• 한국병원경영학회지
• /
• 제25권3호
• /
• pp.29-37
• /
• 2020

Purposes: The purpose of this study was to identify the factors related to the long-stay hospitalization of dementia patients aged 65 years or older who had received inpatient care at geriatric hospitals according to the minute facility characteristics and patient features. Methodology: This study was conducted on 317,353 cases of 1,512 geriatric hospitals using the Health Insurance Review and Assessment Service dataset. The data collected were processed using the SAS Enterprise Guide 4.3 for descriptive statistics, the chi-square test, and the binary logistic regression analysis. Findings: As a result of the study, in the facility characteristics of geriatric hospitals, the long-stay hospitalization of the aged with dementia were found to be related to the type of facility establishment, the number of hospital beds, the number of medical specialists, the number of nursing personnel, and the number of geriatric hospitals by region and province. In the personal features of patients, the long-stay hospitalization was found to be associated with the gender, age, insurance, and the patient classification groups. Practical Implication: Considering the results of this study, it seems that securing the sufficient medical personnel in a geriatric facility, providing the good quality medical services, and preparing the appropriate discharge plan can reduce the unnecessary long-stay hospitalization and spend the medical expenses for the older patients.

• 공학교육연구
• /
• 제23권5호
• /
• pp.76-85
• /
• 2020

The purpose of this study was to develop and validate a measurement scale of core competencies for one Institute of Science & Technology's students in South Korea. Based on the school's core value and mission, items were developed through document analysis, faculty survey, and experts' review. Initial sets of items were administered to students and results were analyzed to finalize the items for the scale, which consists of 4 core competencies (Creativity, Challenge, Collaboration, and Care) and 12 sub-competencies. Through reliability analysis and exploratory factor analysis, 56 items were selected. For a validity test, confirmatory factor analysis was conducted. Results suggest that the measurement scale is reliable and valid in measuring core competencies of students in an Institute of Science & Technology.

• 대한두경부종양학회지
• /
• 제37권2호
• /
• pp.19-24
• /
• 2021

Background/Objectives: The aim of this national population-based retrospective study was to analyze the status and treatment outcome in patients with hypopharyngeal cancer. Materials & Methods: Participants were included in the KNHIS national sample cohort who received a KNHIS health check-up in 2008 and 2009, and we followed these individuals until 2017. Patients were defined as having hypopharynx cancer if they had admissions records for hypopharynx cancer in their national health insurance data from 2010 to 2017. Results: The study cohort included 3,922 patients. According to our nationwide data, 3,533(90.1%) were male with a median age of 65.03±11.04 years at the time of diagnosis. Among parametric models for hypopharyngeal cancer prognosis, old age (Hazard ratio [HR]:1.92; 95% confidence interval[CI]:1.76-2.09), female (HR:0.77; 95% CI:0.66-0.89), and low socioeconomic status (HR:1.216; 95% CI:1.114-1.327) were significantly associated with survival. Compared with concurrent chemoradiotherapy, patients who received no treatment (HR, 1.88; 95% CI, 1.31-2.70), neoadjuvant chemotherapy followed by surgery (HR, 1.21; 95% CI, 1.04-1.41), and chemotherapy alone (HR, 1.16; 95% CI, 1.03-1.27) showed poor prognosis in hypopharyngeal cancer. Conclusion: Our data indicated that age, sex, and income were significant predictors of lifetime survival in patients with hypopharyngeal cancer. Treatment modalities were also associated with prognosis. The data have implications for treatment investigations and prevention strategies.

• 한국융합학회논문지
• /
• 제8권2호
• /
• pp.197-204
• /
• 2017

본 연구는 창의융합인재 선발을 위한 인성교육 및 인성평가의 요소를 탐색하기 위해 예비대학생을 대상으로 한 설문조사를 실시하였다. 연구 결과, 초중등 교육과정에서 타인배려, 대인관계능력, 정직성 관련 인성교육 프로그램이 가장 높은 빈도로 운영되고 있는 것으로 조사되었다. 또한 인성교육 프로그램 효과 및 중요도에 대해 대인관계능력, 타인배려, 성실성 순으로 프로그램 효과가 높으며 중요하게 인식하고 있는 것으로 나타났다. 성별에 따른 인식의 차이를 비교한 결과, 대학생을 대상으로 하는 인성교육의 필요성과 대입 전형에서 인성이 평가요소로 반영될 필요성에 대한 인식에서는 성별에 따른 차이가 유의하게 나타났다. 이러한 연구 결과를 토대로 중 고등학교의 인성 교육과정과 대학 입학전형 제도 개선을 위한 정책 제언을 제시하였다.

• 한국융합학회논문지
• /
• 제8권12호
• /
• pp.149-157
• /
• 2017

입원기간동안 적절하지 않거나 불필요한 처치로 발생될 수 있는 재입원관련 질지표는 질스크리닝 뿐만 아니라 입원환자의 적절하지 못한 지출을 파악할 수 있어서 중요하다. 이 연구는 예방할 수 있는 재입원으로 인해 발생되는 진료비 규모를 파악하고자 한다. 건강보험심사평가원의 2014년도 청구 데이터를 활용하여 종합병원이상 의료기관에 입원한 18세 이상 성인을 대상으로 분석하였다. 입원 유형을 1회 입원군과 재입원군으로 분류하였고, 재입원군은 다시 계획된 재입원과 계획되지 않은 재입원으로 분류하였다. 재입원 간격은 28일 이내로 설정하였다. 암질환, 동반질환, 전문재활 환자의 경우 1회 입원군보다 재입원군의 분포가 더 많았다. 계획되지 않은 재입원 유형 중 동일 기관, 동일 진료과목, 동일 질병군 입원의 경우 재입원에 지출된 총 진료비가 전체 재입원 진료비의 50%가량을 차지하였다. 불필요한 재입원으로 인해 발생되는 진료비는 2014년 1년간 9,990억원 정도였다. 재입원이 잦은 지역, 진료과목, 질병군 등의 패턴을 활용하여 재입원을 줄이려는 노력이 필요하다.

• 한국의료질향상학회지
• /
• 제2권2호
• /
• pp.112-129
• /
• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• 성인간호학회지
• /
• 제12권3호
• /
• pp.384-395
• /
• 2000

This study examined burdens of primary family caregivers, and family functioning of patients with cancer. In addition, the relationship between two concepts was assessed to develop nursing intervention to reduce the burdens of caregiving, and to improve family functioning. Ninety-two primary family caregivers of patients with cancer at a general hospital in Seoul participated in this study. The patients with cancer aged from 19 to 84 years with a mean age of 51 years, and sixty-one percent were male. About 30 percent of the patients suffered liver and billiary tract cancer. Fifty-six percent of the primary family caregivers were spouses of the patients and 70.7 percent were women. Primary family caregivers' burdens were assessed by the Burden Scale originally developed by Zarit (1980) and Novak & Guest(1989) and modified by Jang (1995) for use in Korea. The instrument consists of six subscales: time-dependent burden, developmental burden, physical burden, emotional burden, social burden, and financial burden. Family functioning was assessed by the Family APGAR developed by Smilkstein(1978). The results were as follows: 1. The average burden score was 86.1, indicating a moderate level of burden. The time-dependent burden scored highest followed by developmental, physical, social, financial, and emotional burdens. The mean score of family APGAR was 9.71; among subjects 82.6% were included in dysfunctional families. 2. Of the characteristics of patients, age, gender, number of admissions, and job were found to be associated with the level of burden. There was no significant difference between patient characteristics and family functioning. Of the characteristics of primary family caregivers, caregiver's perception of patient prognosis was significantly related to the level of burden, and family functioning. Caregiver's sex and age were also related to family functioning. The quality of relationship between a patient and a caregiver was significant situational factors affecting the level of burden, and family functioning. In addition, the income of family, and help from other family members were related to the level of burden. Given the results, it is essential to develop nursing intervention to reduce burden and to improve family functioning, such as support groups.

• Asian Pacific Journal of Cancer Prevention
• /
• 제16권14호
• /
• pp.6001-6006
• /
• 2015

Background: Pancreatic cancer is the fourth leading cause of cancer related death with median survival ranging from 3 to 6 months for metastatic disease. Palliative chemotherapy has been the backbone of treatment in advanced stage and has evolved over time. Data pertaining to the disease are scarce from our part of the world where treatment poses a significant challenge due to lack of resources. Materials and Methods: A retrospective chart review was performed for all patients presenting with stage IV pancreatic carcinoma at a tertiary care hospital in Karachi, Pakistan between January 2008 and December 2012. Data were collected using a pre-designed, coded questionnaire looking at patient characteristics, treatment given and outcome. Results: 101 patients were found to be eligible. Mean age was $56.7{\pm}12.8years$, the male to female ratio was 2:1 and most patients had a good performance status. More than half of the tumors were located in the head (57%, n=58) and almost all were adenocarcinomas (95%, n=96). Some 58% (n=59) received first line chemotherapy of which 49% (n=29) received gemcitabine-based regimens and 39% (n=23) received FOLFIRINOX. The median progression free survival for gemcitabine based treatment was 2.9 months (IQR=1.6-5.6) as opposed to 7.3 months (IQR=4.5-9.2) for FOLFIRINOX (P=0.02). Median overall survival was 4.9 months (IQR=2.3-9.5) for first line gemcitabine based treatment and 10.5 months (IQR=7.0-13.2) for first line FOLFIRINOX therapy (P=0.002). Patients on FOLFIRINOX had better survival across all subgroups. Inpatient admissions and dose reductions were more frequent with FOLFIRINOX but the difference between the two regimens was not statistically significant. FOLFIRINOX could be successfully administered as outpatient therapy to a number of patients. Conclusions: FOLFIRINOX remains a suitable first line option in patients with metastatic pancreatic cancer with good performance status even in a resource-poor country where diagnostic and supportive care facilities may be less than optimal and cost is a limitation.

• Progress in Superconductivity
• /
• 제8권1호
• /
• pp.40-45
• /
• 2006

In emergency rooms, patients with acute chest pain should be diagnosed as quickly as possible with higher diagnostic accuracy for an appropriate therapy to the patients with acute coronary syndrome or for avoiding unnecessary hospital admissions. At present, electrocardiography(ECG) and biochemical markers are generally used to detect myocardial infarction and coronary angiography is used as a gold standard to reveal the degree of narrowing of coronary artery. Magnetocardiography(MCG) has been proposed as a novel and non-invasive diagnostic tool fur the detection of cardiac electrical abnormality associated with myocardial ischemia. In this study, we examined whether the MCG can be used fur the detection of coronary artery disease(CAD) in patients, who were admitted to the emergency room with acute chest pain. MCG was recorded from 36 patients admitted to the emergency room with suspected acute coronary syndrome. The MCG recordings were obtained using a 64-channel SQUID MCG system in a magnetically shielded room. In result, presence of CAD could be found with a sensitivity of 88.2 % in patients with acute chest pain without 57 elevation in ECG, demonstrating a possible use in the emergency room to screen CAD patients.

• 대한의용생체공학회:의공학회지
• /
• 제33권3호
• /
• pp.155-162
• /
• 2012

Devices to measure the blood pressure of patients are being used without any calibration in a hospital. It is an important to show consistent values when any medical devices measure the same patients regardless they are sphygmomanometer or fully automatic electronic blood pressure meter. We compared sphygmomanometer and fully automatic electronic blood pressure meters with standard digital blood pressure monitor (SDBPM) to evaluate the consistency of the small healthy subjects. We measured the blood pressure from six healthy subjects (three of 20~40 years and three of 40~60 years old). Two sphygmomanometer and two fully automatic electronic blood pressure meters were used and compared with the SDBPM. Blood pressures measured from right and left arms each and were compared. All six healthy subjects showed normal blood pressure values. In general, left blood pressure values showed higher values than right side. Comparing SDBPM, with the other monitors, the systolic pressure showed ${\pm}$ 34.8% difference and ${\pm}$ 33.3% for the diastolic pressure. Correlation between SDBPM and Sphygmomanometer was 0.59~0.71, and 0.50~0.70 for fully automated digital BP monitors. It fell in grade-D when we apply the BHS(British hypertension society). AAMI(American association for the advancement of medical instrumentation) also showed unsatisfactory results for the mean value (${\leq}$ 5 mmHg) and standard deviation (${\leq}$ 8 mmHg). We tested sphygmomanometer and fully automatic electronic blood pressure meters and compared with a standard digital blood pressure monitor. All devices showed inconsistent blood pressures. A reliable calibration system is highly needed for all devices in all hospitals.