• Title/Summary/Keyword: status of clinical utilization

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Knowledge Discovery in Nursing Minimum Data Set Using Data Mining

  • Park Myong-Hwa;Park Jeong-Sook;Kim Chong-Nam;Park Kyung-Min;Kwon Young-Sook
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.652-661
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    • 2006
  • Purpose. The purposes of this study were to apply data mining tool to nursing specific knowledge discovery process and to identify the utilization of data mining skill for clinical decision making. Methods. Data mining based on rough set model was conducted on a large clinical data set containing NMDS elements. Randomized 1000 patient data were selected from year 1998 database which had at least one of the five most frequently used nursing diagnoses. Patient characteristics and care service characteristics including nursing diagnoses, interventions and outcomes were analyzed to derive the meaningful decision rules. Results. Number of comorbidity, marital status, nursing diagnosis related to risk for infection and nursing intervention related to infection protection, and discharge status were the predictors that could determine the length of stay. Four variables (age, impaired skin integrity, pain, and discharge status) were identified as valuable predictors for nursing outcome, relived pain. Five variables (age, pain, potential for infection, marital status, and primary disease) were identified as important predictors for mortality. Conclusions. This study demonstrated the utilization of data mining method through a large data set with stan dardized language format to identify the contribution of nursing care to patient's health.

Current Prescription Status of Contraindicated Drug Combinations Causing Serotonin Syndrome: Analysis of HIRA-NPS Data

  • Jae Gon Ryu;So Young Kim;Susin Park;Nam Kyung Je
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.4
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    • pp.313-320
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    • 2022
  • Background: Serotonin syndrome is a life-threatening disease if not appropriately treated. This study aimed to investigate the prescription status of contraindicated drug combinations that cause serotonin syndrome and identify the related factors. Methods: A cross-sectional study was conducted using nationwide claims data. Adult patients taking serotonergic drugs with Parkinson's disease or mental disorders were selected. Based on international medical databases (MDBs) and the Korean Drug Utilization Review (DUR), the status of prescribing contraindicated drug combinations that induce serotonin syndrome, the related factors, and the difference between international MDBs and the Korean DUR were analyzed. Results: Of the 49,773 study subjects, 163 (0.3%) were prescribed contraindicated serotonergic drug combinations based on international MDBs, and among them, only 105 (64.4%) were contraindicated by the Korean DUR. Positive influencing factors for prescribing contraindicated drug combinations include patient age between 65 and 74 and physician's specialties (neurologists, and orthopedists). Negative influencing factors were physician's specialty (internists) and medical institution (primary institutions). Conclusion: Despite the implementation of DUR, 3 out of 1,000 study subjects received contraindicated drug combinations that caused serotonin syndrome. Hence, it is necessary to comply with the DUR and improve it in accordance with international MDBs.

The Literary Trends of Herbal Prescription Ukgan-san and its Application in Modern Traditional Korean Medicine (동의보감에 수록되지 않았던 억간산의 문헌상 흐름과 현대 한의학에서의 응용 현황)

  • Cho, Ki-Ho;Kim, Tae-Hun;Jin, Chul;Lee, Ji-Eun;Kwon, Seungwon
    • The Journal of Korean Medicine
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    • v.39 no.3
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    • pp.17-27
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    • 2018
  • Objectives: Ukgan-san does not appear in Traditional Korean Medicine classics. However, it has been used in research and clinical applications in Korea. In this paper, we are aiming to examine the records concerned with Ukgan-san to the present, and announce the present usage state in Korea. Methods: We searched and summarized the contents of previous medical books about Ukgan-san. In order to investigate the current status of utilization of Ukgan-san in Korea, a bibliographic database of Korea, a database of clinical researches, and a database of pharmaceuticals of the Korea Food and Drug Administration were searched. Results: As a result of searching Ukgan-san related documents, Ukgan-san has been developed in China (Ming dynasty). However, its clinical application has been expanded by modern Japanese kampo medicine doctors. In Korea, cases of Parkinson's disease, other movement disorders, and psychiatric disorders have been reported, and randomized controlled trials had been done and planned. In addition, some extracts which are consisted of Ukgan-san are also available. Conclusions: In Korea, Ukgan-san has been influenced by Japan and has been used for clinical and research purposes. The utilization rate in Korea is still small, but the utilization rate will increase according to the results of clinical studies.

The Effect of Patient-Physician Communication Satisfaction on Healthcare Utilization (환자만족이 의료이용에 미치는 영향 - 환자 - 의사 커뮤니케이션 만족을 중심으로)

  • Yoon, Hyejung;You, Myoungsoon
    • Korea Journal of Hospital Management
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    • v.24 no.4
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    • pp.43-56
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    • 2019
  • Purpose: Importance of patient satisfaction related to patient-centeredness has been emphasized, and it is known to have effect on various health outcomes including health resource utilization. However, the effect of patient satisfaction has been discussed mostly in terms of hospital marketing in Korea. This study aims to examine the effect of patient satisfaction in patient-physician communication on healthcare utilization in a nationally representative adult population of South Korea. Method: Patient satisfaction with physician communication is assessed using 4 items in the 2011 Korea Health Panel Survey. Generalized linear regression analysis is conducted using 9,325 adults' healthcare utilization in 2012. Findings: Adjusting for the socio-demographic, economic factors, individual health status, health behaviors and healthcare utilization in 2011, more satisfied individuals, more likely to utilize the outpatient service, especially in clinical setting. Practical Implications: The study findings suggests that in context of South Korea healthcare system such as insufficient medical consultation time and the absence of health delivery system, patient satisfaction as a subjective healthcare quality indicator would have effect on the individual's outpatient visit. This study contributes to stimulate patient satisfaction research and discussion in South Korea to further explore its relationship with potential and various health related outcomes. Further implications of the study are discussed.

Status of the Development and Utilization of Critical Pathways in Medical Institutions in South Korea (국내 의료기관의 표준진료지침 개발 및 운영 현황)

  • Oh, In-Ohg;Chang, Tae-Ik;Kim, Hyun-Jin;Han, Jung-Mi;Lee, Chun-Kyon
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.2-13
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    • 2022
  • Purpose: This study assessed the status of the Development and Utilization of critical pathways (CP) in South Korea. Methods: We surveyed 195 hospitals obtained on the Korean Hospital Association website. Data were collected using structured questionnaires for staff members in charge of CP management personnel in these hospitals. The questionnaire included CP developed by the institutions, the coverage rates and completion rates of CP in the current year, and management indicators related to CP. The questionnaire also included CP support systems and content within the institutions and questions regarding the advantages of CP utilization and obstacles associated with the CP development process. Results: Analysis of the responses from 70 hospitals (35.9% response rate) showed that a total of 1,370 CP sets were developed. The number of CP related to surgery departments was 365 (26.6%), and CP related to surgery and procedure was 1,093 (79.8%), respectively. The CP coverage rate was the most frequently used indicator to monitor the effect of CP (97.1%), followed by the completion rate (90.0%) and the length of stay in hospital (61.4%). CP managers reported that CP were highly useful for communication (3.39±0.493) and accurate information provision (3.39±0.491). The perception that CP violated doctors' autonomy in treatment was relatively low (2.87±0.645). Conclusion: It is necessary to establish an infrastructure in hospitals for CP. CP can facilitate communication and provide accurate information.

Clinical utilization of cord blood over human health: experience of stem cell transplantation and cell therapy using cord blood in Korea

  • Lee, Young-Ho
    • Clinical and Experimental Pediatrics
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    • v.57 no.3
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    • pp.110-116
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    • 2014
  • Cord blood (CB) has been used as an important and ethical source for hematopoietic stem cell transplantation (SCT) as well as cell therapy by manufacturing mesenchymal stem cell, induced pleuripotential stem cell or just isolating mononuclear cell from CB. Recently, the application of cell-based therapy using CB has expanded its clinical utility, particularly, by using autologous CB in children with refractory diseases. For these purposes, CB has been stored worldwide since mid-1990. In this review, I would like to briefly present the historical development of clinical uses of CB in the fields of SCT and cell therapy, particularly to review the experiences in Korea. Furthermore, I would touch the recent banking status of CB.

The Mental Health of Ethnic Minority Youths in South Korea and Its Related Environmental Factors: A Literature Review

  • Lee, Yeeun;Lee, Minji;Park, Subin
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.30 no.3
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    • pp.88-99
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    • 2019
  • Objectives: With increasing concerns for the rapidly growing minority population in South Korea, this literature review addressed a range of mental health risks among multiethnic youths (MY) in South Korea by 1) comparing mental health outcomes with those of native-born youths and 2) identifying multiple layers of relevant environmental factors, from family and school relationships to culture. Methods: We reviewed 54 studies that fulfilled specific inclusion criteria. Results: Multiple common risk/protective factors, including family separation, family relationship quality, parental socioeconomic and mental health status, social relationships at school, and cultural acceptance, were noted. Conclusion: In general, empirical evidence indicates that minority youths have relatively heightened risks for emotional and behavioral problems. Future studies must elucidate the complex interplay between multiple risk and protective factors and the long-term adaptation and mental health service utilization of MY.

Assessment of Zinc Requirement for Human (인체의 아연필요량 측정방법)

  • 윤진숙
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.24 no.2
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    • pp.346-353
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    • 1995
  • The dietary requirement for zinc to maintain optimally the various metabolic and physiological funcitons is still under study. Human beings adapt to reductions in zinc intake by reducing the rate of growth or zinc excretion. Reductions in dietary zinc beyond the capacity to maintain homeostasis lead to utilization of zinc from an exchangeable pool. Loss of a small, critical amount of zinc from this pool leads to both biochemical and clinical signs of zinc deficiency. Zinc requirements have been assessed by balance studies and factorial method. As tissue zinc status influences endogenous losses and the dietary needs, individuls in good status may require higher amounts of zinc than those in poor status. While plasma zinc is insensitive to reducitons in dietary zinc, it is regarded as a valid, useful indicator of the exchangeable pool of zinc. Plasma metallothionein concentrations may prove useful for identifying poor zinc status. It has been suggested that functional end point measurement is the new direciton for zinc requirement. However, determination of the functional response to a marginal zinc intake is difficult because of the lack of a specific, sensitive indicator of zinc status. Presently, no good method for assessment of human zinc requirements exists.

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A Web-based Survey Research on Improving and Utilizing Korean Medicine Clinical Practice Guideline for Ankle Sprain (족관절 염좌 임상진료지침 개정과 활용도 향상을 위한 전자우편 설문조사)

  • Lee, Ji-Eun;Choi, Jin-Bong;Kim, Do-Hyeong;Jeong, Hyun-Jin;Kim, Jae-Hong
    • The Journal of Korean Medicine
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    • v.40 no.2
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    • pp.1-16
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    • 2019
  • Objectives: The purpose of this study was to increase the utilization of Korean Medicine Clinical Practice Guidelines(KMCGP) for ankle sprain by investigating the recognition of guideline developed in 2015 and evaluating the current status of treatment. Methods: An e - mail questionnaire survey was conducted for Korean medicine doctor(K.M.D) registered in Korean Medicine Association. Survey data were analyzed through Excel. Results: The most common Korean medicine treatments used in clinic were acupuncture(adjacent points)(28.5%), cupping therapy(19.7%) and pharmacopuncture(9.8%). The treatments with high patient satisfaction were acupuncture (adjacent points)(27.9%), moxibustion(22.4%) and herbal medicine(10.4%). Herbal medicine(17.9%), tuina(10.7%) and embedding therapy(9.2%) were difficult to perform during treatment because of cost. In the case of a later revision, respondents most thought it is necessary to update evidence and adjust recommendation ratings. A majority of all respondents said they would like to know about the revised guideline through the Internet. In the expected revision effect, the first order was 'presentation of standardized treatment method', the second was 'establishing the basis of Korean medicine treatment', and the third was 'strengthening the status of Korean medicine as therapeutic medicine'. Many respondents wished to add exercise therapy. In order to increase the utilization rate of the guideline, many respondents thought it should be included in textbooks and 90.6% of respondents answered that they would use more than 50% of the revised guideline. Conclusion: It is necessary to update evidence and adjust recommendation ratings and to promote KMCGP. At the same time treatment methods should be taught to K.M.D

The Effect of Stress and Depression on Unmet Medical Needs (스트레스와 우울증이 미충족 의료수요에 미치는 영향)

  • Park, Eun Hee;Park, Eun-Cheol;Oh, Daniel H.;Cho, Eun
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.1
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    • pp.44-54
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    • 2017
  • Background: Mental health issues such as stress and depression have been regarded as major social problems in Korea. We investigated the relationship between stress and depression with unmet medical needs (UMN). Methods: Using the nationwide database of 2010 Korea National Health and Nutritional Examination Survey (K-NHANES), subjects aged 19 years or above were selected (n=6,055). In the K-NHANES questionnaire, subjects were asked about their UMN experience, severity of stress, and perceived depression lasting at least 2 weeks over the past year. The effects of stress and depression on UMN were analyzed in 4 models established by adding predisposing, enabling and need factors in a step-wise fashion. The risks for UMN were also assessed according to the causes of UMN. Results: Individuals who felt stress 'very often' (odds ratio (OR) 3.28, 95% CI=2.23-4.86) and 'often' (OR 2.53, 95% CI=1.93-3.31) and who experienced depression (OR 1.68, 95% CI=1.35-2.10) reported significantly elevated UMN rates, and these effects were substantial especially for the individuals who had UMN due to economic constraint. Females, lower education level, lower income, unemployed status, and negative perceptions about health status were found to be additional risk factors for UMN. Conclusion: Our results confirmed the risks of stress and depression on UMN. It is strongly advisable to create initiatives to improve mental health, particularly stress and depression, and to fulfill individuals' medical utilization needs.