• 한국임상약학회지
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• 제28권2호
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• pp.88-94
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• 2018

Background: We strived to evaluate the status of nivolumab use and associated factors on the clinical efficacy of the drug. Methods: The study was retrospectively conducted in patients who had been administered nivolumab at least once at the cancer center of Seoul National University Hospital from June 2015 to April 2017. Data were collected from electronic medical records. A medication-use evaluation was performed based on the American Society of Health-System Pharmacists mediation-use guidelines. Results: Sixty-six of the 74 patients (89.2%) showed indications approved for nivolumab use by the Korean Ministry of Food and Drug Safety (MFDS; n=55) or the US Food and Drug Administration (FDA; n=11). Approximately 73.0% of the patients were administered the approved dose of 3 mg/kg but 25.7% were administered an unapproved fixed dose of 100 mg. The overall response rate was 21.7%, and the response rate of non-small cell lung cancer patients, who accounted for the largest number of indications, was 18.8%. Adverse reactions were found in 90.1% of the patients and were mostly mild (86%). The expression of programmed death-ligand 1 (PD-L1) was analyzed as a factor affecting treatment response (p=0.028, odds ratio [OR]=11.331). Conclusion: PD-L1 expression was found to affect treatment response. However, caution is required while using an unapproved dosage and in the absence of monitoring for effectiveness and safety. Therefore, an effective protocol or instruction manual for the proper use of nivolumab should be considered.

• 한국직업건강간호학회지
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• 제3권호
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• pp.31-40
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• 1993

The objective of this study was examine sick leave rates of hospital employees. The sick leave data of 2,123 employees in three(3) general hospitals located in Seoul during the period from January 1, 1992 to December 31, 1992 was analyzed to achieve the study objective. The sick leave rates were computed in compliance with the standards recommended by the International Association on Occupational Health. Univariate analysis methods($X^2$-test and ANOVA) were used to assess the sourse of variance in the rates. The results were as follows : 1. The total annual rates of sick leave were 4.8% in frequency(persons), 0.23% in lost time, 0.68 days in duration and 14.0 days in severity. 2. The sick leave rates of frequency(person). duration and lost time were significantly higher in female than male, in groups of 40-49 years than in the other age group, the married than the unmarried and in the long employment of 8 years or above than the short employment. But there was no significant difference in the rate of severity. Only the sick leave rate of frequency(person) was significantly related to the educatial status, but there was no significant difference in other analytical factors of sick leave rate. 3. The main causes of sick leave were injury and poisoning(24.3%), and disease of the digestive system, disease of the nervous system and sense organs, and complications of pregnancy, childbirth and puerperium(respectively 11.6%). The severity rate was the highest in neoplasms(32.2 days), and followed by endocrine, nutritional and metabolic disease and immunity disorders, injury and poisoning, and infections and parasitic disease in descending order. 4. The sick leave rates of frequency(person), duration and lost time were the highest in nutritional workers followed by registered nurses. However, severity rate was the highest in doctors and pharmacists and followed by in nutritional works. 5. The main cause of sick leave was complication of pregnancy, childbirth and puerperium in registered nurses(26.3%), injury and poisoning in nutritional workers(78.6%) and disease of respiratory system and digestive system in other workers.

• 보건교육건강증진학회지
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• 제19권1호
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• pp.31-44
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• 2002

This study was conducted to examine arthritis patients' knowledge level and its related factors. Data were collected from 100 people who suffered from arthritis in Seoul, Busan, Daegu, Daejun, Junjoo, and Pohang from June 1, 2000 to August 31, 2000. The results of this study are summarized as follows. 1. 61.0％ of the subjects was female. The incidence rate of arthritis was higher in the higher age group, lower educated group, and thinner group. In the case of male, the incidence rate was higher in the groups of single, residents in big cities, and technicians. In the case of female, it was higher in the groups of the married, residents in towns or villages, and housewives. 2. Among the sources of obtaining the knowledge related to arthritis, 38.0％ of the respondents obtained the knowledge from physicians and 24.1 ％ got it from TV or Radio. 14.6％ of them obtained it from family members, neighbors, and friends and 14.3％ got it from newspapers, magazines, and pamphlets. Only 5.8％ of them obtained the knowledge from pharmacists. The sources showed significant difference in the variables of age, occupation, marital status, religion, place of residence, and education level. 3. 47.2％ of them thought that education related to arthritis was needed without fail, while 12.5％ thought that it was not necessary. In the question related to concern about arthritis, ‘no concern’ was 31.2％, while ‘concern’ was 7.8％ and ‘a little concern’ was 45.1 ％. 4. The knowledge level of arthritis was 7.35 ± 1.51 points on the basis of 11 points. It showed significant difference in the variables of age, occupation, education level, and economic status. 5. The knowledge was influenced by the variables of economic status, necessity of publicity, treatment period, occupation, education level, and age. The arthritis patients did not have enough knowledge of arthritis because the education was not provided well for them. Therefore, related professionals and organizations must develop education program of arthritis in order to educate them.

• 한국병원경영학회지
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• 제7권1호
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• pp.121-130
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• 2002

As a hospital deals with people in their particular states, namely patients, computerization and automation in organization systems are very limited. Even though state-of-the-art medical systems such as the OCS, the HIS, the EMR, and the FACS are facilitating the computerization and informatization processes, they are for convenience and effectiveness. Ultimately, however, we should depend on specialists including doctors, nurses, pharmacists, and medical engineers. Therefore, a hospital is a representative labor-intensive body. Like other similar organizations, hospitals require a lot of manpower. But they are quite different in that hospital people hold variety and complexity in their qualifications and licenses. In personnel management, a hospital is twice controlled owing to the special characteristics that human life is at stake. First, the quota of medical manpower should be obeyed lest the quality of medical services should be lowered, and their roles and interrelations are even regulated. Second, in spite of the peculiarity of hospitals, the duties of obligatory employment and social insurances should not be neglected like other companies. In order that each hospital can preserve the proper level of medical services, securing the appropriate level of medical personnel has to be regulated. However, as the personnel cost is one of the important indices of hospital management, too much regulation in manpower supply can lead to poor hospital management and, in the end, the drop of the quality of medical services. In sum, as far as hospital personnel is concerned, some autonomy ought to be given to each hospital so that it can control the quality of hospital services. In addition to this minimum regulation of personnel, certain incentive and reward systems like the graded nursing system need to be prepared.

• 한국병원경영학회지
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• 제7권1호
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• pp.19-40
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• 2002

The purpose of this study is to find out if there has been any change in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare program that divides the roles of doctors and pharmacists and the reason for the change if there is any. Two tertiary care hospitals with the largest capacity of 1200 beds and two tertiary care hospitals with the lowest capacity of 600-700 beds were randomly selected. Data of the outpatient visits from March-May 2(xx), before the new healthcare system was adopted, were compared with the data from March-May 2001, after the new policy was adopted. Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. Decrease in re-visits is much higher than the first visits. Female patients decreased more than the male patients. Outpatient visits by economically active patients group aged 25-44 declined much. Tertiary hospitals in Seoul and Kyonggi Province, as well. Outpatient income of tertiary hospitals has dropped up to 14.7% due to the decline in outpatient visits and pharmaceutical income, and resell price system which in turn has caused the hospital financial deficits. While the new program has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs. A full-fledged review of the system should be conducted for the establishment of the new system and I believe this study may be a useful references. Furthermore, more profound and overall studies on the chance in the patients use of hospitals are needed.

• 한국병원경영학회지
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• 제22권3호
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• pp.74-87
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• 2017

Purposes: The purpose is to establish the direction of healthcare R&D through private nonprofit organization. Methodology: The data is divided into two groups: 12 physicians and pharmacists, and 16 persons including professors related to university donation, non-profit foundation executives. Each group was subjected to two Delphi surveys. To analyze the validity of the opinion, the content validity ratio and the consensus of experts were verified. Findings: Funding should be invested in 'development research' and 'application research'. The factors that hinder the donation culture are 'donation prevention system such as tax imposition system and rebate double penalty system', 'insufficient motivation of fund raising person', and 'lack of fund specializing specialist'. The fund raising strategy should be centered on a small number of large donors or a balance between large and small donors. The fund raising target should be effective to raise funds for corporate and individual donors. It is necessary to clarify the purpose of the social problem to be solved by the campaign strategy for promoting donation, to announce the validity of the trust and transparency of the institution, and to emphasize the social investment by the private sector. Practical Implications: It is necessary to present directions through private nonprofit organizations for the future development of healthcare R&D. The legal and institutional deficiencies of the domestic nonprofit organization fundraising infrastructure should be improved. In order to create a social investment climate, it is necessary to improve the awareness of donations and develop various donation programs for the private sector.

• 약학회지
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• 제53권4호
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• pp.217-221
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• 2009

Diabetes mellitus is a group of metabolic disorders characterized by hyperglycemia and abnormalities in carbohydrate, fat, and protein metabolism which is resulting chronic microvascular, macrovascular, and neuropathic complications. Therefore, correct and consistent educations for pharmacotherapy is important and especially drug consultation by the specialty pharmacist of diabetic pharmacotherapy is necessary for all diabetic patients. The purpose of this study is to evaluate the necessity of the specialty pharmacist of diabetic pharmacotherapy and this study was performed from June 31th, 2008 to October 9th, 2008 in Kangnam St. Mary's Hospital, Seoul, S. Korea throughout the questionnaire and evaluated the total 68 patients who were participating the multidisciplinary diabetes team programs. We evaluated the patient characteristics (n=68), learning status (difficulty 70.4%), wanted further education (68.3%) and preference of educator (pharmacist 46%) after finishing team teaching by multidisciplinary diabetes team program. In conclusion, many diabetic patients(80.3%) wanted individual and further drug consultation by the pharmacists who are specialized in the diabetes individually and they are needed.

• 디지털융복합연구
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• 제13권1호
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• pp.275-281
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• 2015

최근 헬스케어는 다양한 의료 서비스를 제공받으려는 사용자가 급격하게 증가하고 있으며, 환자의 정보가 제3자에게 쉽게 노출되어 악용될 수 있어 환자에 따라 병원 관계자(의사, 간호사, 약사 등)의 역할이 명확하게 분류될 필요가 있다. 본 논문에서는 헬스케어 환경에서 환자의 정보가 제3자로부터 안전하게 사용하기 위해서 환자의 속성정보를 분류하고, 병원 관계자는 역할에 따라 권한을 분류하여 계층적 다중 속성을 이용한 환자의 프라이버시 보호기법을 제안한다. 제안 기법은 환자의 프라이버시 속성정보(데이터 소비자, 시간, 센서, 목적, 의무, 위임 그리고 상황 등)를 수학적 모델로 표현하고, 제 3자로부터 환자 정보가 불법적으로 악용되는 것을 예방하기 위해서 환자와 병원관계자 사이의 속성정보를 동기화하여 환자의 프라이버시 정보의 유출을 예방한다.

• 한국병원경영학회지
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• 제7권4호
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• pp.102-122
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• 2002

It has been 2 years since the implementation of the separation policy of drug prescription and dispensing. This study analyzes the changes in community pharmacy operation after the implementation of the policy. The main purposes of the analysis are to determine whether the changes in community pharmacy operation have occurred and to evaluate that the changes are consistent with the intention of the policy, if the changes actually have occurred. For the study a survey on 961 pharmacies chosen by stratified sampling method has been performed. Of the 961 sample pharmacies, 438 pharmacies were responded resulting 45.6% response rate. The sample pharmacies are classified by the location that the pharmacy are operating: the pharmacies around large size hospitals, the pharmacies around clinics or medium to small size hospitals and the pharmacies with no hospitals or clinics around. Based on the classification, the number of pharmacies, number of prescriptions processed, the personnel structure, the changes in facility, and other operational characteristics are compared. The results showed that the pharmacies were tended to concentrate around hospitals and clinic since the implementation of the policy. The number of pharmacists per pharmacy was increased, the size of pharmacy was increased and the facilities were improved to accomodate the requirements of the policy. The work hours a pharmacist spent on dispensing drug have increased almost twice, however, there was no corresponding increase in the time spent on patient education and medication history management, indicating a problem in the provision of quality pharmaceutical services. Based on the results, suggestions to minimize the negative effects of the policy are provided.

• 한국임상약학회지
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• 제20권1호
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• pp.39-49
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• 2010

The present study was aimed to examine the occurrence and influencing factors therapeutic duplication (TD) of medications for anxiety disorders by analyzing the relevant prescription data. In this study, the prescription data issued on March 19, 2008 in domestic medical institutes were utilized. TD was defined as more than two medications under the same therapeutic classification per prescription based on the Anatomical Therapeutic Classification (ATC) code. The assessment of TD was performed based on the number of cases and on the ratio determined. To identify the influencing factor of TD, the variables related to the differences in the TD ratio were analyzed based on the results of the Chi-Square test conducted with the variables; patients, medical institutes, diseases, and treatments. The number and ratio of TD were determined to be 1,333 out of the total of 19,219 anxiety disorder cases, and 6.94%, most cases involving benzodiazepine derivatives, respectively. The TD ratio was found to be higher in relation to males than to females. Patients with national health insurance benefits have a higher TD ratio compared to the medical-aid beneficiaries. The TD ratios were highest in clinics, psychiatry divisions, and Gyeongsang district. The TD ratio of the cases with more than two anxiety disorders was found to be higher than that of the cases with only one anxiety disorder. As the number of medications per prescription increased, the TD ratio was shown to have become gradually higher. In conclusion, in order to prevent TD, the concurrent DUR system should be implemented. The prescribers and pharmacists must be educated regarding duplicated medications to promote the safe and effective use of medicines, without unnecessary TD.