• Journal of Yeungnam Medical Science
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• 제39권4호
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• pp.332-335
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• 2022

We report on changes in the ascending reticular activating system (ARAS) concurrent with the recovery of impaired consciousness following rehabilitation and cranioplasty in a patient with traumatic brain injury (TBI), which were demonstrated on diffusion tensor tractography (DTT). A 34-year-old male patient was diagnosed with a traumatic intracerebral hemorrhage after falling from a height of approximately 7 m and underwent a right frontoparietotemporal decompressive craniectomy and hematoma removal. At 5 months after onset, when starting rehabilitation, the patient showed impaired consciousness, with a Glasgow Coma Scale (GCS) score of 4. Comprehensive rehabilitative therapy was provided until 14 months after onset, and his GCS score improved to 8. Cranioplasty was performed using auto-bone at 14 months after onset. One month after cranioplasty, his GCS score improved to 12. On the 15-month DTT, the deviated lower dorsal ARAS was restored on both sides, and the right side had become thicker. The right lower ventral ARAS was reconstructed, and increased neural connectivity of the upper ARAS was detected in both the prefrontal cortices. Thus, changes in the ARAS were demonstrated in a patient with TBI during recovery of consciousness following rehabilitation and cranioplasty.

• 보건행정학회지
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• 제24권4호
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• pp.304-311
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• 2014

This manuscript treats a new paradigm for the Korean health care system. We give an account of innovative health care delivery and payment models widely discussed in the contemporary US accountable care organization and coordinated care organization. In doing so, we explore a new health care model amenable to foreseeable changes to the health care system. We propose creating an integrated health care system in which the network of health care providers delivers coordinated and comprehensive care for enrolled patients residing within the geographic boundaries served by the provider network; providers may participate voluntarily in one or more networks and assume shared responsibility for patient care and cost; provider networks compete with each other based on cost and quality; and consumers are allowed to choose a network. We expect that the new paradigm will create a financially-sustainable system that assures quality of care and improves patient experience, minimizing the existing system-wide inefficiency through cross-network competition and within-network care coordination.

• 지식경영연구
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• 제19권4호
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• pp.187-201
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• 2018

This paper explores the potential of Blockchain technology in enabling a panacea for health equity. Since Satoshi Nakamoto first described Blockchain technology in 2008 pseudonymous paper, that distributed ledger system is empowered and ranging from finance to law to another sector and beyond. Also impacting healthcare sector and life science. In other words, there are many usage cases being researched in healthcare and Blockchain has shown its considerable special side in recent years. But this paper aims to the distributed ledger that is the special side of Blockchain technology is potentially can panacea for some global health equity issues such as patient data, counterfeit drug and hospital payment management.

• 한국의료질향상학회지
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• 제30권1호
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• pp.33-43
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• 2024

Purpose:The acute hospital accreditation program launched in South Korea has shown positive effects on safety culture and quality of care. However, relative weights have not yet been investigated for accreditation criteria with a hierarchical structure. This study aimed to derive the relative weights of acute-care hospital accreditation criteria. Methods: We conducted an online survey using the analytic hierarchy process (AHP) technique to assess the validity, importance, and urgency of acute hospital accreditation criteria. The AHP online survey link was distributed in November 2022 after obtaining informed consent from 10 experts in hospital accreditation. Results: 'Basic value system' ranked highest, while 'patient care system' ranked second in terms of validity, importance, and urgency. 'Performance management system' had the lowest validity and urgency, while 'organizational management system' carried the lowest importance. Within the 'patient care system' domain, 'surgery and anesthesia sedation management' scored highest in validity and importance, and 'patient care' scored highest in urgency. 'Care delivery system and evaluation' received the lowest scores for all three aspects. In the 'organizational management system' domain, infection control ranked highest in terms of validity, importance, and urgency. The lowest validity was observed for 'management and organizational operation' and the lowest importance and urgency were noted for 'human resource management'. Conclusion: The weights for validity, importance, and urgency, as shown in each domain and chapter, and the number of measurable elements included, are largely inconsistent. This study will contribute to the development of the structure and scientific improvement of accreditation standards.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권3호
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• pp.21-28
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• 2013

Purpose: General hospital in korea is getting large-scaled, specialized and upgraded. So, nursing unit of race track type has been advanced along with a spatial organization, building equipment and environmental approach. This study is to search the guidelines for renovation of nursing unit with race track type in the case of K university hospital in Daejeon. Methods: 9 cases of recently opened general hospital has been analyzed for spatial and environmental design solution. Questionnaires and interviews about user needs of nursing staff, patient and visitors, have been conducted for a nursing care system and facility of nursing units in K university hospital. Results: The user needs are represented as followings. Center core public zone in each floor plan and center core nursing station and supporting areas in nursing unit are good for an adjacency and separation of spatial organization. Toilet of group patient room is necessary to equip for easy, safe and infective aspects, and so toilet install will decrease the patient number and increase the nursing care service. Hall type of station front is good for visibility and observation. It is appropriate to renovate into south facing group patient room for privacy, enough space for nursing care facility and supporting area, enough width of door to move portable medical equipment, room for medical doctor and practical student, noise absorbing of day room. Implications: Upgrading the nursing care service and facility equipment is necessary to reflect the user needs and cooperate with hospital management.

• International journal of advanced smart convergence
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• 제2권1호
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• pp.1-5
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• 2013

This study proposes a remote monitoring of patients and emergency notification system with a camera and pulse wave sensor for U-Healthcare. The proposed system is a server client model based U-Healthcare system which consists of wireless clients that have micro-controller, embedded-board for patient status monitoring and a remote management server. The remote management server observes the change of pulse wave data individually in real-time sent from the clients that is to be remote-monitored based on the pulse wave data stored by users and divides them into caution section and emergency section. When the pulse wave data of a user enters an emergency situation, the administrator can make a decision based on the real-time image information and pulse rate variability. When the status of the monitored patient enters the emergency section, the proposed U-healthcare system notifies the administrator and relevant institutions. An experiment was conducted to demonstrate the pulse wave recognition of the proposed system.

• 보건의료산업학회지
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• 제6권1호
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• pp.27-38
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• 2012

This study is to find out the correlation among the predisposing, enabling, and need factors in Anderson Behavioral Model using the data from Korea Medical Panel Survey conducted in the early part (April 1 - October 31) of 2008. The findings are as follows. It was found that the utilization rate of western medical service was far higher. the influential factor to choose western or oriental medical service taking western medical institutions as the reference group, the influential factor to choose oriental medical institution has significantly increased when the patient who have covered by medical insurance has one accompanied disease and their age was between 45 - 74, compared to the people less than 45 years old. It also increased when the age of the patient was between 45-54 years old, and in the event those who are not covered by medical insurance have accompanied disease and that the disease mobility period is 2-4 years. reviewing the several characteristics of the utilization of western and oriental medical services by the patient with musculoskeletal system disorders, the number of accompanied disease is an influential factor for the utilization of oriental medical services. And, disease mobility period is a significant factor for the utilization of both western and oriental medical services together, though it is not identified in this study. Therefore, it is expected that mutual cooperation between western and oriental medical services is more required for the patient with musculoskeletal system disorders as the aging society rapidly develops. In order to foster oriental medicine, it is required to specialize in competitive disease such as musculoskeletal system disorders.

• 한국콘텐츠학회논문지
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• 제13권3호
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• pp.287-298
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• 2013

본 연구는 전산화된 임상 데이터를 이용하여 환자 중증도를 분별하는 기법을 고안하고 간호사가 작성한 분류 점수와 비교 분석하여 타당성을 검증하기 위하여 일개 종합병원의 7개 병동 재원환자 348명에게 하루동안 간호사가 수행한 행위를 근거로 환자분류(KPCS-1: Korean patient classification system for nurses) 점수를 간호사가 작성하고, 병원정보시스템에 저장되어 있는 임상 데이터를 이용하여 산정, 수집한 점수와 비교하였다. 간호사가 작성한 점수와 임상 데이터를 이용한 환자 중증도 점수 모두 진료과 및 환자유형에 따라 점수 분포를 비교한 결과 유의한 차이가 있는 것으로 나타나 환자분류의 타당성이 동일하게 검증되었으며, 두 방법 간 에는 상관계수 0.96(p<.001)의 높은 상관성이 있었다. 임상 데이터 기법이 다소 높은 점수를 보였으나 일부 영역의 보완을 거친다면 간호사가 환자분류를 작성하지 않고, 병원정보시스템에 저장된 임상 데이터에 연동하여 자동으로 환자 중증도를 분별하는 시스템 개발이 가능하고 이를 간호인력의 성과관리 및 수급계획 등에 활용 할 수 있을 것으로 기대된다.

• 한국임상약학회지
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• 제28권2호
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• pp.124-130
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• 2018

Objective: This study examined the Risk Sharing Agreement (RSA) on pharmaceutical pricing system in Korean national health insurance. Through RSA, the insurer was able to maintain the principles in the price listing process while managing the budget effectively and improving patient access to new drugs. Despite these positive effects, there are still issues raised by some stakeholders, such as lack of transparency in the listing process and doubts about its effectiveness. Therefore, we investigated the impacts of RSA on national health insurance financing and patient access to analyze the effects of RSA. Methods: The impact of RSA was investigated by analyzing the health insurance claims data for 2014~2016. The degree of improvement in patient access was determined by the decreased amount of patients' payment. Results: Results showed that the financial impact of RSA was not significant and patients' access to the new drug greatly improved. Conclusion: These results show that RSA is a good system for improving patient access to new drugs without additional expense on insurance.

• 보건의료생명과학 논문지
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• 제10권1호
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• pp.15-23
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• 2022

본 연구는 보건의료정보관리 전공자들의 환자 개인정보보호에 대한 인식 수준을 파악하여 그 중요성을 올바르게 인지할 수 있는 방안을 모색하기 위해 실시하였다. 연구방법은 부산시 소재 4년제 대학 4개교의 보건의료정보관리 전공 대학생 458명을 대상으로 설문조사를 시행하였다. 분석은 기술통계, t-test 및 ANOVA, Chi-square, 다중회귀분석을 실시하였다. 연구결과 개인정보보호제도에 대한 인식은 68.8%로 높은 수준을 보였다. 의료기관 내 환자 개인정보보호에 대한 지식 수준에 영향을 미치는 요인으로는 고학년, 개인정보보호법에 대한 인지도, 전공과목을 통한 교육 여부로 나타났다. 따라서 개인정보보호에 대한 교육은 전공과목을 통해서 학습하는 것이 필요하며, 의료기관에서 실제로 업무에 적용하고 있는 환자 '개인정보보호 가이드라인' 등을 숙지할 수 있는 체계적인 교육이 필요할 것이다.