• 한국임상약학회지
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• 제26권1호
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• pp.6-12
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• 2016

Objective: This study aimed to explore the readability and comprehensibility of the drug information on a patient leaflet for the senior by employing performance-based user-testing. Methods: We included 36 elderly (65 years old or older) as the senior group (intervention group) and 36 adults (40~59 years old) as the adult group (control). We developed a questionnaire to test if participants could access to drug information. After completing a questionnaire, the participant was interviewed about their understanding over the patient leaflet. We performed t-test, ${\chi}^2$-test or Fisher's exact test to examine differences between two groups in primary outcomes. Results: The senior were less likely able to find information (78%) than the adult (91%); they were much less likely able to understand information (42%) than the adult (69%). While we found differences between the ability of finding and understanding drug information in both groups, the senior group had greater difficulties in understanding all kinds of drug information. They had significant difficulties to remember information after reading the patient leaflet and frequently failed to find proper information even though they were allowed to access freely to the leaflet during interviewing. Conclusion: To secure safe and effective use of drugs for the senior, it is necessary to develop drug leaflets for the senior.

• Industrial Engineering and Management Systems
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• 제7권2호
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• pp.133-142
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• 2008

The Emergency Department (ED) is an integral part of hospitals. Admissions from the ED account for a significant proportion for a hospital's activity. Ensuring a timely and efficient flow of patients through the ED is crucial for optimising patient care. In recent years, ED overcrowding and its impact on patient flow has become a major issue facing the health sector. Simulation is rapidly becoming a tool of choice when examining hospital systems due to its capacity to involve numerous factors and interactions that impact the system. An analytical simulation model is used to investigate potential impacts by changing the following aspects of ED (physical layouts; number of beds; number and rate of patient arrivals; acuity of illness or injury of patients; access to radiology and pathology services; hospital staffing arrangements; and access to inpatient beds). Results of a significant numerical investigation at a hospital are also presented.

• 한국인터넷방송통신학회논문지
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• 제9권5호
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• pp.233-242
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• 2009

의료정보는 환자의 프라이버시 침해 뿐 아니라 환자의 생명에도 직결되기 때문에, 견고하고 유연한 보안모델에 대한 지속적인 연구가 필요하다. 특히, u-헬스케어 환경은 사용자 상황변화가 다양하기 때문에, 보다 더 유연하고 세밀한 접근 권한제어가 필요하다. 본 논문은 u-헬스케어 영역에서 상황타입(Context Type)과 상황제한(Context Constraint)을 정의하고, 의료정보의 비밀등급, 사용자의 권한등급, 사용자의 역할, 사용자 상황에 따른 권한 변경 등을 정의하였다. 또한, 사용자 역할을 기반하여 상황정보 변화에 적용할 수 있는 상황기반 접근제어 모델을 설계하였다. 상황기반 접근제어 모델은 K2BASE를 이용하여 자원과 권한의 관계성과 접근 포인트로 부터 도달 가능한 모든 자원에 대한 권한을 분석하였다. 상황기반 접근제어 모델은 u-헬스케어 영역에서 상황을 기반으로 권한변경과 역할을 유연하게 변경할 수 있고, 권한이 부여된 자원에 의미적으로 연결된 자원을 획득할 수 있어, 상황변화가 다양한 u-헬스케어 영역에서 유연하고 적응적인 접근제어 모델로서 적용 가능할 것이다.

• 정보처리학회논문지C
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• 제17C권2호
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• pp.173-180
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• 2010

IT 기술의 발달에 힘입어 환자들의 위치에 상관없이 편리하게 진료가 가능한 유비쿼터스 헬스케어시스템이 개발되고 있다. 그러나 사용자의 수가 급증하고 다른 병원의 의사나 연구원 또는 환자의 가족들에게 의료 정보를 공개하도록 의료법이 개정되면서 사용자 관리와 프라이버시 침해라는 문제가 발생하였다. 이러한 문제를 해결하기 위하여 본 논문에서는 역할 기반 접근제어 모델에 기반한 사용자 접근 모델은 제안한다. RBAC 모델은 효율적인 사용자 관리 및 접근 제어를 제공하지만, 악의를 가진 사용자가 권한이 있는 역할을 가지고 정보를 유출하고자 할 경우 막을 방법이 없다. 이러한 RBAC의 취약점을 보완하기 위하여 "working status" 파라미터를 역할 속성과 연동하는 RBAC-WS 모델을 제안하였다. 역할에 working 속성을 연동함으로써 허가를 받은 사용자라 하더라도 업무 외 접근을 원천적으로 봉쇄함으로서 내부자에 의한 정보유출 문제를 해결하였다. 또한 RBAC을 위한 함수를 개발하여 도메인이 서로 다른 헬스케어 시스템에서도 유용하게 사용될 수 있도록 하였으며, RBAC-WS 모델의 기능 분석을 위하여 Healthcare 시스템 중 널리 사용되는 PACS에 적용하였다.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제11권12호
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• pp.5835-5854
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• 2017

The implementation of IEEE 802.15.6 in Wireless Body Area Network (WBAN) is contention based. Meanwhile, IEEE 802.15.4 MAC provides limited 16 channels in the Superframe structure, making it unfit for N heterogeneous nature of patient's data. Also, the Beacon-enabled Carrier-Sense Multiple Access/Collision-Avoidance (CSMA/CA) scheduling access scheme in WBAN, allocates Contention-free Period (CAP) channels to emergency and non-emergency Biomedical Sensors (BMSs) using contention mechanism, increasing repetition in rounds. This reduces performance of the MAC protocol causing higher data collisions and delay, low data reliability, BMSs packet retransmissions and increased energy consumption. Moreover, it has no traffic differentiation method. This paper proposes a Low-delay Traffic-Aware Medium Access Control (LTA-MAC) protocol to provide sufficient channels with a higher bandwidth, and allocates them individually to non-emergency and emergency data. Also, a Contention Differentiated Adaptive Slot Allocation CSMA-CA (CDASA-CSMA/CA) for scheduling access scheme is proposed to reduce repetition in rounds, and assists in channels allocation to BMSs. Furthermore, an On-demand (OD) slot in the LTA-MAC to resolve the patient's data drops in the CSMA/CA scheme due to exceeding of threshold values in contentions is introduced. Simulation results demonstrate advantages of the proposed schemes over the IEEE 802.15.4 MAC and CSMA/CA scheme in terms of success rate, packet delivery delay, and energy consumption.

• 보건교육건강증진학회지
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• 제22권1호
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• pp.147-160
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• 2005

The purpose of this study is to identify the nature of the patient service quality of health center, and based on that, to examine the relationship of health center visitor's perceived quality and overall satisfaction. Data were collected on the basis of 'the 3rd Regional Health Care Planning' operated by Rural Health Care Service Technology Aid Task-force Team(RHCSTAT), Ministry of Health and Welfare. Basically, the Manual of 3rd Regional Health Care Planning is composed of structure, process, and outcome measurement indicators. Of these indicators, 21 patient satisfaction questions as outcome indicators are used in this study. The samples are 3,530 patients who visited 80 health centers all of the nation. First, the reliability and validity of patient service quality items was evaluated. Second, the descriptive statistics of health service quality are calculated. Third, through the T-test and ANOVA, the differences of patient satisfaction by responder's general characteristics are compared. In final, to explore the relationship of service quality and overall satisfaction, multiple regression analysis was used. This study shows firstly, the dimension of patient service quality was categorized into 3 dimensions, that is, facilities and environment, staff kindness, and access convenience. Secondly, the reliability and validity of patient service quality items was satisfied. Thirdly, the mean score of staff kindness factors are high in contrast to the facilities and environment. And in regard to the overall satisfaction, the mean score is more higher in Daegu region, County type health center, male group, and upper 65 age group than comparison groups. Lastly, as a result of multiple regression analysis, the effect of patient's perceived service quality, especially, appropriateness of billing time(Beta=0.190) and of reservation time(Beta=0.132) are statistically significant(P<0.01). In conclusion, to satisfy the health need of community people and improve the service quality of the health center, the efforts for the access convenience might be needed. Additionally, the enlargement on health center space and supply of new medical equipment is urgent for the patient satisfaction.

• 정보처리학회논문지C
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• 제10C권3호
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• pp.281-286
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• 2003

최근 환자의 개인적인 의료정보가 외부에 노출되는 것은 사생활적인 측면뿐 아니라 사회 활동 및 환경에도 영향을 준다. 그러므로 불법적인 조작으로부터 환자의 개인적인 의료정보를 안전히 보호하는 것은 중요하다. 이에 본 논문에서는 첫 번째, IC 카드에 전자처방전 정보를 저장하는 방법을 연구하고 두 번째, IC 카드에 저장된 정보에 접근하기 위한 사용자(의사, 간호사, 의료기관 관계자, 약국, 약사, 환자 등)의 접근 권한을 설계한다. 마지막으로 윈도우즈 2000이 지원하는 인증 관리 모델의 보안 API를 이용하여 인증서를 발급하고, 보안 서비스 제공 프로그램을 이용하여 공개키/개인키를 생성하여, 전자처방전에 대해 전자서명을 한다. 본 논문에서 제시한 시스템은 전자처방전의 안전성과 신뢰성을 확실히 보장할 수 있으며, 진료에 대한 서비스를 향상시킬 수 있을 것으로 기대된다.

• Journal of Preventive Medicine and Public Health
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• 제47권5호
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• pp.273-280
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• 2014

Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

• Journal of Medicine and Life Science
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• 제20권3호
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• pp.115-125
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• 2023

Arteriovenous fistula flow dysfunction is the leading cause of vascular access thrombosis and loss in patients undergoing hemodialysis. However, data regarding the influence of access flow rate measurements on the long-term outcomes of access are limited. This study aims to identify accesses at a high risk of thrombosis and loss among patients undergoing hemodialysis by measuring the access flow rate and exploring an optimal threshold value for predicting future access thrombosis. We enrolled 220 patients with arteriovenous fistula undergoing hemodialysis. The primary outcome was the occurrence of access thrombosis. Access flow rates were measured monthly using the ultrasound dilution method and were averaged using all measurements from patients with patent access. In patients experienced access thrombosis, those immediately before the thrombosis were selected. Using these data, we calculated the access flow rate threshold for thrombosis occurrence by analyzing the receiver operating characteristic curve, and the patients were divided into two groups according to whether access flow rates were higher or lower than 400 mL/min. During a median follow-up period of 3.1 years, 4,510 access flows were measured (median measurements per patient, 33 times; interquartile range, 11-54). A total of 65 access thromboses and 19 abandonments were observed. Access thrombosis and loss were higher in the lowflow group than in the high-flow group. This study revealed that low access flow rates are strongly associated with access thrombosis occurrence and subsequent loss of arteriovenous fistulas in patients undergoing hemodialysis.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제6권10호
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• pp.2708-2730
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• 2012

The growing concern for the protection of personal information has made it critical to implement effective technologies for privacy and data management. By observing the limitations of existing approaches, we found that there is an urgent need for a flexible, privacy-aware system that is able to meet the privacy preservation needs at both the role levels and the personal levels. We proposed a conceptual system that considered these two requirements: a graph-based, access control model to safeguard patient privacy. We present a case study of the healthcare field in this paper. While our model was tested in the field of healthcare, it is generic and can be adapted to use in other fields. The proof-of-concept demos were also provided with the aim of valuating the efficacy of our system. In the end, based on the hospital scenarios, we present the experimental results to demonstrate the performance of our system, and we also compared those results to existing privacy-aware systems. As a result, we ensured a high quality of medical care service by preserving patient privacy.