• Title/Summary/Keyword: managed care

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A Study of Computerized Industrial Hygiene Control System (작업환경관리 전산화에 관한 연구)

  • Lee, Song Kwon;Lee, Young Sei;Kim, Young Su;Kim, Yong Lae
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.4 no.1
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    • pp.117-126
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    • 1994
  • Some of the important and vital roles performed by the Health Care Center of Pohang Iron & Steel Co., Ltd.(POSCO) are the periodic monitoring of the work sites as well as regular medical check-ups for each workers to ensure both pleasant and safe working conditions and to protect employees' health. Pohang Steel Works, which has 42 plants, 26 facilities and 12,000 employees, has an annual crude steel production capacity of 9,670,000 using 24,500,000 ton of raw materials. We have measured lots of areal and personal working environment according to Occupational Safety and Health Law semiannually. All data collected on industrial hygiene is stored and managed by personal computer. The developed of a computerized industrial hygiene control system linked to the company's main computer system will provide efficient evaluation of the working environment as well as critical informations on employees' health. Development of this system had begun in May, 1992 and was completed in March, 1994. The computerized industrial hygiene control system can; 1. store industrial hygiene data, providing key pertinent to the diagnosis of occupational related illnesses, and if necessary, the basis for improving the working environment, 2. decide type and time of medical examination of each work for exposure to specific agents, and supply proper protection periodically, 3. prevent occupational related illnesses through evaluation of environmental and biological monitoring, and performance of epidemiological surveillance, 4. facilitate proper job placement through linking of industrial hygiene control and personnel information systems, 5. monitor job processes. levels of chemical agents used, and new agents introduced, 6. and increase productivity by saving time resulting from the implementation of the computerized sysyte,

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Effect of Active Nutrition Care on Underweight Elderly Patients Receiving Long-term Enteral Tube Feeding (장기간 경관급식을 공급받는 노인 환자에 대한 적극적 영양관리의 효과)

  • Yoon, Hwa-Young;Kim, Hye-Kyeong
    • Korean Journal of Community Nutrition
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    • v.23 no.1
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    • pp.48-59
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    • 2018
  • Objectives: This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding. Methods: Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study. Results: Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months. Conclusions: Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving long-term enteral nutrition.

Outcome Assessment of a Demonstration Project on Integration of Home Visiting Health Care and Social Welfare Services (보건소 중심의 방문보건.재가복지 통합시범사업 성과)

  • Ahn Yang-Heui;Jang Sei-Jin;Choi Gyun
    • Journal of Korean Public Health Nursing
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    • v.20 no.1
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    • pp.5-15
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    • 2006
  • Purpose: The objectives of this study was to measure the outcomes of interventions on the health and social welfare of the elderly in a rural community in Korea. The project involved integrating services of one public health center with that of one social welfare agency, which were under different administrative structures. Method: A single group pretest-posttest design was used for this research. Seventy-five elderly residents living alone in a rural community participated in the study. All of them had coverage of free basic medical care and social welfare services by the government. Major activities for the intervention included: developing partnerships among community leaders/institutes; forming committees of community residents; educating care providers and volunteers; developing 8 integrated service programs and instruments; and organizing the networks. The 20-month intervention was care-managed by a public health nurse whom collaborated with social worker, and was assisted by volunteers. The t-test was utilized to analyze the outcome variables including the elder's health, social welfare and quality of life. A major limitation of this study was the lack of a control group. Results: The outcome of the intervention was shown by improved elder's health, social welfare needs, and quality of life. Integrating the services of public health centers with those of social welfare agencies is an effective way to improve the health of the elderly in the community. Conclusion: Developing community capacity with such integrated services will pay an important role in improving the health of the elderly who live alone.

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SWOT Analysis and Expert Assessment of the Effectiveness of the Introduction of Healthcare Information Systems in Polyclinics in Aktobe, Kazakhstan

  • Lyudmila, Yermukhanova;Zhanar, Buribayeva;Indira, Abdikadirova;Anar, Tursynbekova;Meruyert, Kurganbekova
    • Journal of Preventive Medicine and Public Health
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    • v.55 no.6
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    • pp.539-548
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    • 2022
  • Objectives: The purpose of this study was to assess the organizational effectiveness of the introduction of a healthcare information system (electronic medical records and databases) in healthcare in Kazakhstan. Methods: The authors used a combination of 2 methods: expert assessment and strengths, weaknesses, opportunities, and threats (SWOT) analysis. SWOT analysis is a necessary element of research, constituting a mandatory preliminary stage both when drawing up strategic plans and for taking corrective measures in the future. The expert survey was conducted using 2 questionnaires. Results: The study involved 40 experts drawn from specialists in primary healthcare in Aktobe: 15 representatives of administrative and managerial personnel (chief doctors and their deputies, heads of medical statistics offices, organizational and methodological offices, and internal audit services) and 25 general practitioners. Conclusions: The following functional indicators of the medical and organizational effectiveness of the introduction of information systems in polyclinics were highlighted: first, improvement of administrative control, followed in descending order by registration and movement of medical documentation, statistical reporting and process results, and the cost of employees' working time. There has been no reduction in financial costs, namely in terms of the costs of copying, delivery of information in paper form, technical equipment, and paper.

The Outcomes of Open Ankle Fractures in Patients Managed by Early or Delayed Definitive Fixation: A Comparative Analysis of 73 Patients

  • Raghavendra Kaganur;Bhaskar Sarkar;Pragadeeshwaran Jaisankar;Nirvin Paul;Md Quamar Azam;Anurag Bhakhar
    • Journal of Korean Foot and Ankle Society
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    • v.28 no.1
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    • pp.8-14
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    • 2024
  • Purpose: Ankle fracture fixation is the gold standard of treatment but it does have its own complications. There is inadequate data regarding the comparative effectiveness of early vs. delayed fixation for open ankle fracture outcomes. This study compares the clinical and functional outcomes of open ankle fractures treated by early or delayed definitive fixation and identifies the limitations of both methods. Materials and Methods: All 73 patients enrolled in the study underwent surgical intervention within 24 hours of injury. The early fixation group (group A) consisting of 39 patients underwent definitive fixation as an index procedure, while the delayed fixation group (group B) consisted of 34 patients who underwent debridement and external fixator application as an index procedure and definitive fixation when soft tissue condition was conducive. All patients were evaluated at 2, 6, and 12 weeks postoperatively and then three monthly for a year. Results: Enneking and American Orthopaedic Foot and Ankle Society scores were markedly higher in the early fixation group at 6 months postoperatively (p-values <0.001 and 0.011, respectively). However, no discernible intergroup difference was evident at 12 months postoperatively. Between 6 and 12 months, group functional outcome scores were significantly different. At 6 months, there was a substantial difference in dorsiflexion between the two groups (p-values 0.001 and <0.001, respectively), but no difference was observed at 12 months postoperatively. At 6 and 12 months, group average plantar flexions were non-significantly different. Conclusion: Early definitive fixation of complex ankle fractures using a targeted approach produced promising results for lower grade open fractures (grades 1 and 2), and delayed definitive fixation, after initial external fixation to allow for soft tissue stabilization, produced promising results for higher grade open fractures (grades 3A and 3B). At 12-month follow-ups, clinical and functional outcomes achieved using these strategies were equivalent.

Chronic progressive external ophthalmoplegia in a Saudi patient with a mutation in the POLG gene successfully managed with bilateral frontalis sling

  • Algahtani, Hussein;Shirah, Bader;Alsaggaf, Khalid;Al-Qahtani, Mohammad H.;Abdulkareem, Angham Abdulrahman;Naseer, Muhammad Imran;Abuzinadah, Ahmad R.
    • Journal of Genetic Medicine
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    • v.18 no.2
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    • pp.121-126
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    • 2021
  • Chronic progressive external ophthalmoplegia (CPEO) is a complex slowly progressive mitochondrial disorder characterized by extraocular muscle weakness with or without multisystem involvement. The mainstay of therapy in a patient with CPEO is supportive. However, in moderate cases, surgery might be indicated including surgeries for ptosis and strabismus. In this article, we report a Saudi patient with CPEO due to compound heterozygous variants in the DNA polymerase gamma (POLG) gene c.2246T>C p.(Phe749Ser) and c.1735C>T p.(Arg579Trp), which are classified as pathogenic. Proper diagnosis with genetic testing confirmation is important to guide the management and counsel the patient about the prognosis and the management options. The patient was successfully managed with bilateral frontalis sling and illustrates the importance of surgical intervention to improve vision and cosmetic appearance in patients with CPEO. We emphasize the importance of multidisciplinary care in the management of cases of mitochondriopathy, especially CPEO.

The reform of inspection of adult social care market in the UK and policy suggestions for long-term care in South Korea (영국 성인돌봄서비스 시장에 대한 감독 개혁과 한국 장기요양의 시사점)

  • Chon, Yongho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.4
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    • pp.203-210
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    • 2018
  • The UK is famous for being the first country in Europe to adopt the policies of marketisation regarding social welfare. Numerous other countries, including social democratic countries, have followed suit, and South Korea has also adopted the marketisation of care through the introduction of long-term care insurance. The aim of this study is to examine recent reforms concerning adult social care market in the UK, and to determine policy recommendations to further develop the Korean long-term care insurance market. Findings show that the UK has actively regulated and managed the care market. In particular, after the sudden bankruptcy of nursing homes, the CQC systematically analyzes the risks of bankruptcy of big service providers in terms of financial conditions and quality of services according to the six steps detailed in the Care Act 2014. If some service providers experience high levels of risk, the CQC reports results to local authorities in order to manage the risk of bankruptcy of these service providers. Such reforms in the UK suggest a number of policy measures for South Korea in which the problems of long-term care market are prevalent, including increased system management, introduction of a new inspection system, the expansion of public-based inspection organizations, and disclosure of information by the National Health Insurance Corporation.

The Assessment of Patient Satisfaction in Accordance with Hospital Patients Food Service Cluster Groups (병원입원환자의 서비스. 영양관리. 식단 만족 요인집단에 따른 만족도 분석)

  • 장은재;김혜진;홍완수
    • Korean Journal of Community Nutrition
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    • v.5 no.1
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    • pp.83-91
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    • 2000
  • The aims of this study are to evaluate the quality of hospital food services and the evaluate the quality in selected hospitals trough the use of the questionnaires. A survey of 30 hospital food and nutrition service department was undertaken and detailed information was collected from each, including, surveys of 1, 016 patient. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis, t-test X$^2$-test ANOVA principal component analysis , and cluster analysis and cluster analysis. In the case of patient satisfaction with hospital food and food services, overall satisfaction scores of male and female were 3.54 and 3.45 showing higher levels than the average score(3.00) The aspect of the food and food service which received the lowest ratings by patients was 'meal rounding while dining'. After conduction of factor analysis of variables affecting the patients meal satisfaction 3 groups including the 'menu satisfaction factor', 'service satisfaction factor ' and 'nutrition management satisfaction factor ' were selected. 3 clusters were categorized by the 'service cluster' 'nutrition management cluster', 'men cluster', and 'menu nutrition service cluster' after conducting a cluster analysis with influencing variables affecting patients meal satisfaction. The overview results of patient satisfaction by cluster were : in the case of the service group, such factors as taste, portion size, dealing with complaints while dining meal rounding while dining should be managed with caution In case of the nutrition management group, such factors as taste, portion size, temperature of the food intake, and dependence on hospital food should be managed with care, In the case of the menu groups, such factors as punctuality of meal times, contaminated substances in meals and serving mistakes, cleanliness of dishes, kindness of the server meal rounding while dining should by particularly managed with importance.

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A decade of treating traumatic sternal fractures in a single-center experience in Korea: a retrospective cohort study

  • Na Hyeon Lee;Seon Hee Kim;Jae Hun Kim;Ho Hyun Kim;Sang Bong Lee;Chan Ik Park;Gil Hwan Kim;Dong Yeon Ryu;Sun Hyun Kim
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.362-368
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    • 2023
  • Purpose: Clinical reports on treatment outcomes of sternal fractures are lacking. This study details the clinical features, treatment approaches, and outcomes related to traumatic sternal fractures over a 10-year period at a single institution. Methods: A retrospective cohort study was conducted of patients admitted to a regional trauma center between January 2012 and December 2021. Among 7,918 patients with chest injuries, 266 were diagnosed with traumatic sternal fractures. Patient data were collected, including demographics, injury mechanisms, severity, associated injuries, sternal fracture characteristics, hospital stay duration, mortality, respiratory complications, and surgical details. Surgical indications encompassed emergency cases involving intrathoracic injuries, unstable fractures, severe dislocations, flail chest, malunion, and persistent high-grade pain. Results: Of 266 patients with traumatic sternal fractures, 260 were included; 98 underwent surgical treatment for sternal fractures, while 162 were managed conservatively. Surgical indications ranged from intrathoracic organ or blood vessel injuries necessitating thoracotomy to unstable fractures with severe dislocations. Factors influencing surgical treatment included flail motion and rib fracture. The median length of intensive care unit stay was 5.4 days (interquartile range [IQR], 1.5-18.0 days) for the nonsurgery group and 8.6 days (IQR, 3.3-23.6 days) for the surgery group. The median length of hospital stay was 20.9 days (IQR, 9.3-48.3 days) for the nonsurgery group and 27.5 days (IQR, 17.0 to 58.0 days) for the surgery group. The between-group differences were not statistically significant. Surgical interventions were successful, with stable bone union and minimal complications. Flail motion in the presence of rib fracture was a crucial consideration for surgical intervention. Conclusions: Surgical treatment recommendations for sternal fractures vary based on flail chest presence, displacement degree, and rib fracture. Surgery is recommended for patients with offset-type sternal fractures with rib and segmental sternal fractures. Surgical intervention led to stable bone union and minimal complications.

Neonatal Total Nutritional Pharmacy Service at Intensive Care Unit at a University Hospital in Korea (신생아 중환자실 영양요법치료에서 약사의 역할과 영향)

  • Oh, Yun Kyoung;Lee, Gwang Sup;Rhie, Sandy
    • Korean Journal of Clinical Pharmacy
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    • v.23 no.2
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    • pp.167-174
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    • 2013
  • Objective: The study evaluated the impact of pharmacist inventions with the implementation of pharmacistinvolved nutritional support service at neonate intensive care unit in a tertiary teaching hospital. Method: A retrospective and observational study was carried out. The total of 58 infants in neonate intensive care unit was enrolled between January 2011 and October 2012. The pharmacist-involved total parenteral nutritional program was initiated in June of 2012. During the program, pharmacist actively participated in the multidisciplinary round with performing the interventions from reviewing the amount of combined total parenteral nutrition and enteral fluid intakes, the amount of total calories, the glucose infusion rate, and the amounts of proteins per weight in kilogram. The outcome was compared with the results from the control group which reflected the prior period of the program initiation. Result: The number of days of regaining birth weight was significantly shorter (14.5 vs. 19 days, p=0.049) and the percentage of total calorie days with >90 kcal/kg/day was increased significantly (40 vs. 13%, p=0.008) in intervention group compared to the values in control group. In addition, the total mean daily caloric intakes ($84.78{\pm}13.8$ vs. $74.86{\pm}15.36$ kcal/kg/day, p=0.018) was significantly higher in intervention group than those results in control group. There were no significant differences in safety parameters between two groups related to nutritional services of necrotizing enterocolitis, intraventricular hemorrhage, proven sepsis, and also parenteral nutrition-induced hepatotoxicity. Conclusion: Pharmacist-involved total parenteral nutrition managed program was successfully implemented. The outcome showed the improved effectiveness of total parenteral nutrition with pharmacist interventions and no differences in adverse reactions. This could prove the positive effects of pharmacist involvement on nutritional therapy for neonate population.