• 제목/요약/키워드: managed care

검색결과 303건 처리시간 0.031초

응급의료 전달체계의 충실 방안 (A Study in an Effective Programs for Emergency Care Delivery System)

  • 권숙희
    • 한국보건간호학회지
    • /
    • 제9권1호
    • /
    • pp.83-102
    • /
    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

  • PDF

Management of Thoracic Aortic Injury after Blunt Trauma: Nine Cases at a Single Medical Center

  • Lee, Kyungwon;Lee, Jae Gil
    • Journal of Trauma and Injury
    • /
    • 제29권4호
    • /
    • pp.146-150
    • /
    • 2016
  • Purpose: Traumatic aortic injuries are rare, but life threatening condition. They usually occur after high velocity impact on the chest or abdomen such as traffic accident or fall. We report the experiences of the traumatic aortic injuries at a single center. Methods: We retrospectively reviewed the medical records of nine patients with aortic injury resulting from the blunt trauma from Jan. 2010 to May. 2016. Results: The mean age was $51.1{\pm}20.8$ years old, and ten (90.9%) were men. The mechanisms of injury were traffic accidents in seven patients (motorcycle accidents; 3, car accidents; 4), and four in fall injury. Most common injured sites were thoracic aorta (9, 81.8%). Aortic injuries were repaired by endovascular approach in four patients, and by open graft surgery in four. Two patients were managed conservatively. Nine patients survived without any complications. Conclusion: We had experienced different approaches for management of aortic injuries after blunt trauma according to locations and severity of lesions.

항암 치료가 불가한 고령의 4기 담낭암 환자 한방치험 1례 (Single Case Report of a Stage IV Geriatric Gallbladder Cancer Patient treated with Korean Medicine Who Could Not Receive Conventional Therapies)

  • 류한성;오혜경;이지영;윤성우
    • 대한암한의학회지
    • /
    • 제21권1호
    • /
    • pp.27-33
    • /
    • 2016
  • Background : This case is to report a gallbladder cancer patient treated with Korean Medicine who could not receive conventional cancer therapies such as operation and chemotherapy due to her underlying diseases, old age and poor performance. Method and Results : An eighty-year-old female patient was diagnosed with stage IV gallbladder cancer on Feb. 2014 and she already had hypertension, diabetes and Parkinsonism. Comprehensive Korean Medicine (KM) treatments instead of operation and chemotherapy were administrated due to her poor condition and old age. KM treatments were done focused on improving symptoms and quality of life combined with best supportive care. During KM treatments her abdominal pain was generally managed and she survived for 22 months. Conclusion : Further studies should be performed in the future to clarify the survival benefit and symptom management of comprehensive KM treatments.

Association of Psychological Health and Perceived Oral Health in Elderly Individuals: Focusing on Depression, Stress, and Suicidal Ideation

  • Lee, Hyun-Ok;Kim, Sun-Mi;Park, Ji-Young
    • 치위생과학회지
    • /
    • 제17권5호
    • /
    • pp.398-404
    • /
    • 2017
  • The present study aimed to examine the influence of mental health factors on oral health factors using data from the Korean National Health and Nutrition Examination Survey (KNHANES). A total of 1,548 elderly individuals aged over 65 years who completed the screening and health questionnaire were selected as the final study participants. The psychological health factors related to perceived oral health status were depression and stress when the gender was controlled, and in terms of gender, both elderly male and female individuals were stressed and depressed. These results suggested that the psychological health of elderly individuals negatively affects not only perceived oral health but also the quality of life. In addition, the psychological health of the elderly individuals should be systematically managed along with oral health care and overall health care and lifestyle. If a comprehensive health management system is available for low-income groups or an elderly person living alone, it should positively affect and improve the quality of life of elderly individuals.

The Design of mBodyCloud System for Sensor Information Monitoring in the Mobile Cloud Environment

  • Park, Sungbin;Moon, Seok-Jae;Lee, Jong-Yong;Jung, Kye-Dong
    • International journal of advanced smart convergence
    • /
    • 제5권1호
    • /
    • pp.1-7
    • /
    • 2016
  • Recently, introduced a cloud computing technology to the IT industry, smart phones, it has become possible connection between mobility terminal such as a tablet PC. For dissemination and popularization of movable wireless terminal, the same operation have focused on a viable mobile cloud in various terminal. Also, it evolved Wireless Sensor Network(WSN) technology, utilizing a Body Sensor Network(BSN), which research is underway to build large Ubiquitous Sensor Network(USN). BSN is based on large-scale sensor networks, it integrates the state information of the patient's body, it has been the need to build a managed system. Also, by transferring the acquired sensor information to HIS(Hospital Information System), there is a need to frequently monitor the condition of the patient. Therefore, In this paper, possible sensor information exchange between terminals in a mobile cloud environment, by integrating the data obtained by the body sensor HIS and interoperable data DBaaS (DataBase as a Service) it will provide a base of mBodyCloud System. Therefore, to provide an integrated protocol to include the sensor data to a standard HL7(Health Level7) medical information data.

기공양생(氣功養生)과 노인보건(老人保健)에 대한 고찰(考察) (A Study of Gigong-Yangsaeng(Good life) and The old-Health care)

  • 안현국;신용현;구병수
    • 동의신경정신과학회지
    • /
    • 제11권2호
    • /
    • pp.177-187
    • /
    • 2000
  • The purpose of this thesis is to make manifest the relation of Gigong- Yangsaeng(good life) and The old-health care, and through the conclusion, to study that how much the method of Gigong-Yangsaeng con entertain with refreshments to the stop of being old. Especially this thesis managed to divide the effect of the stop of being old by Gigong-Yangsaeng 3 parts and studied, the first effect is mental that, the second effect is the increase of immunity and the third effect is that of the stop of being old by chemical reaction.The results were as follows:The purpose of the method of Gigong-Yangsaeng is to increase the strength of human body and to resist disease and live long by training and practicing ourselves'Gi(energy of power), People call the method of good life and being old like this Gigong-Yangsaeng. Gigong-Yangsaeng is a method of Yangsaeng(good life) to pull off the purpose of being healthy and strong. We can get some effects of Gigong-Yangsaeng by uniting human mind and body into one. Entirely the key of those effects depends on Jo-sin(to control human body). Jo-sik(to control breath). Jo-sim(to control human mind).

  • PDF

Silicone Stent Placement for Primary Tracheal Amyloidosis Accompanied by Cartilage Destruction

  • Ryu, Duck Hyun;Eom, Jung Seop;Jeong, Ho Jung;Kim, Jung Hoon;Lee, Ji Eun;Jun, Ji Eun;Song, Dae Hyun;Han, Joungho;Kim, Hojoong
    • Tuberculosis and Respiratory Diseases
    • /
    • 제76권6호
    • /
    • pp.292-294
    • /
    • 2014
  • Primary tracheal amyloidosis (PTA) can lead to airway obstructions, and patients with severe PTA should undergo bronchoscopic interventions in order to maintain airway patency. Focal airway involvements with amyloidosis can only be treated with mechanical dilatation. However, the PTA with diffused airway involvements and concomitant cartilage destructions requires stent placement. Limited information regarding the usefulness of silicone stents in patients with PTA has been released. Therefore, we report a case of diffused PTA with tracheomalacia causing severe cartilage destruction, which is being successfully managed with bronchoscopic interventions and silicone stent placements.

Clinicopathological Profile of Breast Cancer Patients at a Tertiary Care Hospital in Marathwada Region of Westen India

  • Takalkar, Unmesh Vidyadhar;Asegaonkar, Shilpa Balaji;Kulkarni, Umesh;Kodlikeri, Pushpa R;Kulkarni, Ujwala;Saraf, Mamta;Advani, Suresh
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제17권4호
    • /
    • pp.2195-2198
    • /
    • 2016
  • Background: Breast cancer is the most prevalent malignancy among women with wide differences in clinical profile from region to region. The present study aimed to describe the profile of breast cancer patients attending a tertiary care hospital in Marathwada region of Western India. Materials and Methods: In this descriptive retrospective study, we reviewed records of pathologically diagnosed patients of breast cancer managed at our center from years 2009 to 2015. Data with respect to demographic status, detailed past, medical, familial and personal history, findings of clinical examination and histological features were obtained. Patients were staged according to the Tumor Node Metastasis (TNM) system. Results: Among 260 cases, mean age of presentation was 52.6, with average age of menarche of 11.3 and menopause of 52.6 years. The majority of patients were from urban regions and were postmenopausal (64.3%). Main clinical features presentation were breast lumps. Most patients were in stage II and had infiltrating duct carcinomas. Conclusions: Most common risk factors for breast cancer observed are increasing age, low parity and obesity. Breast cancer was more prevalent among postmenopausal women presenting in stage II with infiltating duct carcinoma in our region of India.

Treatment of Lung Cancer-Related Intractable Hiccups Using Pulsed Radiofrequency: Clinical Experience

  • Cho, Suk Ju
    • Journal of Hospice and Palliative Care
    • /
    • 제21권3호
    • /
    • pp.104-107
    • /
    • 2018
  • 딸꾹질은 대개의 경우에는 특별한 처치 없이도 고식적인 방법으로 멈추지만, 한 달 이상 지속되는 지속성 딸꾹질은 생명을 위협할 정도의 심각한 부작용을 초래한다. 특히 정확한 치료방법 또한 확립되어 있지 않고, 몇몇 보고에서 양측 횡격막 신경차단이 보고되어 있을 뿐이다. 56세 남환의 우측 횡격막을 침범한 말기폐암환자에서 발생한 난치성 지속성 딸꾹질에 대해 박동성 고주파술을 시행하여 좋은 치료 결과를 얻은 바, 문헌고찰과 함께 보고하고자 한다.

소아 복부둔상에 의한 간장손상의 치료 (Management of Liver Injuries Following Blunt Abdominal Trauma in Children)

  • 박진영;장수일
    • Advances in pediatric surgery
    • /
    • 제3권1호
    • /
    • pp.32-40
    • /
    • 1997
  • A clinical review was done of 31 children with blunt liver injury who were admitted to the Department of Surgery, Kyungpook National University Hospital between 1981 and 1990. Seventeen of the 31 children required laparotomy(11 primary repairs, 4 lobectomies, 2 segmentectomies). There were two deaths after laparotomy, one due to associated severe head injury and another due to multiorgan failure. The remaining 14 children, who were hemodynamically stable after initial resuscitation and who did not have signs of other associated intraabdominal injuries, were managed by nonoperative treatment. Patients were observed in a pediatric intensive care unit for at least 48 hours with repeated abdominal clinical evaluations, laboratory studies, and monitoring of vital signs. The hospital courses in all cases were uneventful and there were no late complication. A follow-up computed tomography of 7 patients showed resolution of the injury in all. The authors believe that, for children with blunt liver injuries, nonoperative management is safe and appropriate if carried out under careful continuous surgical observation in a pediatric intensive care unit.

  • PDF