• 근관절건강학회지
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• 제24권2호
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• pp.67-76
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• 2017

Purpose: The purpose of this study was to evaluate preoperative nutritional status in elderly patients with orthopedic surgery and identify related factors for malnutrition risk. Methods: This study enrolled 337 patient's medical record who underwent orthopedic surgery in hospital between January and December 2015. Data was collected retrospectively. Nutritional status was evaluated by using the Nutritional Risk Screening 2002. Multivariable logistic regression analysis was used to identify independent related factors for malnutrition risk. Results: Malnutrition risk developed in 58 patients (17.2%). Logistic regression analysis identified low physical activity, visual impairment, depression, sleep disorder, low serum calcium level, and low serum albumin level as related factors. Conclusion: Orthopedic surgery in elderly patients was associated with high risk of preoperative malnutrition. The results of this study suggest that evaluating the nutritional status and related factors should be done with preoperative status of elderly patients. At the same time, interventions for nutritional care should be adjusted to meet the nutritional needs of individuals and decrease the risk of malnutrition.

• 한국콘텐츠학회논문지
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• 제11권5호
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• pp.270-279
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• 2011

본 연구는 건강보험심사청구자료에 대한 공변량분석과 다중회귀분석을 통해 노인 암환자의 건강보험과 의료급여 이용차이를 분석하고, 의료보장유형이 노인 암환자의 의료이용량에 미치는 영향을 분석함으로써 의료급여 환자의 도덕적 해이가 존재하는지 파악하는 데 목적이 있다. 연구결과, 첫째, 노인 의료급여 암환자가 건강보험 환자에 비해서 장기간 입원으로 총진료비를 많이 사용하고 있었다. 그러나 진료건당 외래진료비와 진료일당 입원진료비는 건강보험 암환자가 많아서 비용이 많이 소요되는 의료서비스를 더 많이 이용하고 있었다. 둘째, 노인 의료급여 암환자일수록 의료기관을 자주 외래방문하고 장기간 입원하여서 총진료비를 많이 사용하고 있었다. 그러나 진료건당 외래진료비와 진료일당 입원진료비는 건강보험 암환자일수록 증가하였다. 노인 의료급여 암환자들의 의료이용량 증가원인이 높은 비급여본인부담을 피해서 본인 부담이 없는 보험급여 의료서비스를 많이 이용 것에 있음을 알 수 있다.

• 성인간호학회지
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• 제22권6호
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• pp.561-569
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• 2010

Purpose: The purpose of this study was to identify the factors related to depression of elderly patients in geriatric hospitals. Methods: The subjects were 195 elderly patients who met the inclusion criteria of scores more than 18 on the K-MMSE score and no reported mental disease. The data were collected from February 20 to March 20, 2009. The research instruments utilized in this study were depression (GDSSF-K), activities of daily living and self esteem (RSES), social support, life satisfaction. Data were analyzed Pearson correlation and Multiple Stepwise Regression using SPSS 15.0. Results: Depression score were negatively correlation with ADL, social support, life satisfaction and self-esteem. Among the factors studied related to depression, life satisfaction had highest explanatory power of 36.5% and it was followed by physical health status and activity of daily living. These explained 43.7% of the depression. Conclusion: The mean GDSSF-K 8.94, which indicates the higher than middle levels of depression. The findings suggest that it is important to develop educational programs to increase life satisfaction, physical health status and activity of daily living. Nursing interventions, including volunteer activities, health promotion program, and sports program could be useful in enhancing these factors.

• 한국엔터테인먼트산업학회논문지
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• 제14권6호
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• pp.201-208
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• 2020

본 연구는 건강보험심사평가원의 청구 자료를 바탕으로 만65세 이상의 주진단이 무릎 관절증으로 슬관절 전치환술을 시행한 환자를 대상으로 의료기관 종별에 따라 재원일수에 영향을 주는 요인을 분석하였다. 연구결과 의료기관 종별에 따라 성별, 연령, 의료보장형태, 중증도, 거주지역 및 병상규모가 재원일수에 영향을 미치는 요인으로 분석되었다. 인구의 고령화로 인한 노인 인구의 증가와 이로 인한 노인 진료비 증가는 가계 및 국가 경제의 많은 부담으로 작용하는 시점에서 본 연구결과를 토대로 재원일수 단축효과와 함께 효율적인 병상운영을 도모해야 할 것이다. 뿐만 아니라 환자의 진료비 부담을 경감시키는 위한 체계적인 관리시스템을 도입하여 노인환자의 양질의 라이프케어를 위한 기초자료로 활용하는 데 본 연구의 의의가 있다.

• 한국정보통신학회:학술대회논문집
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• 한국해양정보통신학회 2006년도 춘계종합학술대회
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• pp.421-425
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• 2006

헬스케어와 무선 기술의 접목은 새로운 생체신호 모니터링 방법과 환자의 이동성 및 편의성을 제공하며 더 나은 방법으로 환자를 돌볼 수 있으며 이러한 장점으로 인해 최근 무선기술을 이용한 ECG 모니터링 및 계측 시스템이 개발되고 있다. 본 논문에서는 중요한 생체신호 중 가장 중요한 신호의 하나인 ECG 신호를 무선센서네트워크를 이용하여 무선으로 받은 후, 이를 서버컴퓨터에서 의사, 간호사 또는 환자의 보호자에게 진단의 기초자료로 제공할 수 있게 빈맥, 서맥, 동정지와 같은 비정상적인 ECG신호를 판단하는 ECG 모니터링 시스템을 구현하였다. 신체에서 계측된 ECG신호는 무선으로 서버와 RS-232로 연결된 베이스스테이션으로 전송되고 서버는 비정상적인 ECG 신호를 검사하여 저장 및 모니터링을 위해 PC/PDA로 데이터를 전송하며, 이러한 시스템을 활용하여 의료비 절감 및 더 편리한 의료서비스를 받을 수 있을 것으로 예상된다.

• 한국건강관리협회지
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• 제1권1호
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• pp.19-20
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• 2003

In Korea association of health promotion(KHAP) there are fourteen laboratories in branch offices and one laboratory in headquarter office. To standardize the reference ranges of all laboratories of KAHP, they have been newly calculated from the laboratory data perfomed during the previous yearsby statistical metod annually for the period of 2000 through2003 so far. The referance ranges of total 56 test items were assigned. Among these there were eight test items that needed referance ranges by age groups and nine test items that needed reference rages by gender. The age grouping was into six groups : baby (0-3y), children(4-12y), adolescent(13-18y), adult(19-64y), younger elderly(19-64y), older elderly(over 80y) with references of statics in Medical Informatics and WHO classification. All the data collected were statistically analyzed with SAS 6.04 for Gaussian distribution that had been repeated two or three times after trimming out the the tests showed Gaussian distribution. Subsequently, Thereference ranges were defined in the rage from the point of lower 2.5% to the point of higher 97.5%. And in case the lower range could be "0", the reference ranges were defined in the range of 0 to 95%. Fifteen laboratoried troughout Korea of KAHP currently have standarzed reference rages of the tests that they perform. This means the patient data and reference values an be exchangeable among laboratories of KHAP.Annual revise of such reference rages can eventually lead to the level of those representing a standard of the national reference ranges.

• 간호행정학회지
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• 제21권2호
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• pp.174-183
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• 2015

Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

• Asian Pacific Journal of Cancer Prevention
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• 제17권10호
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• pp.4591-4597
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• 2016

Purpose: Decisions as to whether to provide adjuvant treatment in older breast cancer patients remains challenging. Side effects of chemotherapy have to be weighed against life expectancy, comorbidities, functional status, and frailty. To aid decision-making, we retrospectively analyzed 110 women with breast cancer treated with a curative intention from 2006 to 2012. Survival data with clinical and pathological parameters were evaluated to address the role of adjuvant chemotherapy in this study population. Method: A total of 110 elderly (>70 years) patients that received mastectomy at two hospitals in Taiwan were observed retrospectively for a medium of 51 months. After mastectomy, patients received conservative treatment or adjuvant chemotherapy, or hormone therapy following clinical guidelines or physician's preference. Data were collected from the cancer registry system. Results: Median age at diagnosis was 75.7 years. Thirty-five percent of patients received adjuvant chemotherapy, these having a significantly younger age ($mean=74.0{\pm}5.3$ vs $77.5{\pm}5.3$, p<0.001) and higher tumor staging (p=0.003) compared with their non-chemotherapy counterparts.Five-year overall survival was non-significantly higher in patients who received adjuvant chemotherapy (with chemotherapy 64.2% vs without chemotherapy 62.6%, p=0.635), while five-year recurrence free survival was non-significantly lower (with chemotherapy 64.1% vs without chemotherapy 90.5%, p=0.80). Conclusions: In this analysis, adjuvant chemotherapy tended to be given to patients with a younger age and higher tumor staging at our institute. It was not associated with any statistically significant improvement in survival and recurrence rate. Until age specific recommendations are available, physicians must use their clinical judgment and assess the tumor biology with the patient's comorbidities to make the best choice. Clinical trials focusing on this critical issue are warranted.

• 한국학교ㆍ지역보건교육학회지
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• 제15권3호
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• pp.67-80
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• 2014

Objectives: This study is aimed to analyze the influential factors on the fear that college students and elderly people feel during the dental treatment and provide basic data needed to develop a plan which can lead them to have a positive perspective on dentistry. Methods: A questionnaire was distributed to 241 outpatients (39 college students, 202 elderly people) visiting dental clinic of 'K' University Hospital in Seoul from January to April, 2013. It was filled in a self-administered manner and collected right away. Results: factor analysis, three factors were configured when the factors with 1.0 or higher of eigenvalue were extracted using 19 questions through which dental fear and anxiety were measured against college students and elderly people. The questionnaires were classified into three categories: Factor I (stimulus response), Factor II (avoidance of the treatment) and Factor III (physiological response which occurs when a patient feels fear). As a result, it was confirmed that the questionnaire tool is highly feasible. In college students, the responses they felt during the dental treatment in the said three factors were as follows: 52.00% in Factor II, 14.14% in Factor II and 6.99% in Factor III (73.129% in total). In elderly people, on the contrary, they were 52.41% in Factor I, 10.57% in Factor II and 7.98% in Factor III (70.958% in total), lower than the college student group. Conclusions: This study is significant in that it confirmed complex relations between dental fear and related variables against college students and elderly people.

• 스마트미디어저널
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• 제1권4호
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• pp.52-58
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• 2012

최근 고령화에 따른 사회적인 문제를 해결하기 위한 대안으로 IT와 BT기술을 접목한 U헬스 의료서비스가 주목을 받고 있다. 활성산소는 체내의 불안정한 상태의 유해산소로서 노화의 주원인이 되고, 다른 질병을 유발할 위험성이 크며, 현대인의 질병 중 약 905가 활성산소와 관련이 있다. 따라서 고 연령층과 지병환자들 뿐만 아니라 일반일들도 활성산소 포화도를 체계적으로 관리해야 할 필요성이 있다. 본 논문에서 신체로부터 측정한 활성산소 측정데이터를 의료기관의 데이터 저장소로 전송하여 서비스 제공자로부터 진단을 받을 수 있는 효과적인 U헬스 시스템에 대하여 소개한다. 제안하는 시스템은 사용자의 신체검사정보확인, 의료기기와 모바일 간의 표준에 따른 블루투스 데이터 통신, 의료정보 기능을 지원하고, 또한 모바일의 3G/4G, Wi-Fi를 이용하여 게이트웨이 역할을 수행하도록 설계하였다. 제안시스템의 U헬스 기기와 모바일 간의 표준에 의한 데이터통신을 통해 의료기관으로부터 언제, 어디서든 진단을 받을 수 있는 효과적인 U헬스 서비스 환경을 구축할 수 있다.