• 제목/요약/키워드: medical certificate

검색결과 106건 처리시간 0.03초

노인의 불명확한 사망원인진단 관련요인 분석과 개선방안 (Analysis and Improving ways of Factors affecting the Ill-defined Causes of Death of the Aged in Korea)

  • 박상희;이태용
    • 보건행정학회지
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    • 제21권2호
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    • pp.329-348
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    • 2011
  • This research analyzed 168,010 cases of death of the aged over 65 from 244,867cases of death excluding 7 unknown age cases from 244,874 all age cases of death by using the death data of the National Statistical Office for 2007 to figure out factors affecting the quality of causes of death statistics of the aged and to suggest the ways of improving the quality of death statistics of the aged in korea. This research tried to derive factors affecting ill-defined cause of death category in acordance with WHO's guidelines and to find causes of lowering the accuracy of causes of death statistics of the aged. This research identified the problems of causes of death statistics of the aged by using both demographic characteristics such as sex, age, marital status, educational attainment, residential region, region size and factors of death items as independent variable to find causes of ill-defined cause of death of the aged. Logistic regression analysis was executed to calculate the hazard ratio about the ill-defined causes of death of the aged and multiple regression analysis was conducted to derive factors affecting the ill-defined cause of death by regional groups through using these independent variables such as the component ratio of over age 65, female death rates, doctors insitutions rate, medical institutions rate, attaching rates of death certificate by neighborhood. As a results of this research, R-code was the highest of ill-defined causes of death, accounting for 82.1%, and senility death(R54) of R-code was the highest, accounting for 91.2%. through subdivided order distribution of the ill-defined causes of death of the aged. As ill-defined causes of death by regional groups, attaching rates of death certificate by neighborhood was the most important factor(p<0.05) and also showed regression model's description with 83.8% ($R^2$=83.8%). Furthermore, Jeon-nam was the highest in the regional groups and these regions such as Je-ju, Jeon-buk, Chung-nam were not only attaching the death certificate by neighborhood but also were high at the rate of ill-defined causes of death. Therefore, this research found that both reconsideration about death certificate by neighborhood and education for doctors who write death certificate were needed the most.

의학사서직의 교육에 대한 연구 (A Study of Education for Medical Librarianship)

  • 윤영대
    • 한국도서관정보학회지
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    • 제34권1호
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    • pp.131-146
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    • 2003
  • 북미, 중국, 일본 및 한국의 의학사서 교육제도와 주제전문사서에 대한 선행 연구의 내용을 문헌적으로 조사 분석하여 우리나라에서 시행가능한 의학사서를 위한 교육 모델을 고안하였다. 교육모델은 의학사서의 정규양성과정, 의학사서의 계속 교육과 의학사서 자격프로그램을 포함하였다.

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소방공무원의 동기부여와 조직몰입간의 관계 (A Study on the Motivation and Organizational Commitment of Fire Officials)

  • 최은숙;이인수;곽명순
    • 한국응급구조학회지
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    • 제10권2호
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    • pp.43-52
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    • 2006
  • Purpose: The purpose of this study was to investigate the relationship between motivator, hygiene factor and organizational commitment of fire officials. Method: The subjects of this study were 228 fire officials in Kongju and Choengju province. Data were collected using self-reporting questionnaire during the period from 1st to 25th of February 2006. Collected data were analyzed using SPSS 12.0 program. Real number, percentage, mean and standard deviation were calculated, and t-test, ANOVA, Pearson correlation coefficient were carried out. Result: The findings of this study as follows: The motivator according to job characteristics was statistically significant differences in certificate(F=3.29, p= .002), aptitude(F=15.49, p= .000). The hygiene factors according to job characteristics was statistically significant differences in certificate(F=2.59 p= .01), aptitude(F=6.72, p= .000). The organizational commitment according to general characteristics were statistically significant differences in age(F= 2.625, p= .036), religion(F=3.869, p= .005). The organizational commitment according to job characteristics were statistically significant differences in experience(F=3.746, p= .001), aptitude(F=13.743, p= .000), wish of practice change(F=8.907, p= .000). The commitment was found to be in significant positive correlations with motivator(r= .436, p= .000) and hygiene factors(r= .336, p= .000). Conclusion: From the results, we recommend that the organization management program develops for increasing motivator in fire officials be used.

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Evaluation of Delhi Population Based Cancer Registry and Trends of Tobacco Related Cancers

  • Yadav, Rajesh;Garg, Renu;Manoharan, N;Swasticharan, L;Julka, PK;Rath, GK
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권6호
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    • pp.2841-2846
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    • 2016
  • Background: Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness. Materials and Methods: We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009. Results: The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively. Conclusions: The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.

일부 의과대학생들의 사망진단서 작성의 정확성 평가 - 사망진단서 작성법 교육 유형에 따른 비교 - (Accuracy of Death Certificates Completed by Medical Students)

  • 김현애;김건엽;감신;오경재;신민호;손석준;김순영;남해성
    • 농촌의학ㆍ지역보건
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    • 제35권1호
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    • pp.89-98
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    • 2010
  • 의과대학 본과 4학년 학생들의 사망진단서의 작성 능력을 살펴보고자, 2007년 5월부터 8월까지 충청도, 전라도, 경상도의 4개 의과대학 본과 4학년 학생 380명을 대상으로 설문조사를 실시하였다. 설문지는 사망진단서 작성을 위한 10개의 사례들과 사망진단서 작성 양식, 그리고 사망진단서 작성과 관련된 교육 경험에 관한 문항들로 구성되었다. 교육 유형별 사망진단서 작성 정확도를 평가하기 위해 학생들이 기술한 사인들이 기준사인과 일치되는 정도와 기재내용의 오류 등을 파악하였다. 설문 미응답자 61명을 제외한 232명의 분석결과는 다음과 같다. 10개 사례에 대한 4단계 사망원인 평균 일치 개수 즉 CD는 $9.6{\pm}3.8$이었다. 4단계 사망원인들 중 최하단에 기재한 원사인의 평균 일치 개수 즉 UC1은 $4.8{\pm}1.7$이었고, 학생들이 기술한 4단계 사망원인들 중에서 사인분류사에 의해 선정 된 원사인의 평균 일치 개수 즉 UC2는 $5.6{\pm}1.5$이었다. UC1과 UC2는 사례중심 교육집단이 이론교육집단 보다 높았다. 주오류의 세부 내용별로 살펴보면 '선행사인 미기입'의 오류를 가진 경우(78.9%)가 가장 많았으며, 다음으로 '한 칸에 두개 사인 기입'(48.3%), 'II부에 I부 기입'(43.1%) 등의 오류를 범하는 경우 등이 많았다. 주오류와 부오류 모두 사례중심교육집단이 이론교육집단보다 평균 오류의 수가 더 적었다. 결론적으로 의과대학 본과 4학년 학생들의 사망진단서 작성능력은 사망진단서 작성 방법에 대한 교육 유형에 따라서 차이가 있으며, 사망원인통계의 정확성 향상을 위해서는 사망원인작성에 대한 교육이 이론 위주보다는 다양한 사례를 경험할 수 있도록 구성될 필요가 있다.

응급의료정보센터의 응급통신관리교육 요구도 분석 (An Analysis of Demand on EMD Education in Emergency Medical Care Information Centers)

  • 엄태환
    • 한국응급구조학회지
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    • 제8권1호
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    • pp.141-148
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    • 2004
  • The purpose of this study which was done by questionnaire survey on doctors, paramedics, radio operators, computer technicians, administrators in Emergency Medical Care Information Centers was to analyze demand on EMD education. The significant 101 data were collected in 12 Emergency Medical Care Information Centers from Dec. 17, 2003 to Jan. 31, 2004 and analyzed by using SPSS. The conclusions from this study were summarized as follows. Composition of respondents who work in Emergency Medical Care Information Centers were 40.7% 26-30 years old in age, 56.4% male in sex, 55.6% medical direction in duty, 76.2% paramedics in certificate. 54.5% out of the paramedics had two years present career, 62.3% had one year past career, 31.0% didn't receive EMD education, 39.0% wanted 5-8 hours continuing education. The paramedics received more EMD education on Introduction to Emergency Medical Concepts, Obtaining Information from Callers, Providing Emergency Care Instructions and wanted more continuing education on Providing Emergency Care Instructions, Key Questions & Pre-Arrival Instructions, Obtaining Information from Callers. This study will be helpful to build up an education system for EMDs such as continuing education, curriculum, certification.

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진료정보 공유를 위한 IC카드 기반 병원 진찰 카드 통합 시스템 구축 (Implementation of A Patient Card Integrating System Using by IC Card To Share A Medical Information)

  • 박두희;이남용;김윤정;이기한
    • 대한의용생체공학회:의공학회지
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    • 제24권6호
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    • pp.533-541
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    • 2003
  • 본 논문은 환자 진료정보 공유 시 환자의 개인 및 진료 정보 보호 문제점을 해결하기 위해서 여러 장의 진찰카드를 하나의 IC카드로 통합하기 위한 시스템을 개발하였다. 먼저, 진료정보 공유를 위한 최소데이터세트를 정의하였고, 이 최소데이터세트를 통합 병원 진찰 IC 카드에 구현하고 발급할 수 있는 발급 시스템을 개발했다. 환자의 개인정보 보안 및 인증을 위해서는 윈도우 2000 기반 전자서명 인증센터를 구축하고 3-DES 적용한 IC 카드 기반의 통합 병원 진찰 IC 카드를 개발했다. 기존 병원 전산시스템과 효율적인 연동을 위한 통합 병원 진찰 IC 카드에 의한 진료접수/예약 시스템을 개발했다. 본 연구에서 개발한 통합 병원 진찰 IC 카드 시스템을 11개 병원에서 1.000명의 환자에게 적용한 결과, 시범 대상 병원들의 환자 진료 접수/예약뿐 아니라 정보 공유의 안정적 확장을 도모할 수 있는 기반을 마련할 수 있었다.

공개키 기반의 안전한 전자의무기록에 관한 프로토콜 설계 및 구현 (Designing and Implementing a PKI-based Safety Protocol for Electronic Medical Record Systems)

  • 진광윤;정윤수;신승수
    • 디지털융복합연구
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    • 제10권4호
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    • pp.243-250
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    • 2012
  • 본 논문에서는 환자의 개인정보를 병원서버에 저장하지 않고 국민건강보험공단 서버에 저장함으로써 개인정보를 보다 안전하게 저장하고, 병원과 환자간의 의료분쟁을 좀 더 원활하게 해결하기 위한 프로토콜을 제안한다. 제안한 전자의무기록에 대한 프로토콜 설계는 RSA의 공개키 알고리즘을 이용한 방식과 DSA의 전자서명을 이용한 방식을 이용하여 설계한다. 또한 통합인증기관을 이용하여 보다 안전하고 신뢰하는 전자의무기록을 구축한다. 제안한 의료정보시스템은 의료인과 환자간의 신뢰관계 확보 및 의료분쟁 시 증거 자료를 제공하고 더 나아가 의료사고를 좀더 줄이고 다양한 응용분야에서 효율적으로 사용될 것이다.

사망진단서(사체검안서) 상의 선행사인으로부터 사망통계의 원사인이 선정되는 비율: (3개 대학병원에서 교부된 사망진단서를 중심으로) (The rate that underlying causes of death for vital statistics are derived from the underlying causes of death recorded at death certificates: (a study on the death certificates issued from three university hospitals))

  • 박우성;박석건;정철원;김우철;탁우택;김부연;서순원;김광환;서진숙;부유경
    • 한국의료질향상학회지
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    • 제11권1호
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    • pp.4-14
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    • 2004
  • Background : To examine the problems involved in writing practice of death certificates, we compared the determination of underlying cause of death for vital statistics using recorded underlying cause of death in issued death statistics. Methods : We collected 688 mortality certificates issue in year of 2,000 from 3 university hospitals. And we also collected vital statistics from ministry of statistics. The causes of death were coded by experienced medical record specialists. And causes of death determined at ministry of statistics for national vital statistics were mapped to causes of death recorded at each death certificates. The rate that underlying causes of death for vital statistics were derived from underlying causes of death recorded at issued death certificates were analysed. Results : 64.5% of underlying cause of death for could be derived from underlying cause of death recorded at issued death certificates, 8.6% derived from intermediate cause of death, and 3.9% derived from direct cause of death. In 23% of cases, underlying cause of death could not be derived using issued death certificates. The rate that underlying cause of death for vital statistics could be derived from underlying cause of death recorded at death certificates was different between 3 university hospitals. And the rate was also different between death certificates and postmortem certificates. We classified the causes of death using 21 major categories. The rate was different between diseases or conditions that caused death too. Conclusion : When we examined the correctness of death certificate writing practice using above methods, correctness of writing could not be told as satisfactory. There was difference in correctness of writing between hospitals, between death certificates and postmortem certificates, and between diseases and conditions that caused death. With this results, we suggested some strategy to improve the correctness of death certificate writing practice.

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정면충돌 시 고령운전자 상해 특성에 관한 실사고 연구 (Real-world Accident Study on Injury Characteristics of Elderly Driver in Car-to-Car Frontal Crashes)

  • 홍승준;박원필
    • 한국자동차공학회논문집
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    • 제19권2호
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    • pp.12-19
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    • 2011
  • Real-world accident cases were investigated to understand injury characteristics of the elderly driver. A total 10 cases of car-to-car frontal crash accidents from passenger car including SUV claimed to domestic car insurance company were reviewed. The injury characteristics of the elderly were analyzed from personal information (gender, age), medical treatment record (medical certificate, curative days), vehicle information (model, air-bag, seatbelt) and damage information. This study showed that elderly driver has higher possibility of thorax injury than non-elderly's. Moreover, Injury type and severity were more severe than non-elderly driver at similar type accident conditions. Also, elderly driver's medical treatment period needs 3 times more than non-elderly driver's.