• Title/Summary/Keyword: health quality assessment service

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Predictors of Blood Transfusion in Hepatoma Embolization (간종양 색전술 환자의 수혈 영향 요인)

  • Kim, Sang-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.384-389
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    • 2017
  • This study was conducted to investigate the patient and hospital characteristics that affect receiving and non-receiving blood transfusion for hepatoma embolization. We analyzed data describing 757 patients of the Health Insurance Review and Assessment Service's 2011 claims sample data. Chi-squared and logistic regression analysis was performed using STATA 12.0. Logistic regression analysis revealed that anemia (Odds ratio (OR)=9.544, 95% confidence interval (CI)=3.362-27.097), female (OR=2.186, Cl=l.240-3.854), age 65-74 (OR=0.506, CI=0.269-0.952), 1000 over bed (OR=0.053, CI=0.018-0.151), out-department (OR=0.211, CI=0.081-0.551), and 700-999 bed (OR=0.105, CI=0.036-0.304) were significant predictors of blood transfusion in tertiary hospitals. Additionally, anemia (OR=69.681, CI=8.545-568.246) and aged 75 or over (OR=0.112, CI=0.025-0.506) were significant predictors of blood transfusion in general hospitals. This research would expected to cost effective and preliminary data of blood transfusion quality.

Application of Molecular Diagnostics Technology in the Development of a Companion Diagnostics for Malignant Solid Tumors (악성 고형암의 항암제 동반진단 기술에서 분자진단기술의 적용)

  • Kim, Jin-Hee
    • The Journal of the Korea Contents Association
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    • v.19 no.3
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    • pp.365-374
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    • 2019
  • Unlike benign tumors, malignant tumors are capable of metastasis, easy to relapse, poor survival, and low quality of life. In Korea, here is a tendency to treat the tumors collectively according to the General Principles of Cancer Chemotherapy(GPCC) of the Health Insurance Review & Assessment Service (HIRA). But recently, companion diagnostics(CDx) is recommended rather than unilateral medication because biomarker-based molecular diagnostics is possible to predict the drug response of patients before drug treatment. Not only domestic but also overseas Food and Drug Administratio (FDA) recommends the development of the CDx system at the stage of drug development to ensure the responsiveness and safety of medicines. In this study, I focused on the necessity of CDx development direction as well as CDx development status through literature review. Furthermore I also discussed CDx types according to the molecular diagnostic technology such as immunohistochemistry (IHC), polymerase chain reaction (PCR), in situ hybridization (ISH), and next-generation sequencing (NGS) not only in the approved CDx but also in the developing one by US FDA. And I suggested the technology issue of CDx development process such as a selection of molecular diagnostics at the time of release, a clear understanding of the CDx mechanism, and a convergence of drug with CDx development. The necessity of social insurance system also was proposed for CDx development.

The Development of Evaluation Indicator for Eco-experience in Rural Village (농촌마을 생태체험 공간으로 활용하기 위한 연못형습지 평가지표 개발)

  • Lee, Sang-Young;Kim, Mi-Heui;Kang, Banghun;Son, Jin-Kwan
    • Journal of Agricultural Extension & Community Development
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    • v.21 no.4
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    • pp.1125-1147
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    • 2014
  • This study was conducted to develop the health evaluation indicator of pond wetland in order to enhance the quality of eco-experience in rural area. The methods for development of evaluation indicator were consisted of 3 stages; 1st, the precedent assessment protocol was applied to 10 pond wetlands in farm villages, and eco-experience expert survey was conducted to selection the evaluation item and criteria at 2nd and 3rd stages. In the results of applying the precedent assessment protocol, we found out two problems; 1) the evaluation result of value determination and conservation value were too simple, and 2) the score by evaluation items were nearly the same, because evaluation criteria in not precisely for application in rural area. These results were reflected to expert survey. According to the 1st survey results, they suggested that 4 items should be maintained, and 3 items should be deleted, and 2 items should be modified among a total of 9 times. Therefore, it was modified into the evaluation protocol having a total of 8 items. According to the 2nd survey results, the selected evaluation items were generally proper. With regard to items for assessing the health condition of pond wetland, we selected a total of 8 items; (1) Connectivity to forest, (2) Connectivity between water body and wetland connection, (3) Number of Vegetation, (4) Surround land use, (5) Interspersion of Vegetation, (6) Crossing Structure, (7) Wetland size, and (8) Outlet structure. In addition, it was suggested that accessibility, visibility, and trash were need for utilization of pond wetland as a place for eco-experience. It is expected that the selected evaluation indicator can help to utilize the pond wetland as an eco-experience space in rural area, and maintain the pond wetland as a space for conservation of biodiversity.

Comparative Analysis of Diversity Characteristics (γ-, α-, and β-diversity) of Biological Communities in the Korean Peninsula Estuaries (하구 순환 유지 여부에 따른 하구 주요 생물 군집별 다양성 특성 연구: 열린하구와 닫힌하구에서의 γ-, α- 및 β-다양성 비교)

  • Oh, Hye-Ji;Jang, Min-Ho;Kim, Jeong-Hui;Kim, Yong-Jae;Lim, Sung-Ho;Won, Doo-Hee;Moon, Jeong-Suk;Kwon, Soonhyun;Chang, Kwang-Hyeon
    • Korean Journal of Ecology and Environment
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    • v.55 no.1
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    • pp.84-98
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    • 2022
  • Estuary is important in terms of biodiversity because it has the characteristics of transition waters, created by the mixing of fresh- and seawater. The estuarine water circulation provides a variety of habitats with different environments by inducing gradients in the chemical and physical environment, such as water quality and river bed structure, which are ultimately the main factors influencing biological community composition. If the water circulation is interrupted, the loss of brackish areas and the interception of migration of biological communities will lead to changes in the spatial distribution of biodiversity. In this study, among the sites covered by the Estuary Aquatic Ecosystem Health Assessment, we selected study sites where changes in biodiversity can be assessed by spatial gradient from the upper reaches of the river to the lower estuarine area. The α-, γ- and β-diversity of diatom, benthic macroinvertebrates, and fish communities were calculated, and they were divided into open and closed estuary data and compared to determine the trends in biodiversity variation due to estuarine circulation. As results, all communities showed higher γ-diversity at open estuary sites. The benthic macroinvertebrate community showed a clear difference between open and closed estuaries in β-diversity, consequently the estuarine transects were considered as a factor that decreases spatial heterogeneity of their diversity among sites. The biodiversity trends analyzed in this study will be used to identify estuaries with low γ- and β-diversity by community, providing a useful resource for further mornitoring and management to maintain estuarine health.

Fish Community Characteristics and Inhabiting Status of Endangered Species in the Bukcheon (Stream) of Seoraksan National Park, Korea (설악산국립공원 내 북천의 어류군집 특성 및 멸종위기종의 서식양상)

  • Park, Seong-Cheol;Choi, Kwang-Seek;Han, Mee-Sook;Ko, Myeong-Hun
    • Korean Journal of Environment and Ecology
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    • v.36 no.4
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    • pp.390-401
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    • 2022
  • This study investigated the characteristics of fish communities and inhabiting status of endangered species in the Bukcheon (Stream) of Seoraksan National Park, Korea from April to September 2020. A total of 4,356 fish of 7 families and 22 species were collected from 17 survey stations during the survey period. The dominant species was Zacco koreanus (relative abundance, 41.8%), and subdominant species was Rhynchocypris kumgangensis (relative abundance, 15.1%), followed by Pungtungia herzi (10.1%), Pseudopungtungia tenuicorpa (5.0%), Coreoleuciscus splendidus (4.1%), Zacco platypus (3.8%), Microphysogobio longidorsalis (3.5%), and Hemibarbus mylodon (2.2%). Among the fish species collected, 14 species (63.6%) were identified as Korean endemic species. There was one natural monument species (Hemibarbus mylodon), and four species of class II endangered wildlife that were designated by the Ministry of Environment (Acheilognathus signifer, Pseudopungtungi tenuicorpa, Gobiobotia brevibarba, and Brachymystax lenok tsinlingensis). Among the four species of class II endangered wildlife, B. lenok tsinlingensis inhabited in the upper stream, and A. signifer, P. tenuicorpa and G. brevibarba inhabited mainly in the middle-lower stream. Also, P. tenuicorpa, H. mylodon, and B. lenok tsinlingensis were inhabited in large numbers. Additionally, two cold-water fish species (R. kumgangensis and B. lenok tsinlingensis) and one landlocked species (B. lenok tsinlingensis) were collected. According to the results of cluster analysis, the dominance index decreased from upstream to downstream, but the diversity, evenness, and richness index increased; the cluster structure was divided into the uppermost, upstream, midstream, and downstream. The water quality of Bukcheon was evaluated as good overall since the river health (index of biological integrity) evaluated using fish was evaluated as very good (11 stations), good (2 stations), and normal (4 stations). However, river repair work was being carried out in some areas and some wastewater was flowing in from the midstream, therefore, supplementary measures to preserve fish habitats are required.

Implementation Strategy for the Elderly Care Solution Based on Usage Log Analysis: Focusing on the Case of Hyodol Product (사용자 로그 분석에 기반한 노인 돌봄 솔루션 구축 전략: 효돌 제품의 사례를 중심으로)

  • Lee, Junsik;Yoo, In-Jin;Park, Do-Hyung
    • Journal of Intelligence and Information Systems
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    • v.25 no.3
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    • pp.117-140
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    • 2019
  • As the aging phenomenon accelerates and various social problems related to the elderly of the vulnerable are raised, the need for effective elderly care solutions to protect the health and safety of the elderly generation is growing. Recently, more and more people are using Smart Toys equipped with ICT technology for care for elderly. In particular, log data collected through smart toys is highly valuable to be used as a quantitative and objective indicator in areas such as policy-making and service planning. However, research related to smart toys is limited, such as the development of smart toys and the validation of smart toy effectiveness. In other words, there is a dearth of research to derive insights based on log data collected through smart toys and to use them for decision making. This study will analyze log data collected from smart toy and derive effective insights to improve the quality of life for elderly users. Specifically, the user profiling-based analysis and elicitation of a change in quality of life mechanism based on behavior were performed. First, in the user profiling analysis, two important dimensions of classifying the type of elderly group from five factors of elderly user's living management were derived: 'Routine Activities' and 'Work-out Activities'. Based on the dimensions derived, a hierarchical cluster analysis and K-Means clustering were performed to classify the entire elderly user into three groups. Through a profiling analysis, the demographic characteristics of each group of elderlies and the behavior of using smart toy were identified. Second, stepwise regression was performed in eliciting the mechanism of change in quality of life. The effects of interaction, content usage, and indoor activity have been identified on the improvement of depression and lifestyle for the elderly. In addition, it identified the role of user performance evaluation and satisfaction with smart toy as a parameter that mediated the relationship between usage behavior and quality of life change. Specific mechanisms are as follows. First, the interaction between smart toy and elderly was found to have an effect of improving the depression by mediating attitudes to smart toy. The 'Satisfaction toward Smart Toy,' a variable that affects the improvement of the elderly's depression, changes how users evaluate smart toy performance. At this time, it has been identified that it is the interaction with smart toy that has a positive effect on smart toy These results can be interpreted as an elderly with a desire to meet emotional stability interact actively with smart toy, and a positive assessment of smart toy, greatly appreciating the effectiveness of smart toy. Second, the content usage has been confirmed to have a direct effect on improving lifestyle without going through other variables. Elderly who use a lot of the content provided by smart toy have improved their lifestyle. However, this effect has occurred regardless of the attitude the user has toward smart toy. Third, log data show that a high degree of indoor activity improves both the lifestyle and depression of the elderly. The more indoor activity, the better the lifestyle of the elderly, and these effects occur regardless of the user's attitude toward smart toy. In addition, elderly with a high degree of indoor activity are satisfied with smart toys, which cause improvement in the elderly's depression. However, it can be interpreted that elderly who prefer outdoor activities than indoor activities, or those who are less active due to health problems, are hard to satisfied with smart toys, and are not able to get the effects of improving depression. In summary, based on the activities of the elderly, three groups of elderly were identified and the important characteristics of each type were identified. In addition, this study sought to identify the mechanism by which the behavior of the elderly on smart toy affects the lives of the actual elderly, and to derive user needs and insights.

The Effect of the Degree of Competition of the Hospital Market Regions on Clinic's Rate of Antibiotics Prescription (병원시장지역 내 경쟁 정도가 의원급 의료기관의 항생제 처방률에 미치는 영향)

  • Jo, Changik;Lim, Jae-Young;Lee, Soo Yeon
    • KDI Journal of Economic Policy
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    • v.30 no.2
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    • pp.129-155
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    • 2008
  • The rate of antibiotics prescription for an acute airway infection significantly varies depending upon the diagnosis type, specialty, and the location of the hospital along with many other related factors. The objective of this study is to empirically investigate the possible relationship between the antibiotics prescription rates for an acute airway infection and the degree of competition in the hospital market regions of mainly the providers of primary medical care services such as clinics, internal medicines, pediatrics and otorhinolaryngology department. Using the data from Health Insurance Review and Assessment Service (HIRA) regarding the hospitals' antibiotics prescription rates for the acute airway infection and controlling for selected variables of demand and supply sectors, this study tries to figure out that the degree of competition in the hospital market, regardless of what type of competition indexes we employed, has a statistically significant effect on the variations of antibiotics prescription rate of the clinics in local areas. This result implies that as an economic consideration itself, the change in the degree of competition in the hospital market can play a crucial role influencing the treatment behaviors of the medical doctors. More specifically, this study reveals that as the degree of competition increases the antibiotics prescription rate goes up. This result means that if the market becomes more competitive in a specific region so that it might cause a reduction in doctor's income, doctors with rational decision-making process, recognize that the benefit created from inducing patients' seemingly unnecessary demand for medical care (income effect) would be higher than the costs associated with sustaining their targeted income (substitution effect). It is because that the doctors are more likely to prescribe antibiotics which create relatively higher margins than other medical care services in order to sustain their targeted income when the hospital market competition becomes tighter. Even though this study empirically confirms that antibiotics prescription can be affected by the economic incentives, it still raises following issues as limitations of the study: first issue is about the representativeness of the hospital regions segregated for this study, which might be weak in explaining whether these regions are mutually exclusive in reality. Patients actually consider the quality of services, transportation cost, time costs, and any other related factors choosing the doctors or hospitals, and in that sense, this study rules out 'border-crossing' in using the medical care services. Second issue arises in capturing the data of antibiotics prescription rate. Since we use the average rate for each medical institution, we cannot figure out the average rate for each patient so that we are not able to control for the variation of patients' medical conditions. It is because of the unavailability of data regarding each patient's medical condition from HIRA. Thirdly, since this study mainly analyzes the medical institutions providing primary care such as clinics, internal medicines, pediatrics, and otorhinolaryngology department, it is skeptical of whether those institutions can represent the hospital market in respective regions and truly reflect the degree of competition. It needs to extend the study areas and disease types as well as any micro data for future studies.

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Needs and Satisfaction of Cancer Patients on the Medical Services in Jeju Special Self-Governing Province (제주지역 암환자의 의료서비스 요구도 및 만족도 분석)

  • Kim, Woo-Jeong;Kim, Min-Young;Chang, Weon-Young;Choi, Jae-Hyuck
    • Journal of Hospice and Palliative Care
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    • v.13 no.3
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    • pp.153-160
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    • 2010
  • Purpose: The purpose of the present study was to investigate needs and satisfaction on the medical services of cancer patients in Jeju Special Self-Governing Province. Methods: Total 174 cancer patients, who visited at the clinic of Jeju National University Hospital, submitted informed consent and participated in this study from July 13 to July 30, 2009. Self questionnaire was used and data were analyzed with Kolmogorov-Smirnov test, Mann-Whitney U test, ANOVA, and Kruskal-Wallis test. Results: Participants expressed the needs of most economical support (3.38 out of 4), followed by counseling of treatment plan (3.22), information of disease (3.07), and disease management except cancer (2.97). Participants were satisfied most with religious counseling (3.41), followed by nursing service support (3.39), employment counseling (3.26), and counseling for family or interpersonal relationships (3.26). The satisfaction of economical support was the lowest (1.98). Satisfaction of men was higher than women, and needs in patients who were living with children was the highest. Patients who were living alone or with children showed the lowest satisfaction about the medical services. There were no significant differences in the general characteristics, however, participants who were older than 60 years of age or had higher income showed lower needs and higher satisfaction. There were no significant differences in the medical characteristics, however, thyroid cancer patients and patients who were treated with radiation therapy or transarterial embolization showed low satisfaction. Conclusion: Cancer patients seemed to need more economical support, information of treatment or disease, and symptom management. Furthermore, there were various needs about the services, depending on family formation or economical support of patients. Therefore, it is certain that patients who were suffering from other cancers, except the 5 major cancers, needed more services. In conclusion, continuous and systemic policy to consider patient's characteristics and needs are needed in community as well as health care system.