• International Journal of Internet, Broadcasting and Communication
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• 제13권1호
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• pp.229-237
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• 2021

This study aimed to help build a quality control program to improve cardiac arrest treatment via analysis of medical records in a local tertiary general hospital to evaluate factors that influence clinical outcomes of in-hospital cardiac arrest. At first, the medical records of in-hospital cardiac arrest were analyzed, and targeted surveys about functional and structural factors associated with cardiopulmonary resuscitation (CPR) were conducted amongst the workforce in charge of cardiac arrest treatment. From January 2012 through June 2013, a total of 486 adult cases of in-hospital cardiac arrests, except for those occurring in the emergency room, were enrolled in this study. Among the patients, those of recovery of spontaneous circulation were 57.8%; 13.8% of patients were discharged alive; 8.9% of patients were discharged without significant neurologic sequela. Despite CPR is usually successful when administered as quickly as possible, in this analysis showed that prompt reaction after initial recognition was significantly lower in nurses compared with doctors. Analysis of survey results showed that confidence in performing CPR was significantly associated with the experience of CPR in doctors, while in nurses educational experience showed a correlation. In order to improve quality of in-hospital CPR system maintaining and increasing confidence of CPR performance is the most important factor. Therefore it can be helpful to develop and apply a phased, customized education program using training simulators as well as personalizing them to increase the personnel's confidence in CPR performance.

• 한국응급구조학회지
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• 제27권1호
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• pp.127-137
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• 2023

Purpose: This study aimed to analyze the treatment outcomes according to the socioeconomic factor of patients who visited the emergency room. Methods: This study conducted frequency analysis, percentage analysis, and Fisher's exact test analysis method, using the R 4.1.2 program based on the 2019 data from the Korea Health Panel. Results: Among the treatment results of 1,648 patients, 392 patients were hospitalized or transferred to other hospitals, 845 were discharged after treatment, 224 were discharged, and 7 died. The Fisher's exact test of treatment outcomes and socioeconomic factors was not statistically significant for status of the worker and employment relationship, but was significant for the housing, household, economic activity, and insurance types, and marital status and education. Conclusion: The results of this study indicate that it is necessary to conduct follow up studies on socioeconomic factors to provide basic data that can contribute to fairness and equity in the health care field.

• 한국의료질향상학회지
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• 제4권1호
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• pp.104-114
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• 1997

Background : Hospitals(Health care providers) are under tremendous pressure to meet consumer demands in order to compete in the rapidly changing health care arena. Through evaluating patient satisfaction, hospitals(health care providers) can learn what the consumer Wants from the health care system. Timely feedback is necessary. The purpose of this study is to evaluate patients' hospital experience and satisfaction using telephone interview and to study the usefulness for telephone interview at assessing patient satisfaction. Method : The 846 patients who were discharged from September 17, 1996 to October 11, 1996 were targeted were telephoned. The informations gathered telephone survey were processed by computer and analyzed for the patient satisfaction, contributing factors. Result : The 846 patients who were discharged from September 17, 1996 to October 11, 1996 were called and 197 patients(23.3%) were successful interviewed. 51.3 percent of respondents were male and mean age is 39 years mean LOS(length of stay) is 13 days and 110(56.1%) patients were admitted by outpatients clinic. The mean calling-time is 5.5 minutes. There is no significant difference between interviewers(telemarketer) in patients satisfaction. Seven telephone interviews are possible by interview a day. There in no significant difference between groups in patients satisfaction in length of stay, path of admission, the interval between discharge and interview. 97.5 percent of respondents were satisfied with telephone interview and 81.7% were satisfied with overall satisfaction and 79.4 % of respondents were good response in interviewers' conclusion. Of six variables that were found to be correlated with telephone interview and eight variables correlated with overall hospital satisfaction, a multiple logistic regression analysis revealed that two most important variables which are significantly correlated with telephone interview are to meet doctors, not ask tediously then three variables which are with overall satisfaction are doctors explain, subject response, convenient facilities. Conclusion : The patients interviewed are satisfied with telephone interview. Telephone interview is good method for assessing patient satisfaction, making high levels of patient satisfaction and for hospital marketing.

• Journal of Dental Anesthesia and Pain Medicine
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• 제15권1호
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• pp.5-10
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• 2015

Background: Patients were subjected to post-discharge follow-up (by telephone) in order to investigate the potential complications of outpatient general anesthesia or deep sedation that could develop in disabled dental patients discharged from the hospital. The ultimate aim of this study was to establish an appropriate response measure for such complications. Methods: The caregivers of 79 disabled patients who underwent dental procedures under general anesthesia at our outpatient clinic were interviewed over telephone. Necessary care instructions were provided during the phone calls when required. The patient satisfaction level regarding the telephonic follow-up care was surveyed by additional telephone calls. Results: Most of the patients did not suffer any serious complications; however, some reported fever and bleeding. The data obtained in this study can be utilized towards the development of caregiver education pertaining to the ambulatory general anesthesia of dental patients with disabilities. Conclusions: Additionally, we hope that the findings of this study will help minimize the effects of complications experienced by disabled dental patients undergoing ambulatory general anesthesia, as well as increase the overall patient satisfaction level.

• 대한임상독성학회지
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• 제8권1호
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• pp.37-42
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• 2010

Purpose: The purpose of this study was to determine the optimal length of time to observe patients with contrast media anaphylaxis in the Emergency Department. Methods: This study included the patients of all age groups who presented with anaphylaxis due to contrast media to the ED of Pusan National University Hospital from January 2006 to August 2009. The medical records were retrospectively reviewed. We analyzed the 100 patients who met the inclusion criteria. Their median age was 55 (46-62), and 38 out of the 100 patients (38%) were male. Results: The most common symptom of patients was urticaria. Corticosteroid and H1 antihistamine were given to most of the patients in the ED. All were discharged after observation in the ED and none were admitted to the ward. The average time from injection of the contrast media to the onset of symptom was 31 minutes (24-39) and the average time to symptom recovery was 127 minutes (89-188). The mean observation time in the ED was 93 minutes (59-153). Biphasic reactions were reported in only one case (1/100, 1%). Conclusion: These results suggest that patients who present with an anaphylactic reaction after radiologic studies that use intravenous contrast media can be safely discharged early from the ED because the symptom recovery time is not long and a biphasic reaction is rare.

• Journal of the Korean Data and Information Science Society
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• 제21권2호
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• pp.279-289
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• 2010

이 논문에서는 호흡곤란을 주호소로 내원한 668명의 환자를 대상으로 입퇴원 결정을 위한 간편한 통계모형을 제안한다. 이것을 위해 55개 변수 중 임상전문가에 의해 중요하다고 선택된 11개 변수를 설명변수로 이용하였다. 먼저 변환과정으로 11개 연속형 변수 각각에 대해 실제 입원과 퇴원 환자의 커널밀도함수에 의해 퇴원구간을 설정하였다. 다음으로 11개 설명변수 중 퇴원구간에 속한 변수의 개수를 가지고 환자의 퇴원여부를 결정하는 최적 모형을 선택하였다. 입원과 퇴원 환자수의 불균형 때문에 최적 모형의 선택기준으로는 민감도와 특이도의 산술평균과 민감도와 정확률의 조화평균을 이용하였다. 그 결과 11개의 검사결과 중 7개 이상에서 퇴원구간이 나오면 퇴원을 결정하는 것이 최적 모형이 되었다.

• 한국의료질향상학회지
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• 제11권1호
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• pp.46-60
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• 2004

Background : Recently, we have experienced various changes in the healthcare environment. Healthcare organizations are facing a financial crisis due to more competitive relationships among themselves as well with low health insurance fees. The purposes of the current study were: (1) to develop a data warehouse-based system for evaluating and monitoring the case management activities, and (2) to measure and analyze its effects. Methods : In order to collect the data for the study, the database on discharged patients was utilized at a university hospital located in Seoul from June 1, 2002 through December 31, 2002. Initially, a data warehouse was built for the case management system. The case management activities were analyzed using structured methodology to establish the case management system. Results : The findings of this study were as follows: (1) A case management system was developed to make it possible to monitor of healthcare quality and resource utilization. The Case management System included monitoring functions regarding utilization reviews, critical pathways, and clinical indicators. (2) Utilizing the case management system, unplanned readmissions were documented among total discharged patients during two months from November 1, 2002 through December 31, 2002. The unplanned readmission rate was 2.3%(276 patients) in total of 11,960 discharged patients. Among them 81 patients(0.7% of total discharges, 29.3% of unplanned readmission) were readmitted to the same physician in charge under the same diagnosis. No significant differences were found in the demographic variables such as gender and age among the patients. (3) After implementing the case management system, 2.9% of average length of stay reduced. Applying cost-benefit analysis, the 2.9% reduction of length of stay represents net profit of ${\backslash}$ 279,592,000 in the year of 2004. In addition, applying value acceleration analysis, cumulative net benefit of ${\backslash}$ 1,481,000,000 was expected by the year of 2007. Also we were able to expect ${\backslash}$ 247,800,000 of cumulative benefit for the prospective 5 years in value linkage analysis. It represents average ${\backslash}$ 787,700,000 of pure net benefit a year. Conclusion : The value of present study would be not only implementing the knowledge management system into the existing case management activities, but also evaluating its effects and estimating its financial benefits. This study suggested that the case management system would be a supportive tool for monitoring and improving the quality of healthcare, and a cost-effective tool for increment of healthcare organization's financial benefit.

• 대한간호학회지
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• 제24권3호
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• pp.484-498
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• 1994

The purpose of this study was to investigate the home care needs in a rural county as a basic study to develop a Korean home care model. A stratified cluster sampling method was used to select 1, 352 household which accounted for 8.8% of Youn Cheon County population. A Standard criterias for home care subject were delineated by five nursing professors representing five different areas of nursing specialty. The developed criteria for home care subjects were as below, 1) Patients who had been discharged from hospital during the previous week. 2) Patients with special medical devices 3) Newborns and the mothers. 4) The chronically ill with poor recovery or control of disease. 5) Subjects with poor health care behavior or ability 6) Subjects with poor social support and / or family resources. 7) Subjects with health related educational needs. Three types of questionnaires were developed to screen home care subjects, one for adults, one for infants and one for the elderly. Also different questionnaire items were developed to evaluate the control and self care ability of chronically ill subjects. After training in interview methods for 2 days, 39 interviewers visited individual households for interviews. As the results of the study showed that 14.1％ of adult subjects and 76.5% of infants and child were judged as having at least one criterion related to home care need, 15.69% of adults and 53% of elderly had at least one chronic illness. The most prevalent chronic illnesses were hypertension, skeletal-neurological disease and diabetes. The prevalence of subjects with home care needs were, those with poor health care behavior(8.89%), with health-re-lated educational needs(8.71%), with poor recovery or control of disease (3.52%), and with poor social support and inadequate family resources(3.19%). There were only 0.3%, 0.37%, 0.11% who were discharged patients, patients with medical devices, or newborns respectively. Thus, the largest home care client group were those who need direct health care and health education. Seventy five percent of the subjects responded that they were willing to use and pay for home care service if it is offered in the future. It is suggested that recently discharged patients and patients with special medical devices can be cared for by hospital based home care nurses, but other home care clients can be cared for by com-munity based home care nurses.

• Journal of Preventive Medicine and Public Health
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• 제15권1호
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• pp.139-143
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• 1982

A study was carried out in 81 retreatment patients with sputum positive pulmonary tuberculosis who had previously been treated with first-line drugs for more than one year at Health Center. The Following results were obtained; 1. Of the total 81 case of retreatment patients, male patients occupied 63(77.8%) and 18(22.2%) were female. Age group of $30{\sim}49$ years was 54.3% of total cases. 2. By extent of disease, moderate advanced cases were 53.1% and far advanced cases were 35.8%. 3. Of 81 patients admitted to the study. 65(80.3%) completed 1 year treatment 16(19.7%) patients discharged prematurely before 1 year. 4 patients terminated their treatment during $9{\sim}11$ months after registration. 4. Completment rate of chemotherapy was highest (90%) at age of under 30 years. 5. Intractable patients with persistant positive sputum test for A.F.B. even after 12 months of retreatment were occupied 9(13.8%) of total retreatment cases.

• Tuberculosis and Respiratory Diseases
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• 제73권3호
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• pp.169-173
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• 2012

Background: Spontaneous pneumomediastinum is a rare and benign condition that generally occurs in young generations without any precipitating factor or underlying disease. The purpose of this study is to review our experience in dealing with this entity and detail a reasonable course of assessment and management. Methods: From December 1999 to May 2012, 32 spontaneous pneumomediastinum patients were managed in our hospital. We retrospectively reviewed the result of management. Results: Patients ranged in age from 10 to 38 years, with the mean age of $18.3{\pm}5.6$ years. Twenty-five patients were men and seven were women. Initial WBC count was $10,039{\pm}2,993/{\mu}L$ and thirty-one patients underwent computed tomography. Twenty-two patients underwent esophagography and results were shown to be normal. Twenty-five patients were admitted in the hospital and the mean duration of admission was $3.4{\pm}2.0$ days. All patients were managed conservatively and discharged without any complications. Conclusion: Spontaneous pneumomediastinum is a benign condition combined with mild inflammatory signs and secondary causes must to excluded to avoid unfavorable outcomes and select proper management modality.