• Journal of Preventive Medicine and Public Health
• /
• 제37권1호
• /
• pp.26-36
• /
• 2004

Objective : To examine the association between hospital procedure volume and treatment outcomes following allogeneic bone marrow transplantation (allo-BMT). Methods : Out of 1,050 patients who received allo-BMTs between 1998 and 2000 in 21 Korean hospitals, 752 with first allo-BMT and complete data were included in this study. Study subjects were divided into the following three groups according to cumulative hospital experience of all-BMTs during the study period: low (<30 cases), medium (30-49) and high ($\geq$50 cases) volume. Patient outcome was defined as early survival at day 100 and one-year survival. Multiple logistic regression analyses were performed to examine the association between hospital experience and survival at day 100 and one year. Results : When the low volume group was defined as the reference group, the adjusted relative risks (RR) of survival at day 100 for the high volume group were 2.46(95% CI, 1.13-5.36) for all patients, 2.61(1.04-6.57) for those with leukemia, and 2.20(0.47-10.32) for those with aplastic anemia. For one-year survival, adjusted RR for the high volume group were 2.52(1.40-4.51) for all patients, 1.99 (1.01-3.93) for leukemia, and 6.50(1.57-26.80) for aplastic anemia. None of the RR for the medium volume group was statistically significant. Patient factors showing significant relationship with survival were donor-recipient relation, human leukocyte antigen matching status, time from diagnosis to transplant, and disease stage. Conclusions : The study results suggest that the cumulative experience of hospitals in providing allo-BMT is positively associated with patient survival.

• Journal of Korean Neurosurgical Society
• /
• 제39권1호
• /
• pp.20-25
• /
• 2006

Objective : The authors analyze prospectively the result of transcranial doppler[TCD] in normal pressure hydrocephalus and compared its cerebral blood flow parameters to radionuclide cerebrospinal fluid[CSF] flow study, postoperative brain computed tomography[CT] findings and clinical outcome, and studied the relationship between cerebral hemodynamics and clinical performance. Methods : Twenty five patients with hydrocephalus undertook pre- and post-operative TCD but only preoperative CSF flow study was performed. Mean flow velocity[Vm], pulsatility index[PI] and resistance index[RI] were assessed through TCD and changes in ventricle size and cortical gyral atrophy were checked through brain CT. Results : Postoperative hydrocephalus showed an increase in Vm[ACA P=0.037, MCA P=0.034], decrease in PI[ACA P=0.019, MCA P=0.017] and decrease in RI [ACA P=0.017, MCA P=0.021] compared to preoperative TCD parameters in the postoperative improvement group. In the postoperative improvement group, postoperative TCD parameters correlated with CSF flow study grade [Vm : $R^2=-0.75$, PI : $R^2=0.86$, RI : $R^2=0.78$] and ventriculocranial ratio change correlated with PI change [$R^2=0.73$]. The convexity gyral atrophy and initial TCD parameters showed close relationship to outcome. Conclusion : PI and RI can be used as an indicator of post operative prognosis, and with the addition of CSF flow study values, can also be used as a tool to predict pre-op and post-op patient status and successful shunt surgery.

• 보건행정학회지
• /
• 제23권1호
• /
• pp.66-77
• /
• 2013

The purpose of this empirical study is to investigate the factors of self-leadership depending on individual characteristics, job characteristics, and qualities of leader-member exchange. Additionally, this study aims to discover the effect of self-leadership's outcome factors on organizational citizenship behavior and innovative activities. In order to verify research model and hypothesis, questionnaires were collected from department members working at general hospitals, hospitals, and clinics in metropolitan area of Seoul, which were 85 departments and 344 respondents. Collected data were analyzed with SPSS ver. 19.0 and Amos ver. 18.0 statistical package using Structural Equation Model. The results of the analysis showed that both individual characteristics and job characteristics have significant positive effect on self-leadership. Also, self-leadership had significant positive relationship on innovative action and organizational citizenship behavior. The implications of this study are as follow. First, this study empirically explained how self-leadership is applied in healthcare organizations. Second, it verified the relationship between causal factors and outcome factors of self-leadership. Also, prior researches of self-leadership have been conducted on business companies, but this study explored self-leadership at healthcare organizations, which increased external validity. Nowadays, many people are interested in the effect of leadership in order to overcome issues coming from enlarged organizations and to improve performance. Self-leadership will contribute to maximizing voluntary efforts of human resources and performance in a rapidly changing healthcare industry.

• 보건교육건강증진학회지
• /
• 제22권1호
• /
• pp.147-160
• /
• 2005

The purpose of this study is to identify the nature of the patient service quality of health center, and based on that, to examine the relationship of health center visitor's perceived quality and overall satisfaction. Data were collected on the basis of 'the 3rd Regional Health Care Planning' operated by Rural Health Care Service Technology Aid Task-force Team(RHCSTAT), Ministry of Health and Welfare. Basically, the Manual of 3rd Regional Health Care Planning is composed of structure, process, and outcome measurement indicators. Of these indicators, 21 patient satisfaction questions as outcome indicators are used in this study. The samples are 3,530 patients who visited 80 health centers all of the nation. First, the reliability and validity of patient service quality items was evaluated. Second, the descriptive statistics of health service quality are calculated. Third, through the T-test and ANOVA, the differences of patient satisfaction by responder's general characteristics are compared. In final, to explore the relationship of service quality and overall satisfaction, multiple regression analysis was used. This study shows firstly, the dimension of patient service quality was categorized into 3 dimensions, that is, facilities and environment, staff kindness, and access convenience. Secondly, the reliability and validity of patient service quality items was satisfied. Thirdly, the mean score of staff kindness factors are high in contrast to the facilities and environment. And in regard to the overall satisfaction, the mean score is more higher in Daegu region, County type health center, male group, and upper 65 age group than comparison groups. Lastly, as a result of multiple regression analysis, the effect of patient's perceived service quality, especially, appropriateness of billing time(Beta=0.190) and of reservation time(Beta=0.132) are statistically significant(P<0.01). In conclusion, to satisfy the health need of community people and improve the service quality of the health center, the efforts for the access convenience might be needed. Additionally, the enlargement on health center space and supply of new medical equipment is urgent for the patient satisfaction.

• 한국환경복원기술학회지
• /
• 제12권2호
• /
• pp.73-82
• /
• 2009

The traffic volume of Seoul is extremely high in comparison to other major cities in Korea, and the result has been harmful physical and mental exposure to pollution by Seoulites on a regular basis. The street air pollution is more important than the others, because the air pollution generated by street traffic directly impacts the health of nearby pedestrians. This problem requires urgent attention and resolution. Among the factors creating the air pollution originating from the street, is the configuration of streets, which have emerged as the most significant because it is related to air and pollutant dispersion. Therefore, this study was conducted under the assumption that street form affects the air quality. Study sites were classified by street characteristics, and air quality was analyzed in each class. Then the OSPM (Operational Street Pollution Model) was employed to simulate the relationship between street configuration and air quality of streets within the old city center and new city center in Seoul. After that this study analyzed the correlation between air pollution and the spatial configuration of urban streets (ex. street width, building height, building density, etc.) to determine their contributions to air pollution. The outcome of this study is as follows : First, the result that was derived from the correlation analysis between street configuration and air quality hewed that the air pollution of the street is influenced by the average height of building, width of the roads as well as traffic volume. On the roadside, the concentration level of $NO_2$ is mainly affected by the average height of building and the deviation of building height along the street and CO is affected by street width. The outcome of this study can be used as a basis for more sound urban design policies, and the promotion of desirable street environments for pedestrians.

• 간호행정학회지
• /
• 제6권2호
• /
• pp.245-257
• /
• 2000

The purpose of this study was to validate caregiver outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 73 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not at all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. Eight outcome label were considered to be 'supporting' and three outcome label were considered to be 'nonsupporting'. 2. 'Caregiver-Patient Relationship' attained an OCV score of 0.64 and the highest OCV score among caregiver outcomes.. 3. 'Caregiver Emotional Health' attained an OCV score of 0.54 and the lowest OCV score among caregiver outcomes. Replication study will be needed and outcomes sensitive to Korean culture need to be developed.

• 한국정보시스템학회지:정보시스템연구
• /
• 제22권2호
• /
• pp.105-129
• /
• 2013

Recently, since the interest with well-being has been getting higher than ever, people want reliable source of information related with health and medical treatment. Because of the characteristics of information related with medical care, there have been difficulties to find the information from books, television and internet surfing, for treating disease. Misinformation that can be obtained when considering dangerous situations or side effects, the role of the e-Health system is becoming more important. The objective of this study is an analysis of correlation and effect among patient's information need, e-Health system use and system outcome. To achieve the object of this study, e-Health system had been given to patients of breast cancer in Wisconsin and Detroit for 16 weeks. As a result, 282 sample was gathered and modified to meet purpose of the study. As a result, the information needs of patients due to the performance of the e-Health systems and shown to affect even the perception of patients' emotional and physical health and social support.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제32권5호
• /
• pp.488-492
• /
• 2010

This review evaluates the literature on the relationship between mandibular condylar process fracture and temporomadibular joint (TMJ). The topic of condylar fracture generated more discussion and controversy than any other field of maxillofacial trauma associated with TMJ. Disturbance of occlusal function, devia-tion of mandible, internal derangements of TMJ, and ankylosis of the joint with resultant inability to move the jaw are sequelae of condylar process fracture. Thus it is necessary to understand how the masticatory system adapts to the structural alterations that accompany fractures of the mandibular condyle. Treatment of condylar process fracture include two methods ; closed treatment and open treatment. If one chooses totreat closed, one must understand that adaptations in the musculature, skeleton, and dentition will be necessary. Open treatment of condylar process fractures probably requires fewer adaptations within the masticatory system to provide a favorable functional outcome. However, one must weigh the risk of open surgery against the possible improvement in outcome. The risks are not just surgical risk, but biological risk as well, such as disruption of the blood supply to the condyle. This review presents relevant aspects of change of TMJ associated with condylar process fracture.

• 한국IT서비스학회지
• /
• 제10권4호
• /
• pp.191-204
• /
• 2011

Recently, many software companies are trying to improve the software quality and project outcome with more costs and efforts in development time. In the software convergence and integration environments, it is required efforts to gain high quality of software. In other words, it is required to utilize software engineering knowledge and technology for higher software quality and better software project productivity. The Software development productivity can be varied by software process capability according to building a framework for software development, selection and use of appropriate technology, human resource management. Software process capability will influence software project outcome which is the general opinion. This study provides empirical evidence about software engineering efforts and investment approach to lead software project performance. We measured the software engineering efforts by SW engineering level and analyzed the corelation between software engineering level and schedule deviation. And, we verified that this performance is affected by the size of software company. As a result, software process capability is important to build a infrastructure and develop systematically software project. The higher software engineering level can lead to improved software project performance.

• Journal of Korean Neurosurgical Society
• /
• 제38권5호
• /
• pp.350-354
• /
• 2005

Objective : The aim of this study is to assess the immediate and long-term efficacy of percutaneous vertebroplasty for treating painful vertebral osteoporotic fractures. Methods : A retrospective review of 149patients who had undergone 167 vertebroplasty procedures for osteoporotic fractures was performed. Clinical, radiologic, and procedural datas were analyzed as parameters of prognostic significance, including age, sex, bone marrow density score, symptom duration, bone cement filling grade, number of fractured vertebrae, compression grade of vertebrae, leakage of bone cement, volume of bone cement injected and complications. Results : In 158 of the 167 procedures assessed, immediate pain relief was obtained [94.6%]. The extent of collapse of the vertebral body was assessed as a parameter for prognostic significance [p=0.015]. Three months postoperatively, no improvement of the pain was observed in four of the 167 procedures that had undergone the vertebroplasty [2%]. At long-term follow-up, the improvement of pain was not correlated with the compression grade of vertebrae [p=0.420]. Conclusion : The immediate outcome of vertebroplasty are less effective in vertebrae more collapsed.