• 기본간호학회지
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• 제12권3호
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• pp.395-403
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• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.

• Industrial Engineering and Management Systems
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• 제7권2호
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• pp.133-142
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• 2008

The Emergency Department (ED) is an integral part of hospitals. Admissions from the ED account for a significant proportion for a hospital's activity. Ensuring a timely and efficient flow of patients through the ED is crucial for optimising patient care. In recent years, ED overcrowding and its impact on patient flow has become a major issue facing the health sector. Simulation is rapidly becoming a tool of choice when examining hospital systems due to its capacity to involve numerous factors and interactions that impact the system. An analytical simulation model is used to investigate potential impacts by changing the following aspects of ED (physical layouts; number of beds; number and rate of patient arrivals; acuity of illness or injury of patients; access to radiology and pathology services; hospital staffing arrangements; and access to inpatient beds). Results of a significant numerical investigation at a hospital are also presented.

• 한국과학교육학회지
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• 제35권3호
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• pp.343-352
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• 2015

본 연구는 과학고 자기주도학습전형에서의 쟁점항목을 탐색하고 이에 대한 중요도를 분석하여 자기주도학습전형 진행의 시사점을 도출하는 것을 목적으로 수행되었다. 이를 위해서 문헌조사와 과학고 입학담당관(혹은 입학사정관) 면담 등을 통해 예비-잠정쟁점사항을 추출한 후 교육전문가 및 현장전문가의 검토를 받았다. 그리고 전형전문가 델파이 조사를 거쳐서 내용타당도를 검정한 후 쟁점항목 96개를 도출하여 설문도구를 개발하였다. 이를 바탕으로 설문조사를 실시하였다. 설문조사는 20개 과학고의 입학담당관들을 대상으로 이메일을 이용하였다. 설문의 내용은 개별 쟁점항목에 대하여 입학담당관들의 인식의 중요도와 개별 학교에서의 발생유무였다. 수집된 자료들에 대한 쟁점항목 중요도와 발생 빈도수를 통계 처리하여 두 요인의 평균값을 기준으로 상하로 구분한 후 2차원 분류표에 유형별로 배치하였다. 이 과정에서 도출된 4가지의 유형별 쟁점은 다음과 같다. 첫 번째 유형은 개별 쟁점들의 중요도와 발생빈도수에 대한평균이 전체의 평균보다 모두 낮은 28개의 항목으로 이들은 경미한 쟁점에 해당한다. 두 번째 유형은 전체 평균보다 개별 쟁점의 중요도 평균은 높지만 발생빈도수 평균은 낮은 29개 항목의 잠재적 쟁점이다. 세 번째는 평이한 쟁점으로 이것은 두 요인에 대한 전체 평균에 비해 개별 쟁점의 중요도 평균은 낮지만 발생빈도수는 높은 17개 항목이다. 마지막으로 주요 쟁점이다. 이것은 두 요인에 대한 개별 쟁점항목들의 평균이 전체 평균보다 모두 높은 22개의 항목이다. 본 연구결과로 도출된 자기주도학습전형 쟁점항목들의 종류와 유형들은 이 전형을 실시하는 학교에서 전형현장에서 활용될 수 있을 것으로 보며, 특히 주요 쟁점에 대해서는 전형계획 수립 과정에서 적극 고려되어야 할 것이다.

• 한국콘텐츠학회논문지
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• 제19권11호
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• pp.132-143
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• 2019

본 연구는 교육대학의 입시 제도가 사교육과 어떤 관련성이 있는지를 알아보고, 사교육 경감을 위한 교육대학 입시 제도의 개선 방향에 대해서 탐색하고자 하였다. 이를 위해 현장에서 대학 입시를 담당하는 대구·경북 지역의 고등학교 3학년 담임교사들과 교육대학 입시를 실제적으로 경험한 D 교육대학 1학년 재학생을 대상으로 교육대학 입학 전형 요소와 사교육과의 관련성에 대한 인식을 알아보았다. 연구 결과, 교육대학 입시에서 내신 강화가 공교육을 강화하는 효과도 있지만, 내신이 중요하다는 인식이 강하게 작용하여 오히려 사교육을 강화하는 역작용이 발생할 여지가 있다는 의견이 많았다. 농촌 지역인 경상북도와 대도시인 대구 지역의 전형 요소별 인식 차이가 커서 지역 사회의 특성을 고려한 전형과 각 교육대학이 위치한 지역별 특성을 반영한 입시 제도의 도입이 필요하다. 정시 전형의 요소별 점수 반영 비율에 대해서 3학년 담임교사들은 수능 점수 반영 비율을 낮추어야 한다는 의견을 제시했으며, 이와 함께 면접 반영 비율의 상향을 주장하였다. 본 연구의 결과를 통해 사교육 감소를 위한 교육대학 입시제도의 개선 방향에 대한 시사점은 서류 평가의 공정성 확보가 요구되며, 면접의 강화와 함께 나타날 수 있는 사교육 문제의 해결을 위해서 면접의 방향 및 문항에 대한 공개가 뒤따라야 한다는 것이다.

• Tuberculosis and Respiratory Diseases
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• 제80권2호
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• pp.201-209
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• 2017

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. Methods: This study was retrospectively conducted in elderly patients aged ${\geq}65years$, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014. We analyzed the risk factors of MRSA in these patients and developed a scoring system to predict MRSA infection. Results: A total of 762 patients were enrolled in this study, including 19 (2.4%) with MRSA infection. Healthcare-associated pneumonia (HCAP) showed more frequent MRSA infection compared to community-acquired pneumonia (4.4% vs. 1.5%, respectively; p=0.016). In a multivariate logistic regression analysis, admissions during the influenza season (odds ratio [OR], 2.896; 95% confidence interval [CI], 1.022-8.202; p=0.045), chronic kidney disease (OR, 3.555; 95% CI, 1.157-10.926; p=0.027), and intensive care unit admission (OR, 3.385; 95% CI, 1.035-11.075; p=0.044) were identified as predictive factors for MRSA infection. However, the presence of HCAP was not significantly associated with MRSA infection (OR, 1.991; 95% CI, 0.720-5.505; p=0.185). The scoring system consisted of three variables based on the multivariate analysis, and showed moderately accurate diagnostic prediction (area under curve, 0.790; 95% CI, 0.680-0.899; p<0.001). Conclusion: MRSA infection would be considered in elderly CO-pneumonia patients, with three risk factors identified herein. When managing elderly patients with pneumonia, clinicians might keep in mind that these risk factors are associated with MRSA infection, which may help in selecting appropriate antibiotics.

• 한국환경과학회지
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• 제25권6호
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• pp.839-851
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• 2016

The effect of weather on disease was investigated based on results reported in academic papers. Weather-sensitive disease was selected by analyzing the frequency distributions of diseases and correlations between diseases and meteorological factors (e.g., temperature, humidity, pressure, and wind speed). Correlations between disease and meteorological factors were most frequently reported for myocardial infarction (MI) (28%) followed by chronic ischemic heart disease (CHR) (12%), stroke (STR) (10%), and angina pectoris (ANG) (5%). These four diseases had significant correlations with temperature (meaningful correlation for MI and negative correlations for CHR, STR, and ANG). Selecting MI, as a representative weather-sensitive disease, and summarizing the quantitative correlations with meteorological factors revealed that, daily hospital admissions for MI increased approximately 1.7%-2.2% with each $1^{\circ}C$ decrease in physiologically equivalent temperature. On the days when MI occurred in three or more patients larger daily temperature ranges ($2.3^{\circ}C$ increase) were reported compared with the days when MI occurred in fewer than three patients. In addition, variations in pressure (10 mbar, 1016 mbar standard) and relative humidity (10%) contributed to an 11%-12% increase in deaths from MI and an approximately 10% increase in the incidence of MI, respectively.

• 한국환경보건학회지
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• 제26권2호
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• pp.80-90
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• 2000

To determine the effect of air pollutants in Taejon City, we used medical insurance claim data for asthma and the data monitored from telemetry system of Ministry of Environment for air pollutants and meteorological factors. From November 1st, 1997 to October 31th, 1998, 95,629 asthma patients were covered by medical insurance at Taejon City. Subjects were composed of 49,563 males (51.8%) and 46.336 females(48.2%), and among the subjects, the proportion under 15 years old was 62.8% of the total. During the study period, daily mean concentrations of each air pollutants-So2, No2, CO, O3 and TSP-were 9.8 ppb, 17.6 ppm, 1.414 pp, 17.3 ppb and 60.6 $\mu\textrm{g}$/㎥, respectively, which were lower than each of the environmental recommended exposure levels, Through the simple correlation analysis between each air pollutants and meteorological factors, O3 was positively correlated with temperature, but negatively with relative humidity. TSP, SO2, NO2, CO were negatively correlated with meteorological factors, and these air pollutants except O3 were positively correlated with each other, O3 was correlated with TSP positively but the others negatively. Estimating relative risks of each air pollutant with the baseline general additive model, daily mean concentrations of TSP(Lag 0, 1, 4, 5day) were significantly associated with the increase of the asthma admission. Two age subgroups, under 15 and 15~54 have shown various association of all air pollutants concentration with the asthma admission. However, in case of over 54 age subgroup, only TSP(Lag 0 day) among all air pollutants was associated with the asthma admission. Each of ambient outdoor pollutant concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations were much lower than the environmental recommended exposure levels. Therefore, continuous effort lowering air pollutant concentration and introducing an active environmental conservation policy should be implanted for preventing hazardous health effects. Considering major proportion of asthma admissions, high susceptibility and less confounding factors among the age subgroup under 15 will be a useful target population for assessing such health effect monitoring.

• 보건행정학회지
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• 제30권1호
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• pp.72-81
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• 2020

Background: The out-of-pocket maximum is one of the distinctive healthcare systems which sets a ceiling on co-payment in order to reduce the burden of households from the unpredictable medical expenditure. However, this leads to an increase in the demand for healthcare services especially in long-term care hospitals (LTCHs) in Korea. Methods: This study analyzed the influence factor of medical service overuse of 165,592 inpatients in LTCHs which out-of-pocket maximum is applied, by utilizing data from the National Health Insurance Service (2016). Based on Anderson Model, the medical service overuse, as a dependent variable, was defined as long-stay admission more than 180 days at the LTCHs. Independent variable was comprised of predisposing factors (gender, age), enabling factors (income level, types of out-of-pocket maximum) and need factors (illness level, patient use of tertiary hospital). Results: The most powerful factor of medical service overuse in LTCHs was availability of pre-payment for the out-of-maximum (odds ratio [OR], 191.66; p<0.001). This tendency was found in high income level status (p<0.001). Furthermore, mild inpatients (OR, 1.50; p<0.001) which had no experience with the tertiary hospitals (OR, 2.06; p<0.001) were more relevant to the medical service overuse in LTCHs, compared to the severe inpatients. Conclusion: It is suggested that a separate standard of out-of pocket maximum with regards to LTCHs is required to secure the beneficial functions of long-term hospitals and prevent unnecessary financial leakage to achieve sustainable and financially sound National Health Insurance.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권1호
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• pp.25-33
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• 2021

Objectives: Many conditions of the oral and maxillofacial region require hospitalization and in-patient care. The average length of stay (LOS) of these patients varies and is usually affected by multiple confounding variables. However, even with an increasing number of hospital admissions, published evidence on the factors that affect the LOS of oral and maxillofacial patients is lacking. Therefore, this study assessed the LOS of in-patients at the oral and maxillofacial surgery department of a government-funded, multi-specialty hospital in Malaysia, based on their reasons for admission and other factors. Materials and Methods: Our samples were collected retrospectively over a 5-year period and included patients with maxillofacial infections, post-trauma stabilization, facial bone fracture surgery, benign and malignant lesion surgery, dentoalveolar surgery, and other maxillofacial surgeries as reasons for admission. Factors potentially affecting LOS were also recorded, and their significance was determined using multiple logistic regression analyses. A P-value of less than 0.05 was considered to be statistically significant. Results: A total of 1,380 patients were included in this study. Most (84.5%) of our in-patients were of Malay ethnicity, and males outnumbered females in our sample by 502 subjects. The median LOS of our in-patients was 3 days. Sex, ethnicity, age, reason for admission, and American Society of Anesthesiology (ASA) classification were factors that significantly affected LOS. Conclusion: The median LOS reported in this study was 3 days. LOS was significantly affected by sex, ethnicity, age, reason of admission and ASA classification.

• 응용통계연구
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• 제23권5호
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• pp.987-996
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• 2010

대학 입학전형은 각 대학의 교육목적에 맞고 그 교육목표를 이룰 수 있는 적합한 인재상에 부합하는 학생들을 선발하는 것에 있다. 그리고 최근 입학사정관제의 도입으로 학생의 잠재력을 발굴하여 선발하는 전형을 정착시키려는 노력을 하고 있다. 이 점에서 과연 다양한 평가방식이 학생들의 질적 특성까지 반영하여 그들의 잠재력이 잘 평가되는지, 또 전형요소에 따라 계열, 모집단위 등의 특성에 맞는 학생들이 제대로 평가되고 있는지에 대하여 통계적 타당성을 검증할 필요성이 있다. 대학학업성취도를 바탕으로 하여 여러 요인들의 영향력을 통계적 방법으로 분석한다.