• 제목/요약/키워드: Patient Discharge

검색결과 731건 처리시간 0.026초

젖산 산화효소-카탈라아제-미토콘드리아 전극 제작 및 특성 분석 (Fabrication and Characterization of Lactate Oxidase-catalase-mitochondria Electrode)

  • 시키;마니칸단 키에르티 부샨;최영봉;김창준
    • Korean Chemical Engineering Research
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    • 제62권3호
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    • pp.238-245
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    • 2024
  • 젖산 전극은 환자의 건강상태와 스트레스 수준, 및 운동선수의 피로도를 실시간으로 모니터링하는 젖산 센서 또는 젖산 연료전지 전극으로 활용될 수 있다. 본 연구에서는 젖산 산화효소, 카탈라아제, 미토콘드리아로 구성된 고성능 전극을 제작하고 전극의 표면분석 및 전기화학적 특성을 조사하였다. 단일벽 탄소나노튜브로 개질된 탄소종이(CPSWCNT)는 개질 전보다 전기 전도성이 크게 향상되었다. 젖산 산화효소, 카탈라아제, 그리고 미토콘드리아가 부착된 전극(CP-SWCNT-LOx-Cat-Mito)은 젖산 산화효소와 카탈라아제가 부착된 전극에 비하여 많은 전류를 생산하였다. 빌리루빈 산화효소(BOD)가 부착된 전극(CP-SWCNT-BOD)이 생산하는 환원전류량은 전해질의 산소 존재 유무에 따라 크게 영향을 받았다. CP-SWCNT-LOx-Cat-Mito (anode)와 CP-SWCNT-BOD (cathode)로 구성된 연료전지는 133 ㎂/cm2로 방전 시 0.2 V의 셀 전위를 유지하며 29 ㎼/cm2의 전력을 생산하였다. 본 연구결과는 미토콘드리아가 젖산 센서 및 연료전지 성능 향상에 필수적인 생체물질임을 시사한다.

The Clinical Impact of β-Blocker Therapy on Patients With Chronic Coronary Artery Disease After Percutaneous Coronary Intervention

  • Jiesuck Park;Jung-Kyu Han;Jeehoon Kang;In-Ho Chae;Sung Yun Lee;Young Jin Choi;Jay Young Rhew;Seung-Woon Rha;Eun-Seok Shin;Seong-Ill Woo;Han Cheol Lee;Kook-Jin Chun;DooIl Kim;Jin-Ok Jeong;Jang-Whan Bae;Han-Mo Yang;Kyung Woo Park;Hyun-Jae Kang;Bon-Kwon Koo;Hyo-Soo Kim
    • Korean Circulation Journal
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    • 제52권7호
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    • pp.544-555
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    • 2022
  • Background and Objectives: The outcome benefits of β-blockers in chronic coronary artery disease (CAD) have not been fully assessed. We evaluated the prognostic impact of β-blockers on patients with chronic CAD after percutaneous coronary intervention (PCI). Methods: A total of 3,075 patients with chronic CAD were included from the Grand Drug-Eluting Stent registry. We analyzed β-blocker prescriptions, including doses and types, in each patient at 3-month intervals from discharge. After propensity score matching, 1,170 pairs of patients (β-blockers vs. no β-blockers) were derived. Primary outcome was defined as a composite endpoint of all-cause death and myocardial infarction (MI). We further analyzed the outcome benefits of different doses (low-, medium-, and high-dose) and types (conventional or vasodilating) of β-blockers. Results: During a median (interquartile range) follow-up of 3.1 (3.0-3.1) years, 134 (5.7%) patients experienced primary outcome. Overall, β-blockers demonstrated no significant benefit in primary outcome (hazard ratio [HR], 0.88; 95% confidence interval [CI], 0.63-1.24), all-cause death (HR, 0.87; 95% CI, 0.60-1.25), and MI (HR, 1.25; 95% CI, 0.49-3.15). In subgroup analysis, β-blockers were associated with a lower risk of all-cause death in patients with previous MI and/or revascularization (HR, 0.38; 95% CI, 0.14-0.99) (p for interaction=0.045). No significant associations were found for the clinical outcomes with different doses and types of β-blockers. Conclusions: Overall, β-blocker therapy was not associated with better clinical outcomes in patients with chronic CAD undergoing PCI. Limited mortality benefit of β-blockers may exist for patients with previous MI and/or revascularization.

일개 종합병원을 이용한 농.어촌지역 퇴원환자의 질병분포에 관한 연구 (The Analysis of Disease Distribution of patients discharged from a general hospital in a farming and fishing village region)

  • 유은영;김율
    • 한국산학기술학회논문지
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    • 제11권12호
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    • pp.4863-4872
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    • 2010
  • 본 연구는 농 어촌지역 환자들을 대상으로 질병양상을 살펴보고 의료이용 실태를 분석하여 농 어촌지역 의료 관련 기관의 보건의료서비스 계획수립에 필요한 자료를 제공 하고자 시행되었다. 노령화가 진행된 농 어촌지역 G도 G군에 소재한 종합병원을 대상으로 2009년 7월부터 12월까지 6개월 동안 퇴원환자 2,365건 전수의 의무기록 자료를 토대로 분석하였다. 분석결과, 조사대상 환자의 성별은 남자 55.3%, 여자 44.7%, 연령별은 70세 이상 후기 고령자가 42%로 나타냈다. 입원유형별로는 외래경유 입원환자가 65.5%이며, 진료과목으로는 내과 49.7%, 정형외과 16.7%, 신경외과 13.8% 순이었다. 주 진단명(3단 분류)별 10대 다 빈도에서 S00-T98 18.4%, J00-J99 15.5%, I00-I99 11.5% 순이었다. 평균재원일수는 14.8일이었으며, 주 진단명을 포함한 상병개수는 평균 5.6개이었다. 주 진단명(3단 분류) 다빈도 10대에서 성별, 보험유형별, 입원경로, 연령별 분포 등이 통계적으로 유의한 차이가 있었다. 월별 주 진단명(3단 분류) 다 빈도 10대 분류 분포는 통계적 유의한 차이가 있었다. 주 진단명(3단 분류) 다 빈도 10대분류에 따른 평균재원일수와 상병개수는 통계적으로 유의한 차이가 있었다. 결론적으로, 농 어촌지역의 질병분포는 작업환경과 연중 신체적 무리가 가는 노동행위에 따른 외상성 질환 및 호흡기 질환과 노령화에 따른 각종 만성질환 등 이었다.

사지동맥의 색전제거술 -26례의 분석- (Embolectomy of Arteries of Extremities -Clinical analysis of 26 cases)

  • 강종렬;구본일
    • Journal of Chest Surgery
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    • 제30권2호
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    • pp.172-178
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    • 1997
  • 인제대학교 서울 백병원에서 실시한 말초동맥 색전제거술을 후향적으로 분석하였다. 1987년 3월부터 1996년 2월까지 26명의 환자가 색전제거술을 시술받았고 남자는 18명 여자는 8명이였으며 평균연령은 56.8세 였다. 24명의 환자에서 휴식시 동통이 주소였고 2명의 환자에서 급성 증상의 회복후 장기간의 간헐적 파행을 호소하였으며 10명의 환자에서만 신경/근육 증상을 보였다. 대부분의 색전은 심인성으로 빈도가 높은 원인질환으로8명의 환자는 허혈성 심질환, 11명의 환자는 심장판막질환이 있었다. 동맥색전 부위는 상지동맥이 6명, 안장색전증이 2명, 하지동맥 18명이였고 대퇴동맥이 11명으로 가장 많았다. 술전 동맥조영술은13명의 환자에서 진단과 수술계획을 위해 실시하였으나 나머지 환자에서는 실시하지 않았다. 2명만이 6시간이내 색전제거술을 실시하였으나 나머지 환자는 모두 6시간 이후에 수술하였 다. 모든 환자에서 우회로 조성술 엄이 포가티 색전제거 카테터를 사용하여 색전제거술을 하였는데, 상지동맥 색전증은 상완동맥 절개로 수술하였고, 안장색전증의 경우 양측 서혜부 절개로 접근하였으며, 하지동맥 색전증은 경대퇴동맥 접근을 하 느립\ulcorner3명의 원위부 슬와-경골동맥 색전증 환자에서 재수술시 경술와 동맥 색전제거술을 시행하였다. 수술 전후로 18명의 환자가 헤파린이나 푸락시파린으로 항응 고제 요법을 받았고 17명의 환자에서 퇴원시 와파린을 투여하였으며 항응고제 투여의 적응증은 심판막 질환, 심방세동, 말초동맥 죽상경화증, 재발색전 등이었다. 색전제거술후 14명의 환자에서 좋은 결과가 있었고, 5명에서 재수술후 증상 호전되었으며, 심한 하지동맥 죽상경화증을 보인 환자 1명에서 슬관절 이하 하지절단을 시행하였다. 색전재발은 1명, 사망 환자는 2명이 였는데, 사인은 각각 급성 신부전과 뇌동맥 혈전증이였다. 색전제거술 합병증으로 재관류 손상, 가성동맥류, 내막박리 등이 각각 1례 발생하였다. 결론적으로 사지동맥 색전증치 진단이 지연되고 있고, 허혈성 심질환을가진 고령환자가 증가되고 있는 경향이었다. 술전 동맥조영술은 항상 진단과 수술을 위해 필요하지 않으며 항응고제는 적응증에 따라 선택적으로 투여하여 색전재발을 방지할 수 있다. 원위부 슬와-경골동맥 색전증의 경우, 경대퇴동 맥 접근으로 선택적인 경골동맥 색전제거에 어려움이 있었다.

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가정간호사 제도에 대한 인식 및 태도 조사연구 (A Study on the recognition and Attitude of Home Health Nursing System)

  • 이성자
    • 한국보건간호학회지
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    • 제12권1호
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    • pp.132-146
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    • 1998
  • This Study was attempted to provide the basic data necessary in the development and introduction of Home Health Nursing System by investigating the recognition and attitude level of Home Health Nursing System. The data were collected by means of questionaires presented to 74 patients who had been admitted in C general hospital in Chon Ju, from June 30, 1997. As the tool for this study, the questionares developed by Kim Yong. Soon, et al (1990) and Han Bok Hee(1993) were modified and supplemented for the aim of this study. The computer was used for data analysis. The items about the charateristics of the subjects and the attitude to the management plan of Home Health Nursing System were represented as the frequency and percentage. The standard deviation and calculation average were produced on the items related to definition, recognition, necessity, expected effect of the attitude of Home Health Nursing System and the items related to admission. The ANOVA test was .used according to the characteristics of variables to analyze the necessity and difference of Home Health Nursing System. The results of this study were as follows 1) The general characteristics of the subjects were as follows ; for sex, man, $58.1\%$ ; for age, 50-59 years, $29.7\%$ ; for the level of education, high school, $51.4\%$ ; $79.7\%$ of them were married; for the family forms, small family, $73.0\%$ ; and $68.9\%$ of them take the monthly income over 100 million won. 2) The characteristics related to admissions of the subjects were as follows ; for clinic, surgical department, $78.4\%$ ; addmission not more then 7days, $47.3\%$ ; for the operation-performance $71.6\%$ of them were experienced; for the admission route, via outpatients clinic, $54.1\%$ ; for waiting period to the admission day, 1-2 days, $71.6\%$. 3) The difficulties comming from the hospitalization were related mostly to the factor that they felt hospital life more inconvenient than home.(3.66) The reasons for the difficulties in the admission which was due to insufficient beds in the hospital was related to the concentration to the general hospital because of 'The Whole National Medical Insurance System'(4.05). 4) On the previous informations about the Home Health Nursing System, those who have heard of only the name were 42 $(56.8\%)$, and on the recognition of it, they thought that it is periodic treatment by the licenced nurses for the recovering pateints after early discharge(3.73). On the attitude about the necessity of Home Health Nursing System, they thought that it is necessary because of the increasing trend of a psychological disease by the change of environment and complexity of the social structure(4.24). On the expected effect of Home Health Nursing System, they answered that it is convinient for the family of the patient to take care of them(4.l8). 5) On the attitude to the management plan of the Home Health Nursing System, those who had intention to participate in the system in the case of systemic support were 42(56.8). In the visiting time, 'visit periodically' and 'visit when the patient needs' were $28(37.8\%)$ respectively. For the application of medical insurance, if possoble, they will use $(91.9\%)$; for the method of payment for the treatment, 'pay by the time required' was $23(31.1\%)$, for the subject of management, 'National public institute must operate' was $33(44.6\%)$. 6) The relationship between the general characteristics of the subjects and the necessity of Home Health Nursing System showed the notable difference in the age (F=3.508, P<0.05) and marrage state (F=5.402, P<.023).

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ATS 인공 판막의 조기 임상성적 및 도플러 심에코 검사 소견 (Early Clinical Outcome and Doppley Echocardiographic Data after Cardiac Valve Replacement with the ATS prosthesis)

  • 박계현;박승우
    • Journal of Chest Surgery
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    • 제30권7호
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    • pp.663-669
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    • 1997
  • ATS 인공판막을 이용하여 심장판막 치환수술을 시행받은 100명의 연속적인 환자를 대상으로 조기 성적 과 외래 추적 결과를 분석하였다. 또한 수술 후 시행한 도플러 심에코 검사 결과를 통하여 이 판막의 혈역학 적 특성을 살펴보았다. 환자들의 평균 연령은 48.6세였으며 총 124개의 판막이 치환되었다. (승모판막 71, 대 동맥판막 46, 삼첨판막 7) 가장 많이 사용된 크기는 승모판막에서는 27 mm(40.8%), 29 mm(35.2%)였고 대동 맥판막에서는 23 mm(30.4%), 21 mm(28.3%)였다. 수술후 조기 사망은 1례도 없었고 총 950 patientmonths의 외래추적이 이루어졌다(추적율=99%). 만기 사망도 없었으며 혈전-색전증이나 판막의 구조적 결합에 의한 합병증은 발생하지 않았다. 2명의 환자가 각각 Valsava동의 파열과 심내막염에 의한 대동맥 인공판막 dehi nce로 재수술을 받았고 고혈압을 가지고 있던 환자 1명에서 두개내 출혈이 발생하였다. 도플러 에코검사 결과 판막 전후의 최대 및 평균 압력차는 승모판막의 경우 각각 평균 6.9 mmHg, 2.6 mmHg였고 대동맥판막의 경우 26.4 mmHg, 14.2mmHg였으며 승모판막의 평균 개구부 면적은 2.7 cm2였다. 27-mm이상 크기\ulcorner 승모판막에서는 판막크기에 따른 압력차나 개구부 면적의 차이가 없었으나 대동맥판막에 서는 판막크기의 감소와 압력차의 증가간에 유의한 상관관계가 있었다. 19-mm와 21-mm 대동맥판막의 경우 는 최대 및 평균 압력차가 각각 52.2 mmHg, 26.9 mmHg 및 27.1 mmHg, 13.3 mmHg였다. 상기 연구결과로써 ATS 인공판막의 조기 임상 성적은 만족스러운 것으로 결론지을 수 있으며 혈역학적 특성은 기존의 동일 유형 판막들과 비교하여 더 우수하다고 할 수는 없으나 차이가 없는 것으로 판단된다.

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가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정∙방문간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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의료이용 전.후 기대와 만족수준 비교 (Consumer expectation and consumer satisfaction before and after health care service)

  • 박장순;유승흠;손태용;박은철
    • 한국병원경영학회지
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    • 제8권1호
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    • pp.112-134
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    • 2003
  • The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.

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심외도관 협착 환자에서 자가조직을 이용한 재수술(Peel 수술); 조기 및 중기성적 (Replacement of Obstructed Extracardiac Conduits with Autologous Tissue Reconstructions (Peel operation); Early and Midterm Results)

  • 성시찬;장윤희;이충원;박진수;이형두;반지은;추기석
    • Journal of Chest Surgery
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    • 제40권3호
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    • pp.193-199
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    • 2007
  • 배경: 저자들은 라스텔리 수술(Rastelli operation) 후 도관협착을 해결하기 위해 협착된 도관을 제거한 후 그 후벽을 자가조직으로 이용하고 판막을 삽입한 후 전벽을 인공 첩포로 덮는 peel 수술을 시행하여 왔다. 이 수술의 결과를 후향적으로 조사하였다. 대상 및 방법: 2002년 5월부터 2006년 7월까지 모두 9명의 심외도관 협착 환자에서 peel 수술을 시행하였다. 라스텔리 수술 후 평균 $5.1{\pm}1.7$년 후 재수술을 하게 되었으며 peel 수술 시 환아의 평균 나이는 $7.5{\pm}2.4$년(범위: $2.9{\sim}10.1$년)이었다. 진단명은 심실중격결손을 동반한 폐동맥 폐쇄증이 6예, 총동맥간이 2예, 완전 대혈관 전위가 1예였다. 술 전 평균 우심실유출로 압력차는 $88.3{\pm}22.2mmHg\;(58{\sim}125mmHg$)였다. 1예에서는 단엽 우심실유출로 첩포(monocusp ventricular outflow patch, MVOP)를 이용하였고 나머지 8예에서는 조직판막(bioprosthetic valve)을 삽입하였다. 모든 예에서 대동맥차단은 하지 않았으며 평균 체외순환시간은 154 ($133{\sim}181$분)이었다. 수술 후 평균 추적기간은 20개월($1{\sim}51$개월)이었으며 3-D CT로 우심실유출로의 상태를 관찰하였다. 결과: 수술사망과 만기사망은 없었다. 술 후 퇴원 시 우심실유출로 평균 압력차이는 $20.4mmHg\;(0{\sim}29.6mmHg$)였다. peel 수술 후 재수술은 없었으며 최근 초음파 검사에서 우심실 압력차이 (n=7, 최소 1년 이상 추적)는 26 mmHg ($13{\sim}36mmHg$)으로 약간의 상승은 있었으나 MVOP를 사용한 1예를 제외한 전 예에서 폐동맥판 폐쇄부전은 없었다. 3-D CT검사상 우심실유출로의 수축, 혈전형성, 가성동맥류의 증거는 발견하지 못하였고 우심실유출로의 통로가 잘 유지되고 있었다. 결론: peel 수술은 라스텔리 수술 후 도관협착을 해결할 수 있는 안전하고 효과적인 수술법으로 생각한다.

말기암환자 정보시스템을 이용한 우리나라 암환자 완화의료기관의 이용현황 (The Current Status of Utilization of Palliative Care Units in Korea: 6 Month Results of 2009 Korean Terminal Cancer Patient Information System)

  • 신동욱;최진영;남병호;서원석;김효영;황은주;강진아;김소희;김양혁;박은철
    • Journal of Hospice and Palliative Care
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    • 제13권3호
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    • pp.181-189
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    • 2010
  • 목적: 최근 보건의료 정책 결정은 근거에 기반하여 이루어지는 추세에 있으며, 말기암환자 정보시스템은 이러한 필요에 부응하기 위하여 개발되었다. 본 고에서는 말기암환자 정보시스템의 개발과정 및 6개월 데이터로부터의 통계 결과를 보고하고자 한다. 방법: 말기암환자 정보시스템의 입력항목은 실무 전문가들의 자문을 받아 개발되었으며, 이벨로스 임상연구관리시스템을 기반으로 구축하였다. 2009년 보건복지가족부에서 지정된 34개 암환자완화의료 기관에 2009년 1월 1일부터 6월 30일까지 등록된 환자들에 대한 정보가 수집되었다. 분석은 기술적 통계를 이용하였다. 결과: 총 2,940명의 전국적으로 대표성 있는 데이터로부터 아래와 같은 결과를 얻었다. 평균연령은 $64.8{\pm}12.9$ 세였고, 56.6%가 남자였다. 폐암(18.0%)이 가장 많았다. 2인 이상의 의사에 의하여 말기진단을 받은 경우는 50.3% 였으며, 입원 당시 말기라는 사실을 알고 있는 환자는 69.7%였고, 거의 절반에 가까운 환자가 특별한 의뢰 없이 입원하였다. 평균 통증 및 최고 통증은 입원 1주 후에 통계적으로 유의하게 감소하였다. 사망 퇴원한 환자가 73.4%였으며, 집으로 퇴원하는 경우는 13.3%에 불과했다. 1회당 평균 입원일수는 $20.2{\pm}21.2$일이었으며, 중위값은 13일이었다. 결론: 말기암환자 정보시스템의 운영을 통하여 완화의료 기관 이용 환자 및 가족의 특성, 서비스 제공에 관한 현황 등에 관한 전국적으로 대표성 있는 자료를 얻을 수 있었다.