• Archives of Reconstructive Microsurgery
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• 제23권2호
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• pp.93-96
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• 2014

The microscope is a surgical instrument with wide use in plastic surgeries more often than other departments due to the high rate of microscopic surgeries. Unfortunately, because the microscope is used mainly for digital replantations and free flaps, the utilization rate is low compared to the price and usability of the microscope itself. From September 2013 to March 2014, a foreign body which was untraceable with radiology in a patient who desired surgical exploration (one case), and a foreign body which was detected but was smaller than 3 mm (two cases) were removed using the microscope. All foreign bodies, which were fish bone, thin metals, or wooden objects, matching the history of the patients, were completely removed without damage. There were no complications and patient satisfaction was high through follow-up. We have described the microscope as the last and optimal examination tool in removal of micro foreign bodies. A simple change of thought, so that the microscope can be used as a second diagnostic tool will decrease complications by foreign bodies.

• 대한한의학방제학회지
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• 제25권1호
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• pp.39-49
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• 2017

Objectives : The contents of the literature associated with the medical records were entered into the database. We want to find the structure and search methods for efficient utilization of the database. Methods : The contents were entered into the database using the 'Access 2014 of the MS'. The Query Sentences were created and utilized for a search. Results : We could find information about the prescriptions, medical records and patients by the herbs and symptom combinations using the single table named 'Integrated Knowledge' and queries. Integrated Knowledge is a table that gathered patient information, prescription information and symptom information together. Conclusions : If you store patient, prescription and symptom information on a single table, you could search and use the results by various combinations of the various elements included in the table. These results could help curing patients on the basis of evidence-based treatment at the clinics.

• 보건의료산업학회지
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• 제6권2호
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• pp.101-109
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• 2012

This study purposed to analyze the differences of cost, length of stay, and number of visits between patients who referred from clinics to a general hospital and patients who directly visit a general hospital. Study sample included 402 patients (177 patients who were not referred from clinics, 225 patients who referred from clinics) who visited the Dept. of Gastroenterology in a university hospital in Daejeon from January to June in 2007. Cost and patients' information were collected from Hospital Information System and medical record. SPSS v.12.0 was used for the statistical analysis. Multiple regression analysis found that for inpatients, location variables and malignant tumors of digestive organs had a significant influence on cost variable. For outpatients, a referring hospital type and visiting month had significant influences on total cost, and sex and visiting month (February) had significant relationship with number of visit. The study results help to understand the differences of patient care depending on whether they were referred from clinics or not. Hospital managements could use the results for marketing purposes, and it could provide valuable information for increasing the competitiveness of hospital in a given market.

• Imaging Science in Dentistry
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• 제48권1호
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• pp.67-72
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• 2018

Historically, Eagle syndrome is a term that has been used to describe radiating pain in the orofacial region, foreign body sensation, and/or dysphagia due to a unilateral or bilateral elongated styloid process impinging upon the tonsillar region. Because elongated styloid processes-with or without associated Eagle syndrome-can present with various symptoms and radiographic findings, it can be challenging for healthcare practitioners to formulate an accurate diagnosis. Abnormal styloid anatomy can lead to a multitude of symptoms, including chronic orofacial/neck pain, thus masquerading as more commonly diagnosed conditions. In this report, we describe a patient who presented to our department with styloid process elongation and fracture. A careful history, physical examination, and a cone-beam computed tomography (CBCT) investigation led to the diagnosis. The patient was then referred for appropriate care. This case report demonstrates the utilization of CBCT in differentiating a fracture site from a pseudo-joint that might mimic a fracture.

• 대한예방한의학회지
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• 제14권1호
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• pp.137-149
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• 2010

In recent decades, as the utilization of complementary and alternative medicine in the United State have been growing rapidly, regulatory controls surrounding complementary and alternative medicine(CAM) aims to ensure patient protection against unproven practices and to provide safe and effective treatments. Regulation and policy method on licensing CAM practitioners varies across the states. Over 85% of the states have the licensing system for acupuncturists, chiropractors, and naturopaths. For acupuncture, although the requirements for formal education are various across the states, a unified written examination has been adopted by almost entire states which have acupuncturist licensing law. Medicare, the public medical insurance, does not cover CAM practices except chiropractic and biofeedback. In some states, however, Medicaid programs cover some CAM therapies including acupuncture, naturopathy, and massage therapy. 67% of Health Maintenance Organizations, the private health plans, provide at least one modality of CAM services. In conclusion, government policies have been strengthened to ensure patient protection, and will continue to integrate CAM practices that are proven to be safe and effective into mainstream health care system.

• Industrial Engineering and Management Systems
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• 제13권2호
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• pp.193-202
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• 2014

Patients' satisfaction while receiving medical service is affected by whether or not their preferences can be met, including time and physician preference. Due to scarcity of medical resource in China, efficient use of available resources is urgently required. To guarantee the utilization ratio, the scheduling decisions are made after all booking information is received. Two integer models with different objectives are formulated separately, maximizing the degree of satisfaction and revenue. The optimal value of the two models can be considered as the bound of corresponding objectives. However, it is improper to implement any of the extreme policies. Because revenue is a key element to keep the hospital running and satisfaction degree is related to the hospital's reputation, neither the revenue nor the satisfaction can be missed. Therefore, hospitals should make a balance. An integrated model is developed to find out the tradeoff between the two objectives. The whole degree of mismatching that is related to patient satisfaction and other separate mismatching degree are considered. Through a computational study, it is concluded that based on the proposed model hospitals can make their decisions according to service requirement.

• PNF and Movement
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• 제11권1호
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• pp.79-88
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• 2013

Purpose : Currently, ICF to describe the functions and disability in the world has been used as a universal language. ICF tools based on ICF, the rehabilitation management of clients have been developed to be efficient. This study was designed to describe clinical decision for functional goal of clients to used ICF tools. Methods : In the following the utilization of all developed ICF tools will be described within a case example of a 53-year-old women, suffering from cerebellum disorder. As problems in the subject's functional activities was difficulties in changes sitting postures, standing postures and maintaining standing postures. Activity limitation was determined change sitting, standing posture as a goal through discussion with the patient. Results : After setting the identified problems as the purpose of intervention through the assessment, we find out the outcomes using the ICF evaluation display. Consequently, with functional activities limitation that discovered from assessment(categorical profile, assessment sheet), sitting postures to standing postures and maintaining standing postures were improved. Conclusion : This study was showed ICF tools based on Rehab-cycle for the patient's functional goals clinical practice. The future study, the ICF in clinical practical tools for effective use will require more attempt.

• 근관절건강학회지
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• 제28권2호
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• pp.161-173
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• 2021

Purpose: This study examined: 1) what it meant for patients to have multimorbidity 2) how they manage their illness using health care facilities, and 3) what contextual backgrounds exist regarding the health care system. Methods: This qualitative research obtained individual in-depth interviews from 22 patients. Participants were selected by purposive sampling among those who saw physicians more often than the national average from the 2013 medical-claim data. The transcribed data were analyzed using Ground theory. Results: Multimorbidity patients suffered from "chain-like serial symptoms" and "pain without a breakthrough". They expressed themselves as "indeed patients among patients", "my body is a general hospital", and "an incompletely normal person". There was a demand to resolve the anxiety arising from the situation in which the body keeps getting sicker without showing any signs of recovery. In a state of reduced social support and a lack of trust in the doctor, their desire to be healed led them to receive a temporary relief through dependence on medical institutions. Conclusion: This research recognized the desire of multimorbidity patients to seek temporary relief through dependence on medical institutions. A more patient-centered directed care plan, specific to the needs of the patients with multimorbidity is required.

• Journal of Trauma and Injury
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• 제35권3호
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• pp.151-158
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• 2022

Purpose: There is a strong correlation between trauma and pain. Pain increases the rate of depression, posttraumatic stress disorder, and even mortality in trauma patients. Methods: This institution-based, provider-blinded and patient-blinded, observational study was conducted among trauma patients treated at Tikur Anbessa Specialized Hospital. Over the course of 3 months, this study included patients who had no prior pain management at other hospitals before presentation, and who presented within 24 hours of the traumatic event. Results: Of the 74 patients evaluated, none of the patients had their pain level scored. The researcher-provided pain scale showed a severe subjective pain score for 79.7% of the patients and a severe functional activity score for 59.5% of the patients. Analgesia was provided at an average of 55.4 minutes after presentation and all patients received either diclofenac or tramadol. Satisfactory pain reduction after analgesia was 28.8% for patients initially complaining of severe pain, 54.6% for moderate pain, and 66.7% for mild pain, with the difference being statistically significant (P<0.05). Forty percent of patients discharged home received no analgesia after the first dose provided upon presentation. Conclusions: Pain scoring was nonexistent during the course of the study. The poor utilization rate of analgesia combination and opioids led to unsatisfactory pain outcomes in patients evaluated and followed for 24 hours after presentation.

• 한국산학기술학회논문지
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• 제14권2호
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• pp.713-720
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• 2013

본 연구는 의과 일부 상병에 국한된 지역간 의료이용변이 연구의 범위를 한방으로 확대하여 다양한 실증적 연구기반을 마련하고 의과 상병의 지역간 의료이용변이가 한방에서도 존재하는지, 존재한다면 그 요인은 무엇인지를 파악하여 한방 의료서비스의 합리적 이용을 위한 정책수립에 필요한 기초 자료를 제공하는데 그 목적이 있다. 2010~2011년 건강보험 자료에서 의과, 한방외래 다빈도 10대 상병을 선정하고 86개 군 지역을 대상으로 지역 간 의료이용 변이여부를 분석하였다. 분석결과 한방에서도 지역별의료이용변이가 존재하는 것으로 나타났는데 내원일당진료비는 공급자측면 보다는 수요자특성이 주요한 요인으로 작용하였고 수진자당진료비는 공급자와 수요자특성이 동시에 주요한 요인으로 작용하였다. 따라서 한방 의료서비스의 합리적 이용을 위한 의료의 과다이용과 미 충족 방지를 위해 한방 의료서비스 표준화, 한방의료 역할강화, 올바른 의료이용과 불필요한 의료행위를 줄이기 위한 정보제공 및 정보공유 확대정책이 필요하다.