• Journal of Korean Academic Society of Home Health Care Nursing
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• 제12권1권
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• pp.117-135
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• 2005

Purpose: Expecting a new system of nursing security for elderly in operation in 2007, a substantial expansion of nursing facilities for elderly and quality management of those facilities are imperative now. Therefore. specific quality management measures or schemes which could be used for the operation of small-scale nursing homes are in urgent need. The purpose of this study was to develop a Quality Management Index(QMI) to guide Nursing Home management. Method: This study developed a QMI for small-scale nursing homes, which focused on quality management in structural dimensions such as environment, staffs, local community network, atmosphere, and quality management in process dimensions such as nursing, communication, resident satisfaction. The QMI developed in this study is based on extensive review of literature and the actual experiences of nursing home operation. It consists of 7 dimensions, 39 components and 148 indexes, which have been verified by three times validity tests of experts group. Then the QMI was used to evaluate the quality management levels of nursing homes in Korea. Result: In sum, after analyzing all nursing homes in Korea operated by nurses, this study found that there were significant differences of quality management level among facilities in several dimensions such as environment, staffs, local community connections, communication. In dimensions such as nursing, atmosphere, resident satisfaction, however, little differences of quality management level among facilities were reported. It is considered that this result has to do with several factors like the size of facilities, operation expenses, operation forms, the disposition of professional human resources, and philosophy and management policy of the owners. As far as generalization is concerned, however, it needs to be noted here that the sample size for this study is not statistically big enough to generalize the results. Conclusion: Having Developed a QMI for small-scale nursing home with 7 dimensions, 39 components and 148 indexes, this study is expected to be used in developing more elaborated quality evaluation tools for nursing homes, and also function as a practical guide of quality management for those who are opening and managing nursing homes. I hope this quality index could lead to further development of a standardized quality management index, and eventually contribute to quality improvement of nursing homes.

• Journal of Trauma and Injury
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• 제27권4호
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• pp.165-169
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• 2014

Purpose: Trauma is one of the most common and lethal causes of death in Korea, especially in people under the age of 40. However, a considerable percentage of trauma patients are lost each year due to the scarce resources of the trauma system. The purpose of this study was to determine the recognition of trauma and trauma system. Methods: From April 8th to 22nd, 2014, visitors and in-patients in our medical center were interviewed and surveyed with a questionnaire, which included 28 questions regarding the trauma system, such as the most common cause of death, the locations of trauma centers, the importance of trauma centers, and consent for supporting trauma centers financially. Results: The majority of the respondents recognized trauma as a common cause of death; this was particularly true for people younger than 40. Most respondents' expectancy for the optimal time for trauma patient transport was high, recognizing that major trauma patients should receive urgent care. The respondents felt that trauma centers are important and needed, just as much as police stations and libraries are. Among 178 respondents, 140 (80.5%) were willing to financially support the trauma system. Conclusion: The respondents were aware of the seriousness of trauma and generally agreed on the need for trauma centers. In order to meet the needs and the demands of the people, and to reduce preventable death rate, the trauma system should be improved not only in quality but also in quantity with better and more facilities and manpower, with the aid of publicity from trauma organizations and funding from the government.

• Health Policy and Management
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• 제28권4호
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• pp.352-359
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• 2018

Background: The purpose of this study is to propose an analysis of trends and characteristics of high-cost patients who take over 40% of total national health insurance medical expenses. Methods: It has been analyzed the tendency of high-cost patients by open data based on the medical history information of 1 million people among national health insurance subscriber from 2002 to 2015. To conduct detailed study of characteristics of high-cost patients, multiple regression has been performed by sex, age, residence, main provider, and admission status based on the top 5% group. Results: The amount of medical expenses and the number of high-cost patients have gradually increased in decades. The number of high-cost patients for Korean won (KRW) 5,000,000 category has increased by 7.6 times, KRW 10,000,000 category has increased by 14.1 times in comparing of year 2002 and 2015. Top 5% medical expenses have increased by 4.6 times. In consideration of the characteristics of patients, the incidence of high medical expenses has been higher in female patients than male ones, the older patients than in the younger. Patients residence in Gyeonsang or Jeonla province have had a high incidence of medical expenses than other area. The disease including dementia, cerebral infarction, and cerebrovascular disease for high-cost patients has been also increased. Conclusion: The major increase factor for high medical expenses is the aging of population. The elderly population receiving inpatient care residing in the province that increases high medical costs have to management. There is an urgent need to develop a mechanism for predicting and managing the cost of high-cost medical expenses for patients who have a heavy financial burden.

• International Journal of Computer Science & Network Security
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• 제23권8호
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• pp.17-25
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• 2023

The alarming global prevalence of Type 2 Diabetes Mellitus (T2DM) has catalyzed an urgent need for robust, early diagnostic methodologies. This study unveils a pioneering approach to predicting T2DM, employing the Extreme Gradient Boosting (XGBoost) algorithm, renowned for its predictive accuracy and computational efficiency. The investigation harnesses a meticulously curated dataset of 4303 samples, extracted from a comprehensive Chinese research study, scrupulously aligned with the World Health Organization's indicators and standards. The dataset encapsulates a multifaceted spectrum of clinical, demographic, and lifestyle attributes. Through an intricate process of hyperparameter optimization, the XGBoost model exhibited an unparalleled best score, elucidating a distinctive combination of parameters such as a learning rate of 0.1, max depth of 3, 150 estimators, and specific colsample strategies. The model's validation accuracy of 0.957, coupled with a sensitivity of 0.9898 and specificity of 0.8897, underlines its robustness in classifying T2DM. A detailed analysis of the confusion matrix further substantiated the model's diagnostic prowess, with an F1-score of 0.9308, illustrating its balanced performance in true positive and negative classifications. The precision and recall metrics provided nuanced insights into the model's ability to minimize false predictions, thereby enhancing its clinical applicability. The research findings not only underline the remarkable efficacy of XGBoost in T2DM prediction but also contribute to the burgeoning field of machine learning applications in personalized healthcare. By elucidating a novel paradigm that accentuates the synergistic integration of multifaceted clinical parameters, this study fosters a promising avenue for precise early detection, risk stratification, and patient-centric intervention in diabetes care. The research serves as a beacon, inspiring further exploration and innovation in leveraging advanced analytical techniques for transformative impacts on predictive diagnostics and chronic disease management.

• Journal of Christian Education in Korea
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• 제73권
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• pp.39-54
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• 2023

In this study I want to explore faith formation through the framework of practice. First, I will describe discipleship as a lifelong process of identity formation, defining Christian religious education as a faith community's intentional work of equipping people to walk in the way of Jesus through apprenticeship in faith practices. I will argue that this process is more about the teaching of practices and engaging in theological reflection on practices than it is about dispensing correct information. This idea is not original with me, but has been expounded by many others particularly in the past decade in the U.S., as part of a larger movement within theological discourse emphasizing the centrality of practice. Second, I will describe some resources from educational theorists that can help us to understand what it means to educate through practices toward an identity as Christians. And finally, I will suggest that in our complex, broken and wounded world, as Christian religious educators we especially have a calling to equip disciples in two urgent faith practices: earth-care, and dealing with conflict.

• Journal of Hospice and Palliative Care
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• 제19권1호
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• pp.26-33
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• 2016

Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders. Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital. Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days. Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.

• Journal of Internet Computing and Services
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• 제21권3호
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• pp.133-144
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• 2020

The number of elderly people with dementia is increasing as fast as the proportion of older people due to aging, which creates a social and economic burden. In particular, dementia care costs, including indirect costs such as increased care costs due to lost caregiver hours and caregivers, have grown exponentially over the years. In order to reduce these costs, it is urgent to introduce a management system to care for dementia patients. Therefore, this study proposes a sensor-based abnormal behavior detection system to manage dementia patients who live alone or in an environment where they cannot always take care of dementia patients. Existing studies were merely evaluating behavior or evaluating normal behavior, and there were studies that perceived behavior by processing images, not data from sensors. In this study, we recognized the limitation of real data collection and used both the auto-encoder, the unsupervised learning model, and the LSTM, the supervised learning model. Autoencoder, an unsupervised learning model, trained normal behavioral data to learn patterns for normal behavior, and LSTM further refined classification by learning behaviors that could be perceived by sensors. The test results show that each model has about 96% and 98% accuracy and is designed to pass the LSTM model when the autoencoder outlier has more than 3%. The system is expected to effectively manage the elderly and dementia patients who live alone and reduce the cost of caring.

• The Journal of Korean Academic Society of Nursing Education
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• 제7권2호
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• pp.264-274
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• 2001

About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

• Smart Media Journal
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• 제7권2호
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• pp.60-70
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• 2018

Recently with the entrance to the aging society, the demand on health care services is being increased. However, there are still few GUI types of research considering the characteristics of new-silver generation progressively preparing for their golden(old) age. As the new-silver generation showed less reluctance to the information acquired through the Internet comparing to general seniors, but it is urgent to conduct researches about GUI of mobile healthcare services considering their physical, psychological and social characteristics. Hence, the purpose of this study was to propose some guidelines of GUI evaluation so that new-silver generation being emerged as main consumer group in future medical consumption could efficiently use mobile health care services. As the research methods, first, this study analyzed the characteristics of new-silver generation through reviewing literature and previous studies and understood the status quo of mobile health care services, and second, it analyzed the visual composition factors being preferred in each field of current mobile healthcare application and drew out a usability evaluation matrix of mobile GUI design appropriate for elderly people's characteristics. Third, with the drawn evaluation matrix, this study conducted the usability evaluation of 8 subjects in new-silver generation ranging from 57 years old to 65 years old through a heuristic way. This study expects that it would be contributed in increasing the GUI usability by proposing some guidelines for GUI being appropriated for new-silver generation user's characteristics, and thinks that researches about developing health-care mobile applications will be continued in future at the same time.

• 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.