• Title/Summary/Keyword: health quality assessment service

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Presence of Thrombectomy-capable Stroke Centers Within Hospital Service Areas Explains Regional Variation in the Case Fatality Rate of Acute Ischemic Stroke in Korea

  • Park, Eun Hye;Gil, Yong Jin;Kim, Chanki;Kim, Beom Joon;Hwang, Seung-sik
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.6
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    • pp.385-394
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    • 2021
  • Objectives: This study aimed to explore the status of regional variations in acute ischemic stroke (AIS) treatment and investigate the association between the presence of a thrombectomy-capable stroke center (TSC) and the case fatality rate (CFR) of AIS within hospital service areas (HSAs). Methods: This observational cross-sectional study analyzed acute stroke quality assessment program data from 262 hospitals between 2013 and 2016. TSCs were defined according to the criteria of the Joint Commission. In total, 64 HSAs were identified based on the addresses of hospitals. We analyzed the effects of structure factors, process factors, and the presence of a TSC on the CFR of AIS using multivariate logistic regression. Results: Among 262 hospitals, 31 hospitals met the definition of a TSC. Of the 64 HSAs, only 20 had a TSC. At hospitals, the presence of a stroke unit, the presence of stroke specialists, and the rate of endovascular thrombectomy (EVT) treatment were associated with reductions in the CFR. In HSAs, the rate of EVT treatment (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99) and the presence of a TSC (OR, 0.93; 95% CI, 0.88 to 0.99) significantly reduced the CFR of AIS. Conclusions: The presence of a TSC within an HSA, corresponding to structure and process factors related to the quality of care, contributed significantly to lowering the CFR of AIS. The CFR also declined as the rate of treatment increased. This study highlights the importance of TSCs in the development of an acute stroke care system in Korea.

Quality Assessment of Soybean Curd Supplemented with Saltwort(Salicornia herbacea L.) (함초를 첨가한 두부의 품질특성)

  • Kim, Myung-Hee;Shin, Mi-Kyung;Hong, Geum-Ju;Kim, Kang-Sung;Lee, Kyung-Ae
    • Korean journal of food and cookery science
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    • v.26 no.4
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    • pp.406-412
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    • 2010
  • This study was conducted to investigate the effects of saltwort on the quality characteristics of tofu. In addition, we examined the potential for commercialization of tofu containing saltwort. For this study, saltwort was added to tofu at 0%, 4%, 8%, 12%, 16% and 20% and quality and sensory tests were administered. Analyzing the mineral contents of saltwort juice, K was present in the greatest amount, followed by Mg, P, Ca, and F (in decreasing order). There were significant differences in yield rates and turbidity between the groups. Acidity was highest in the control group, and acidity and volume of tofu tended to decrease with an increase in saltwort powder. L value and a value decreased as the content of slaltwort powder increased, but b value increased with increasing saltwort powder concentration. Hardness, chewiness, and gumminess were rated higher in the control and the 4% supplement groups than the others groups. In the sensory evaluation, cross section and soybean flavor were the highest in the 4% saltwort supplement group, and the presence of an "off-flavor" increased with the content of saltwort powder. The saltiness score was highest in the 20% supplement group. The 4% and 8% supplement groups were favored in the "feel after swallowing" assessment. Softness was the lowest in the 20% supplement group, and the 4% supplement group had the highest overall acceptability. As demonstrated by these results, the addition of saltwort positively affected the overall sensory evaluation of tofu and supplementation with saltwort at 4% and 8% might be considered the most appropriate choices. In conclusion, saltwort tofu expected to increase the functionality of new products, particularly with respect to product variety and health improvement.

Using Machine Learning Techniques to Predict Health-Related Quality of Life Factors in Patients with Hypertension (머신러닝 기법을 활용한 고혈압 환자의 건강 관련 삶의 질 요인 예측)

  • Jae-Hyeok Jeong;Sung-Hyoun Cho
    • Journal of The Korean Society of Integrative Medicine
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    • v.12 no.3
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    • pp.11-24
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    • 2024
  • Purpose : This study aims to identify the factors influencing health-related quality of life through machine learning of the general characteristics of patients with hypertension and to provide a basis for related research on patients, such as intervention strategies and management guidelines in the field of physical therapy for health promotion. Methods : Annual data from the second Korean Health Panel (Version 2.0) from 2019 to 2020, conducted jointly by the Korea Health and Social Research Institute and the National Health Insurance Service, were analyzed (Korea Health Panel, 2024). The data used in this study was collected from January to July 2020, and the data was collected using computer-assisted face-to-face interviews. Of the 13,530 household members surveyed, 1,368 were selected as the final study participants after removing missing values from 3,448 individuals diagnosed with hypertension by a doctor. Results : The results showed that walking (P2) was the most significant factor affecting health-related quality of life in random forest, followed by perceived stress (HS1), body mass index (BMIc), total household income (TOTc), subjective health status (SRHc), marital status (Marr), and education level (Edu). Conclusion :To prevent and manage chronic diseases such as hypertension, as well as to provide customized interventions for patients in advanced stages of the disease, research should be conducted in the field of physical therapy to identify influencing factors using machine learning. Based on the findings of this study, we believe that there is a need for additional content that can be utilized in the field of physical therapy to improve the health-related quality of life of patients with hypertension, such as diagnostic assessment and intervention management guidelines for hypertension, and education on perceived stress and subjective health status.

The Medial Sural Artery Perforator Flap versus Other Free Flaps in Head and Neck Reconstruction: A Systematic Review

  • Yasser Al Omran;Ellie Evans;Chloe Jordan;Tiffanie-Marie Borg;Samar AlOmran;Sarvnaz Sepehripour;Mohammed Ali Akhavani
    • Archives of Plastic Surgery
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    • v.50 no.3
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    • pp.264-273
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    • 2023
  • The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap, and yet is less commonly utilized than other free flaps in microvascular reconstructions of the head and neck. The aim is to conduct a high-quality Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)- and Assessment of Multiple Systematic Reviews 2 (AMSTAR 2)-compliant systematic review comparing the use of the MSAP flap to other microvascular free flaps in the head and neck. Medline, Embase, and Web of Science databases were searched to identify all original comparative studies comparing patients undergoing head and neck reconstruction with an MSAP flap to the radial forearm free flap (RFFF) or anterolateral thigh (ALT) flap from inception to February 2021. Outcome studied were the recipient-site and donor-site morbidities as well as speech and swallow function. A total of 473 articles were identified from title and abstract review. Four studies met the inclusion criteria. Compared with the RFFF and the ALT flaps, the MSAP flap had more recipient-site complications (6.0 vs 10.4%) but less donor-site complications (20.2 vs 7.8%). The MSAP flap demonstrated better overall donor-site appearance and function than the RFFF and ALT flaps (p = 0.0006) but no statistical difference in speech and swallowing function following reconstruction (p = 0.28). Although higher quality studies reviewing the use of the MSAP flap to other free flaps are needed, the MSAP flap provides a viable and effective reconstructive option and should be strongly considered for reconstruction of head and neck defects.

Analysis of Major Factors Related to Smartphone Addiction According to Gender Differences in Health College Students (보건계열 대학생들의 성별 차이에 따른 스마트폰 중독 관련 주요 요인 분석)

  • Choo, Yeon-Ki;Bae, Won-Sik;Kim, Hae-In
    • Journal of The Korean Society of Integrative Medicine
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    • v.10 no.2
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    • pp.135-143
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    • 2022
  • Purpose : This study was to compare and analyze major factors related to smartphone addiction according to the gender of health-related college students. Methods : 720 people who voluntarily participated and agreed to fill out the questionnaire were randomly sampled. Smartphone addiction was measured using the Smartphone Addiction Scale Short Version (SAS-SV), sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), anxiety symptoms were measured using the self-assessment anxiety scale (SAS), and depression symptoms were measured using the self-assessment depression scale (SDS). In addition, the age of each individual and the main function of smartphone use were also investigated. Results : The prevalence of smartphone addiction was higher among female students than male students (p<.05), while male students mainly played games and female students mainly used multimedia (video/music) viewing and social networking services (p<.05). In addition, male students showed a high association with smartphone addiction in the group where games were the main function of smartphone use, the group with low sleep quality, and the group with anxiety symptoms (p<.05), but for female students, multimedia (video/music) Or, the group in which social networking service is the main function of smartphone use, the group with low sleep quality, and the group with symptoms of anxiety and depression showed a high correlation with smartphone addiction (p<.05). Conclusion : It is expected that the results of this study will be used as basic data for providing customized solutions considering the characteristics of smartphone addicts.

Effects of Uncertainty, Social Support, and Sick Role Behavior on Health-Related Quality of Life in Patients with Peripheral Arterial Disease (말초동맥질환자의 불확실성, 사회적 지지, 환자역할행위 이행이 건강 관련 삶의 질에 미치는 영향)

  • Lee, Hye Ju;Kim, Youn Kyoung
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.314-326
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    • 2020
  • Purpose: This study was conducted to examine the effects of uncertainty, social support, and sick role behavior on health-related quality of life in patients with peripheral arterial disease. Methods: This study is a descriptive research using self-reporting questionnaire. Data were collected from 167 patients with peripheral arterial disease. Measurement tools were Multidimensional Scale of Perceived Social Support(MSPSS), Mishel's Uncertainty in Illness Scale (MUIS), Sick role behavior measurement tools and SF-36 Version I. The data were analyzed using descriptive statistics, correlation, and regression analysis by using SPSS/WIN 24.0. Results: Factors that significantly influenced physical health-related quality of life were age (β=-.19, p=.010), monthly income (β=.17, p=.027), uncertainty (β=-.29, p<.001), and exercise and rest (β=.28, p<.001) that all together accounted for 32.6% of the variance. Factors that significantly influenced mental health-related quality of life were monthly income (β=.20, p=.015), drinking (β=.17, p=.040), uncertainty (β=-.24, p=.001), and exercise and rest in sick role behavior (β=.26, p=.003) that all together accounted for 18.2% of the variance. Social support was an insignificant factor on physical and mental health-related quality of life. Conclusion: To improve the health-related quality of life of people with peripheral arterial disease, it is necessary to develop a systematic nursing intervention program including a strong support system, education, strategies for alcohol abstinence, and exercise and rest therapy.

A Study on Health Information Websites for Migrant Marriage Women (결혼이주여성 대상 건강정보 웹사이트 분석)

  • Chang, Durk Hyun;Koo, Bon Jin
    • Journal of the Korean Society for Library and Information Science
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    • v.50 no.4
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    • pp.77-96
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    • 2016
  • This study attempts to suggest effective structures and contents of health-related information websites for migrant marriage women in Korea. Emphasis was put on the strategy to provide them with quality health information service through the internet websites. Specifically, this study surveys major issues, problems, and solutions related to collecting, organizing and serving health related information on internet websites. It is based on the analysis to the needs of and the barriers to access health information on such internet websites. For this, the study collected data from 6 websites and analyzed the menu structure, contents, and the presentation of information. It is expected that the results of the study will provide multicultural agencies with primary data to construct a web-based health information service programs for migrant marriage women.

Developing a Hospital-Wide All-Cause Risk-Standardized Readmission Measure Using Administrative Claims Data in Korea: Methodological Explorations and Implications (건강보험 청구자료를 이용한 일반 질 지표로서의 위험도 표준화 재입원율 산출: 방법론적 탐색과 시사점)

  • Kim, Myunghwa;Kim, Hongsoo;Hwang, Soo-Hee
    • Health Policy and Management
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    • v.25 no.3
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    • pp.197-206
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    • 2015
  • Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.

Assessment of Microbiological Quality of Outsourced School Meals (외부 운반 학교급식의 미생물학적 품질 평가)

  • Jeong, Hyun-Suk;Ryu, Kyung
    • Journal of the Korean Dietetic Association
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    • v.18 no.4
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    • pp.372-384
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    • 2012
  • The purpose of this study was to provide a basic resource for establishment of hygienic management standards for meal delivery from the central kitchen to schools. Flow diagrams for delivery of food were analyzed, and time-temperature conditions of the food and environment were measured. Four different foods samples including Mexican salad, radish salad, stir-fried pork and vegetables, and stir-fried chicken and vegetables were collected after production and before service. Microbiological analysis was performed for aerobic plate counts (APC), Enterobacteriaceae, coliforms, E. coli, Salmonella spp., S. aureus, B. cereus, C. perfringens, and L. monocytogenes. After completion of production of cooked foods 2~3 hours were taken for the cooked foods to reach the temperature danger zone. Food temperatures at the meal service did not meet the recommended temperatures ($10/57^{\circ}C$) for conventional school food service systems. The highest APC counts were observed in radish salad (5.70 log CFU/g), followed by Mexican salad (5.18 log CFU/g). Enterobacteriaceae and coliform counts were within acceptable levels of those recommended by the UK Public Health Laboratory Service. No E. coli or pathogens were found. These results provide useful information for determination of microbiological hazards in school food service systems, and suggest that time-temperature control during delivery is necessary for the safety of cooked foods.

An Analysis of the Disagreement in Disease Coding in South Korean Medical Institutions: Focusing on the Health Insurance Claim Data of Outpatients (우리나라 의료기관의 질병 코딩 불일치성 분석 : 외래환자 건강보험 청구 자료를 중심으로)

  • Jeon, Yun-Hee;Kang, Gil-Won
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.533-540
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    • 2018
  • The purpose of this study was to use the data from the Health Insurance Review and Assessment Service to analyze the disagreement in disease coding given by different medical institutions on the same disease of the same patient and provide basic data that could help improve the quality of national public health statistics. 9,976,826 patients' data records from the Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) of 2014 were analyzed. The disagreement in disease coding differed by movement paths for medical institutions; the disagreement rate tended to increase when moving from a medical institution other than public health centers to a public health center and decrease remarkably when moving from a specialized general hospital to another. Therefore, this analysis of disagreement in disease coding among medical institutions suggests the need to supplement the system so that domestic medical institutions can realize consistent disease coding.