• 제목/요약/키워드: dental institution

검색결과 181건 처리시간 0.028초

의료기관(醫療器管)의 의료(醫療)서비스 질(質) 개선(改善)에 관한 연구(硏究) - 환자만족도(患者滿足度)(Patient Satisfaction)를 중심으로 - (A study of medical service quality improvement in a medical institution)

  • 전병욱;홍성천;유병완
    • 대한한의정보학회지
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    • 제15권1호
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    • pp.67-76
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    • 2009
  • Quality management is a recent phenomenon. Advanced civilizations that supported the arts and crafts allowed clients to choose goods meeting higher quality standards than normal goods. There are many methods for quality improvement. Health care, refers to the treatment and management of illness, and the preservation of health through services offered by the medical, dental, complementary and alternative medicine, pharmaceutical, clinical laboratory sciences (in vitro diagnostics), nursing, and allied health professions. Health care embraces all the goods and services designed to promote health, including "preventive, curative and palliative interventions, whether directed to individuals or to populations. The overall impact of managed care remains widely debated. Proponents argue that it has increased efficiency, improved overall standards, and led to a better understanding of the relationship between costs and quality. Practices can solicit feedback from patients in a variety of ways: phone surveys, written surveys, focus groups or personal interviews. What do I do with the results? While you don't have to act on every suggestion that your patients give you, you should take action on the key items that are causing dissatisfaction.

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Quantitative Review of Oral Cancer Research Output from Pakistan

  • Khan, Zohaib;Muller, Steffen;Ahmed, Shahzad;Tonnies, Justus;Nadir, Faryal;Samkange-Zeeb, Florence
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권11호
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    • pp.4733-4739
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    • 2015
  • Background: Oral cancer is the most common cancer among men and second only to breast cancer among women in Pakistan. For the effective control and prevention of oral cancer, Pakistan needs to recognize the importance of research and generation of the evidence-base which can inform policy making and planning and implementation of intervention programs. The objective of this review was to quantify oral cancer research output in Pakistan. Materials and Methods: A systematic electronic search in "Medline", "ISI-Web of Science" and "Pakmedinet", supplemented by a Google search, was carried out in January and February, 2014, to identify literature from Pakistan relevant to oral cancer. The selection of publications for the review was carried out according to preset criteria. Data were recorded and analyzed using Microsoft Excel. Results: A total of 166 publications comprising 62 case series, 36 cross sectional, 31 case control, 10 basic laboratory research, eleven reviews and two trials, were included in this review. Some 35 % of the publications focused on risk factors for oral cancer. COMSATS Institute of Information Technology was the institution with the highest contribution. Conclusions: There is a lack of research in the field of oral cancer research in Pakistan. Focused efforts should be put in place to improve both quality and quantity of oral cancer research in the country.

수종 음료수의 법랑질과 상아질 침식에 관한 연구 (A STUDY OF THE INFLUENCES OF ACIDIC BEVERAGES ON EROSION OF ENAMEL AND DENTIN)

  • 장기택
    • 대한소아치과학회지
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    • 제24권4호
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    • pp.719-726
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    • 1997
  • The aim of this study was to evaluate the in vitro effects of exposure to acidic beverages on microhardness of enamel and dentin. Thirty enamel specimens and thirty dentin specimens were obtained from extracted bovine maxillay incisiors. Enamel and dentin specimens were divided into three groups and treated with acidic beverages as follows; Group 1 : cola(pH 2.52), Group 2 : plain soda water(pH 2.93) and Group 3 : orange juice(pH 3.75). Erosive treatment was performed by storing each specimens for 5 min in 50ml solution of cola, soda water and orange juice. Average microhardness values(VHN) were determined before and after erosive treatment. All beverages produced significant loss of microhardness of enamel and dentin. Microhardness of enamel was reduced in the following order: Group 1 : $42.71{\pm}4.36(%)$, Group 2 : $37.09{\pm}6.25(%)$, Group 3 : $35.46{\pm}4.98(%)$. Microhardness of dentin was reduced in the following order: Group 1 : $17.14{\pm}3.42(%)$, Group 2 : $13.89{\pm}3.18(%)$, Group 3 : $13.82{\pm}3.50(%)$. The differences between group 1 and group 2, 3 were statistically significant(p< 0.05).

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치과위생사 의료인화에 대한 현안과제와 직무확충 방안 (Problems to Solve and Job Enlargement on the Inclusion of Dental Hygienists in the Category of Medical Personnel)

  • 이다솜;한경순
    • 치위생과학회지
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    • 제18권6호
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    • pp.340-348
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    • 2018
  • 본 연구는 치과위생사 의료인화에 대한 요구와 논의가 있는 현 시대적 상황에서 치과의료인력을 대상으로 치과위생사를 위한 선행과제와 의료인이 되었을 때의 긍정적 부정적 효과, 확장 가능한 전문업무에 대해 파악하고자 하였다. 치과위생사 259명, 치과의사 128명을 대상으로 치과위생사 의료인화에 대한 인식과 선행 과제, 긍정 및 부정적 효과와 확장 가능한 전문업무 등에 대해 조사 분석하여 다음과 같은 결론을 얻었다. 치과위생사 의료인화에 대해 치과위생사의 94.2%, 치과의사의 46.9%가 인지하였고, 치과위생사는 협회매체(52.5%), 치과의사는 치과신문(23.4%)을 통해 인지하는 경우가 많았다. 찬성도는 치과위생사의 95.0%, 치과의사의 64.1%였으며, 당위성은 치과위생사가 84.9%, 치과의사 51.6%였다. 당위성의 근거로 치과위생사는 업무 전문성과 교육과정 부합성이 높았고 업무 부합성이 낮았으나 치과의사는 의료체계 유사성이 높았고 교육과정 부합성이 가장 낮았다. 의료인화를 위한 선행 과제 중 직업적 영역에서 치과위생사와 치과의사 모두 직업의식과 윤리의식이 높았다. 제도적 영역에서도 두 직종 모두 치위생교육 질 관리가 가장 높았으며, 학제 일원화가 가장 낮았다. 사회적 영역에서 치과위생사는 중앙정부설득과 국민공감대 형성이 높았고, 치과의사는 유관단체 협력과 중앙정부 설득이 높았다. 치과위생사 의료인화 시 긍정적 효과는 치과위생사 인식 확장이 치과위생사와 치과의사 모두 가장 높았고, 부정적 효과는 치과위생사의 경우 임금상승 심화와 위임진료 증가가 높았고, 치과의사는 임금상승 심화와 구인난 심화가 높았다. 의료인화 시 확장 가능한 전문업무로는 독자적 치주관리프로그램 운영으로 치과위생사(79.9%)와 치과의사(69.6%) 모두에게 가장 높게 나타났다. 치과위생사는 치주관리를 위한 진단(44.4%)과 전신질환자 구강건강관리(44.0%), 비외과적 치주처치(41.3%), 근육 정맥주사(27.4%) 순이었고, 치과의사는 근육 정맥주사(44.1%), 비외과적 치주처치(34.3%), 전신질환자 구강건강관리(29.4%), 치주관리를 위한 진단(13.7%) 순이었다. 이상의 결과를 통해 치과위생사 의료인화가 가지는 의미에 대한 충분한 검토와 논의가 필요할 것으로 생각되고, 의료인화와 관련하여 치과위생사의 업무가 합리적으로 조정되고 합법화하는 데 본 연구가 활용되기를 기대한다.

2002년도 (사단법인)일본구강외과학회 지정연수기관이 검진한 구강악안면영역의 악성종양에 관한 역학적 연구 (EPIDEMIOLOGICAL STUDY OF MALIGNANT TUMORS IN THE ORAL AND MAXILLOFACIAL REGION - SURVEY OF MEMBER INSTITUTIONS OF THE JAPANESE SOCIETY OF ORAL AND MAXILLOFACIAL SURGEONS, 2002)

  • Yasunori, Ariyoshi;Masashi, Shimahara;Ken, Omura;Etsuhide, Yamamoto;Harumi, Mizuki;Hiroshige, Chiba;Yutaka, Imal;Shigeyuki, Fujita;Masanori, Shinohara;Kanichi, Seto
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제34권2호
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    • pp.141-150
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    • 2008
  • We studied 1809 oral cancer patients who visited and were treated in 2002 at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons, which is composed of 39 dental university hospitals, 44 medical university hospitals, 64 general hospitals, and 1 unknown institution. The patients consisted of 1071 (59.2%) males and 738 (40.8%) females (male:female ratio, 1.45:1), who had a mean age of 65.2 years old. The tongue (40.2%) was the most common site affected, followed by the gingiva (32.7%), buccal mucosa (10.1%), and oral floor (9.0%). There were 6 cases of intraoral multiple cancer. In histopathological examinations, squamous cell carcinoma (88.7%) was the most common type found, followed by adenoid cystic carcinoma (2.1%), and mucoepidermoid carcinoma (1.7%). In addition, non-epithelial tumors comprised 1.8%, among which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1%), followed by T1N0 (21.4%), T4N0 (8.0%), and T2N1 (7.6%). Distant metastasis occurred in 17 patients (1.0%). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm.

건강보험 상대가치 개정 연구의 성과와 한계 (The Refinement Project of Health Insurance Relative Value Scales: Results and Limits)

  • 강길원;이충섭
    • 보건행정학회지
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    • 제17권3호
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    • pp.1-25
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    • 2007
  • Relative value scales introduced in 2001 remarkably improved health insurance fee schedule, but current relative value scales have many problems. In the beginning the government intended to introduce 'resource based relative value scales(RBRVSs)' like USA, but political adjustment of RBRVS studied in 19.17 weakened the relationship between relative value scale and resource consumption. So unbalance of health insurance fees are existing till now. Also relative value was not divided to physician work and practice expense, and malpractice fee was not divided separately. To correct the unbalance of current relative value scales, the refinement project of health insurance relative value scales started in 2003. The project team divided relative value scales into three components, which are physician work, practice expense, malpractice fee. Physician work was studied by professional organizations like Korean medical association. To develop the practice expense relative value, project team organized clinical practice expert panels(CPEPs) composed of physicians, nurses, and medical technicians. CPEPs constructed direct expense data like labor costs, material costs, equipment costs about each medical procedures. The practice expense relative values of medical procedures were developed by the allocation of the institution level direct & indirect costs according to CPEPs direct costs. Institution level direct & indirect costs were collected in 21 hospitals, 98 medical clinics, 53 dental clinics, 78 oriental clinics, and 46 pharmacies. The malpractice fee relative values were developed through the survey of malpractice related costs of hospitals, clinics, pharmacies. Putting together three components of relative values in one scale, the final relative values were made. The final relative values were calculated under budget neutrality by medical departments, that is, total relative value score of a department was same before and after the revision. but malpractice fee relative value scores were added to total scores of relative values. So total score of a department was increased by the malpractice fee relative value score of that department This project failed in making 'resource based' relative value scales in the true sense of the word, because the total relative value scores of medical departments were fixed. However the project team constructed the objective basis of relative value scale like physician's work, direct practice expense, malpractice fee. So step by step making process of the basis, the fixation of total scores by the departments will be resolved and the resource based relative value scale will be introduced in true sense.

Hand & rotary root canal instrument의 근관내 삭제 형태에 관한 전자현미경적 비교 (SEM EVALUATION OF THE PREPARED ROOT CANALS BY HAND AND Ni-Ti ROTARY ROOT CANAL INSTRUMENTS)

  • 오태석;박정원
    • Restorative Dentistry and Endodontics
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    • 제23권1호
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    • pp.477-486
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    • 1998
  • Recently the development of rotary instrument makes it possible that in root canal treatment operator saves much more time, maintans original curved canal shape and easily prepares continuous tapered root canal. The purpose of this experiment was to examine the smoothness of the internal surface of prepared root canal and the effectiveness of debridement in prepared root canal by SEM for the comparison of hand and Ni-Ti rotary instrument. 25 extracted human teeth were access opened and # 10 K-type file was introduced into canal until it was appeared at the apical foramen. The working length was established by subtracting 0.5mm from this measurement. Group 1. The root canal preparation was done to # 30 with working length and then step-back until # 45 with K-Flexofile (Maillefer, Swiss). Group 2. Root canal preparation was done by Naviflex Ni-Ti file (Brasseler, USA) as the same technique with group 1. Group 3. Canal was prepared by Profile .04 (Maillefer, Swiss) taper until #30. Group 4. With use of Quantec (Tycom, USA) root canal was prepared from file number 1 to 8. In group 1 and 2, the root canal irrigant was NaOCl and the other groups, NaOCl and RC-prep (Premine Dental Products, USA) was used. The prepared teeth were notched with high-speed bur as bucco-lingual direction and fractured with chisel and mallet, then examined with SEM. Group 1 showed smooth internal surface. There were scratches mainly to the axial direction. Group 2 showed similar characteristics to those in group 1. Group 3 showed more smoother and linear cutting surface with bised scratches. Group 4 has the almost same characteristics group 3 and there was no difference in the file design. Ni-Ti rotary root canal instrument prepare the dentinal wall more smoother than hand instrument. The effectiveness of debridement was not fully affected by file design. The isthmus area and accessory canals of the root canal system were not prepared in any group. According to the result, hand and rotary type instrumentation techniques were effective in removal of major amount of tissue from root canal but it was not complete. In the direction of cutting movement there was difference between them.

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내원경로 분석을 통한 전문과목으로서의 구강내과의 역할 (The Analysis of Patients in Oral Medicine and the Evaluation of Oral Medicine as a Special Field)

  • 정태용;유지원;강진규;안형준;최종훈
    • Journal of Oral Medicine and Pain
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    • 제30권4호
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    • pp.391-400
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    • 2005
  • 전문의는 일반의(General Practitioner)와는 차별된 전문성을 가지고 증상의 난이도가 높은 환자를 처리하는 능력이 요구되는 진료과목의 필요성을 기반으로 하고 있다. 또한 전문의제도는 국민의료적인 측면에서 임상 각 분야에 있어 단일과목을 전공하는 의사를 양성하여 그들로 하여금 의료 전 과목에 관한 기본적 이론과 실기를 교육받은 일반의사의 능력에서 벗어나는 진료기능을 의료전달체계에서 담당하도록 하여 국민의료의 향상을 기하는 데 있다. 한편, 구강내과는 악안면 통증, 연조직 질환, 법의치과분야, 구강진단분야를 다루는 전문과목으로서 그 전문성이 매우 중요한데, 구강내과학적 측면에서 비추어 볼 때, 현대화 사회로 갈수록 현대인들은 대도시 중심의 생활환경의 변화와 함께 일상적 스트레스가 증가함에 따라 측두하악장애, 구강내 연조직 질환, 삼차신경통과 같은 신경병변 등의 유병율이 증가하고 있으며, 이에 대한 환자들의 의존도가 높아지고 있는 추세이다. 이에 본 연구는 2004년 8월부터 2005년 4월까지 연세대학교 치과대학병원 구강내과 외래에 내원한 초진환자 3,707명을 대상으로 하여, 의뢰율 및 내원경로를 중심으로 분석한 결과 다음과 같은 결론을 얻었다. 1. 구강내과에 의뢰된 전문 진료분야로는 구강안면통증, 구강 연조직 질환, 법의치과분야, 구강진단분야로 나타났다. 2. 구강내과에 의뢰된 환자의 비율은 58.51%로 과반수를 넘는 환자들이 의뢰되었다. 3. 의뢰환자 중 의뢰기관의 영역분석을 시행한 결과, 치과에서 의뢰된 경우가 83.23%로 가장 많았고 의과 및 한의과 영역에서 의뢰된 경우는 16.78%를 보였다. 4. 자의내원한 환자 중 인터넷 및 매스미디어에서 구강내과 전문분야에 대한 사전 검색 및 주변의 권유에 의해 내원한 환자들이 응답자의 30.52%를 차지하였다. 이상의 결과를 종합해 볼 때, 구강내과는 대부분 의뢰된 환자를 진료하고 있으며, 치과영역 뿐 아니라 의과영역에서의 의뢰율이 높은 것으로 보아 치과영역에서는 일반의들이 치료할 수 없는 수준의 진료영역을 담당하고 있는 것으로 볼 수 있으며 의과학 분야에서는 구강내과학적 전문성을 요하는 질환을 구강내과와 협진하에 해결하려는 것으로 사료되어 전문과목으로서 구강내과학의 역할과 비중이 매우 높음을 확인할 수 있었고, 이는 향후 전문치의제도 인력수급 및 이의 기반이 되는 전공의의 정원책정에서 시장적 접근 및 규범적 접근의 기초자료로 활용되어야 할 것이다.

중학교 체질검사 실태에 관한 연구 (A study on physical examination of middle school students)

  • 박성희
    • 한국학교보건학회지
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    • 제14권1호
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    • pp.131-143
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    • 2001
  • The primary aim of this dissertation is to contribute to the improvement of methods in physical examination by providing quality information for the current school system and advice for improving status. Present status, controversial points and possible remedies in physical examination were analyzed on a frequency and percentage basis. An $x^2$-test was used to verify the statistics between the results from the examination and each variable. In case of multiple categories of variables, an $x^2$ cs was adopted. Chronological data as well as both total and sampling physical examination data verified the statistics using an $x^2$-test. This thesis is based both on the data from middle school health care specialists in Gyunggi Province and on the analysis of physical examinations reported from local schools to the municipal education agency from 1997 to 1999. The results of the study are as follows: First, according to the survey, only 29.0% of the total schools had their school doctors examine all the students while most of the educational institutions failed to implement the whole process of physical examination on the list. It also turned out that the more students the schools have, the lower the rate of implementation of physical examination by school doctors(p=0.014). Second, the average time a school doctor spends for checkup turned out to be approximately 1.7 minutes per student This means that the quality of the physical examination is not guaranteed in the process. Third, 47.7% of those surveryed say that a dental examination was performed, each taking 21.24 seconds on average. In addition, it shows that some 31.5% wanted to have a task force team for dental checkups at the local health center. Given the fact that dental caries among students is progressively on the rise, the dental health centers that are now set up in some elementary schools should be expanded to cover the whole educational institution in order to raise awareness of the importance of dental care. Fourth, 48.5% of those surveyed say that a comprehensive physical examination should be adopted to promote the health of high schoolers. Since it takes a lot of public funds to implement a comprehensive method, it is essential to make sure that in-depth studies should be based on the frequency and methods of physical examination. Fifth, regarding such diseases among 3rd year middle school students in 1999, statistics shows that there was a slight difference in the prevalence rate of color blindness, and allergic diseases for male students ; and color blindness, hearing disturbance and allergic disease for female students. For those items, however, it is too little to say that there is a significant difference and accordingly it is assumed to be a problem of the measuring process. Sixth, the result of analysis on the sample physical examination and the total physical examination of the year 1999 shows as follows: For male students in the 3rd year of middle school, a slight difference appeared to those students in 11 items including eye problems and eye disease, otitis media, tonsillar hypertrophy, spinal shape, respiratory urinary allergic disease and other abnormal diseases(p<0.05). Particularly, the prevalence rate between students with and without disease was shown to be two times more in the following: eye problems, otitis media, tonsill hypertrophy, allergic diseases, etc. For female students in the 3rd year, prevalence rate showed little difference in 14 items(p<0.05). For items including eye problem, otitis media, tonsill hypertrophy, allergic disease, etc. it was shown that the rate was two times more between students with and without diseases. Physical examinations under the current school system are not producing any fundamental results for the health of the students. Methods and results are not trustworthy. Accordingly, a drastic overhaul of the current practices is needed in frequency, methods and items on the list in order to promote the health of the students. Cost-benefit studies as well as political considerations to ensure the development of efficient methods for physical examination are urgently needed at this moment.

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간이 영양상태 평가법에 의한 급식서비스 이용 노인의 영양 위험도와 관련 요인 (Nutritional Risk and its Related Factors Evaluated by the Mini Nutritional Assessment for the Elderly who are Meal Service Participants)

  • 한경희;최미숙;박정숙
    • Journal of Nutrition and Health
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    • 제37권8호
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    • pp.675-687
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    • 2004
  • This study is designed to assess the prevalence at risk of malnutrition according to the Mini Nutritional Assessment (MNA) and evaluate the factors influencing on the nutritional risk of the elderly. Three hundred and nine elderly (110 men and 199 women: mean age =74.1) who participated in meal service in the Chung-buk province were investigated. Mean MNA total score was 21.9 and women had significantly lower MNA scores than men (respectively, 21.5 and 22.8). In the mean time mean MNA-SF (Short Form) score was 10.7, respectively 10.6 for the women and 11.0 for the men, with the difference being statistically significant. The MNA classified 33% of the elderly as well-nourished, 61.7% as at risk of malnutrition and 5.3% as overt malnourished. However, MNA-SF categorized the examinees 40.2% as good and 59.8% at nutritional risk. Those who identified as malnourished elderly had significantly lower mean BMI, mid-arm and calf circumference, poorer functional abilities (ADL, IADL) , lower MAR and food habits scores, and higher number of nutrient $\leq$ 75% of RDA than those with at risk of malnutrition and well nourished. Also socioeconomic status such as educational level, self-rated economic status, poverty level, and marital status significantly influenced nutritional status. Similar effect was observed in self-rated nutritional status and health status, dental status, appetite change according to MNA score. Stepwise multiple regression analysis indicated that weight loss was the most predictive item in the total MNA and MNA-SF score. It was found that items such as mobility, living status (home vs institution) , mode of feeding, and pressure sores were inappropriate for assessment of the elderly who are able to participate meal service program. Also, some modifications of items in MNA are needed in order to apply to Korean elderly. Even though the MNA seems to be an useful tool to screen those old people at risk of malnourished, a lot of work is still to be done with this assessment tool to secure its reliability.