• Anatomy and Cell Biology
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• 제57권2호
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• pp.294-304
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• 2024

Type 2 diabetes mellitus is increasingly becoming more prevalent worldwide together with hospital care costs from secondary complications such as bone fractures. Femoral fracture risk is higher in diabetes. Therefore, this study aimed to assess the osteometric and microarchitecture of the femur of Zucker Diabetic Sprague-Dawley (ZDSD) femur. Ten-week-old male rats (n=38) consisting of 16 control Sprague-Dawley (SD) and 22 ZDSD rats were used. The rats were terminated at 20 weeks and others at 28 weeks of age to assess age, diabetes duration effects and its severity. Bilateral femora were taken for osteometry, bone mass measurements and micro-focus X-ray computed tomography scanning to assess the trabecular number (TbN), thickness (TbTh), spaces (TbSp), bone tissue volume to total volume (BV/TV) and volume (BV). Diabetic rats had shorter (except for 20-weeks-old), lighter, narrower, and less robust bones than SD controls that wered more robust. Although cortical area was similar in all diabatic and control rats, medullary canal area was the largest in ZDSD rats. This means that the diabetic rats bones were short, light and hollow. Diabetic rats aged 20 weeks had reduced BV, BV/TV, TbN with more spacing (TbSp). In contrast, the 28 weeks old diabetic rats only showed reduced BV and TbN. Discriminant function analysis revealed, for the first time, that osteometric parameters and TbTh, TbN, and TbSp were affected by diabetes. This knowledge is valuable in the management of diabetic complications.

• Hip & pelvis
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• 제34권1호
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• pp.56-61
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• 2022

Purpose: Histopathologic analysis of femoral head specimens following total hip arthroplasty (THA) is a routine practice that represents a significant use of health care resources. However, it occasionally results in discovery of undiagnosed hematopoietic malignancy and other discrepant diagnoses such as avascular necrosis. The purpose of this study was to determine the rate of discordant and discrepant diagnoses discovered from routine histopathological evaluation of femoral heads following THA and perform a cost analysis of this practice. Materials and Methods: A review of patients undergoing primary THA between 2004-2017 was conducted. A comparison of the surgeon's preoperative and postoperative diagnosis, and the histopathologic diagnosis was performed. In cases where the clinical and histopathology differed, a review determined whether this resulted in a change in clinical management. Medicare reimbursement and previously published cost data corrected for inflation were utilized for cost calculations. Results: A review of 2,134 procedures was performed. The pathologic diagnosis matched the postoperative diagnosis in 96.0% of cases. Eighty-three cases (4.0%) had a discrepant diagnosis where treatment was not substantially altered. There was one case of discordant diagnosis where lymphoma was diagnosed and subsequently treated. The cost per discrepant diagnosis was $141,880 and per discordant diagnosis was $1,669 when using 100% Medicare reimbursement and Current Procedural Terminology (CPT) code combination 88304+88311. Conclusion: Histopathologic analysis of femoral head specimens in THAs showed an association with high costs given the rarity of discordant diagnoses. Routine use of the practice should be at the discretion of individual hospitals with consideration for cost and utility thresholds.

• Neonatal Medicine
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• 제16권1호
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• pp.25-35
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• 2009

목적 : 본 연구는 전국의 7개 대학병원 NICU를 대상으로, NICU 입원 현황, 입원 비용을 살펴 보아, 실제 NICU 환아들에 대한 입원비용의 내용을 분석하고, 이것의 문제점을 찾아 보아, 입원비용의 환자 본인 부담 감소 및 기타 제도적인 제안을 통해 향후 NICU 관리의 향상을 목적으로 본 연구를 실시하였다. 방법 : 전국에 분포한 7개 대학병원의 NICU를 대상으로 2005년 7월부터 2006년 6월까지 일 년 간 입원현황 및 입원비용에 대해 설문지를 통한 조사를 실시하여 분석하였다. 총 78개 병원에서 1년간 NICU 입원 환자 수는 총 3,488명이렀다. 조사 분석 내용은 (1) NICU 입원 현황(체중별 분포, 출생체중과 입원기간의 관계 분포). (2) 입원 비용(보험급여, 비급여 비용과 비율, 출생체중별 이비원비. 입원일수에 따른 총 입원비, 1인당 비급여 비용의 분포, 비급여 항목 등이다. 결과 : NICU 입원아 중에서 미숙아를 포함하는 LBWI 군과 고위험신생아가 반반씩이었다. 입원기간은 1,000g 이하인 경우 평균 2.5-3개월, 1,000-1,499g은 1.5-2.5개월, 1,500-1,999g은 1-1.5개월, 2,000-2,499g은 0.5개월, 2,500g 이상은 7일-10일이었다. 총입원진료비에서 보험급여가 77.1%, 비급여가 22.9% (법적비급여 19.5%, 임의 비급여 3.4%)이었다. 1인당 총 입원비 평균은 총액이 4,360천원 이었고 이중 급여 부분이 3,677천원, 비급여가 1,007천원이었다. 출생체중별 입원비는 체중 500g 미만 35,000천원, 500-999g 18,000천원, 1,000-1,499g 16,000천원, 1,500-1,999g 4,200천원, 2,000-2,499g 1,600천원, 2,500-2,999g 1,500천원, 3,000-3,499g 1,400천원, 3,500-3,999g 1,200천원, 4,000g 이상 1,100천원 이었다. 입원일 수 따른 총 입원비의 중앙값은 1-4일 850천원, 6-9일 1,300천원, 10-14일 1,800천원, 15-19일 3,150천원, 20-24일 4,250천원, 25-29일 5,500천원, 30-34일 7,000천원, 35-39일 8,250천원, 40-44일 9,000천원, 45-50일 11,000천원, 50-54일 12,500천원, 55-59일 13,500천원, 60-64일 14,500천원, 65-69일 16,000천원, 70-74일 18,000천원, 75-79일 23,000천원, 80-84일 24,000천원, 85-89일 25,000천원, 90-94일 27,000천원, 95-99일 28,000천원, 100-199일 30,000천원, 200일 이상 35,000천원이었다. 결론 : NICU는 미숙아 뿐만 아니라, 질병 신생아들을 치료하는 중요기능을 가지고 있었다. 출생체중별 분포 및 입원기간의 분포를 파악할 수 있었다. NICU 입원비는 출생체중이 작을수록, 입원기간이 길수록 많이 발생하고 있는데, 총입원액 중에서 환자가족이 부담하는 비급여 부분이 아직도 약 1/4을 차지하고 있어, 보호자들의 부담이 많다. 이에 대한 정부의 제도적 뒷받침이 필요하다고 생각된다.

• Journal of Periodontal and Implant Science
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• 제26권3호
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• pp.689-699
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• 1996

The purpose of this research is to determine elements affecting the out-of-pocket cost of woman. The sample consisted of 1907 women living Iksan city. The survey was conducted by means of questionnaires. The model used in the analysis of out-of-pocket cost was the Andersen-Newman model, while the analysis techniques used were stepwise multiple regression and path analysis. The number of independent variables used in the analysis was 28 in total, ie 19 predisposing components, 6 enabling components, and 3 need components. In this study, the amount of variance by the model was 17 percent. Number of restricted activity days caused by oral disease, perceived susceptibility of dental disease, having a regular dental care, dental treatment costs, education level and income were found to have significant major effects on out-of-pocket cost. Number of restricted activity days caused by oral disease was the most important variable affecting out-of-pocket cost of woman. Also out-of-pocket cost shows larger effect due to enabling components than frequency of dental utilization.

• 한국병원경영학회지
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• 제11권3호
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• pp.73-93
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• 2006

This study aims at providing necessary informations for management decision-making to the hospital manager, such as ratios of fixed and variable cost to total operating expense, and variable cost ratio to operating revenues, and determinant factors affecting cost behavior. A study model and related hypotheses were established, data were collected from 41 private university hospitals for the 6years from 1998 to 2003, and regression analyses were performed to test the hypotheses. The results of the analyses and conclusions are as follows; First, labor cost and administration cost within the same number of beds have not only fixed quality of the cost, but variable quality of that. Also, the ratio of the variable costs to operating revenue of the metropolitan was estimated 76.9% and that of other area hospitals was 80.1%. Second, the major factors affecting the increase rate of the operating expense were the increase rates of the number of inpatients, the number of employee, and the number of hospital operating bed. This result implies that maintaining a optimal hospital bed size and efficient operation of the beds are important strategic factors of hospital management.

• 한국IT서비스학회지
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• 제17권1호
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• pp.105-119
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• 2018

The healthcare business is growing as a global core business because of the phenomenon of global aging, as well as in South Korea, skyrocketing health care costs accordingly, and changing the paradigm from treatment to the prevention-centered medical service. Especially, as the digital healthcare service stands out as a solution, major countries actively promote and support policies at the government level. Thus, this study will present attributes of a market-oriented service that would vitalize the digital healthcare service industry by investigating major attributes of the digital healthcare service. To analyze the relationships of the influences of attributes, this study used Interpretive Structural Modeling. As a result of literature research and ISM, this study can understand the eight basic attributes of the digital healthcare service (network scalability, context awareness, connection among information platforms, cost, trust, security, ease of use, usefulness) and analyze the relationships of the influences among the attributes. In addition, as this study finds some significant differences in Order Winner and Order Qualifier between the experts' group (security) and the users' group (trust, ease of use, usefulness), It provides meaningful implications for revitalization and promotion of digital healthcare service industry.

• International Journal of Contents
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• 제6권4호
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• pp.8-13
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• 2010

Due to the expense of health care and the need to contain costs, many stroke patients are discharged from hospitals while still in an impaired condition. Using Tele-rehabilitation, these patients can receive rehabilitation services remotely. A pegboard is a conventional rehabilitation therapeutic device that integrates cognition, sensation and hand motor function. This study proposes a Tele-rehabilitation content with automated pegboard and shows its functional feasibility. The evaluation of the pegboard session was automated with RFID (radio frequency identification), and a 16-hole pegboard was rapid-prototyped. After a pegboard session is completed, the session result is uploaded to a server automatically for viewing on a web browser by a remote therapist. The therapist can also send messages to remote patients to encourage them or to manage the rehabilitation process.

• Journal of Nutrition and Health
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• 제20권6호
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• pp.442-455
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• 1987

The purpose of the study were to assist foodservice managers in complex decision making by utilizing computerized cost accounting system and to relieve managers from repetitive and routine tasks so that more adequate patient care and consultation can be provided. The scope of the computer-assisted cost accounting system consists of budget, menu planning, purchasing, inventory, cost control and financial reporting. The content of the computerized system are summarized as follows ; 1) For budgeting monthly income was estimated by calculating unit cost of each meal and forecasting serving numbers. The actual serving numbers for patients and employees were totaled everyday, and utilized as the basic data base for estimating income and planning menu. The monthly lists of meal sensus were generated. 2) for menu planning concersion factors were computed based on the standarized recipe for 50 servings. Daily menus for patients and employees which include total amounts of each ingredient and cost analyzed information were generated. 3) Daily and monthly purchasing report for each food item classified by patient and employee meals were generated. 4) Inventory transactions such as recipts and issues were totalized daily for each stocked item, and monthly inventory reports were generated. 5) Cost analysis reports for each menu item were generated into two ways based on the budget coat as well as the purchasing cost. 6) Editing new recipes and updating food costs change to the data base were carried out. 7) Financial reports were generated monthly, first-half and second-half of the year, and yearly basis.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제14권6호
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• pp.2377-2397
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• 2020

Human activity recognition is widely used in smart homes, health care and indoor monitor. Traditional approaches all need hardware installation or wearable sensors, which incurs additional costs and imposes many restrictions on usage. Therefore, this paper presents a novel device-free activities recognition system based on the advanced wireless technologies. The fine-grained information channel state information (CSI) in the wireless channel is employed as the indicator of human activities. To improve accuracy, both amplitude and phase information of CSI are extracted and shaped into feature vectors for activities recognition. In addition, we discuss the classification accuracy of different features and select the most stable features for feature matrix. Our experimental evaluation in two laboratories of different size demonstrates that the proposed scheme can achieve an average accuracy over 95% and 90% in different scenarios.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2016년도 춘계학술대회
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• pp.560-563
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• 2016

의료와 헬스케어 분야의 변화는 디지털 기술로부터 시작된다. 디지털 헬스케어라는 새로운 분야는 기존 헬스케어 및 의료 기술이 디지털 기술과 융합되어 시작된 것으로 ICBM(사물인터넷 클라우드 빅데이터 모바일), 인공지능, 로봇, 가상 증강현실, 웨어러블기기 등 ICT 기술을 활용해 건강관리 질병관리 등 헬스케어서비스 효과를 높이고 의료비용을 절감시키는 융합산업이다. 최근에는 구글 알파고와 IBM 왓슨 등 인공지능기술을 헬스케어 영역에 접목되고 있다. 따라서 본 연구에서는 디지털 헬스케어의 주요 기술, 생태계와 플랫폼, 그리고 미래의료서비스 변화 및 이슈를 분석한다.