• Title/Summary/Keyword: Principal diagnosis

검색결과 193건 처리시간 0.03초

조현병 환자의 재원일수 결정요인 : 건강보험 입원환자데이터셋 자료를 이용하여 (The Determinants of the Length of Stay in Hospital for Schizophrenic Patients: Using from the Health Insurance Claim Data of Inpatients)

  • 전윤희;정미영
    • 디지털융복합연구
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    • 제18권1호
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    • pp.257-263
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    • 2020
  • 본 연구는 건강보험심사평가원 자료를 이용하여 조현병 환자의 인구사회학적 특성, 의료기관 특성, 입퇴원 특성이 재원일수에 미치는 영향을 분석하여 국가 보건 정책 질 향상을 위한 기초 자료로 활용하고자 시행하였다. 건강보험심사평가원 2016년 환자 데이터셋(HIRA-NIS)에서 조현병이 주진단인 4,692명의 진료비 명세서를 연구대상으로 하였다. 조현병 환자의 재원일수 영향 요인을 확인하기 위하여 인구사회학적 특성, 의료기관 특성, 입퇴원 특성을 설명변수로, 재원일수를 종속변수로 회귀분석을 실시하였다. 연구결과 재원일수에 주요하게 영향을 미치는 요인은 여자, 연령, 의료 급여, 병원급, 요양병원, 강원도, 정신질환 부진단, 기타 부진단 등으로 밝혀졌다. 공공 데이터를 이용하여 조현병 환자의 재원일수에 영향을 미치는 요인을 찾고자 함에 의의가 있으며, 중증도는 고려하고 있지 않아 향후 중증도에 따른 재원일수의 차이에 대한 연구가 진행되어야 할 것으로 보여 진다.

Clinical image quality evaluation for panoramic radiography in Korean dental clinics

  • Choi, Bo-Ram;Choi, Da-Hye;Huh, Kyung-Hoe;Yi, Won-Jin;Heo, Min-Suk;Choi, Soon-Chul;Bae, Kwang-Hak;Lee, Sam-Sun
    • Imaging Science in Dentistry
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    • 제42권3호
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    • pp.183-190
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    • 2012
  • Purpose: The purpose of this study was to investigate the level of clinical image quality of panoramic radiographs and to analyze the parameters that influence the overall image quality. Materials and Methods: Korean dental clinics were asked to provide three randomly selected panoramic radiographs. An oral and maxillofacial radiology specialist evaluated those images using our self-developed Clinical Image Quality Evaluation Chart. Three evaluators classified the overall image quality of the panoramic radiographs and evaluated the causes of imaging errors. Results: A total of 297 panoramic radiographs were collected from 99 dental hospitals and clinics. The mean of the scores according to the Clinical Image Quality Evaluation Chart was 79.9. In the classification of the overall image quality, 17 images were deemed 'optimal for obtaining diagnostic information,' 153 were 'adequate for diagnosis,' 109 were 'poor but diagnosable,' and nine were 'unrecognizable and too poor for diagnosis'. The results of the analysis of the causes of the errors in all the images are as follows: 139 errors in the positioning, 135 in the processing, 50 from the radiographic unit, and 13 due to anatomic abnormality. Conclusion: Panoramic radiographs taken at local dental clinics generally have a normal or higher-level image quality. Principal factors affecting image quality were positioning of the patient and image density, sharpness, and contrast. Therefore, when images are taken, the patient position should be adjusted with great care. Also, standardizing objective criteria of image density, sharpness, and contrast is required to evaluate image quality effectively.

통계적 분석기법을 이용한 공정 운전 향상의 방법 (Process operation improvement methodology based on statistical data analysis)

  • Hwang, Dae-Hee;Ahn, Tae-Jin;Han, Chonghun
    • 제어로봇시스템학회:학술대회논문집
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    • 제어로봇시스템학회 1997년도 한국자동제어학술회의논문집; 한국전력공사 서울연수원; 17-18 Oct. 1997
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    • pp.1516-1519
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    • 1997
  • With disseminationof Distributed Control Systems(DCS), the huge amounts of process operation data could have been available and led to figure out process behaviors better on the statistical basis. Until now, the statistical modeling technology has been susally applied to process monitoring and fault diagnosis. however, it has been also thought that these process information, extracted from statistical analysis, might serve a great opportunity for process operation improvements and process improvements. This paper proposed a general methodolgy for process operation improvements including data analysis, backing up the result of analysis based on the methodology, and the mapping physical physical phenomena to the Principal Components(PC) which is the most distinguished feature in the methodology form traditional statistical analyses. The application of the proposed methodology to the Balst Furnace(BF) process has been presented for details. The BF process is one of the complicated processes, due to the highly nonlinear and correlated behaviors, and so the analysis for the process based on the mathematical modeling has been very difficult. So the statisitical analysis has come forward as a alternative way for the useful analysis. Using the proposed methodology, we could interpret the complicated process, the BF, better than any other mathematical methods and find the direction for process operation improvement. The direction of process operationimprovement, in the BF case, is to increase the fludization and the permeability, while decreasing the effect of tapping operation. These guide directions, with those physical meanings, could save fuel cost and process operator's pressure for proper actions, the better set point changes, in addition to the assistance with the better knowledge of the process. Open to set point change, the BF has a variety of steady state modes. In usual almost chemical processes are under the same situation with the BF in the point of multimode steady states. The proposed methodology focused on the application to the multimode steady state process such as the BF, consequently can be applied to any chemical processes set point changing whether operator intervened or not.

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요양병원 입원환자의 애니메이션 모바일 전자동의서 적용: DNR 동의서를 중심으로 (Application of Animation Mobile Electronic Informed Consent in Inpatient of Long-term Care Hospital: Focused on DNR Informed Consent)

  • 박지경;김지온
    • 디지털융복합연구
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    • 제13권11호
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    • pp.187-196
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    • 2015
  • 본 연구는 요양병원 입원환자를 대상으로 애니메이션 모바일 DNR 전자동의서를 적용한 후, DNR 전자동의서의 내용이해도와 사용편리성을 평가하고자 시도되었다. 2014년12월1일부터 16일까지 요양병원 입원환자 100명을 대상으로 DNR 전자동의서를 적용하였으며, 자료분석은 SPSS 21.0K를 이용하여 빈도분석, 교차분석, t-test와 ANOVA를 실시하였다. 연구결과는 첫째, 향후 심정지가 발생했을 때, DNR 선택 33.0%, CPR 선택 54.0%로 나타났으며, 주진단에 따른 DNR과 CPR 선택에 통계적으로 유의한 차이가 있었다. 둘째, DNR 전자동의서의 내용이해도는 2.50점, 사용편리성은 2.37점이었다. 이상의 연구 결과를 근거로 애니메이션 전자동의서가 동의서 내용에 대한 이해를 높여서 환자 스스로 DNR 및 CPR 시행을 결정하고, DNR 동의서를 직접 작성하는데 도움을 줄 수 있을 것으로 사료된다.

Trends of Breast Cancer and its Management in the Last Twenty Years in Aden and Adjacent Governorates, Yemen

  • Harhra, Nasser Aa;Basaleem, Huda O.
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권9호
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    • pp.4347-4351
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    • 2012
  • Background: Breast cancer is the most common cancer of women and the principal cause of death in middle aged women. The objective of this study was to describe the trend of breast cancer and its management in Aden and adjacent south-eastern governorates of Yemen during the last 20 years. Patients and Methods: This is a retrospective analysis of previous studies on patients with breast cancer in Aden and adjacent south-eastern governorates, Yemen (January 1989 through December 2007). The studied variables were: sex, age, time and type of presentation, disease stage, pathological types and the performed surgical treatment. The sources of information were the treatment registry of Aden health office, archives of Al-Gamhouria teaching hospital; major referral and other public and private hospitals in Aden and Aden Cancer Registry. Results: The total number of patients was 476, 99% being females. The age range was 19-88 years. The most affected age was 30-50 years (60.5%), 95% presenting after one month of having breast symptoms. Forty-five percent presented with signs of advanced local disease, while 59.2% had palpable axillary lymph nodes on presentation. Early breast cancer (stages I-II) occurred in 47%, and late breast cancer (stages III-IV) in 51.5%. Invasive ductal carcinoma was the commonest pathology (89.3%). The main surgical treatment was mastectomy (modified radical mastectomy (50%). Conclusion: Breast cancer is predominantly a disease of young with late presentation and advanced disease. Improving health awareness and earlier diagnosis of the disease by health education, encouraging breast self-examination, and providing the mammography equipment and mammary clinics in hospitals are recommended. Establishment of oncology and radiotherapy centers in Aden is a necessity.

신장반사로 인한 근활성도 예측 모델을 이용한 삼두박근 반사 해석 (Analysis of Elbow Reflexes Using Activation Model for Stretch Reflex)

  • 강문정;조영남;채제욱;유홍희
    • 대한기계학회논문집B
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    • 제39권3호
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    • pp.215-221
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    • 2015
  • 삼두박근 반사는 인체 상지에서 발생하는 대표적인 신장반사이며 경추의 이상 등을 판단하는데 중요한 역할을 수행한다. 본 연구에서는 이를 생체역학적으로 해석하기 위하여 새롭게 정의된 신장반사 해석 모델을 이용하여 해석적으로 상완 이두박근과 삼두박근의 근활성도 및 상완의 운동 정보를 예측하였다. 해석을 통해 예측된 운동 정보와 실험 결과가 같도록 하는 근활성도를 구하고, 이를 근전도 실험 결과와 비교하여 해석 모델과 방법의 타당성을 검증하였다. 제안된 모델과 실험을 통해 얻은 관절의 각도들의 최소자승오차는 0.056 으로 기존의 모델을 사용하여 얻은 오차의 절반 수준이다. 이것은 제안된 모델이 실제 현상과 잘 부합한다는 것을 나타낸다.

맥경(脈經) 권삼(卷三) 오장(五臟)의 허(虛).실(實).적(賊).미사(微邪)에 따른 맥상(脈象)과 병증(病證)에 대(對)한 연구(硏究) II (A Study on the Pulse Conditions and Symptoms of Diseases Related with Pathogenic Factor of Deficiency Type, Excess type, Zei Pathogenic Factor and Indistin ct Pathogenic Factor of the Five Viscera in the Third Volume in the Maek Kyoung(脈經) Ⅱ)

  • 성백만;박경
    • 대한한의진단학회지
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    • 제9권1호
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    • pp.23-46
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    • 2005
  • Background and purpose: Maek Kyoung(脈經) is a book written, compiled, and edited by Wang Hui circa 3 A.D. This book is the first technical book devoted to the diagnostics. These are very important data but never make a special study and translate. so I hope this treatise can be great help to understand diagnosis study. Methods: Maek Kyoung(脈經) consists of ten volumes, and the third volume consists of the five chapters, including inter-generation and inter-restriction of the five viscera and the six entrails and prognosis of diseases. This treatise is made up of principal, notes, study and conclusion, we tried to make a translation faithful to the original. Results and Conclusion: Chapter 3 refers to five things. The first is relation between spleen and stomach, the second is how to diagnose diseases by using intergneration and inter-restriction of five elements, the third is roles of spleen that has an influence on four viscera through four seasons, the forth is the fact that quantity of gastroqi decides prognosis of diseases, and the fifth is that climate change has influence on the seriousness of diseases. Chapter 4 refers to four things. The first is relation between lung and large intestines, the second is ordinary and extraordinary pulse condition of lung, the third is that pulse condition including its speed, and the forth is how to diagnose diseases by using intergneration and inter-restriction of five elements and climate change.

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민간의료기관을 이용하는 결핵환자의 의료이용 분석 (Medical Care Utilization of Tuberculosis Patients in Private Sector)

  • 강길원;윤석준;김창엽;신영수
    • Journal of Preventive Medicine and Public Health
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    • 제31권4호
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    • pp.814-827
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    • 1998
  • In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital (45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of care. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of rare was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area.

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하지 근골격계질환 평가를 위한 삼차원 근.건모델의 임상적용 (A Clinical Application of 3D Muscle-Tendon Complex Model for the Estimation of Lowerbody Musculoskeletal Disorders)

  • 임용훈;최재일;최안렬;민경기;윤태선;박광용;문정환
    • Journal of Biosystems Engineering
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    • 제34권1호
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    • pp.57-62
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    • 2009
  • Kinematic analysis of MTC (Muscle-Tendon Complex) units is a key indicator for diagnosis of patients with musculoskeletal disorders because the contracture or shortening of musculo-tendinous units is known to produce pathological gaits. Therefore, the principal objective of this study was to assess the length change in the triceps surae prior to and after wearing an AFO (Ankle-Foot Orthoses) in patients with musculoskeletal disorders during a gait. In this study, analyses were conducted using a Muscle Tendon Complex model coupled with the trajectory data from markers attached to anatomical landmarks. As a result, the maximum length change in the triceps surae during a gait was 4.87% when a barefoot walking group and a walking group with AFO were compared. In particular, the difference in length changes between both groups in Soleus MTC units was found to be statistically significant in all gait phases. Our results revealed that MTC length in the AFO walking group was clearly increased over that of the barefoot walking group. In the future, further studies will be required in order to more adequately assess musculoskeletal disorders using many cases studies with regard to agricultural working conditions because this study deals with the kinematic analysis of musculo-tendinous units in the case of clinical experiments.

Gamma Knife Surgery for Brain Metastasis from Renal Cell Carcinoma : Relationship Between Radiological Characteristics and Initial Tumor Response

  • Kim, Jin-Wook;Han, Jung-Ho;Park, Chul-Kee;Chung, Hyun-Tai;Paek, Sun-Ha;Kim, Dong-Gyu
    • Journal of Korean Neurosurgical Society
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    • 제42권2호
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    • pp.92-96
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    • 2007
  • Objective : The authors have speculated that metastatic brain lesions from renal cell carcinoma (RCC) show diverse radiological patterns and tumor responses after Gamma knife surgery (GKS), and have hypothesized that these can be predicted from tumor radiological characteristics. The goal of the current study was to identify the radiological characteristics of RCC brain metastases and the predictors of initial radiosurgical response after GKS. Methods : A retrospective analysis was performed on 48 lesions in 18 patients with RCC brain metastasis treated by GKS. The radiological characteristics of these lesions in magnetic resonance images (MRI) were classified into 3 categories according to enhancement patterns in T1-weighted images and signal intensity characteristics in T2-weighted images. Responses to GKS were analyzed according to these categories, and in addition, other potential predictive factors were also evaluated. Results : MRI findings in the three categories were diverse, though numbers of the lesion were comparable. At 2-month MRI follow-ups after GKS, response rate was 54% and the local tumor control rate 83%. T2 signal intensity was found to be the principal predictive factor of response to GKS, namely negative predictive factor. Other variables such as age, sex, tumor volume, dose, duration from initial diagnosis to GKS, and previous systemic therapies failed to show significant relationships with treatment response by multivariate analysis. Conclusion : Careful evaluation of the radiological characteristics of brain metastases from RCC is important prior to GKS because MRI heterogeneity has predictive value in terms of determining initial tumor response.