• Journal of Trauma and Injury
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• 제24권2호
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• pp.89-94
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• 2011

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

• 한국임상약학회지
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• 제16권2호
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• pp.113-122
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• 2006

Purpose: A retrospective study was performed to assess the efficacy and tolerance of ${\beta}-blocker$ administration in patients with heart failure and diabetes. Method: Records of 164 patients who were treated for the heart failure condition more than a year were studied retrospectively. Patients were divided into 4 groups based on their diabetes(DM) status and the administration of ${\beta}-blockers$ ($DM+{\beta}-blocker$ group: 14, DM w/o ${\beta}-blocker$: 19, No DM + ${\beta}-blocker$: 62, No DM + no ${\beta}-blocker$: 69). All patients had been receiving conventional therapy such as digoxin, ACE-I, ARB, diuretics, nitrates, aspirin, anticoagulants or lipid-lowering agents. The primary endpoints (death and hospital admission) were recorded during 1 year period and hemodynamic factors (HR, LVEF, SBP, DBP) were obtained from all patient groups before and after 12 months of ${\beta}-blocker$ treatment. To evaluate toxicity of ${\beta}-blocker$, SCr, BUN, AST, ALT and Alkaline phosphatase were obtained. Result: There were less death and hospital admission in DM + ${\beta}-blocker$ group than in DM without ${\beta}-blocker$ group (p=0.014). Relative risk of hospital admission for $DM+{\beta}-blocker$ group over no DM group was 1.17. Long term ${\beta}-blocker$ administration was associated with an improvement of heart rate in patients with DM (P< 0.02) with no significant improvement of LVEF, SBP, DBP. in DM patient. In patient without DM, ${\beta}-blocker$ was associated with improvement in LVEF, HR and DBP (P<0.01, P<0.03), but not in SBP. The incidence of toxicity was similar between the four group with no significant difference. Conculsion: Treatment of heart failure patients with ${\beta}-blocker$ appears to be beneficial in terms of hospital admission event and several hemodynamic factors. The toxicities of ${\beta}-blocker$ treatment were not significant and the treatment is generally well-tolerated in most of the heart failure patients.

• Journal of Information Processing Systems
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• 제11권4호
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• pp.583-600
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• 2015

Generally, the wireless network provides priority to handover calls instead of new calls to maintain its quality of service (QoS). Because of this QoS provisioning, a call admission control (CAC) scheme is essential for the suitable management of limited radio resources of wireless networks to uphold different factors, such as new call blocking probability, handover call dropping probability, channel utilization, etc. Designing an optimal CAC scheme is still a challenging task due to having a number of considerable factors, such as new call blocking probability, handover call dropping probability, channel utilization, traffic rate, etc. Among existing CAC schemes such as, fixed guard band (FGB), fractional guard channel (FGC), limited fractional channel (LFC), and Uniform Fractional Channel (UFC), the LFC scheme is optimal considering the new call blocking and handover call dropping probability. However, this scheme does not consider channel utilization. In this paper, a CAC scheme, which is termed by a uniform fractional band (UFB) to overcome the limitations of existing schemes, is proposed. This scheme is oriented by priority and non-priority guard channels with a set of fractional channels instead of fractionizing the total channels like FGC and UFC schemes. These fractional channels in the UFB scheme accept new calls with a predefined uniform acceptance factor and assist the network in utilizing more channels. The mathematical models, operational benefits, and the limitations of existing CAC schemes are also discussed. Subsequently, we prepared a comparative study between the existing and proposed scheme in terms of the aforementioned QoS related factors. The numerical results we have obtained so far show that the proposed UFB scheme is an optimal CAC scheme in terms of QoS and resource utilization as compared to the existing schemes.

• 보건의료산업학회지
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• 제5권4호
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• pp.27-39
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• 2011

Many Koreans have been interested in health functional foods(HHFs). Use of health functional foods is growing rapidly. This study aims to identify the determinants of HFFs use focusing on health related factors. The subjects were 24,626 samples from Korea Health Panel in 2008. The subjects were divided into two group: under the 20 years old and 20 old and over. The logistic regression model was used to examine influence of health-related factors on use of HFFs for each group. About thirty percent of the subjects have used HFFs. The larger family size, higher education level of parents, more stable economic status and chronic diseases were positively related to use more HFFs in younger 20 years old. Higher education level, more stable economic status, chronic diseases were more likely to use HFFs in 20 years of age and over. Health related factors such as disability, chronic diseases, admission, and physician visit affect the use of HFFs in both groups. We confirmed that health related factors as well as socio-demographic and economic factors affect use of HFFs. In-depth knowledge about relationship between health related factors and HFFs is required.

• 한국치위생학회지
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• 제14권1호
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• pp.9-15
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• 2014

Objectives : The purpose of the study was to investigate the influencing factors of major and university choice in the changing environments that kick out the insincere universities keeping pace with the national policy. Methods : A self-reported questionnaire was completed by 177 subjects after receiving informed consents. The questionnaire consisted of general characteristics, influencing factors on university and department choice including multiple application. Chi-square test was used for analysis of the difference between early and regular admission. Results : Employment was the most important reason for choice of dental hygiene department that accounted for 96%. The access route for university information was college homepage for entrance information that accounted for 72.3% and 76.3% of applicants were advised by their parents for their choice for university. The information was mainly composed of school life(92.1%) and employment (81.9%). The applicants wanted to meet the students(58.8%) and to come in contact with the university homepage(57.1%). Early and regular applicants differed in reasons for college entrance(p=0.032), information delivery for major(p=0.013) and multiple application for entrance(p<0.01). Conclusions : University homepage and communication with the students will give much information to the applicants. So the university had better choose the homepage and communication for marketing strategy.

• Journal of Preventive Medicine and Public Health
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• 제42권6호
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• pp.416-423
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• 2009

Objectives : This study was performed to examine medical care utilization of psychiatric patients and to explore patients' characteristics associated with extended hospitalization. Methods : Data were extracted from information of Korean Health Insurance Review and Assessment Service. All data associated with admission and outpatient clinic visit were analysed by patient characteristics. We selected first psychiatric admission patients who diagnosed mental and behavioral disorders due to use of alcohol (main disease code: F10), schizophrenia and related disorders (F20-29) and mood disorders (F30~33) from January to June 2005. We analysed status of admission, mean length of stay, regular access to outpatient clinic and rates of extended hospitalization during 3 years. Bivariate and multivariate analyses were conducted to identify factors associated with extended hospitalization. Results : The number of psychiatric patients during the first six month of 2005 was 30,678. The mean length of stay was longest for schizophrenia and related disorders but shortest for mood disorders. Patients who experienced an extended hospitalization were 18.8% of total subjects. An extended hospitalization was more common in schizophrenia and related disorders than other diagnostic groups. The factors associated with the extended hospitalization were age, sex, diagnostic group, type of insurance and medical care utilization groups. Conclusions : The study indicates the problem of an extended hospitalization for psychiatric patients in Korea. It is suggested that variations in rates of extended hospitalization among medical care utilization group may need an active early intervention system in psychiatric treatment service. Particular attention needs to be devoted to planning and funding for reducing extended hospitalization.

• 재활치료과학
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• 제9권3호
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• pp.103-120
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• 2020

목적 : 본 연구는 재활·요양병원 환자의 사회적 입원이 증가하고 있는 현상에 대해 작업치료사의 관점에서 분석하고자 하였다. 연구방법 : 작업치료사들의 관점을 확인하기 위하여 재활 서비스 평가 도구 RSAT를 기반으로 주관식 설문지를 구성하였고, 2019년 8월 전국 3년차 이상의 작업치료들에게 설문지를 배포 및 수거하였다. 설문지의 응답자료를 van Kaam의 현상학적 연구 방법을 통해 분석하였고, 유효 세부서술에 대해 Word cloud로 다빈도 단어를 분석하였다. 결과 : 배포한 설문지는 수도권, 충청권, 경상권에서 46명의 작업치료사들로부터 응답을 받았다. 설문지의 응답자료는 2개의 범주(categories)와 4개의 주제(theme), 13개의 하위주제(subtheme)로 분석되었다. 2개 범주는 '병원의 체계'와 '작업치료 임상의 내·외부적 요인'으로 나타났으며 '병원의 체계'에 따른 주제는 '다학제 팀 접근의 어려움'과 '퇴원계획 체계의 미흡'으로 나타났다. '작업치료 임상의 내·외부적 요인'에 따른 주제로는 '작업치료사의 어려움'과 '작업치료 실시의 어려움'으로 분석되었다. 결론 : 작업치료사들은 재활·요양병원 환자들의 지역사회 복귀가 어려운 가장 큰 원인이 합리적이지 못한 작업치료 관련 요양급여체계에 있다고 지적하였다. 퇴원 및 지역사회 적응을 위한 작업치료 서비스 체계의 미흡함 역시 환자들로 하여금 퇴원하지 못하고 결국 다시 병원으로의 입원을 하게 만드는 주요 원인의 하나로 인식하고 있었다. 향후 작업치료 처방 및 의료 급여 체계를 환자의 재활 목적에 맞도록 다면화할 필요가 있음을 제언한다.

• 한국심리학회지:학교
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• 제8권1호
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• pp.43-59
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• 2011

본 연구의 목적은 메타분석을 통해 청소년 리더십 관련 변인들을 알아보고 효과의 크기를 비교함으로써 현행 입학사정관 리더십 전형제도를 위한 시사점을 도출하는 것이다. 이러한 연구 목적을 달성하기 위한 구체적인 연구 문제는 다음과 같다. 첫째, 선행되었던 청소년 리더십연구는 주로 어떤 변인들을 다루어왔으며, 이들 변인들을 선행연구의 범주대로 분류할 수 있는가? 둘째, 청소년 리더십 관련 변인군의 효과크기는 어느 정도인가? 셋째, 관련 변인군의 하위 요인들의 효과크기는 어느 정도인가? 이를 위해 본 연구는 10년간의 청소년 리더십 관련 연구 20편을 수집하여 메타분석을 통해 각 영향변인의 92개 효과크기를 비교, 분석하였다. 본 연구의 구체적인 연구결과는 다음과 같다. 첫째, 청소년 리더십 관련 변인은 인구학적 변인, 조직 활동 변인, 가정환경 변인, 사회심리적 변인으로 분류될 수 있었고, 둘째, 가장 큰 효과크기를 보인 변인은 사회심리적 변인군이었으며(ES=.9624) 셋째, 하위 요인으로는 자아존중감(ES=1.3231), 생활만족도(ES=1.1737) 순으로 효과크기가 큰 것으로 나타났다. 마지막으로 연구결과를 근거로 앞으로 국내 입학사정관 리더십 전형의 학생선발방법을 위한 제언을 제시하였다.

• Journal of Chest Surgery
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• 제52권6호
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• pp.400-408
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• 2019

Background: For decades, trauma has been recognized globally as a major cause of death. Reducing the mortality of patients with trauma is an extremely pressing issue, particularly for those with severe trauma. An early and accurate assessment of the risk of mortality among patients with severe trauma is important for improving patient outcomes. Methods: We performed a retrospective medical record review of 582 patients with severe trauma admitted to the emergency department between July 2011 and June 2016. We analyzed the associations of in-hospital mortality with the baseline characteristics and initial biochemical markers of patients with severe trauma on admission. Results: The overall in-hospital mortality rate was 14.9%. Multivariate logistic regression analysis showed that the patient's Rapid Emergency Medicine Score (REMS; odds ratio [OR], 1.186; 95% confidence interval [CI], 1.018-1.383; p=0.029), Emergency Trauma Score (EMTRAS; OR, 2.168; 95% CI, 1.570-2.994; p<0.001), serum lactate levels (SLL; OR, 1.298; 95% CI, 1.118-1.507; p<0.001), and Injury Severity Score (ISS; OR, 1.038; 95% CI, 1.010-1.130; p=0.021) were significantly associated with in-hospital mortality. Conclusion: The REMS, EMTRAS, and SLL can easily and rapidly be used as alternatives to the injury severity score to predict in-hospital mortality for patients who present to the emergency department with severe trauma.

• 보건행정학회지
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• 제25권1호
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• pp.3-10
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• 2015

Background: Previous studies showed differences in healthcare utilization among insurance types. This study aimed to analyze the difference in healthcare utilization for percutaneous transluminal coronary angioplasty inpatients by insurance types after controlling factors affecting healthcare utilization using propensity score matching (PSM). Methods: The 2011 national inpatient sample based on health insurance claims data was used for analysis. PSM was used to control factors influencing healthcare utilization except insurance types. Length of stay and total charges were used as healthcare utilization variables. Patients were divided into National Health Insurance (NHI) and Medical Aid (MA) patients. Factors representing inpatients (gender, age, admission sources, and Elixhauser comorbidity index) and hospitals (number of doctors, number of beds, and location of hospitals) were used as covariates in PSM. Results: Tertiary hospitals didn't show significant difference in length of stay and total charges after PSM between two insurance types. However, MA patients showed significantly longer length of stay than that of NHI patients after PSM in general hospitals. Multivariate regression analysis provided that admission sources, Elixhauser comorbidity index, insurance types, number of doctors, and location of hospitals (province) had significant influences on the length of stay in general hospitals. Conclusion: Study results provided evidences that healthcare utilization was differed by insurance types in general hospitals. Health policy makers will need to prepare interventions to influence the healthcare utilization differences between insurance types.