• Title/Summary/Keyword: Value-based healthcare

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Evaluation of Image for Phantom according to Normalization, Well Counter Correction in PET-CT (PET-CT Normalization, Well Counter Correction에 따른 팬텀을 이용한 영상 평가)

  • Choong-Woon Lee;Yeon-Wook You;Jong-Woon Mun;Yun-Cheol Kim
    • The Korean Journal of Nuclear Medicine Technology
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    • v.27 no.1
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    • pp.47-54
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    • 2023
  • Purpose PET-CT imaging require an appropriate quality assurance system to achieve high efficiency and reliability. Quality control is essential for improving the quality of care and patient safety. Currently, there are performance evaluation methods of UN2-1994 and UN2-2001 proposed by NEMA and IEC for PET-CT image evaluation. In this study, we compare phantom images with the same experiments before and after PET-CT 3D normalization and well counter correction and evaluate the usefulness of quality control. Materials and methods Discovery 690 (General Electric Healthcare, USA) PET-CT equiptment was used to perform 3D normalization and well counter correction as recommended by GE Healthcare. Based on the recovery coefficients for the six spheres of the NEMA IEC Body Phantom recommended by the EARL. 20kBq/㎖ of 18F was injected into the sphere of the phantom and 2kBq/㎖ of 18F was injected into the body of phantom. PET-CT scan was performed with a radioacitivity ratio of 10:1. Images were reconstructed by appliying TOF+PSF+TOF, OSEM+PSF, OSEM and Gaussian filter 4.0, 4.5, 5.0, 5.5, 6.0, 6,5 mm with matrix size 128×128, slice thickness 3.75 mm, iteration 2, subset 16 conditions. The PET image was attenuation corrected using the CT images and analyzed using software program AW 4.7 (General Electric Healthcare, USA). The ROI was set to fit 6 spheres in the CT image, RC (Recovery Coefficient) was measured after fusion of PET and CT. Statistical analysis was performed wilcoxon signed rank test using R. Results Overall, after the quality control items were performed, the recovery coefficient of the phantom image increased and measured. Recovery coefficient according to the image reconstruction increased in the order TOF+PSF, TOF, OSEM+PSF, before and after quality control, RCmax increased by OSEM 0.13, OSEM+PSF 0.16, TOF 0.16, TOF+PSF 0.15 and RCmean increased by OSEM 0.09, OSEM+PSF 0.09, TOF 0.106, TOF+PSF 0.10. Both groups showed a statistically significant difference in Wilcoxon signed rank test results (P value<0.001). Conclusion PET-CT system require quality assurance to achieve high efficiency and reliability. Standardized intervals and procedures should be followed for quality control. We hope that this study will be a good opportunity to think about the importance of quality control in PET-CT

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A policy case study for cultivation of global small giant companies in Healthcare areas: Focusing on German case (보건의료 분야 글로벌 강소기업 육성을 위한 정책사례연구: 독일을 중심으로)

  • Kim, Na-Hyeong;Han, Neung-Ho;Pak, Myong-Sop
    • Korea Trade Review
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    • v.42 no.4
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    • pp.69-91
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    • 2017
  • Since the global financial crisis, major countries have been executing policies related to two top-priority goals to create more jobs: revitalization of entrepreneur activity and the cultivation of small and medium-sized companies. In South Korea, the interest of policy makers is increasingly focusing on the role of SMEs that have a technological competitive edge in the realization of a "job-centered creative economy." Due to the nature of the field, the health and medical industry requires a particularly long time until the achievement of industrialization, Also, because of the complex distribution structure, it is essential for related government ministries and institutions to jointly devise strategies. A lack of policy supports for the industry has thus far resulted in its development being relegated for the most part of small and medium-sized companies, which consequently means low global competitiveness. Now is the time for the South Korean government to provide the revolutionary supported options and strategies. This study aims to propose a general policy direction and policy areas for the cultivation of Korea's small and medium-sized companies in the healthcare industry into global small giant companies through an exploration of the German case. It is crucial to first cultivate the international competitiveness of Korean small and medium-sized companies (as in the case of Germany) so that they can grow into global small giant companies. Another important task is the creation of an environment that expedites the qualitative growth of promising SMEs as well as technological development. After securing competitiveness in terms of both product quality and technology in the global health market, substantive policy supports will be necessary to cultivate global small giant companies that are export-based (e.g. job creation effect, sales value added).

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Prediction of Cognitive Progression in Individuals with Mild Cognitive Impairment Using Radiomics as an Improvement of the ATN System: A Five-Year Follow-Up Study

  • Rao Song;Xiaojia Wu;Huan Liu;Dajing Guo;Lin Tang;Wei Zhang;Junbang Feng;Chuanming Li
    • Korean Journal of Radiology
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    • v.23 no.1
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    • pp.89-100
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    • 2022
  • Objective: To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). Materials and Methods: A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer's disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. Results: The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aβ42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer's continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer's disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. Conclusion: We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.

The Analysis of Brand Value and Market Share at the Largest Hospitals the Metropolitan Area (수도권 초대형병원의 브랜드 가치와 시장점유율 분석)

  • Kang, Han Seom;Park, So Youn;Kim, Hyo Jeong;Kim, Young Hoon
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.41-50
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    • 2018
  • The purpose of this research is to evaluate Brand Value by using the K-BPI(Korea Brand Power Index) of Korea Management Association which is based on consumer awareness, as well as to identify how Brand Value which is composed of top of awareness, unaided awareness, aided awareness, image, possibility of purchasing, preference, affects on the Market Share perceived by consumers. This research subjects were 10 hospitals with more than 1,000 beds in Seoul and Gyeonggi-do, and survey subjects were 20 or older adults living in the metropolitan area of Korea. Using K-BPI for measuring Brand Value and used calculation of Market Share according to consumer preference model for measuring Market Share. The major results of this research are as follows: First, this research identified that the top 5 hospitals of largest hospitals in metropolitan area measured by using K-BPI and Market Share were same hospitals as Big 4 hospitals of previous research evaluating the comprehensive competitiveness of hospitals and also same as hospitals that appeared recently. Second, Big 5 hospitals ranked first to fifth in both Brand Value and Market Share. To identify the relationship between K-BPI items(top of awareness, unaided awareness, aided awareness, image, availability, preference) and Market Share, multiple linear regression was used by dividing 5 upper and 5 lower group of hospitals per each. The group of 5 upper hospitals had a significant effect on Market Share, with 'top of awareness', 'unaided awareness', 'aided awareness'. The group of 5 lower hospitals had a significant effect on Market Share with 'unaided awareness', 'aided awareness'. The results of this study and hospitals of the first to third hospitals published in the K-BPI press release reported by KMAC in 2017, and the previous studies evaluating the comprehensive competitiveness hospitals, all had one thing in common that Big 4 hospitals ranked high position. This suggests that evaluation of Brand Value also can be a evaluation measure of hospital. A new competitiveness of hospital is expected by managing brand awareness to have a brand competitiveness and by securing intrinsic Market Share of consumer to reach hospital use ultimately.

The First Newborn Screening Study of T-Cell Receptor Excision Circle and κ-Deleting Recombination Excision Circle for Severe Combined Immunodeficiency in Korea: A Pilot Study (국내 최초 T-Cell Receptor Excision Circle과 κ-Deleting Recombination Excision Circle 신생아 선별검사에 관한 연구)

  • Son, Sohee;Kang, Ji-Man;Kim, Jong Min;Sung, Sein;Kim, Yi-Seoul;Lee, Haejeong;Kim, BitA Reum;Lee, Yeon Kyoung;Ko, Sun Young;Shin, Son Moon;Kim, Yae-Jean
    • Pediatric Infection and Vaccine
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    • v.24 no.3
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    • pp.134-140
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    • 2017
  • Purpose: Severe combined immunodeficiency (SCID) is the most serious form of primary immunodeficiency. Infants with SCID are susceptible to life-threatening infections. To establish newborn screening for SCID in Korea, we performed a screening test for T-cell receptor excision circle (TREC) and ${\kappa}$-deleting recombination excision circle (KREC) in neonates and investigated the awareness of SCID among their parents. Methods: Collections of dried blood spots from neonates and parent surveys were performed at the Samsung Medical Center and Cheil General Hospital & Women's Healthcare Center in Korea. The amplification crossing point (Cp) value <37.0 was defined as TREC/KRECpositive based on cutoff values from measuring multiplex real-time polymerase chain reaction. A Cp value >39.0 was defined as negative. Results: For TREC/KREC screening, 141 neonates were enrolled; 63 (44.7%) were male. One hundred forty neonates (99.3%) had positive TREC/KREC results at the time of the initial test; 82.3% and 75.9% were positive and 17.0% and 23.4% were weakly positive for TREC and KREC, respectively. In one neonate (0.7%), the initial TREC/KREC test result was negative. However, repeated tests obtained and confirmed a positive result. For an awareness survey, 168 parents were engaged. Only 2% of parents (3/168) knew that the newborn screening test for SCID had been introduced and performed in other countries. Eighty-four percent of parents (141/168) replied that nationwide newborn SCID screening should be performed in Korean newborns. Conclusions: In this study, newborn SCID screening was performed along with assessment of public awareness of the SCID test in Korea. The study results showed that newborn SCID screening can be readily applied for clinical use at a relatively low cost in Korea.

Design and Embodiment for Constructing Mobile Medical Information System Combining Bio-sensor and IT Technology (바이오센서 기술과 IT기술을 융합한 휴대용 의료정보 시스템 구축을 위한 설계 및 구현)

  • Kim, Heon;Lee, Sung-Koo
    • Journal of Digital Contents Society
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    • v.9 no.1
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    • pp.27-31
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    • 2008
  • u-Health is a representative realization method of ubiquitous IT and it is being embossed as an industry that can make our lives abundant. Through the u-Health, the diagnosis will go beyond the restriction of space, which is based on hospital, and be positioned as a universal value in a daily life by combining diagnosis and life naturally. The purpose of this study is to suggest systematic, intelligent, mobile medical information system that has the same effect as the assistant of specialist by providing scientific and objective knowledge, which is suitable for u-Health age. Mobile medical information system can provide user with the opinion of specialist by planting the experience, knowledge and decision making process of specialist that are necessary for solving the problem requiring special medical knowledge and passing through an inference process.

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Comorbidity Adjustment in Health Insurance Claim Database (건강보험청구자료에서 동반질환 보정방법)

  • Kim, Kyoung Hoon
    • Health Policy and Management
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    • v.26 no.1
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    • pp.71-78
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    • 2016
  • The value of using health insurance claim database is continuously rising in healthcare research. In studies where comorbidities act as a confounder, comorbidity adjustment holds importance. Yet researchers are faced with a myriad of options without sufficient information on how to appropriately adjust comorbidity. The purpose of this study is to assist in selecting an appropriate index, look back period, and data range for comorbidity adjustment. No consensus has been formed regarding the appropriate index, look back period and data range in comorbidity adjustment. This study recommends the Charlson comorbidity index be selected when predicting the outcome such as mortality, and the Elixhauser's comorbidity measures be selected when analyzing the relations between various comorbidities and outcomes. A longer look back period and inclusion of all diagnoses of both inpatient and outpatient data led to increased prevalence of comorbidities, but contributed little to model performance. Limited data range, such as the inclusion of primary diagnoses only, may complement limitations of the health insurance claim database, but could miss important comorbidities. This study suggests that all diagnoses of both inpatients and outpatients data, excluding rule-out diagnosis, be observed for at least 1 year look back period prior to the index date. The comorbidity index, look back period, and data range must be considered for comorbidity adjustment. To provide better guidance to researchers, follow-up studies should be conducted using the three factors based on specific diseases and surgeries.

A Study on Taekwondo Uniform Wear and Design Preference -Focused on Target General Consumer and Taekwondo Player- (태권도복 착용 현황 및 디자인 선호에 관한 연구 -일반 소비자와 태권도 선수를 대상으로-)

  • Lee, Haeun;Choi, Jungwook
    • Journal of Fashion Business
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    • v.20 no.2
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    • pp.1-15
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    • 2016
  • Currently, a lot of people are aware of their health and well-being, so they are concerned about their healthcare. 'Taekwondo' is one of the popular sports that Korean people are passionate about Taekwondo has also become globalized. The uniform of Taekwondo is gaining importance. Taekwondo involves a lot of movement, hence the pattern should facilitate the movement. In addition Taekwondo uniform pattern should meet the demands of functionality, fit and consumer design preferences. This study aimed to provide the basic data for development of Taekwondo uniform pattern based on design preferences and functionality to wearer satisfaction. The result of this method indicated fit and design details. Also, the length of pants, top, and sleeve was too wide, which has to more fitted for both of genders. For females, the breakpoint was too low, which requires some increase to make females feel more secure. In conclusion, the results of this study indicated that in order to increase 'Takwondo' value, Taekwondo uniform is required to be more fashionable and comfortable to wear, which could influence other sports wear.

An Integer Programming Formulation for Outpatient Scheduling with Patient Preference

  • Wang, Jin;Fung, Richard Y.K.
    • Industrial Engineering and Management Systems
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    • v.13 no.2
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    • pp.193-202
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    • 2014
  • Patients' satisfaction while receiving medical service is affected by whether or not their preferences can be met, including time and physician preference. Due to scarcity of medical resource in China, efficient use of available resources is urgently required. To guarantee the utilization ratio, the scheduling decisions are made after all booking information is received. Two integer models with different objectives are formulated separately, maximizing the degree of satisfaction and revenue. The optimal value of the two models can be considered as the bound of corresponding objectives. However, it is improper to implement any of the extreme policies. Because revenue is a key element to keep the hospital running and satisfaction degree is related to the hospital's reputation, neither the revenue nor the satisfaction can be missed. Therefore, hospitals should make a balance. An integrated model is developed to find out the tradeoff between the two objectives. The whole degree of mismatching that is related to patient satisfaction and other separate mismatching degree are considered. Through a computational study, it is concluded that based on the proposed model hospitals can make their decisions according to service requirement.

Analysis of Media Frames of Moon Jae-in Care policy (문재인 케어 정책에 대한 미디어 프레임 분석)

  • Lee, Geun-Chan
    • The Korean Journal of Health Service Management
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    • v.12 no.3
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    • pp.13-26
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    • 2018
  • Objectives: This study investigated how Korean daily newspapers frame the present government's health insurance coverage expansion policy, Moon Jae-in Care. Methods: A contents analysis was conducted to construct news frames represented in the four Korean daily newspapers' editorials and columns on Moon Jae-in Care during from April 2017 to April 2018. News text was classified into three different layers of frames: expressive element, narrative structure, and implied values. Results: The analysis revealed that the frequency of narrative frames was as follows: health system improvement (20.8%), public burden (14.6%), opposition by doctors (14.6%), and populism (12.5%). The financial sustainability accounted for 41.7% of the value frame, followed by procedural legitimation (18.8%), and coverage expansion (16.7%). The results also revealed that reported frames were different among newspapers: Chosun Ilbo tended to report in a negative tone, while Hankyoreh shinmun and Kyunghyang shinmun used a positive tone. Conclusions: This finding suggests that there are salient framings in reports on Moon Jae-in Care. Based on the results, the government needs to present a detailed financing plan on Moon Jae-in Care in detail. I discussed another implication of media frames results.