• Journal of Preventive Medicine and Public Health
• /
• 제31권4호
• /
• pp.814-827
• /
• 1998

In this study we analyzed the insurance claims data to investigate the medical care utilization pattern of tuberculosis patients in private sector. We selected the claims of principal or secondary diagnosis with tuberculosis from claims database of National federation of Medical Insurance, from December 1995 to November 1996. Both spell-based analysis and person-based analysis were carried out. In spell-based analysis, type and location of treatment facilities, distribution of diagnoses, number of outpatient/inpatient treatments were analyzed. Additionally in person-based analysis, number of tuberculosis patients, demographic characteristics, number of treatments per person, frequency and pattern of change in source of care were analyzed. The results were as follows 1. The number of treatments with tuberculosis was 863,641 from 1 December 1995 to 30 November 1996. The number of patients was 313.964. 2. Most of tuberculosis patients in private sector were treated in general hospital (45.8%) and clinics(42.2%) 3. About 77.7% of tuberculosis patients who were treated more than two times did not change the source of care. 18,9% of tuberculosis patients changed source of care only once. Even when we limited tuberculosis patient to those who were treated more than five times and whose treatment period were longer than six months, 94.7% of patients did not change source of care at all, or changed treatment facility only once. 4. The probability of change in source of rare was higher in pulmonary tuberculosis, in twenties, and in rural area respectively than other tuberculosis. In conclusion, healer shopping of tuberculosis patients was not serious as expected. However special attention is needed to pulmonary tuberculosis in twenties and rural area.

• Journal of Preventive Medicine and Public Health
• /
• 제18권1호
• /
• pp.41-50
• /
• 1985

To find out the differences in medical practice according to the environment of patient care and managerial situation of the medical care institutions, normal spontaneous vaginal delivery and acute appendicitis were selected, which is suitable for comparison because of their high comparability. A total of 473 cases of normal spontaneous vaginal delivery and 408 cases of acute appendicitis was sampled from the claims to Korea Medical Insurance Cooperations during January to June 1984. Complicated cases were excluded from population and sampling was restricted from 40 to 60 percentile for total charges by the type of medical care facility in order to rule out the influence originating from case mix. Important items representing type and quantity of medical care service were compared by type of facility. Major findings are as follows : 1. University hospital shows the highest in charges per case and decrease in order of general hospital, and clinic. 2. In case of normal spontaneous vaginal delivery, average length of stay shows statistically significant difference by type of facility. 3. Charge amount for each service item affected by practice pattern shows statistically significant difference mostly by type of facility. It is suggested that medical practice pattern is different by type of facility for medical services. 4. Difference in total medical expenditure by type of facility is affected more with charges for materials, consumables and drugs than with fee for service activity. 5. In administering drugs to patients, hospital and clinic show higher injection rate than university and general hospital. 6. Clinical Laboratory tests were common in order of uninalysis, hemoglobin, hematocrit, white blood cell count, urine microscopic examination in cases of normal spontaneous vaginal delivery; white blood cell count, urinalysis, hemoglobin, hematocrit, urine microscopic examination, white blood cell differential count, in cases of acute appendicitis. 7. The result for Laboratory test and Radiologic study shows extreme difference by type of facility. Test rate is lowest in clinic and increase hospital, general hospital, and university hospital in order, both in type and frequency.

• Tuberculosis and Respiratory Diseases
• /
• 제70권3호
• /
• pp.257-260
• /
• 2011

A 65-year-old woman was admitted due to poor oral intake and a dry cough over the previous 3 months. The physical examination was remarkable for bibasilar crackles, and plain chest radiography showed reticulation in both lower lung fields. A pulmonary function test demonstrated a restrictive pattern with a reduced diffusing capacity of the lung for carbon monoxide. High resolution computed tomography showed reticulation and honey-combing in both peripheral lung zones, which was consistent with usual interstitial pneumonia pattern. Her skin showed livedo reticularis. The erythrocyte sedimentation rate and C-reactive protein level were elevated, and hematuria was noted on urinary analysis. A serologic test for auto-antibodies showed seropositivity for Myeloperoxidase-Anti-neutrophil cytoplasmic antibody (MPO-ANCA). A kidney biopsy was performed and showed focal segmental glomerulosclerosis. She was diagnosed as having pulmonary fibrosis with microscopic polyangiitis (MPA) and treated with high dose steroids. Here we report a case of pulmonary fibrosis coexistent with microscopic polyangiitis.

• The Journal of Korean Physical Therapy
• /
• 제6권1호
• /
• pp.49-60
• /
• 1994

Stress is experienced when a person tries to maintain stability in the face of life change but is not able to meet the adaptive demands of change. This can be especially true for the parents who has a cerebral palsy childs who needs long term rare, where parents, are the primary source of care and responsibility. Successful coping leads to maintenance of the parents role and this has an effect on the health status of the child. This descriptive study was attempted to identify stress factors, levels and helpful coping patterns for parents who must take care of cerebral palsy children. Data were collected from 43 subjects who were parents of children diagnosed with cerebral palsy The informations gathered from March 25, 1994 to April 14, 1994 by means of structured questionnaires were analyzed. Two instruments were used to collect the data 1) Lee's stress questionnaire consisted of 33 stress factors and measured by four point Likert scale. 2) Modified Chronic Health Inventory for parents: The modified CHIP included 43 items of coping methods with four point Likert scale. The results of this study were as follows: 1) Stress items could have a maximum score of three points, for a total possible score of 132 points. The mean score for the total was 92.02 points. The item mean score was 2.85 points showing that the parents were experiencing moderate to much stress. 2) The items with the highest stress items were 16 items. The stress items with the lowest mean scores were 10 items. 3) Of the stress categories: The highest stress category was related to changes in the illness status of the child and difficulty in taking rare of the child. The second stressful category was related to the prognosis of the child's condition. The least stress was noticed to social-personal relationships and the responsibility of the care givers. 4) Items measuring coping in the parents had a maximum score of three points each with a total possible roping score of 172 points. The mean score for the total was 103,9 paints. The item mean score was 2.42 points indicating that there were responses of little helpful to moderately helpful on each coping pattern. 5) The most helpful coping items were 7 items. The least helpful coping items were 2 items. 6) Effectiveness of the coping for each patterns was examined : Understanding the illness condition from communication with parents of children with the same condition and consultation with the medical team was the most helpful coping pattern. Family's coorperation and integration and optimism were a moderately helpful coping pattern. Social support psychological stability and self esteem were the least helpful toping pattern. In conclusion, the highest stress for parents of children with cerebropalsy was found to be very stressful changes in the illness of the child and to taking care of a child who is suffering. The parents were helped by the coping methods using understanding of the illness condition through consultation with the medical learn and communication with parents in the same situation. Based on the knowledge, care could develop intervention strategies appropriate for them, help them to develop their effective coping patterns, and give support them in the process of coping with their stress.

• 한국인공지능학회지
• /
• 제9권2호
• /
• pp.15-21
• /
• 2021

This paper conducted a feasibility study by applying an Internet of Things and Artificial intelligence-based management system for the elderly living alone in an aging society. The number of single-person families over the age of 50 is expected to increase, and problems such as health, safety, and loneliness may occur due to aging. Therefore, by establishing an IoT-based care system for the elderly living alone, a stable service was developed through securing a rapid response system for the elderly living alone and automatically reporting 119. The participants of the demonstration test were subjects under the jurisdiction of the "Seongnam Senior Complex," and the data collection rate between the IoT sensor and the emergency safety gateway was high. During the demonstration period, as a result of evaluating the satisfaction of the IoT-based care system for the elderly living alone, 90 points were achieved. We are currently in the COVID-19 situation. Therefore, the number of elderly living alone is continuously increasing, and the number of people who cannot benefit from care services will continue to occur. Also, even if the COVID-19 situation is over, the epidemic will happen again. So the care system is essential. The elderly care system developed in this way will provide safety management services based on artificial intelligence-based activity pattern analysis, improving the quality of in-house safety services.

• 한국디지털건축인테리어학회논문집
• /
• 제13권1호
• /
• pp.23-31
• /
• 2013

This paper presents computer graphics applying the traditional Korean house(Hanok) style interior to unit-care space of Welfare Facility and proposes the possibility as interior design and construction materials. In this paper, the proposed computer graphic-based model is a single-story building that provides convenient traffic between rooms. Computer graphic-based model is presented by Auto CAD, 3D program (Sketch-UP v.8), rendering program (Podium v.2) based on the traditional Korean house and related work of unit-care welfare facility. Computer graphic-based model that combined unit-care and the traditional Korean house has the following characteristics. In each room of living space, wallpaper and flooring Korean paper(Hnaji) is considered and windows, door, furniture of traditional pattern were placed. The living room(Daechung) that is representative of the traditional Korean house and the corridor (toenmaru) are the elements to save the image of the traditional Korean house as much as possible. Especially, the corridor (toenmaru) is placed to conveniently use in nursing-care facility and home-care support facility. A public space is placed around the inside court (An-madang), while the living space (unit-care) has a sense of independence by separation. Bathroom and kitchen have a modern design for functionality than aesthetic elements.

• 성인간호학회지
• /
• 제15권2호
• /
• pp.267-277
• /
• 2003

Purpose: The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit. Method: The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+. Result: The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction & shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%. Conclusion: This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.

• 한국의료질향상학회지
• /
• 제10권1호
• /
• pp.20-27
• /
• 2003

Background : The doctors' strike was not only a manmade disaster but also a chance to apply a new pattern of emergency medical service for patients. We hope to propose a new pattern of emergency medical service by comparing the patterns of emergency medical service given by resident and staff during the doctors' strike. Methods : We reviewed the medical records of patients who received emergency medical service in the Emergency Department(ED) of Deagu Catholic University Hospital during 3 days a week prior to the residents' strike (July 21-23, 2000) with those of patients receiving emergency medical service during the first 3 days of the residents' strike (July 28-30, 2000). We evaluated the patient's severity, the cause of the ED visit, the performance on the laboratory study, ECG, and radiological study, the disposition, and the length of ED stay. Also, we compared the collected data by presenting doctor and by patient's severity. Results : The staff performed fewer tests admitted fewer emergent and non-emergent patients than the residents. Also, the length of ED stay was shorter in both the emergent (212.76 vs. 321.40 minutes) and the non-emergent groups (117.68 vs. 171.39 minutes) for patients presenting to staff. Conclusion : It is desirable that emergency medical service is given by staff, not by resident.

• Journal of Preventive Medicine and Public Health
• /
• 제16권1호
• /
• pp.121-127
• /
• 1983

To identify the changes in professional services pattern after introducing the deligated system of claims review started in 1982, a university hospital under this system was examined. For comparison, claims of the hospital to Federation of Korean Medical Insurance Societies, where this system is not accepted, were reviewed. A total of 600 cases each were studied operated at the Departments of General Surgery & Orthopedic Surgery in 1981 and 1983. The results are summarized as follow: 1. Percentages of hospital charges for basic care was decreased by 10.2% and that for medical service increased by 8.4% in 1983. 2. After the introduction of the deligated review system, percentages of cutting off the claims was decreased by 12.4% for basic care and increased by 3.8% for medical services. 3. Percentage of testing liver function, and the frequency of administering high cost intravenous fluid injection, applicating Robinul as anesthetic premedication were decreased respectively after introducting the deligated services system.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제1권2호
• /
• pp.73-81
• /
• 1996

The construction of the health care facilities in terms of medical institutional source cost much and affect on management of another sources like, staffs for the health care delivery systems and the medical service For it is hard to amend and change the physical component of the facilities, the reasonability and the efficiency of the facilities should be the major considering point. Consequently, the purpose of this study is to represent the basic data for determining the size of general hospital by analyzing the use pattern of existing facilities and investigating annual use pattern and user's distance from the facilities.