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Effect of Human Implantable Medical Devices on Dose and Image Quality during Chest Radiography using Automatic Exposure Control (자동노출제어를 적용한 흉부 방사선 검사 시 인체 이식형 의료기기가 선량과 화질에 미치는 영향)

  • Kang-Min Lee
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.257-265
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    • 2024
  • In this study, we applied AEC(Auto Exposure Control), which is used in many chest examinations, to evaluate whether medical devices inserted into the body affect the dose and image quality of chest images. After attaching three HIMD(Human implantable medical devices) to the ion chamber, the Monte Carlo methodology-based program PCXMC(PC Program for X-ray Monte Carlo) 2.0 was applied to measure the effective dose by inputting the DAP(Dose Ares Product) value derived from the Pacemaker and CRT and Chemoport Additionally, to evaluate image quality, we set three regions of interest and one noise region on the chest and measured SNR and CNR. The final study results showed significant differences in DAP and Effective dose. There was a significant difference between Pacemaker and CRT when AEC was applied and not applied. (p<0.05) When applied, the dose increased by 37% for Pacemaekr and 52% for CRT. Chemoport showed a 10% increase in effective dose depending on whether AEC was applied, but there was no significant difference. (p>0.05) In the image quality evaluation, there was no significant difference in image quality between all HIMD insertions and AEC applied or not. (p>0.05) Therefore, when the HIMD was inserted into the chest during a chest x ray and overlapped with the ion chamber sensor, the effective dose increased, and there was no difference in image quality even at a low dose without AEC. Therefore, when performing a chest X-ray examination of a patient with a HIMD inserted, it is considered that performing the examination without applying AEC is a method that can be considered to reduce the patient's radiation exposure.

A Study on the Factors Affecting Subjective Health Index of the Aged in Daejon Area (일부지역 노인들의 주관적 건강수준에 영향을 미치는 요인에 관한 연구)

  • 민경진;김근조;차춘근
    • Korean Journal of Health Education and Promotion
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    • v.18 no.2
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    • pp.1-26
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    • 2001
  • This research is aimed to define how the depression, performing ability of IADL and muscular-skeletal pain of the Aged, according to their residential circumstance, sex and age, can affect the subjective health index and how all these are related and associated with. For the period of June 1 to July 31, 2000, in order to study and define how the depression, performing ability of IADL and muscular-skeletal pain are related to the subjective health index of the Aged, we have conducted an enquete through a direct interview with 693 persons over age sixty-five (65) in Daejon and in other adjacent areas, divided into three different residential types “The Aged living at home”, “The Aged living at welfare facilities” and “The Aged living alone”. We have studied all the data and information obtained through this enquete and have analyzed χ²-test, t-test, ANOVA, analysis of simple correlation, analysis of factor. by SPSS10.0/PC+. The results were as follows: Generally, the four (4) factors depression, IADL performing ability, muscular-skeletal pain and the subjective health index of the Aged, are a lot influenced by and related to their residential circumstance, their sex and their age. With regard to the depression of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 48.3 point which reflects comparatively the higher points and the female-Aged is more depressed. In analyzing depression of the Aged by their age, it appears that the Aged between eighty (80) to eight-four (84) years of age, gains 49.2 point which is the highest points and simultaneously we could realize that depression follows age, - the more the age gets, the more the depression is increased. In analyzing depression of the Aged by their residential type, it shows that “the Aged living alone” gains 50.9 point and is most depressed. With regard to the IADL performance of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 23.8 point, which shows the performance of the female-Aged is less independent. In addition, it was also found that the IADL performing ability is becoming less and less independent following their age increasing. In analyzing IADL performance by their residential type, it appears that “the Aged living at welfare facilities” gains the lowest 21.5 point and is least independent. We conclude that some assistances from others are required for the Aged living at welfare facilities in their performing IADL. With regard to the muscular-skeletal pain of the Aged by their sex, it was analyzed that, on an average, the female-Aged gains 3.0 point and the female-Aged suffers from this pain more severely. In analyzing this pain by their residential type, it was found that, on an average, the 3.0 point goes for “the Aged living alone”, which explains the Aged living alone is having the most serious pain. With regard to the subjective heath index of the all Aged participated in this research, the analysis indicates 8.8 point and this is considered as a general standard (7-10 point). In analyzing this index by their sex, the female-Aged gains 8.6 point only and it explains a lot of female-Aged consider they are not really healthy. In analyzing this index by their residential type, “the Aged living at welfare facilities” and “the Aged living alone” gain the comparatively lower point, -respectively 8.4 point for the Aged living at welfare facilities and 8.8 point for the Aged living alone. The Aged of these two residential types express they are obviously in a bad condition of health, which makes us think a lot. With regard to the factors affecting the subjective health index of the Aged, it was analyzed that this index can significantly be influenced by their depression, their pain, their age and by how much they are satisfied with their current living conditions, and also analyzed that the correlative relation certainly exists between the depression and pain, and the subjective health index, - that is, the more the depression and pain are serious, the lower the subjective health index indicates. As for the IADL, it appears that the IADL's relation with this index is not that significant and even not important.

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The Demands on Parish Nursing Services by Pastors in Busan (부산지역 목회자의 교구간호사업 요구조사)

  • Sohn, Sue-Kyung;Kang, Kyung-Ja;Lee, Jj-Hyun;Lee, Young-Eun;Park, Choon-Hwa
    • Research in Community and Public Health Nursing
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    • v.13 no.1
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    • pp.182-196
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    • 2002
  • The purpose of this study was to provide the basic resources for developing a parish nursing program. We did this by investigating what demands were made on the parish nursing service by the parishes or churches under review. The subjects of this study were 96 pastors located throughout the City of Busan. NP (New paragraph) $\gg$ We conducted our research by utilizing a modified version of the study created by Hwang (2000) and by using the help of prior research and professionals gathered from the parish nurse questionnaire by Djupe (1990). The data in this study were collected from July 1 to Oct. 31, 2001, using the questionnaire method. The Data were analyzed by: (a) frequency: (b) percentage: (c) mean: (d) standard deviation, and x^2-test$ with SPSS/PC program. The study has found the follows: 1. For subjects making demands on the parish nursing service, 95.8% were in need of using the services of parish nurses. On the demands of parish nursing service for the subjects, 95.8% the necessity of parish nursing services. And they answered by their intention of asking for parish nursing service practice. 2. Of the subjects under review, 71.9% were part-time workers and 28.1% were full-time employees 71.9% of part time and 28.1% of full times duty. In terms of the method of pay for work, 41.8% were pay free or freelance while 51.2% were on salary. And engagement intention of parish nurse as preacher was 88.5%. 3. The demand for nursing services in various categories were as follows. (a) hospice care: (4.02 1.11), (b) health screening: (3.98 1.09), (c) home visiting: (3.97 1.16), (d) group health education: (3.81 1.12), (e) organization of volunteer groups: (3.75 1.12), (f) individual health education: (3.75 1.14), (g) advice on choosing hospital or hospital consultation: (3.69 1.21) and (h) individual counseling: (3.51 1.31). 4. In terms of the specific services rendered by parish nurses. our study found that services were needed for the following: physical symptom management; preparation before death in spiritual preparation for death, blood pressure check in health examination, home visiting where the patient makes phone call, management of chronic disease in group health education, disease management in individual health education, advice on choosing hospital, or hospital consultation: and physical problems in individual counseling. 5. With respect to whether there was a correlation between what church a pastor came from and the types of demands made, there was NO significant difference found. 6. In relation to the characteristics of the subjects and their church and the hope demands (duty pattern and method of payment and engagement intention of parish nurse as preacher) for parish nurses, these had non significant differences. In conclusion, the perception of parish nursing service is very high. Moreover, we found that there is a great demand for well ordered parish nursing services to promote the health of each congregation. Before doing so, it would be better to make things known and to consider the relevant characteristics shown in the researched results.

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Environmentally Associated Spatial Distribution of a Macrozoobenthic Community in the Continental Shelf off the Southern Area of the East Sea, Korea (한국 동해 남부해역 대륙붕에 서식하는 대형저서동물군집 공간분포를 결정하는 환경요인)

  • Lee, Jung-Ho;Lee, Jung-Suk;Park, Young-Gyu;Kang, Seong-Gil;Choi, Tae Seob;Gim, Byeong-Mo;Ryu, Jongseong
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.19 no.1
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    • pp.66-75
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    • 2014
  • This study aims to understand environmental factors that determine spatial distribution of macrozoobenthic community in the southern area (ca 100-500 m depth) of East Sea, Korea, known as a candidate site for carbon storage under the seabed. From sixteen locations sampled in the summer of 2012, a total of 158 species were identified, showing density of $843indiv/m^2$ and biomass of $26.2g\;WW/m^2$, with increasing faunal density towards biologically higher diverse locations. Principal component analysis showed that a total of 33 environmental parameters were reduced to three principal components (PC), indicating sediment, bottom water, and depth, respectively. As sand content was increasing, number of species increased but biomass decreased. Six dominant species including two bivalve species favored high concentrations of ${\Omega}$ aragonite and ${\Omega}$ calcite, indicating that the corresponding species can be severely damaged by ocean acidification or $CO_2$ effluent. Cluaster analysis based on more than 1% density dominant species classified the entire study area into four faunal assemblage (location groups), which were delineated by characteristic species, including (A) Ampelisca miharaensis, (B) Edwardsioides japonica, (C) Maldane cristata, (D) Spiophanes kroeyeri, and clearly separated in terms of geography, bottom water and sediment environment. Overall, a discriminant function model was developed to predict four faunal assemblages from five simply-measured environmental variables (depth, sand content in sediment, temperature, salinity and pH in bottom water) with 100% accuracy, implying that benthic faunal assemablages are closed linked to certain combinations of abiotic factors.

A Construction of the C_MDR(Component_MetaData Registry) for the Environment of Exchanging the Component (컴포넌트 유통환경을 위한 컴포넌트 메타데이타 레지스트리 구축 : C_MDR)

  • Song, Chee-Yang;Yim, Sung-Bin;Baik, Doo-Kwon;Kim, Chul-Hong
    • Journal of KIISE:Computing Practices and Letters
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    • v.7 no.6
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    • pp.614-629
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    • 2001
  • As the information-intensive society in 21c based on the environment of global internet is promoted, the software is getting more large and complex, and the demand for the software is increasing briskly. So, it becomes an important issue in academic and industrial field to activate reuse by developing and exchanging the standardized component. Currently, the information services as a product type of each company are provided in foreign market place for reusing a commercial component, but the components which are serviced in each market place are different, insufficient and unstandardized. That is, construction for Component Data Registry based on ISO 11179, is not accomplished. Hence, the national government has stepped up the plan for sending out public component at 2001. Therefore, the systems as a tool for sharing and exchange of data, have to support the meta-information of standardized component. In this paper, we will propose the C_MDR system: a tool to register and manage the standardized meta-information, based upon ISO 11179, for the commercialized common component. The purpose of this system is to systemically share and exchange the data in chain of acceleration of reusing the component. So, we will show the platform of specification for the component meta-information, then define the meta-information according to this platform, also represent the meta-information using XML for enhancing the interoperability of information with other system. Moreover, we will show that three-layered expression make modeling to be simple and understandable. The implementation of this system is to construct a prototype system of the component meta-information through the internet on www, this system uses ASP as a development language and RDBMS Oracle for PC. Thus, we may expect the standardization of the exchanged component metadata, and be able to apply to the exchanged reuse tool.

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S-MADP : Service based Development Process for Mobile Applications of Medium-Large Scale Project (S-MADP : 중대형 프로젝트의 모바일 애플리케이션을 위한 서비스 기반 개발 프로세스)

  • Kang, Tae Deok;Kim, Kyung Baek;Cheng, Ki Ju
    • KIPS Transactions on Software and Data Engineering
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    • v.2 no.8
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    • pp.555-564
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    • 2013
  • Innovative evolution in mobile devices along with recent spread of Tablet PCs and Smart Phones makes a new change not only in individual life but also in enterprise applications. Especially, in the case of medium-large mobile applications for large enterprises which generally takes more than 3 months of development periods, importance and complexity increase significantly. Generally Agile-methodology is used for a development process for the medium-large scale mobile applications, but some issues arise such as high dependency on skilled developers and lack of detail development directives. In this paper, S-MADP (Smart Mobile Application Development Process) is proposed to mitigate these issues. S-MADP is a service oriented development process extending a object-oriented development process, for medium-large scale mobile applications. S-MADP provides detail development directives for each activities during the entire process for defining services as server-based or client-based and providing the way of reuse of services. Also, in order to support various user interfaces, S-MADP provides detail UI development directives. To evaluate the performance of S-MADP, three mobile application development projects were conducted and the results were analyzed. The projects are 'TBS(TB Mobile Service) 3.0' in TB company, mobile app-store in TS company, and mobile groupware in TG group. As a result of the projects, S-MADP accounts for more detailed design information about 'Minimizing the use of resources', 'Service-based designing' and 'User interface optimized for mobile devices' which are needed to be largely considered for mobile application development environment when we compare with existing Agile-methodology. Therefore, it improves the usability, maintainability, efficiency of developed mobile applications. Through field tests, it is observed that S-MADP outperforms about 25% than a Agile-methodology in the aspect of the required man-month for developing a medium-large mobile application.

An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly (노인의 근력강화운동이 일상생활기능 및 삶의 질에 미치는 효과)

  • Kim, Hee-Ja;Hong, Yeo-Shin
    • Research in Community and Public Health Nursing
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    • v.6 no.1
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    • pp.55-73
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    • 1995
  • An Effect of Muscle Strength Training Program on Muscle Strength, Muscle Endurance, Instrumental Activities of Daily Living and Quality of Life in the Institutionalized Elderly Recent statistics shows that the aged are the fastest growing segment of our population by increasing life span. The age group of over 60 shows multiple health problems and the most serious handicapping problem of these. are related to the changes in muscular skeletal system. With aging, people lose. their muscle mass and muscle strength resulting from biological changes and physical inactivity. Studies documented a 30-50% loss of muscle mass in an advanced age and thus, ordinary life activities can be seriously affected due to weakened muscle strength. Preservation of muscle strength of lower limb is especially important in the aged. Since it is readily affected from reduced physical activity in old age, sometimes to the detriment of moving or walking. So muscle strength exercise program designed for the elderly to improve leg muscle strength and leg muscle endurance. The research design used was nonequivalent control group pretest - protest design. The purposes of this study were to test the effect of muscle strength exercise program utilizing Leg Press on muscle strength, muscle endurance, instrumental activities of daily living(IADL), cognitive perceptual variables and quality of life. Forty nine subjects participating in this study consisted of twenty four male and twenty five female. Twenty four experimental group subjects were selected from C-institution in Chung Buk province, and twenty five control group subjects were selected from O-institution in Chung Nam province. The mean age of subjects was 72.8 years. Muscle strength training program utilizing Leg Press for the experimental group was carried out three times a week for 9 weeks. The data was collected from August, 1993 to October, 1993. Data were analyzed with $X^2-test$, t-test, ANCOVA test, Kruskal Wallis 1-Way ANOVA test using SPSS PC program. Results were obtained as follows : 1) The experimental group showed significantly higher scores on muscle strength (leg lift strength, back lift strength and grip strength) and muscle endurance than control group after the experiment $\ulcorner$F=52.35(p=.001), F=54.07(p=.001), F=6.97(p=.011), F=18.17(p=.001)$\lrcorner$ 2) Experimental group were significantly higher scores on IADL than control group(F=7.51, p=.009). 3) Experimental group showed significantly higher scores on economical state and self esteem aspects of the quality of life scale than control group $\ulcorner$F=10.59(p=.002), F=6.97(p=.011)$\lrcorner$. But there were no differences in emotional state, physical and functional state and relationship with reatives in the quality of life between groups. 4) Scores on IADL showed a significant difference with the level of muscle strength and muscle endurance $\ulcornerx^2=7.73(p=.025),\;x^2=8.86\;(p=.011)\lrcorner$ 5) Scores on self esteem and physical and functional state aspects of the quality of life scale showed a significant difference with the level of IADL $\ulcornerx^2=11.39(p=.003),\;x^2=9.02(p=.011)\lrcorner$. 6) Scores of experimental group after the experiment in cognitive perceptual variables (perceived benefit on exercise, perceived health status, self efficacy, emotion on exercise) were significantly higher than those of control group $\ulcorner$F=32.09(p=.001), F=5.07(p=.029), F=20.63 (p=.001), F=30.38(p=.001)$\lrcorner$. As a result of this study, the effect of strength training exercise program with Leg. Press had improved muscle strength, muscle endurance, IADL, and the perception of self esteem, physical and funtional state, and economical state. Thus strength training program could be beneficially applied for the prevention of disablity and promotion of health and wellbeing in the aged easily and safely. The subjects in the experimental group have maintained their exercises till six months after the cessation of the experiment. This seem to illustrate that changes in cognitive perceptual variables and the improvement in health status have reinforced motivation for the continuation of voluntary exercises. A further study is necessary to determine the factors affecting maintainance of muscle strength exercise and to assess the effect of weight training program on bone density.

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Effects of Nordic Walking Exercise on muscular strength, Flexibility, Balance and Pain in Older Woman with Knee Osteoarthritis (노르딕 워킹이 퇴행성 무릎 관절염 노인여성의 근력과 유연성, 균형 및 통증에 미치는 영향)

  • Oh, Yoo-Sung;Kim, Ji-sun;Jang, Woo-Seong
    • Journal of the Korean Applied Science and Technology
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    • v.36 no.4
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    • pp.1312-1326
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    • 2019
  • The purpose of this study is to examine whether the 12-week Nordic walking can improve the physical function and arthritis pain of elderly women with osteoarthritis This study were divided into randomly assigned Nordic Walking Exercise Group (n=9) and Control Group (n=7) for 16 Elderly women diagnosed with Osteoarthritis (age: 73±3.79 year, height: 154.3±4.09 cm). The exercise group used Nordic sticks to carry out 30 minutes of Nordic walking exercise three times a week for 12 weeks, and the kinetic intensity was set at 40-60% of HRR. The control group maintained daily life for the same period. Body composition (weight, percentage body fat, skeletal muscle mass), muscular strength, Flexibility (muscular strength of upper and lower limbs, flexibility of upper and lower limbs), balance ability (static balance, dynamic balance) and pain level were measured as subordinate variables. These indicators were measured twice before and after the exercise program. The study shows that percentage body fat and skeletal muscle mass in the body composition function over 12 weeks of Nordic walking exercise have significant effects after the exercise than before (p=004)(p=.003), and it also shows significant interaction effects between the groups and timings(p=.018)(p=.005). In muscular strength, Flexibility factors, there were significant effects between the groups and timings in the upper limb muscular strength and the lower limb flexibility (p=.009)(p=.036), and a significant difference between the exercise group and the control group(p=.006) in the lower limb muscular strength. In addition, in the upper limb flexibility, there was a more significant difference after the exercise than before(p=.020). There were improvement effects after the exercise than before in the balance ability and the static balance(p=.016), but no difference in the dynamic balance(p>.05). In pain, there was a significant improvement after the exercise than before(p=.022), and a significant difference between the exercise group and the control group(p=.013). In conclusion, the 12-week Nordic walking exercise has positive effects on the body composition functions of the elderly women with Osteoarthritis, and has a positive effect on the improvement of upper limb muscular strength and lower limb flexibility in the health fitness factors. These effects are believed to have contributed effectively to the improvement of the level of pain by contributing to the improvement of physical and motor functions of the elderly women with Osteoarthritis. Therefore, it is considered that Nordic walking exercise, which enhances stability and balance of the patients with Osteoarthritis by using poles, is an effective exercise method for the improvement of the body and motor functions by lowering the pain of the joints and reducing the muscular strength and percentage body fat.

A Collaborative Video Annotation and Browsing System using Linked Data (링크드 데이터를 이용한 협업적 비디오 어노테이션 및 브라우징 시스템)

  • Lee, Yeon-Ho;Oh, Kyeong-Jin;Sean, Vi-Sal;Jo, Geun-Sik
    • Journal of Intelligence and Information Systems
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    • v.17 no.3
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    • pp.203-219
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    • 2011
  • Previously common users just want to watch the video contents without any specific requirements or purposes. However, in today's life while watching video user attempts to know and discover more about things that appear on the video. Therefore, the requirements for finding multimedia or browsing information of objects that users want, are spreading with the increasing use of multimedia such as videos which are not only available on the internet-capable devices such as computers but also on smart TV and smart phone. In order to meet the users. requirements, labor-intensive annotation of objects in video contents is inevitable. For this reason, many researchers have actively studied about methods of annotating the object that appear on the video. In keyword-based annotation related information of the object that appeared on the video content is immediately added and annotation data including all related information about the object must be individually managed. Users will have to directly input all related information to the object. Consequently, when a user browses for information that related to the object, user can only find and get limited resources that solely exists in annotated data. Also, in order to place annotation for objects user's huge workload is required. To cope with reducing user's workload and to minimize the work involved in annotation, in existing object-based annotation automatic annotation is being attempted using computer vision techniques like object detection, recognition and tracking. By using such computer vision techniques a wide variety of objects that appears on the video content must be all detected and recognized. But until now it is still a problem facing some difficulties which have to deal with automated annotation. To overcome these difficulties, we propose a system which consists of two modules. The first module is the annotation module that enables many annotators to collaboratively annotate the objects in the video content in order to access the semantic data using Linked Data. Annotation data managed by annotation server is represented using ontology so that the information can easily be shared and extended. Since annotation data does not include all the relevant information of the object, existing objects in Linked Data and objects that appear in the video content simply connect with each other to get all the related information of the object. In other words, annotation data which contains only URI and metadata like position, time and size are stored on the annotation sever. So when user needs other related information about the object, all of that information is retrieved from Linked Data through its relevant URI. The second module enables viewers to browse interesting information about the object using annotation data which is collaboratively generated by many users while watching video. With this system, through simple user interaction the query is automatically generated and all the related information is retrieved from Linked Data and finally all the additional information of the object is offered to the user. With this study, in the future of Semantic Web environment our proposed system is expected to establish a better video content service environment by offering users relevant information about the objects that appear on the screen of any internet-capable devices such as PC, smart TV or smart phone.

A Preliminary Study for Expending of Hospital-Based Horne Health Care Coverage - Focused on Accident Inpatients Who has the Workers Compensation Insurance - (병원중심 가정간호사업 관리대상범위 확대를 위한 기초연구)

  • Lee, Sook-Ja;Lee, Jin-Kyung;Ryu, Ho-Sihn
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.5-18
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    • 1999
  • This study was attempt to encourage for developing on rehabilitation delivery system and programs as a substitute service instead of hospitalization for accident patients at work, such as hospital based home health care nursing service. It needs vary substitutes service of hospitalization to curtail the length of stay for inpatients who were hospitalized with workers compensation insurance. It focused on developing an estimation of early discharge day of accident inpatients based on a detail statement of treatment for 115 inpatients who were hospitalized at General Hospital in 1997. This study has four specific purpose as follows. First, to find out the status of health service utilization. Second, to estimate the early discharge days and income increasing effect based on the early discharge for those patients. Third, to identify the factors to affect total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze of the length of stay and medical expenditure for inpatients who were hospitalized due to the accident, the authors conducted with micro-analysis and macroanalysis from medical records and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria. such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the tests consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, stable conditions. In addition to identify affected variables for medical expenditure. the length of stay and income effect due to early discharge day, the data was analyzed with multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study as follows. First, the mean length of stay was 37.1 days, whereas the mean length of stay due to early discharge was 28.2 days at the hospital. The estimation of early discharge days were shown that depends on the length of stay. The longer length of stay, the longer length of early discharge days, such as under 7 days length of stay patients was to estimated the mean length of stay was 4.9 days and early discharge days was 4.6. whereas the mean length of stay was 122.6 days and early discharge days was 92.0 respectively. The mean medical expenditure per day were found to be 133.409 Won. whereas the mean medical expenditure per day was shown negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to 11 early discharge days per bed was around 2,150,000 won. However, it means not the real benefits from early discharge, but the income increasing amount without considering medical prime cost in general hospital. Therefore, it needs further analysis on the cost containments and benefits under the considering as well turn over rates per bed as the medical prime costs. The length of stay was most significant and the sign was positive to the total medical expenditure, as expected. Surgery and patient's residential area also an important variable in explaining medical expenditure. The level of complications was most significant variable in explaining the length of stay. The level of the needs on horne health care nursing service which can be used for early discharge accident patients were shown very high. The needs distribution varied from 65.5% of patients and 88.9% of caregivers, to 96.4% of doctors, and 99.1% of nurses. In addition horne health nurse responded that they can be managed the accident inpatients from early discharge. From these research findings. the following suggestions has been drawn it needs to develop strategies on rehabilitation delivery system in order to focused on consumer's side which is planned for 21 century health policy in Korea. Vary intermediate facilities and horne health care would have been developed in the community based for comprehensive rehabilitation services as a substitutes of hospitalization for shortening the length of stay of hospitalizations. In hospital based horne health care nursing service, it's available immediately to utilize for the patients who wanted rehabilitation services as a substitutes of hospitalization under the cooperations with workers compensation insurance company.

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