• 간호행정학회지
• /
• 제23권2호
• /
• pp.111-117
• /
• 2017

Getting evidence in to practice tends to focus on strategies, theories and studies that aim to close the gap between research knowledge and clinical practice. The evidence to practice gap is more about systems than individual clinician decision making. The absence of evidence for administration and management in the organization of healthcare is persistent. Teaching nurses and providing evidence as the solution to evidence-based healthcare is no longer axiomatic. Previous studies have concluded that unit level strategies integrate multi-professional teams with organizational needs and priorities. This 'best fit' approach that characterizes how healthcare is structured and delivered. The published literature shows that increased readiness for change is aligned with integrated approaches informed by conceptual models. The Joanna Briggs Collaboration is the largest global collaboration to integrate evidence within a theory informed model that brings together academic centres, hospitals and health systems for evidence synthesis, transfer and implementation. The best approaches to implementation are tailored to local culture and context, benchmark against international evidence, combine a theory informed model and stakeholder perspectives to improve the structure and processes of health care policy and practice.

• 보건행정학회지
• /
• 제28권3호
• /
• pp.263-271
• /
• 2018

Health technology assessment (HTA) is defined as multidisciplinary policy analysis to look into the medical, economic, social, and ethical implications of the development, distribution, and use of health technology. Following the recent changes in the social environment, there are increasing needs to improve Korea's healthcare environment by, inter alia, assessing health technologies in an organized, timely manner in accordance with the government's strategies to ensure that citizens' medical expenses are kept at a stable level. Dedicated to HTA and research, the National Evidence-based Healthcare Collaborating Agency (NECA) analyzes and provides grounds on the clinical safety, efficacy, and economic feasibility of health technologies. HTA offers the most suitable grounds for decision making not only by healthcare professionals but also by policy makers and citizens as seen in a case in 2009 where research revealed that glucosamine lacked preventive and treatment effects for osteoarthritis and glucosamine was subsequently excluded from the National Health Insurance's benefit list to stop the insurance scheme from suffering financial losses and citizens from paying unnecessary medical expenses. For the development of HTA in Korea, the NECA will continue exerting itself to accomplish its mission of providing policy support by health technology reassessment, promoting the establishment and use of big data and HTA platforms for public interest, and developing a new value-based HTA system.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제30권2호
• /
• pp.7-14
• /
• 2024

Purpose: This study aims to examine the trends in healthcare architecture research by analyzing papers published in KIHA (Journal of the Korea Institute of Healthcare Architecture) and HERD (Health Environments Research and Design Journal) in the USA. The analysis categorizes these papers into Evidence-Based Design (EBD) and non-EBD research from a comparative perspective. Methods: A systematic literature review was conducted on 370 papers published in KIHA and 399 papers published in HERD from 2007 to 2022. The research trends were analyzed based on the researchers' fields of study, research focus, and research attributes. Results: The findings indicate that HERD involves researchers from 43 different fields, whereas KIHA involves researchers from 16 fields, indicating less diversity. HERD predominantly includes interdisciplinary and empirical studies, while KIHA primarily features theoretical and single-discipline studies. Papers in HERD generally demonstrate a higher level of evidence compared to those in KIHA. Implications: Direct comparisons should be approached with caution due to the differing contexts of healthcare architecture research in the two countries. The methodological efforts in HERD and the functional analysis results in KIHA provide valuable references for the future direction of healthcare architecture research. Expanding collaborative and interdisciplinary research involving various professionals is essential to advance the field.

• Asian Pacific Journal of Cancer Prevention
• /
• 제14권12호
• /
• pp.7401-7407
• /
• 2013

Aim: To compare survival outcomes after whole brain radiation therapy (WBRT), stereotactic radiosurgery (SRS), and WBRT plus SRS combination therapy in Korea, by performing a quantitative systematic review. Materials and Methods: We searched 10 electronic databases for reports on Korean patients treated with WBRT or SRS for brain metastases published prior to July 2010. Independent reviewers screened all articles and extracted the data. When a Kaplan-Meier survival curve was available, median survival time and standard errors were calculated. Summary estimates for the outcomes in each study were calculated using the inverse variance random-effects method. Results: Among a total of 2,761 studies, 20 studies with Korean patients (n=1,053) were identified. A combination of 12 studies (n=566) with WBRT outcomes showed a median survival time of 6.0 months (95%CI: 5.9-6.2), an overall survival rate of 5.6% (95%CI: 1-24), and a 6-month survival rate of 46.5% (95%CI: 37.2-56.1). For nine studies (n=412) on SRS, the median survival was 7.9 months (95%CI: 5.1-10.8), and the 6-month survival rate was 63.1% (95%CI: 49.8-74.8). In six studies (n=75) using WBRT plus SRS, the median survival was 10.7 months (95%CI: 4.7-16.6), and the overall and 6-month survival rates were 16.8% (95%CI: 6.2-38.2) and 85.7% (95%CI: 28.3-96.9), respectively. Conclusions: WBRT plus SRS showed better 1-year survival outcome than of WBRT alone for Korean patients with metastatic brain tumors. However, the results of this analysis have to be interpreted cautiously, because the risk factors of patients were not adjusted in the included studies.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제28권4호
• /
• pp.21-30
• /
• 2022

Purpose: To prove the credibility of EBD, it is necessary to define concepts regarding the nature of credible knowledge and the hierarchy of evidence. In addition, the relationship between EBD and EBP needs to be addressed through a practical viewpoint. Methods: The systematic review is applied to define the nature of knowledge and the characteristics of research papers in architectural EBD while analyzing the field of study, knowledge focus and types of keywords of the first author. Results: As a whole, the types of research focus evaluated using the most frequent keywords include function(40.86%), specialized knowledge(30.52%), professional practice(21.37%), and health(5.78%). Empirical research(83.72%) is more likely to be found than theoretical research(13.95%). The EBD research papers ranked as top-tier are only 7(2.03%) among a total of 344, while the research papers ranked in the third to fourth tiers are 276(80.23%). Implications: There is a deficiency of reliable 1-2 tier research papers. From a practical viewpoint, it would be realistic to recommend that healthcare architects appropriately evaluate the quality of EBD research and apply it in practice, rather than to conduct EBD research themselves. This systematic review illustrates the nature of EBD research.

• Journal of Preventive Medicine and Public Health
• /
• 제46권4호
• /
• pp.201-209
• /
• 2013

Objectives: The goal of this study was to perform an economic analysis of a primary stenting with drug-eluting stents (DES) compared with bare-metal stents (BMS) in patients with acute myocardial infarction (AMI) admitted through an emergency room (ER) visit in Korea using population-based data. Methods: We employed a cost-minimization method using a decision analytic model with a two-year time period. Model probabilities and costs were obtained from a published systematic review and population-based data from which a retrospective database analysis of the national reimbursement database of Health Insurance Review and Assessment covering 2006 through 2010 was performed. Uncertainty was evaluated using one-way sensitivity analyses and probabilistic sensitivity analyses. Results: Among 513 979 cases with AMI during 2007 and 2008, 24 742 cases underwent stenting procedures and 20 320 patients admitted through an ER visit with primary stenting were identified in the base model. The transition probabilities of DES-to-DES, DES-to-BMS, DES-to-coronary artery bypass graft, and DES-to-balloon were 59.7%, 0.6%, 4.3%, and 35.3%, respectively, among these patients. The average two-year costs of DES and BMS in 2011 Korean won were 11 065 528 won/person and 9 647 647 won/person, respectively. DES resulted in higher costs than BMS by 1 417 882 won/person. The model was highly sensitive to the probability and costs of having no revascularization. Conclusions: Primary stenting with BMS for AMI with an ER visit was shown to be a cost-saving procedure compared with DES in Korea. Caution is needed when applying this finding to patients with a higher level of severity in health status.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권12호
• /
• pp.5107-5110
• /
• 2014

Background: The incidence rate of thyroid cancer has been increasing worldwide in recent years, and it is also the most prevalent cancer when it comes to the number of patients among Korean women. With it, ultrasonographic screening test has also become very common. However, there is still controversy over the performance of this screening test. Therefore, the National Evidence-based Healthcare Collaborating Agency (NECA) organized a Round-table Conference on the issues regarding ultrasonographic screening for thyroid cancer in Korea. The objective of the conference was mainly about delivering worthwhile information reflecting social value for the current situation, which was based on evidence surrounding thyroid cancer screening that relevant experts investigated and agreed on. The significance of this Round-table Conference lies in the fact that we reviewed the current evidence, and we were able to discuss the social value and future direction for ultrasonographic screening in Korea.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제29권1호
• /
• pp.21-28
• /
• 2023

Purpose: Evidence-based design is the process of making design decisions based on reliable research to achieve the best results, so it is important to accumulate reliable evidence through research. Therefore, the purpose of this study is to present new evidence by applying the evidence-based design process to improve the digital signage for each room spaces in hospitals and verifying its effectiveness. Method: Through the 8-step process of evidence-based design, improved digital signage for each room spaces are installed. It conducted surveys and statistical analysis to prove hypotheses by linking design and research. Results: The hypotheses established in the study are: 1) improvement in the readability of digital signage is correlated with patient satisfaction; 2) Improving the intuitiveness of digital signage correlates with patient satisfaction; 3) Improving the sufficiency of digital signage correlates with patient satisfaction. As a result of satisfaction analysis and correlation analysis, all of the above hypotheses were proven. Implications: Although the hospital sign system is the element that patients rely on most intuitively in the long journey of reception, waiting, examination, and treatment, there is insufficient evidence to refer to or apply it when designing. It is necessary to expand future research to expand the evidence that can be applied to hospital sign design.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제20권2호
• /
• pp.7-16
• /
• 2014

Purpose: The purpose of this study is to provide understandings about EBD research trends in Korean healthcare architecture research. Method: The systematic literature review was conducted, while comparing the characteristics of research papers in Journal of Korea Institute of Healthcare Architecture with EBD related research papers among them. Results: It is found that the difference of research method utilized between healthcare research in general and EBD research. Specifically, a research method most utilized in general is a field study. In EBD research, however, literature review is most frequently used. Implications: This study can be used as a reference point for further development of EBD research in Korean healthcare architecture. In addition, research results can be used as a communication tool with healthcare specialists such as doctors and consultants in a healthcare project team. Thus, this study is anticipated to play a preliminary role for the development of healthcare architecture design in Korea.

• Asian Pacific Journal of Cancer Prevention
• /
• 제15권12호
• /
• pp.4787-4793
• /
• 2014

Background: Many cancer patients experience poor pain control due to various factors, including misconceptions regarding the use of opioid analgesics. For management of cancer pain, interventions involving education of both patients and physicians have been attempted. Objectives: This review aimed to assess the current evidence of the benefits of education for the management of cancer pain. Methods: We searched the Medline, EMBASE, Cochrane library, and major Korean databases to identify relevant studies. We included most study designs, but excluded case series. The primary outcomes were pain intensity and quality of life (QoL). Two reviewers assessed the risk of bias using the Cochrane's tool for RCT and Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for non-randomized studies, independently. Results: After extensive searches, 3,324 publications were screened, and 32 studies were selected. The education interventions used in the included studies included a wide variety of education methods, but the most common method was a booklet produced for patients. Regardless of the education method used, the results of the meta-analysis were as follows. The SMDs of the most severe, average, and current pain in the RCTs were significant. The SMD of worst, average, and current pain were -0.34 (-0.55, -0.13), -0.40 (-0.64, -0.15), and -0.79 (-1.35, -0.23). In the non-randomized studies, the effects on average pain were significant, but those on worst and current pain were not. Conclusions: Education intervention reduced the pain of cancer patients. Therefore, patient education could be considered to be an effective method of cancer pain management. However, our data should be interpreted with caution, and studies using standardized protocols are needed to confirm these observations.