• Journal of Korean Clinical Nursing Research
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• v.28 no.2
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• pp.198-209
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• 2022

Purpose: The purpose of the study was to shorten the KPCS-1 (Korean Patient Classification System-1) for predicting nursing care need level and to explore whether the patients can be clustered by their acuity and dependency. Methods: The participants were inpatients in two surgical wards and two internal medicine wards at a teritory hospital during 14 days investigations. The KPCS-1 was evaluated once a day for all inpatients and 2,082 cases of data from a total of 411 patients were analyzed. Results: The items were reducted from 50 items to 26 items by partial least squares analysis and expert review. Through factor analysis, it was confirmed that hygiene, diet, elimination, and exercise were categorized as dependence factors. Patients were clustered with low acuity/low dependency (average score: 7.68±2.81/1.05±1.33), high acuity/low dependency (average score: 17.20±4.15/1.94±2.40), medium acuity/high dependency (average score: 13.56±5.30/9.66±2.64) through cluster analysis. The total score of the three groups for their nursing care needs was 8.73±3.36, 19.14±5.74, and 23.24±6.31 in order, and the results showed a statistically significant difference (F=1712.12, p<.001). Conclusion: The shortening of the KPCS-1 and the new criteria for categorizing patients according to acuity and dependence will increase clinical utility and be useful for manpower assignment criteria in detail.

• Journal of Biomedical Engineering Research
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• v.44 no.3
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• pp.167-175
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• 2023

Chest PA is the basic examination of radiographic imaging. Moreover, Chest PA's demands are constantly increasing because of the Increase in respiratory diseases. However, it is not meeting the demand due to problems such as a shortage of radiological technologist, sexual shame caused by patient contact, and the spread of infectious diseases. There have been many cases of using artificial intelligence to solve this problem. Therefore, the purpose of this research is to build an artificial intelligence dataset of Chest PA and to find a posture evaluation method. To construct the posture dataset, the posture image is acquired during actual and simulated examination and classified correct and incorrect posture of the patient. And to evaluate the artificial intelligence posture method, a posture estimation algorithm is used to preprocess the dataset and an artificial intelligence classification algorithm is applied. As a result, Chest PA posture dataset is validated with in over 95% accuracy in all artificial intelligence classification and the accuracy is improved through the Top-Down posture estimation algorithm AlphaPose and the classification InceptionV3 algorithm. Based on this, it will be possible to build a non-face-to-face automatic Chest PA examination system using artificial intelligence.

• Journal of Chest Surgery
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• v.23 no.2
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• pp.342-351
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• 1990

In recent years there are so many medical informations that surgeons should know to handle or analyze their large amount of surgical cases. Proper use of computer system offers new opportunities for the storage and manipulation of their hospital informations. But little is reported about which system, is appropriate, how much can we do with such a system, or what kind of work can be done with that, especially in the area of Thoracic and Cardiovascular Surgery section. Authors designed a computer-based patient file management system using 16 Bit AT IBM personal computer and dBASE IV program, and developed a coding system for the diagnosis and operation name, which offers the basis for the classification of the surgical patient data. And the result of some experiences which was got from the total surgical cases of Thoracic and Cardiovascular Section, Seoul District Armed Forces General Hospital during past 5years, was described.

• Korean Institute of Interior Design Journal
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• v.23 no.6
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• pp.195-203
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• 2014

This study selects factors affecting form type of hospital architecture by considering studies and references on hospital architecture type in korea and other countries in general. Also this study classifies general hospitals chronologically and analyzes type change of general hospitals in relation with periodic change of healthcare environment. Through this, this study aims to analyze chronological change of general hospitals' form type and provide the current of hospital architecture's general type. The form type classification of this study is classification according to the form of ward, classification according to the relationship between ward and D.T.D(Diagnostic and Treatment department), classification according to the relationship between O.P.D(Out Patient department) and D.T.D, classification according to the rate of centralization, classification according to the circulation system. The form type of ward changed from plate type to tower type, and the circulation system of ward changed from middle corridor to double corridor, the number of Team Nursing chaged from 1 to 2 in 1990. On the other hand the chage of others classifications took place from 1990' to 2010'. It is judged that this overall change is appeared by a change from an inpatien-oriented system to an outpatient-oriented system followed by an increase in number of outpatients, an increase in amenities in ground floor and adoption of healing environment for patients and visitors.

• Journal of Gastric Cancer
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• v.18 no.2
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• pp.142-151
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• 2018

Purpose: The modification of the cancer classification system aimed to improve the classical anatomy-based tumor, node, metastasis (TNM) staging by considering tumor biology, which is associated with patient prognosis, because such information provides additional precision and flexibility. Materials and Methods: We previously developed an mRNA expression-based single patient classifier (SPC) algorithm that could predict the prognosis of patients with stage II/III gastric cancer. We also validated its utilization in clinical settings. The prognostic single patient classifier (pSPC) differentiates based on 3 prognostic groups (low-, intermediate-, and high-risk), and these groups were considered as independent prognostic factors along with TNM stages. We evaluated whether the modified TNM staging system based on the pSPC has a better prognostic performance than the TNM 8th edition staging system. The data of 652 patients who underwent gastrectomy with curative intent for gastric cancer between 2000 and 2004 were evaluated. Furthermore, 2 other cohorts (n=307 and 625) from a previous study were assessed. Thus, 1,584 patients were included in the analysis. To modify the TNM staging system, one-grade down-staging was applied to low-risk patients according to the pSPC in the TNM 8th edition staging system; for intermediate- and high-risk groups, the modified TNM and TNM 8th edition staging systems were identical. Results: Among the 1,584 patients, 187 (11.8%), 664 (41.9%), and 733 (46.3%) were classified into the low-, intermediate-, and high-risk groups, respectively, according to the pSPC. pSPC prognoses and survival curves of the overall population were well stratified, and the TNM stage-adjusted hazard ratios of the intermediate- and high-risk groups were 1.96 (95% confidence interval [CI], 1.41-2.72; P<0.001) and 2.54 (95% CI, 1.84-3.50; P<0.001), respectively. Using Harrell's C-index, the prognostic performance of the modified TNM system was evaluated, and the results showed that its prognostic performance was better than that of the TNM 8th edition staging system in terms of overall survival (0.635 vs. 0.620, P<0.001). Conclusions: The pSPC-modified TNM staging is an alternative staging system for stage II/III gastric cancer.

• Health Policy and Management
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• v.32 no.2
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Health Policy and Management
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• v.32 no.2
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• pp.125-136
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• 2022

The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Journal of Korean Foot and Ankle Society
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• v.13 no.1
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• pp.80-84
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• 2009

Purpose: The purpose of this article is to assess the efficacy of a bioabsorbable polylactide (PLA) plate and screw for treating injuries of ankle fractures. Materials and Methods: 24 patients who underwent an open reduction and internal fixation operation for ankle fractures from July 2005 to March 2007 were enrolled into the study. There were 15 men and 9 women. The average age of the patients was 44 years and the average follow-up period was 16 years and two months (16.2 months). All cases were divided into low grade fracture patient (11) who belongs in type A and B of Danis-Weber classification and high grade fracture patient (13) who belongs in type C1, C2 of Danis-Weber classification, and each groups were analyzed by clinical (Meyer score) and radiological finding at the time of their last follow-up evaluation. Results: The clinical results according to Meyer scoring system, showed that all patient with low grade fracture had good to excellent result, but only 54% of patient with high grade fracture had good to excellent result. According to Cedell's radiologic finding, there were 91% cases above fair in low grade fracture. But there were 62% of patient above fair result in high grade fracture, the reduction losses were seen in 38% of patient with high grade fracture. Conclusion: Bioabsorbable PLA plate and screw is good internal fixation device which doesn't have additional operation for removal of implant because of slow absorption within the human body. It showed sufficient strength for acquisition and maintenance of reduction in low grade fracture, but need attention to use because of many cases of reduction loss in high grade fracture. So, it seems to be safe and effective when used in heeling of low grade fracture under considering about type of fracture sufficiently.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.379-389
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• 2003

Purpose: The objective of our study was to figure out costs of nursing services in general nursing units based on the PCS in order to determine an appropriate nursing fee schedule. Method: The data were collected from 8 hospitals from September 9 to October 8, 2002. The costs of nursing services in general nursing units was analyzed by nursing hours based on the nursing intensity. The inpatient in the general nursing units were classified by Park's PCS tool(2000). Results: The distribution of patients by PCS ranged from class I to Class III in general nursing units. The higher PCS in general nursing units consumed more nursing hours. As a result, the higher nursing intensity, the more the daily average nursing costs in general nursing units. Conclusion: We found that the higher PCS, the more the daily average nursing costs in general nursing units. In conclusion, our study provides the evidence to refine the current nursing fee schedule that it does not differentiated from the volume of nursing services based on the nursing hours.

• Journal of Korean Clinical Nursing Research
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• v.19 no.1
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• pp.33-44
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• 2013

Purpose: This study was done to develop a valid and reliable Classification System for Critical Care Nursing (CSCCN) to be used in Intensive Care Units (ICUs). Methods: Head nurses and staff nurses of 17 ICUs in 6 hospitals classified 307 patients to verify interrater reliability. To verify construct validity, the staff nurses classified 404 patients according to CSCCN comparing difference in medical department and type of stay in ICU. For conversion index, 78 patients from 4 ICUs of 'S' hospital were classified and nursing time was measured by 107 nurses and 18 nurse aids using stopwatches. Results: The developed CSCCN has 11 categories, 76 nursing activities and 101 criteria. The reliability was verified as having high agreement (r=.946). The construct validity was verified comparing differences in medical department and type of stay in ICU. According to scores, four groups in the CSCCN classification were identified. According to the conversion index, one score on the CSCCN means 7.2 minutes of nursing time. Conclusion: CSCCN can be used to measure diverse and complex nursing demands including psycho-social aspects of ICU patients and convert nursing demands to numbers.