik-Ki;Lee, Tae-Hoon
    • Journal of Korean Society of Transportation
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    • v.30 no.1
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    • pp.7-18
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    • 2012
  • This study suggested a method of forecasting market-share of each mode after introducing new urban rail transit lines. The study reflected the observed market share of presently operating urban rail transit into forecasting process in order to improve accuracy in predicting market share of each modes. For more realistic representation of the forecasting model, we categorized O/D pairs according to attributes of trip distance, access time and number of transfers. The analysis results of traveler's mode choice behavior with observed data showed that the trip distances are longer, the share of urban rail tends to be higher, and that the number of transfers is fewer and the access times are lesser, the share of urban rail also tends to be higher. Then, incremental logit model was used in estimating mode choice probabilities for O/D pairs along with rail transit lines while utilizing observed market shares of each modes and differences in transit service level. As the next step, the market share of rail transit after introducing new rail transit lines was forecasted by using incremental logit model with the intial share values calculated the previous analysis step. It also reflected changes in level of service for automobile in highway due to changes in highway systems and changes in mode shares after introducing new lines of rail transit. It can be expected that the proposed method would more realistically duplicates phenomena of mode choice behavior for rail transit and that it would be more theoretically logical than the typical existing methods using SP data and incremental logit model or using addictive logit model in this country.

The status of 「Logic and Writing in Home Economics Education」 course and the students' perception about the course (「가정과 논리 및 논술」 교과목의 운영 실태 및 가정교육과 학생의 인식)

  • Choi, Min-Ji;Chae, Jung-Hyun;Jun, Mi-Kyung
    • Journal of Korean Home Economics Education Association
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    • v.27 no.1
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    • pp.51-65
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    • 2015
  • The purpose of the study was to describe the operating status of "Logic and Writing in Home Economics Education(HEE)" course and the students' perception about the course. For this study, the syllabuses of "Logic and Writing" course in HE education department were reviewed. The survey method was used in this descriptive study. Respondents in this study were 116 students taking the "Logic and Writing in Home Economics Education" course. Questionnaires from the students were collected through on-line and off-line mail. The results of the study were as the follows: First, goals of the "Logic and Writing in HE Education" course were as the follows in order: to enhance writing skill about various subjects related to Home Economics; to foster HE teachers' professionalism through persuasive power logically; to foster writing skill logically; to prepare HE teacher recruitment exam; and to foster teaching skills to enhance students' writing. The student evaluation methods in the course were mainly attendance, examination, tasks, discussion and presentation, and class participation. Second, degree of satisfaction of students taking the course was higher than average. The student respondents perceived that the course was helpful to improve their logical thinking and critical analytical skill, writing skill related to HE education and education, ability to express one's opinion clearly and exactly, understanding of the fundamental concept of logic and the structure and method of the essay, comprehensive understanding of HE education, and ability to solve the problems specifically. However, they responded that it was difficult to practice writing, to discuss and debate frequently, to follow uncertain assessment criteria, and to present frequently. They wanted the instructor to give the feedback more frequently.

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Analyses of the Efficiency in Hospital Management (병원 단위비용 결정요인에 관한 연구)

  • Ro, Kong-Kyun;Lee, Seon
    • Korea Journal of Hospital Management
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    • v.9 no.1
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    • pp.66-94
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    • 2004
  • The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

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A Study of Establishing the Plan of Lodging for the Workers of Gaesung Industrial Complex (개성공단 근로자 기숙사 건립 계획 연구)

  • Choi, Sang-Hee;Kim, Doo-Hwan;Kim, Sang-Yeon;Choi, Eun-Hee
    • Land and Housing Review
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    • v.6 no.2
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    • pp.67-77
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    • 2015
  • Now that it is the current situation that the smooth supply and demand are necessary for 2nd phase of beginning construction and stable development of Gaesung Industrial Complex, this study was willing to offer the planning criteria and model to establish the lodging for the workers in Gaesung Industrial Complex based on the agreement that both South and North Korea agreed in 2007. Regarding the plan, its standard and the alternative were reviewed considering welfare of workers, economic efficiency, technical validity, possibility of agreement and long-term development. The exclusive area per capita was calculated through Labor Standards Act of Korea and status survey of lodging for the workers provided to border line area between China and North Korea and the economic alternative based on one room for 6 persons with the public restroom was compared with that of development type based on one room for 4 persons with indoor restroom. Especially regarding the proposed site, the area with the optimized position was set by considering gradient, accessibility and convenience of development out of the area of Dongchang-ri where was agreed already and the priority of the proposed site that can keep the existing building site and provide was offered. The necessary period for whole construction was set as approximately 36 months. Regarding construction method, RC Rahmen method was selected as the optimized alternative considering the workmanship of manpower of North Korea and conditions of supply and demand of materials and cluster-type vehicle allocation plan based on 4~6 units considering the efficiency of supplying service facilities and convenient facilities along the simultaneous accommodation of 15,000 people was offered. It was analyzed that total business expenses of approximately 80~100 billion Korean Won would required though there were the difference for each alternative in the charged rental way that the development business owner develops by lending the inter-Korea Cooperation Fund and withdraws the rent by the benefit principle. The possibility of withdrawing the rent was analyzed assuming that the period of withdrawing the investment is 30 years. Especially for the operation management after moving, the establishment of the committee of operating the lodging for the workers of Gaesung Industrial Complex (tentative name) was offered with the dualized governance that the constructor takes charge of operational management, collecting fees and management of infrastructure and human resource management is delegated to North Korea.

Importance of End User's Feedback Seeking Behavior for Faithful Appropriation of Information Systems in Small and Medium Enterprises (중소기업 환경에서의 합목적적 정보시스템 활용을 위한 최종사용자 피드백 탐색행위의 중요성)

  • Shin, Young-Mee;Lee, Joo-Ryang;Lee, Ho-Geun
    • Asia pacific journal of information systems
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    • v.17 no.4
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    • pp.61-95
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    • 2007
  • Small-and-medium sized enterprises(SMEs) represent quite a large proportion of the industry as a whole in terms of the number of enterprises or employees. However researches on information system so far have focused on large companies, probably because SMEs were not so active in introducing information systems as larger enterprises. SMEs are now increasingly bringing in information systems such as ERP(Enterprise Resource Planning Systems) and some of the companies already entered the stage of ongoing use. Accordingly, researches should deal with the use of information systems by SME s operating under different conditions from large companies. This study examined factors and mechanism inducing faithful appropriation of information systems, in particular integrative systems such as ERP, in view of individuals` active feedback-seeking behavior. There are three factors expected to affect end users` feedback-seeking behavior for faithful appropriation of information systems. They are management support, peer IT champ support, and IT staff support. The main focus of the study is on how these factors affect feedback-seeking behavior and whether the feedback-seeking behavior plays the role of mediator for realizing faithful appropriation of information systems by end users. To examine the research model and the hypotheses, this study employed an empirical method based on a field survey. The survey used measurements mostly employed and verified by previous researches, while some of the measurements had gone through minor modifications for the purpose of the study. The survey respondents are individual employees of SMEs that have been using ERP for one year or longer. To prevent common method bias, Task-Technology Fit items used as the control variable were made to be answered by different respondents. In total, 127 pairs of valid questionnaires were collected and used for the analysis. The PLS(Partial Least Squares) approach to structural equation modeling(PLS-Graph v.3.0) was used as our data analysis strategy because of its ability to model both formative and reflective latent constructs under small-and medium-size samples. The analysis shows Reliability, Construct Validity and Discriminant Validity are appropriate. The path analysis results are as follows; first, the more there is peer IT champ support, the more the end user is likely to show feedback-seeking behavior(path-coefficient=0.230, t=2.28, p<0.05). In other words, if colleagues proficient in information system use recognize the importance of their help, pass on what they have found to be an effective way of using the system or correct others' misuse, ordinary end users will be able to seek feedback on the faithfulness of their appropriation of information system without hesitation, because they know the convenience of getting help. Second, management support encourages ordinary end users to seek more feedback(path-coefficient=0.271, t=3.06, p<0.01) by affecting the end users' perceived value of feedback(path-coefficient=0.401, t=6.01, p<0.01). Management support is far more influential than other factors that when the management of an SME well understands the benefit of ERP, promotes its faithful appropriation and pays attention to employees' satisfaction with the system, employees will make deliberate efforts for faithful appropriation of the system. However, the third factor, IT staff support was found not to be conducive to feedback-seeking behavior from end users(path-coefficient=0.174, t=1.83). This is partly attributable to the fundamental reason that there is little support for end users from IT staff in SMEs. Even when IT staff provides support, end users may find it less important than that from coworkers more familiar with the end users' job. Meanwhile, the more end users seek feedback and attempt to find ways of faithful appropriation of information systems, the more likely the users will be able to deploy the system according to the purpose the system was originally meant for(path-coefficient=0.35, t=2.88, p<0.01). Finally, the mediation effect analysis confirmed the mediation effect of feedback-seeking behavior. By confirming the mediation effect of feedback-seeking behavior, this study draws attention to the importance of feedback-seeking behavior that has long been overlooked in research about information system use. This study also explores the factors that promote feedback-seeking behavior which in result could affect end user`s faithful appropriation of information systems. In addition, this study provides insight about which inducements or resources SMEs should offer to promote individual users' feedback-seeking behavior when formal and sufficient support from IT staff or an outside information system provider is hardly expected. As the study results show, under the business environment of SMEs, help from skilled colleagues and the management plays a critical role. Therefore, SMEs should seriously consider how to utilize skilled peer information system users, while the management should pay keen attention to end users and support them to make the most of information systems.

A Study on Accounting for Nursing Cost by Korean Diagnosis Related Groups (K - DRGs) (종합병원(綜合病院)의 간호행위양상(看護行爲樣相)에 따른 간호원가(看護原價) 산정(算定)에 관(關)한 연구(硏究))

  • Oh, Hyo-Sook
    • Journal of Korean Public Health Nursing
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    • v.3 no.2
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    • pp.5-46
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    • 1989
  • The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

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A Study on the Development of an Instrument for Evaluating the Quality of Nursing Care (간호의 질 평가도구 개발에 관한 일 연구)

  • 유지수
    • Journal of Korean Academy of Nursing
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    • v.7 no.2
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    • pp.11-21
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    • 1977
  • Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

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Real-time Body Surface Motion Tracking using the Couch Based Computer-controlled Motion Phantom (CBMP) and Ultrasonic Sensor: A Feasibility Study (CBMP (Couch Based Computer-Controlled Motion Phantom)와 초음파센서에 기반한 실시간 체표면 추적 시스템 개발: 타당성 연구)

  • Lee, Suk;Yang, Dae-Sik;Park, Young-Je;Shin, Dong-Ho;Huh, Hyun-Do;Lee, Sang-Hoon;Cho, Sam-Ju;Lim, Sang-Wook;Jang, Ji-Sun;Cho, Kwang-Hwan;Shin, Hun-Joo;Kim, Chul-Yong
    • Progress in Medical Physics
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    • v.18 no.1
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    • pp.27-34
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    • 2007
  • Respiration sating radiotherapy technique developed In consideration of the movement of body surface and Internal organs during respiration, is categorized into the method of analyzing the respiratory volume for data processing and that of keeping track of fiducial landmark or dermatologic markers based on radiography. However, since these methods require high-priced equipments for treatment and are used for the specific radiotherapy. Therefore, we should develop new essential method whilst ruling out the possible problems. This study alms to obtain body surface motion by using the couch based computer-controlled motion phantom (CBMP) and US sensor, and to develop respiration gating techniques that can adjust patients' beds by using opposite values of the data obtained. The CBMP made to measure body surface motion is composed of a BS II microprocessor, sensor, host computer and stopping motor etc. And the program to control and operate It was developed. After the CBMP was adjusted by entering random movement data, and the phantom movements were acquired using the sensors, the two data were compared and analyzed. And then, after the movements by respiration were acquired by using a rabbit, the real-time respiration gating techniques were drawn by operating the phantom with the opposite values of the data. The result of analysing the acquisition-correction delay time for the data value shows that the data value coincided within 1% and that the acquistition-correction delay time was obtained real-time $(2.34{\times}10^{-4}sec)$. And the movement was the maximum movement was 6 mm In Z direction, In which the respiratory cycle was 2.9 seconds. This study successfully confirms the clinical application possibility of respiration gating techniques by using a CBWP and sensor.

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The Status of Nursing Ethics Education in Korea 4-year-College of Nursing (간호윤리 교육현황 - 4년제 대학교육을 중심으로 -)

  • Han Sung-Suk;Kim Yong-Soon;Um Young-Rhan;Ahn Sung-Hee
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.2
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    • pp.376-387
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    • 1999
  • Purpose : To provide fundamental data to present further direction of education on Nursing Ethics by investigating the status of Nursing Ethics education performed at 4-year-Colleges of Nursing. Korea. Methods : A descriptive survey study The data collected from 28 universities through a questionnaire to examine the status of Nursing Ethics education in Korea. Results : I. Teaching Nursing Ethics class as a independent subject-6(21.4%) universities. 1) The average of 23.67 hours(2 credits) in the total educational hours. 2) Teaching method-theoretical class, discussion of case study, discussion of related issues, presentation of video tapes and discussion, team education, role play, and submission of reports. 3) Education contents-Nursing profession and ethics, the dignity of human life, necessity of bioethics, ethical theory and refutation, code for nurses, ethical issues between nurses and patients, nurses and co-workers, and nurses and nurses 6 universities 4) 5 universities-Included ethical decision making, artificial insemination, external insemination, artificial abortion, organ transplantation, brain death, human subject of study suicide, and euthanasia. II. Teaching Nursing Ethics as an inclusive theme in other subjects-22 (78.57%) universities. 1) Educated in Introduction of Nursing (14 universities), Nursing Management, Nursing Ethics and Philosophy, Special Nursing, Nursing and Law, and Professional Nursing. 2) Educational course-Taught in freshman level at 14 universities, average 9.32 education hours. Conclusion: Showed not only that universities, not operating Nursing Ethics as a independent class, unreasonably operate and assign too many contents in comparing with its education hours and are likely to become only a cramming education but also professors whose major is not Nursing Ethics presently in charge need to take a chance to supplement their knowledge and teaching method.

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The Application of B-Type Natriuretic Peptide Level of the Dyspneic Patients : Differentiation Between Cor Pulmonale and Left Ventricular Dysfunction (호흡곤란을 주소로 내원한 환자에서 혈청 B-type Natriuretic Peptide 검사의 유용성 : 폐성심과 좌심부전의 감별에 대하여)

  • Park, Hong-Hoon;Kim, Sehyun;Choi, Jeongeun;Kim, Kang-Ho;Cheon, Seok-Cheol;Lee, Jihyun;Lee, Yong-Gu;Kim, In-Jae;Cha, Dong-Hoon;Hong, Sang-Bum;Lee, Ji-Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.320-329
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    • 2003
  • Background : The serum B-type natriuretic peptide (BNP) is released from the ventricles as a response to volume or pressure overload of the ventricles. A few studies have reported that the BNP measurements are useful in differentiating between heart failure and pulmonary causes in patients who visited the emergency department with dyspnea as the chief complaint. It is difficult to differentiate a right heart failure from a left heart failure in the emergency room. However, there is no report on the application of a BNP assay to differentiate in right heart failure from left heart failure. In this study, the BNP levels were measured from dyspneic patients in the emergency department to determine whether or not the BNP level would be useful in differentiating the cause of the dyspnea from right ventricular failure and left ventricular failure. Method : 89 patients who visited emergency department of the Bundang Cha Hospital with dyspnea from June 2002 to March 2003 were selected. The 29 patients from the outpatient clinics and inpatients were randomly selected as the control. Results : The BNP levels of patients in the left heart failure group were significantly different from that of the patients in the right heart failure group ($682{\pm}314$ pg/mL vs. $149{\pm}94$ pg/mL, p=0.000). When the BNP cut-off level was designated as 219 pg/mL using the receiver operating characteristic curve, the sensitivity was 94.3%, and specificity was 92.9%. In addition, the positive predictive value was 97% and the negative predictive value was 86.7% in differentiating right heart failure from left heart failure. Conclusion : Measurements of the serum BNP levels is an accurate and rapid method that can aid in distinguishing between right heart failure and left heart failure.