• Asian Pacific Journal of Cancer Prevention
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• v.13 no.7
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• pp.3061-3064
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• 2012

Aim: An epidemiological shift has resulted in increase in the prevalence of non-communicable diseases (NCD). Unlike other NCDs which are easily and definitely preventable, the knowledge of cancer prevention is still limited at present. Various aetiological factors are difficult to control since those are habit forming. Hence an available remedy remains its secondary and tertiary prevention for which appropriate planning is of paramount importance. Evidence based planning requires careful analysis of data with a view to prioritize various cancers. Keeping in view the fact that the adaptation of smoking free status in Chandigarh city might have a far reaching positive effect on the cancer related morbidity of the people, the following study was undertaken to provide base line data to be used for future comparisons. Methods: The registers maintained in the Department of Radiotherapy were checked and those belonging to the years 1999 to 2009 were utilized to analyze the cancer morbidity in respect to age, sex, and year of presentation to health care facility. Results: A total of 4,600 cancer patients (males=2276, females=2324) demonstrated a gradual increase in the number of cancer cases from 150 in the year 1999 to 783 in the year 2009. The most common cancers amongst males were cancer of gastro-intestinal tract (GIT) and lung (including larynx) constituting 37.3% and 27.1% of the total, respectively. In females these were cancers of breast and cervix representing 33.3% & 17.6% of total cancer cases, respectively, and lung cancer constituted 5.3%. The maximum cases of bone cancer (53.8% of all bone cancers) were observed amongst children aged less than 20 years and lung cancer (48.2% of all lung cancers) among the elderly aged 60-69 years. The.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.23.1-23.8
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• 2017

Background: The aim of this study is to validate a new three-dimensional craniofacial stereophotogrammetry imaging system (3dMDface) through comparison with manual facial surface anthropometry. The null hypothesis was that there is no difference between craniofacial measurements using anthropometry vs. the 3dMDface system. Methods: Facial images using the new 3dMDface system were taken from six randomly selected subjects, sitting in natural head position, on six separate occasions each 1 week apart, repeated twice at each sitting. Exclusion criteria were excess facial hair, facial piercings and undergoing current dentofacial treatment. 3dMDvultus software allowed facial landmarks to be marked and measurements recorded. The same measurements were taken using manual anthropometry, using soluble eyeliner to pinpoint landmarks, and sliding and spreading callipers and measuring tape to measure distances. The setting for the investigation was a dental teaching hospital and regional (secondary and tertiary care) cleft centre. The main outcome measure was comparison of the craniofacial measurements using the two aforementioned techniques. Results: The results showed good agreement between craniofacial measurements using the 3dMDface system compared with manual anthropometry. For all measurements, except chin height and labial fissure width, there was a greater variability with the manual method compared to 3D assessment. Overall, there was a significantly greater variability in manual compared with 3D assessments (p < 0.02). Conclusions: The 3dMDface system is validated for craniofacial measurements.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.1
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• pp.103-112
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• 2003

Purpose : This study was designed to describe the economic awareness, economic knowledge, and attitude toward cost-effectiveness in nursing of hospital nurses. Method : The sample included 272 nurses conveniently selected from 5 tertiary care hospitals. Data were collected on general characteristics of nurses, the economic awareness level, the knowledge level of economics, and the attitude toward cost-effectiveness. Data were analyzed using SPSS PC version 10.0. Result : 1) The mean of economic awareness level of hospital nurses was 44.87 (SD=3.53) with a possible range of 5${\sim}$50. The mean of the knowledge level of economics was 58.3 (SD=11.9) with a possible range of 0${\sim}$100. 2) The mean of attitude toward cost-effectiveness in nursing was 39.95 (SD=5.01) with a possible range of 5${\sim}$50, which means moderately positive. 3) Analyzing the relationships between economic awareness level and knowledge level of economics, and attitude toward cost-effectiveness, the knowledge level of economics was positively related with the economic awareness level (r=.192, p=.002) and the attitude (r=.133, p=.029). The economic awareness level was positively related with the attitude (r=.470, p=.000). 4) Backward multiple regression revealed that the linear combination of economic awareness, job position, place of employment, and the presence of CQI committee accounted for 26.1% of the variance in the attitudes toward cost-effectiveness nursing care. Conclusion : Findings reveal that RNs lack basic knowledge of economics and its link to nursing practice, yet, they want a voice in economic decision making. In an effort to fill the void of economic knowledge and respond to nurses' call for greater input, in-service programs and curricula for generic programs must be developed.

• Journal of Korean Foot and Ankle Society
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• v.15 no.3
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• pp.165-169
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• 2011

Purpose: The objective of this study was to analyze diabetic foot patients' direct service costs until the cure of the disease. Materials Methods: The subjects of this study were randomly sampled 60 patients who had been treated for diabetic foot at one of two tertiary hospitals and cured of the disease during from January 2008 to December 2009, and whose diagnostic code was E11.5 or E14.5. Data were collected from medical records and direct service costs were analyzed using data on the payments of individual service charges. Direct service costs spent at other medical institutions for the same disease were excluded. Collected data were analyzed using descriptive statistics. Results: The subjects' mean hospital stay was 29 days, and mean period until cure was 132 days. The inpatient cost per patient was 10,844,648 won, outpatient cost was 715,751 won, and home care services cost was 641,854 won, so total direct service cost per patient was 11,913,419 won. The total direct service cost in patients who had their foot amputated was 12,769,822 won, 1.3 times higher than without amputation, who had vascular intervention was 16,219,477 won, 1.9 times higher than non-vascular intervention, who had both infection and artery occlusion was 17,522,435 won, 2.0 times higher than either infection or artery occlusion. Conclusion: In diabetic foot patients, the direct service cost was highest as 17,522,435 won in patients accompanied with both infection and occlusion of lower extremity artery.

• Journal of Preventive Medicine and Public Health
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• v.25 no.4 s.40
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• pp.399-412
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• 1992

This study was designed to investigate factors relating to fiscal deficit for regional health insurance. The financial statements for the fiscal year 1990 of nationwide 254 regional medical insurance societies were analyzed. Important findings are summarized below: 1. There were differences in the main reason fur the financial deficit among regions when deficit and surplus societies were compared by regions. The total revenue per enrollee, especially revenue from the premium contribution of a deficit society was significantly smaller than that of a surplus society in large cities and counties. On the other hand, the total expenditure per enrollee of a deficit society was larger than that of a surplus society in small cities. 2. Both low premium rate at the beginning of health insurance program and less effort to increase the premium rate were main factors for the smaller revenue from the contribution of a deficit society in large cities and counties. 3. Larger expenditures per covered person of a deficit society in small cities were explained with larger medical expenditures especially for out-patients services rather than larger administrative expenses. 4. A regression analysis showed that utilization rates in out-patient services were significantly associated with income and numbers of total medical care institution per capita within a region where a health insurance society located. Also expenses paid by insurer per visit were associated with the proportion of utilization for tertiary care hospitals as well as the proportion of utilization of public health centers.

• Clinical and Experimental Pediatrics
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• v.60 no.11
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• pp.353-358
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• 2017

Purpose: To develop and evaluate a simple screening tool to assess hearing loss in newborns. A derived score was compared with the standard clinical practice tool. Methods: This cohort study was designed to screen the hearing of newborns using transiently evoked otoacoustic emission and auditory brain stem response, and to determine the risk factors associated with hearing loss of newborns in 3 tertiary hospitals in Northern Thailand. Data were prospectively collected from November 1, 2010 to May 31, 2012. To develop the risk score, clinical-risk indicators were measured by Poisson risk regression. The regression coefficients were transformed into item scores dividing each regression-coefficient with the smallest coefficient in the model, rounding the number to its nearest integer, and adding up to a total score. Results: Five clinical risk factors (Craniofacial anomaly, Ototoxicity, Birth weight, family history [Relative] of congenital sensorineural hearing loss, and Apgar score) were included in our COBRA score. The screening tool detected, by area under the receiver operating characteristic curve, more than 80% of existing hearing loss. The positive-likelihood ratio of hearing loss in patients with scores of 4, 6, and 8 were 25.21 (95% confidence interval [CI], 14.69-43.26), 58.52 (95% CI, 36.26-94.44), and 51.56 (95% CI, 33.74-78.82), respectively. This result was similar to the standard tool (The Joint Committee on Infant Hearing) of 26.72 (95% CI, 20.59-34.66). Conclusion: A simple screening tool of five predictors provides good prediction indices for newborn hearing loss, which may motivate parents to bring children for further appropriate testing and investigations.

• Journal of Trauma and Injury
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• v.26 no.4
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• pp.261-265
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• 2013

Purpose: The aim of this study is to evaluate the transfer pattern of multiple trauma patients after acute phase management and to determine whether the time between the surgeon's decision and the actual transfer correlates with the patient's insurance type. Methods: Three hundred ninety-two(392) multiple trauma patients visited the emergency room from January 2011 to April 2013. Among the 143 patients who were admitted by a trauma surgeon, 47 were transferred to another hospital after acute phase management. The age, gender, trauma mechanism, Revised trauma score (RTS), Injury severity score (ISS), insurance type, length of ICU stay and hospital stay were analyzed through a retrospective chart review. Results: The mean age was 47.7 years, and traffic accident was the most common mechanism(26, 55.3%). The mean RTS and ISS were 6.93 and 22.7, respectively. Twenty-five patients(53%) were covered by National health insurance, and 20 patients(42.6%) were covered by automobile insurance. Patients were transferred to primary (4.3%), secondary(80.9%), tertiary(4.3%) and care(10.6%) hospitals. The mean time from transfer decision to actual transfer was significantly longer for patients who were covered by automobile insurance than it was for patients who were covered by national health insurance (p=0.038). Conclusion: An appropriate transfer system at the end of acute phase care is essential for managing trauma centers with limited staffing and facilities. In addition, the mean time from transfer decision to actual transfer seemed to be definitely related to the type of insurance covering the patient.

• Child Health Nursing Research
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• v.30 no.1
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• pp.54-66
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• 2024

Purpose: This study investigated participation in and perceptions of antibiotic stewardship among nurses at a children's hospital. Methods: This descriptive study included 125 nurses working in the inpatient ward, intensive care unit and emergency room of a single tertiary children's hospital. The study measured 14 factors influencing antibiotic stewardship behaviors using the theoretical domains framework. Each factor was analyzed by categorizing it into components (capability, opportunity, and motivation) that have been proposed as influencing factors in the COM-B model of behavior. One-way analysis of variance and Pearson correlation coefficients were used to explore differences in antibiotic stewardship behaviors and influencing factors according to general characteristics and the correlation between antibiotic stewardship behaviors and COM-B components. Results: No statistically significant difference in antibiotic stewardship behaviors was found based on the experience of antibiotic stewardship education or the nursing department. However, significant differences were observed in the perception levels of factors related to antibiotic stewardship behaviors according to the experience of antibiotic stewardship education in skill (physical) (p=.042), knowledge (p=.027), intentions (p=.028), and social influences (p=.010). Additionally, significant differences were observed in perception levels according to the sub-components of the COM-B model, specifically physical capability (p=.042), psychological capability (p=.027), and social opportunity (p=.010). Conclusion: To expand nurses' involvement and roles in antibiotic stewardship, nurses should acknowledge the significance of appropriate antibiotic use, aiming to enhance the quality of medical care and ensure patient safety. In pursuit of this objective, tailored education aligning with the specific needs and practices of nurses is essential.

• Journal of the Korean Dietetic Association
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• v.19 no.3
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• pp.265-286
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• 2013

The present study was conducted to develop a standardized job description for clinical dietitians working in hospitals. A developing curriculum (DACUM) method was used for the job analysis of clinical dietitians. Based on DACUM analysis with 14 members, including clinical dietitians and professors majoring in clinical nutrition and job analysis, information on the duties, tasks, and task elements of clinical dietitians was determined. To verify the job descriptions derived from DACUM analysis, a total of 46 tertiary and general hospitals with over 500 beds were recruited for the survey. The final developed job description for clinical dietitians included 7 duties, 27 tasks, and 93 task elements. The duties consisted of nutritional assessment, nutrition diagnosis, nutrition intervention, nutrition monitoring evaluation, consultation cooperation, nutrition research, and self-development. The mean scores of perceived importance, performance, and difficulty on the clinical dietitian's task elements (out of a maximum score of 5.0) were 4.5, 3.7, and 3.5, respectively, with significant differences between the items (P<0.001). The perceived importance and performance grid of clinical dietitian's tasks showed that "construction and maintenance of collaboration" (E2) and "activity of quality improvement" (F1) received relatively low scores for performance despite their high importance scores; thus the performance of these tasks requires significant improvement. In conclusion, the job descriptions of clinical dietitians developed from this study are useful for the qualitative improvement of clinical nutrition services in hospitals.

• Journal of Preventive Medicine and Public Health
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• v.40 no.1
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• pp.36-44
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• 2007

Objectives : There have been few studies examining the differences in health care utilization across social classes during the last year of life. Therefore, in this study we analyzed the quantitative and qualitative differences in health care utilization among cancer patients across educational classes in their last year of life, and derived from it implications for policy. Methods : To evaluate health care utilization by cancer patients in the last year of life, Death certificate data from 2004 were merged with National Health Insurance data (n=60,088). In order to use educational level as a social class index, we selected the individuals aged 40 and over as study subjects (n=57,484). We analyzed the differences in the medical expenditures, admission days, and rates of admission experience across educational classes descriptively. Multiple regression analysis was conducted to evaluate the association between medical expenditures and independent variables such as sex, age, education class, site of death and type of cancer. Results : The upper educational class spent much more on medical expenditures in the last one year of life, particularly during the last month of life, than the lower educational class did. The ratio of monthly medical expenditures per capita between the college class and no education class was 2.5 in the last 6-12 months of life, but the ratio was 1.6 in the last 1 month. Also, the lower the educational class, the higher the proportion of medical expenditures during the last one month of life, compared to total medical expenditures in the last one year of life. The college educational class had a much higher rate of admission experiences in tertiary hospitals within Seoul than the other education classes did. Conclusions : This study shows that the lower educational classes had qualitative and quantitative disadvantages in utilizing health care services for cancer in the last year of life.