• Journal of Preventive Medicine and Public Health
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• 제27권4호
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• pp.807-814
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• 1994

This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

• Clinical and Experimental Pediatrics
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• 제61권2호
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• pp.59-63
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• 2018

Purpose: Cardiomyopathy is becoming the leading cause of death in patients with Duchenne muscular dystrophy because mechanically assisted lung ventilation and assisted coughing have helped resolve respiratory complications. To clarify cardiopulmonary function, we compared cardiac function between the home ventilator-assisted and non-ventilator-assisted groups. Methods: We retrospectively reviewed patients with Duchenne muscular dystrophy from January 2010 to March 2016 at Gangnam Severance Hospital. Demographic characteristics, pulmonary function, and echocardiography data were investigated. Results: Fifty-four patients with Duchenne muscular dystrophy were divided into 2 groups: home ventilator-assisted and non-ventilator-assisted. The patients in the home ventilator group were older ($16.25{\pm}1.85years$) than those in the nonventilator group ($14.73{\pm}1.36years$) (P=0.001). Height, weight, and body surface area did not differ significantly between groups. The home ventilator group had a lower seated functional vital capacity ($1,038{\pm}620.41mL$) than the nonventilator group ($1,455{\pm}603.2mL$). Mean left ventricular ejection fraction and fractional shortening were greater in the home ventilator group, but the data did not show any statistical difference. The early ventricular filling velocity/late ventricular filling velocity ratio ($1.7{\pm}0.44$) was lower in the home ventilator group than in the nonventilator group ($2.02{\pm}0.62$. The mitral valve annular systolic velocity was higher in the home ventilator group (estimated ${\beta}$, 1.06; standard error, 0.48). Patients with Duchenne muscular dystrophy on a ventilator may have better systolic and diastolic cardiac functions. Conclusion: Noninvasive ventilator assistance can help preserve cardiac function. Therefore, early utilization of noninvasive ventilation or oxygen may positively influence cardiac function in patients with Duchenne muscular dystrophy.

• 성인간호학회지
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• 제28권1호
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• pp.43-52
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• 2016

Purpose: The aim of this study was to identify demographic, clinical, physical, and psychosocial factors affecting discharge delay in lumbar spinal surgery patients who were treated according to a critical pathway. Methods: A sample of 170 patients with lumbar spinal surgery agreed to participate in the study, between April 1, 2014 and August 30, 2015. Data were analyzed by mean, standard deviation, t-test, ${\chi}^2$-test, ANCOVA, and logistic regression analysis using SPSS 22.0 program. Results: Approximately fifty-nine percent of the participants was delayed discharge. On logistic regression analysis, female gender (OR=2.63, 95% CI=1.40~4.94), age (OR=1.03, 95% CI=1.01~1.05), spondylolisthesis (OR=4.49, 95% CI=1.90~10.61), and spinal fusion operation (OR=4.14, 95% CI=1.89~9.05) were significant factors predicting discharge delay of the participants. However, discharge delay was not related with pain, physical function, depression, or family support. Conclusion: An analysis of discharge delay may assist in evaluating and revising critical pathway for optimal care. In addition, nurses need to understand the factors affecting discharge delay of the given population who were treated according to a critical pathway.

• Clinical and Experimental Pediatrics
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• 제58권5호
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• pp.183-189
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• 2015

Purpose: Catheter urine (CATH-U) and suprapubic aspiration (SPA) are reliable urine collection methods for confirming urinary tract infections (UTI) in infants. However, noninvasive and easily accessible collecting bag urine (CBU) is widely used, despite its high contamination rate. This study investigated the validity of CBU cultures for diagnosing UTIs, using CATH-U culture results as the gold standard. Methods: We retrospectively analyzed 210 infants, 2- to 24-month-old, who presented to a tertiary care hospital's pediatrics department between September 2008 and August 2013. We reviewed the results of CBU and CATH-U cultures from the same infants. Results: CBU results, relative to CATH-U culture results (${\geq}10^4$ colony-forming units [CFU]/mL) were widely variable, ranging from no growth to ${\geq}10^5CFU/mL$. A CBU cutoff value of ${\geq}10^5CFU/mL$ resulted in false-positive and false-negative rates of 18% and 24%, respectively. The probability of a UTI increased when the CBU bacterial count was ${\geq}10^5/mL$ for all infants, both uncircumcised male infants and female infants (likelihood ratios [LRs], 4.16, 4.11, and 4.11, respectively). UTIs could not be excluded for female infants with a CBU bacterial density of $10^4-10^5$ (LR, 1.40). The LRs for predicting UTIs based on a positive dipstick test and a positive urinalysis were 4.19 and 3.11, respectively. Conclusion: The validity of obtaining urine sample from a sterile bag remains questionable. Inconclusive culture results from CBU should be confirmed with a more reliable method.

• Child Health Nursing Research
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• 제17권2호
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• pp.136-144
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• 2011

Purpose: The purpose of this study was to analyze teaching status and knowledge about children with Attention Deficit Hyperactivity Disorder (ADHD) in elementary school teachers. Methods: The participants of this study were 204 elementary school teachers in Busan. From July to September 2010, the researchers collected data by using self-report questionnaires consisted of questions about their teachers' characteristics and teaching status and KADDS (36 items) developed by Sciutto, Terjesen and Frank. Frequency, percentage, arithmetic mean, standard deviation, t-test and ANOVA were used to analyze the data using SPSS WIN 16.0 program. Results: Less than 50% of the participants had previous education on ADHD. According to this experience, there were significant differences in participants' knowledge about children with ADHD (t=4.703, p<.001). For the 36 items, participants had an average of $19.19{\pm}4.58$ points out of a possible 36. Moreover, lack of knowledge about teaching children with ADHD and communication problems with the parents of these children were considered to be the most disturbing factors. Conclusion: These results suggest that networks among teachers, parents and medical care professionals should be established. The results also indicate that educational programs for elementary school teachers should be developed in order to identify and teach children with ADHD appropriately.

• 한국컴퓨터정보학회논문지
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• 제21권12호
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• pp.157-163
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• 2016

Purpose : This study purposed on the understanding of psychology in the elderly women using depression scale and electroephalography. The subjects were thirty elderly women in geriatric care hospital. All participants were elderly women over 65 years old. The subjects signed up with informed consent and they were divided into a normal elderly group, an exercise elderly group and a hospital elderly group. They were randomly assigned with 10 persons. Methods : The study instruments were Geriatric Depression Scale(GDS) and Poly-G-I. Brain wave activity was measured by 'power spectrum analysis' of TeleScan program. Statistic analysis consisted of average, standard deviation, One-way ANOVA and post-hoc Tukey using SPSS 21.0 version. The significance was set at .05. Results : Depression scale results showed that the exercise elderly group were $10.60{\pm}5.36$ points which was the lowest among the three groups. The Normal elderly group was $16.20{\pm}5.59$, and the hospitalized elderly group was $16.70{\pm}6.76$ points. There was no significant difference between the normal elderly group, exercise elderly group and hospitalized elderly group. The hospitalized group showed statistical difference in relative theta power in the area of Fp1, F3, F4, T3, P3 as compared to the normal elderly group and the exercise elderly groups. There was no significant difference between relative beta power and relative gamma power in three groups. Conclusion : Geriatric depressed scale showed no significant difference in each group. This is indicated in the mental problems associated with depression. This indicates a higher level of depression in the hospitalized elderly women, more than in the normal elderly women and exercise elderly women groups.

• Perspectives in Nursing Science
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• 제5권1호
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• pp.33-43
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• 2008

Objective: This study explored the reuse of data captured into an electronic nursing record system using the International Classification for Nursing Practice to support nursing research of inpatient's falls. Methods: Risk factors relevant to inpatients falls ;n an acute setting were identified from the literature review. Four risk assessment tools and two risk identification studies were selected. To examine the availability of coded data in an electronic nursing record system for the identified fall fisk factors, we reviewed 11.319 hospital-day records of 118 patients who were reported by the self-report system. Results: We identified 24 fall risk factors of five categories from the literature review, which were used to identify the standard nursing statements addressing fall risks. One hundred thirty five nursing statements were searched from the hospital's nursing data dictionary of statements and were matched with 14 fall fisk factors. Using the 135 statements. we found that mental status, catheter of drip in situ, abnormal gait, insomnia, surgical procedure. and dizziness/vertigo appeared frequently in the nursing records of inpatients with fall s. Also we found 6 risk factors more through the record review. Conclusion: The electronic records would be a good research source for inpatients' falls. Specifically international classification for nursing practice based nursing record system has the potential for promoting clinical researches.

• 센서학회지
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• 제19권3호
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• pp.169-175
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• 2010

Urinalysis is an important clinical test to diagnose urinary diseases, and dipstick method with visual inspection is widely applied in practice. Automated optical devices recently developed have disadvantages of long measurement time, big size and heavy weight, accuracy degradation with time, etc. The present study proposed a new computer scanning technique, in which the test strip and the standard chart were simultaneously scanned to remove any environmental artifacts, followed by automated differentiation with the minimum distance algorithm, leading to significant enhancement of accuracy. Experiments demonstrated an accuracy of 100 % in that all test results were identical with the human visual inspection. The present technique only uses a personal computer with scanner and shortens the test time to a great degree. The results are also stored and accumulated for later use which can be transmitted to remote locations through a network, thus could be easily integrated to any ubiquitous health care systems.

• The Journal of Korean Physical Therapy
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• 제29권5호
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• pp.281-286
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• 2017

Purpose: The purpose of this study was to examine the correlations among the resting physical factors related to a six-minute walk test (6MWT) and to determine the effects of the resting physical factors on the distance and intensity related to the 6MWT in healthy female subjects. Methods: A total of 43 healthy female subjects ($22.84{\pm}3.90yrs$) participated in this study. They performed the 6MWT, and the physical factors related to the 6MWT were assessed. SPSS 20.0 was used to analyze the data, and the mean and standard deviation were calculated, and the collected data were analyzed by the Pearson's correlation coefficient (among physical factors related to 6MWT) and independent t-test (between six-minute walk distance [6MWD] groups and six-minute walk intensity [6MWI] groups). Results: The 6MWD had a significant negative correlation with the resting HR (beat/min) in healthy female subjects (r=-0.49, p<0.05). The 6MWI had a significant negative correlation with the resting systolic blood pressure (SBP) (r=-0.45, p<0.01). A comparison of the 6MWD revealed the long distance group (LDG, 700-799 m) to be significantly higher than the middle distance group (MDG, 600-699 m) in the 6MWI (%), %predicted distance (%), predicted VO2max (mL/kg/min), resting HR (beat/min), and resting SBP (mmHg)(p<0.05). In the comparison of 6MWI, the moderate intensity group (MIG, 64-75%HRmax) was significantly lower than the low intensity group (LIG, 50-63%HRmax) in the resting SBP (mmHg) (p<0.05). Conclusion: These results suggest that the resting physical factors are related to the 6MWD and 6MWI of the 6MWT in healthy females. In particular, SBP is associated with not only the 6MWD but also the 6MWI in 6MWT.

• 한국노년학
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• 제36권4호
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• pp.1157-1176
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• 2016

본 연구는 요양시설 노인과 요양보호사에게 있어 식사의 의미를 이해하고자 일상생활방법론을 활용하여 참여 관찰과 심층면담을 적용하여 주제 분석하였다. 연구결과 노인에게 있어 요양시설 식사는 개인의 다양성에 대한 철학이 없는 획일의 식사문화로 인식한 것과 같이 요양보호사 역시 요양시설 노인에게 있어 식사는 편의적 논리에 따른 운영으로 나타났다. 노인에게 있어 식사는 없어서는 안 될 공기와 같은 필수 요소로 건강 회복의 염원을 담고 있었으나 요양보호사는 단지 생존을 위한 수단으로 아무 의미가 없이 생명 연장을 실현하고 있었다. 노인에게 간식은 권력 및 일상의 탈출이었으나 요양보호사에게 있어 간식은 또 다른 통제 수단이었다. 본 연구의 결과를 토대로 노인장기요양보험의 시행 법령 및 요양시설 운영진의 입장이 아닌 요양시설에서 생활하고 있는 노인의 다양성을 반영한 실질적인 식사 운영 지침의 개발과 노인 존중과 이해에 대한 지속적인 교육의 필요성을 제시하였다.