• 한국콘텐츠학회논문지
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• 제5권5호
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• pp.287-295
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• 2005

본 논문에서는 유비쿼터스 컴퓨팅 기술의 여러 응용 서비스에서 가장 핵심적인 요소 기술 중의 하나인 사용자의 상황인식시스템에 대하여 기술한다. 제안하는 시스템은 실험 대상자의 우측 상완에 착용하는 $SenseWear(R)PRO_2R$ Armband (BodyMedia사)에 내장된 2차원 가속도센서를 이용하여, 센서에서 출력되는 가속도 변화량의 절대치의 평균치인 MAD(mean of absolute difference)를 계산하여 활동량을 정량화 하였으며, PC 기반의 눕기, 앉기, 걷기, 뛰기 4단계 동작의 인체동작상태 구분과 한정된 응급상활을 인지하는 퍼지추론 시스템으로 구현하였다. 본 시스템으로 측정한 수직방향의 MAD는 눕기, 앉기, 걷기, 뛰기에서 각각 0.204 g/s, 0.373 g/s, 2.808 g/s, 16.243 g/s이었다. 이들을 이용하여 분석한 인체동작 인식률은 눕기, 앉기, 걷기 뛰기에 대하여 각각 96.7 %, 93.0 %, 95.2 %, 98.4 %로 나타났으며, 제한된 상황에서의 응급상황인식률은 100 %이었다.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.484-494
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• 2000

Objective : To evaluate the relative benefits and the costs associated with the introduction of the new pharmaceutical provision called 'Mandatory Prescription System' which separates the role of physicians from that of pharmacists with respect to the prescription and dispensation of from the perspective of consumers (i.e., patients). Methods : The costs of the system were measured by considering both direct and indirect costs. Direct costs included additional payments for ambulatory care and dispensing fees that occurred under the new system. indirect costs consisted of transportation expenses and costs related to time spent for physician consultation, waiting for the prescriptions to be filled, and extra traveling. Benefits identified in this study were the reduction of drug misuse and overuse, and the overall decrease in drug consumption among the Korean population. Sensitivity analysis was peformed for the inclusion of benefits for outpatients of hospitals, price elasticity, and increased fees for established patients. Results : The net benefit was estimated to be about minus 1,862 billion won and the benefit-cost ratio was 0.478. This indicates that the costs of 'Mandatory Prescription' outweigh its benefits, relative to the previous system. The sensitivity analysis results for all the variables considered in this study consistently showed the benefit-cost ratio to be less than 1. Conclusion : The results of this study suggest that implementing Mandatory Prescription System in Korea might be inefficient from the consumer's perspective. The results of this study do not coincide with the results of previous studies, presumably because of the differences in study design and in which items of costs and benefits were considered.

• Journal of Preventive Medicine and Public Health
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• 제19권1호
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• pp.137-145
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• 1986

A Nationwide health care utilization survey was conducted from March 11 to September 19, 1985 to assess the level of illness and the magnitude of medical care utilization. A probability sample of 15,427 persons was taken from 180 Enumerated Districts designated by the Economic Planning Board. Of those 4,500 housewives were proxy respondents. A interview was conducted with pre-tested questionnaire schedule which was recorded by well trained interviewers. Age and sex compositions of the study population were similar to those of general population structure in 1985. The major findings of this survey are as follows : 1) A total of 64.5% of the study population lived in city area and 35.5% lived in county area. 2) While no difference was observed in interview rate between city and county area, it showed statistically significant difference in the medical security program coverage rate between the two areas(44.7% and 37.1%, respectively) 3) Morbidity rate was 79 per 1,000 persons during the two week periods. There was difference in age and sex adjusted morbidity rates between city and county area. Furthermore morbidity rates by the status of the program were significantly difference between the two areas. 4) Average ambulatory care utilization rate was 7.2 visits per person per year and average admission rate was 1.8 per 100 persons per year. There was significant difference in average ambulatory care utilization rate by the program. but no significant difference in medical utilization rate between city and country area. 5) The major symptoms of the perceived illness was the respiratory system(44.1%). 6) A total of 50.4% of the perceived illness among the covered group by the program were treated at the hospital and clinics, but those who are not covered used primarily drug stores(61.3%).

• 대한물리치료과학회지
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• 제12권3호
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• pp.47-58
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• 2005

The purpose of this study is to estimate how much the motility of affected and unaffected lower limb respectively would have effects on their ambulation through comparing the difference between their affected and unaffected lower limb and studying the correlation between such difference and their ambulation. In addition, the study also intends to find out remedial measures suitable for improving their ambulation with relevant physical treatment. To do this, a quantitative electromyogram(QEMG) test was done to both quadriceps and hamstring of affected and unaffected lower limb so as to yield IP values. Based on such IP values, RMS(root mean square) values as the total sum of IP values were found with QEMG analysis system (made by Medelec Co.) and then the ambulation depending on the difference in muscular strength were analyzed by ink-foot print method as well as the corresponding statistics were processed by T-test through SPSS. The effect of differences in muscular strength of quadriceps in affected and unaffected limb of hemiplegic patients on their ambulation was also different in each element of ambulation. However, there was not any statistically significant difference (p>.05). The differences in muscular strength of hamstring in unaffected limbs of hemiplegic patients only affect stride length. It was statistically significant. The effect of difference in muscular strength of the hamstring in affected limb of hemiplegic patients on their ambulation was very different between strong and weak group in terms of walking velocity, step per minute, stride and step length, showing statistically significant difference(p<.05). Although there was a difference in the step length of the affected limb, it was not statistically significant(p>.05). For the unaffected hamstring, there were significant differences of stride length between in unaffected limb and in affected limb. For the affected hamstring, there were also significant differences in walking velocity, step per minute, stride and step length. Besides, it was found that the difference of the muscular strength between strong and weak group was at the highest. Thus, the effect of difference in muscular strength on ambulatory factors such as walking velocity, step per minute, stride and step length did not show any statistical significance but differences in affected and unaffected quadriceps. However, it was found that both the difference of stride in unaffected hamstring and the difference of all ambulatory factors except from step length with affected limb had effects on ambulation depending upon muscular strength.

• 한국의료질향상학회지
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• 제9권2호
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• 대한간호학회지
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• 제26권2호
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• pp.399-412
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• 1996

Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.

• 한국임상약학회지
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• 제21권3호
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• pp.249-255
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• 2011

Objective: To examine the drug use (prescribing) pattern of serious drug-drug interactions (DDIs, contraindicated drug interactions) using real world data. Prescription patterns were examined in terms of dispensing types. Method: Retrospective drug utilization review (DUR) study was performed. One hundred and six datasets of serious DDIs (DDI pairs) were determined among DDI datasets that Ministry of Health & Welfare announced for the DUR system from 2004 to 2005. Electronically transacted ambulatory patients' prescription database to Health Insurance Assessment and Review Services (HIRA) from July, 2005 to June, 2006 was collected with personal information deidentified and analyzed in terms of types of dispensing as a contributing factor. Results: After prescription data analysis per each patient, total number of DDI cases using 95 DDI pairs was 5,511, which accounted for 2.6 cases per patients. DDI cases between two drugs from each of community pharmacy dispensing- type prescription were considerable (63% vs. 24% in those from each of in-institutional dispensing-type prescription and vs. 13% in those from a community pharmacy dispensing-type prescription and an in-institutional dispensingtype prescription). Conclusions: DDI cases from different prescribers were found to be significant. Thus, the concurrent DUR process between prescriptions from different physicians and institutions should be implemented for the safe drug use.

• 대한예방한의학회지
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• 제10권2호
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• pp.95-120
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• 2006

The purpose of this paper is to investigate the structure of cost-sharing for oriental medical services in the national health insurance. Out-of-pocket payment in ambulatory oriental medical care is a co-payment of KRW3,000 up to total expenses of KRW15,000, and co-insurance rate of 30% thereafetr. The empirical analysis based on medial claims data shows that the frequency of medical claims for outpatient care are mostly concentrated just below a total expenses of KRW15,000, and it decreases beyond a total expense of KRW15,000, while it rebounds between KRW17,000${\sim}$20,000. This means the current co-payment(KRW3,000) in oriental medical services should be applied up to a total payment of KRW17,000${\sim}$20,000, or the level of co-payment should be adjusted upward to KRW45,000 in order to be consistent in cost-sharing, between co-payment and co-insurance.

• 전기학회논문지
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• 제56권7호
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• pp.1331-1338
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• 2007

A new method for detecting and eliminating the Electrocardiogram(ECG) artifact from the scalp Electroencephalogram(EEG) is proposed. Based on the single channel EEG, the proposed method consists of 4 procedures: emphasizing the R-wave of ECG artifact from EEG using the least squares acceleration(LSA) filter, detecting the R-wave from the LSA filtered EEG using the phase space method and R-R interval, generating the delayed impulse synchronized to the R-wave and elimination of the ECG artifacts based on the adaptive digital filter using the impulse and raw EEG. The performance of the proposed method was evaluated in the two separating parts of R-wave detection and, ECG estimation and elimination from EEG. In the R-wave detection, the proposed method showed the mean error rate of 6.285(%). In the ECG estimation and elimination using simulated and/or real EEG recordings, we found that the ECG artifacts were successfully estimated and eliminated in comparison with the conventional multi-channel techniques, in which independent component analysis and ensemble average method are used. From this we can conclude that the proposed method is useful for the detecting and eliminating the ECG artifact from single channel EEG and simple for ambulatory/portable EEG monitoring system.

• 대한치과마취과학회지
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• 제10권1호
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• pp.45-49
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• 2010

Adrenoleukodystrophy (ALD) is a rare X-linked genetic disorder associated with various central nervous system problems and adrenal insufficiency. It is common in childhood and symptoms include loss of previously acquired neurological abilities, seizures, ataxia, Addison's disease as well as degeneration of visual and auditory function. These children frequently require anesthesia during imagining procedure such as MRI or during some surgical procedures like gastrostomy. There is special need for careful management because of numerous anesthetic challenges like difficulty in cooperation, seizure disorders, life-threatening airway obstruction, copious oral secretion and possibility of aspiration. In addition, adrenal involvement and hypofunction must be considered for safe anesthesia management. We report a successful anesthetic management in a patient with ALD for dental procedures.