• Title, Summary, Keyword: 표준진료지침

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Standard Clinical Procedure(Critical Pathway) on Dental Conscious Sedation for the Disabled Children (장애아동 진정치료에 대한 표준진료지침의 개발)

  • Kim, Minsu;Bae, Youngeun;Kim, Jiyeon;Jo, Anna;Yoon, Hyunseo;Song, Eunju;Jeong, Taesung
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.42 no.3
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    • pp.226-232
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    • 2015
  • Critical pathway (CP) defines the optimal care process, sequencing and timing of intervention by multidisciplinary health care teams for a particular diagnosis and procedure. The aim of the study was to evaluate the clinical usefulness and the satisfaction of patients and dental staff after implementation of a critical pathway for the dental treatment of disabled children and adolescents under conscious sedation. Thirty patients are divided in two groups (Pre-CP and CP) at the department of Pediatric Dentistry of Pusan National University Dental Hospital. The satisfaction levels of patients/guardians and the staff members were collected by survey questionnaire. The parents' satisfaction was significantly improved after the implementation of CP. Also, medical/dental staff members were highly satisfied with its usefulness. The application of a critical pathway for disabled children and adolescents might be useful and improve the satisfaction of the parents and medical/dental staff members.

Medical Data Based Clinical Pathway Analysis and Automatic Ganeration System (임상데이터기반 표준진료지침 자동 생성 시스템 분석 및 연구)

  • Park, Hanna;Bae, In Ho;Kim, Yong Oock
    • The Journal of Korean Institute of Communications and Information Sciences
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    • v.39C no.6
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    • pp.497-502
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    • 2014
  • In general, all physicians have some standardized diagnosis and treatment methods. However, there are differences in the precise order and examination depending on the hospital size, system, medical equipment, etc. To reduce this difference, the interest about standardized guidelines recently increased and a variety of research is being conducted. The uniform guideline cannot reflect the differences of each situation and environment to meet the hospitals. Therefore, standardized medical guidelines(=clinical pathway) should provide customized guidelines based on the relevant medical data to ensure the quality of the medical service and the doctor's autonomy. In this paper, we will analyze medical data made by two thyroid specialists in the same hospitals. Moreover, this paper mentions the implement of automatic generating clinical pathway system which consider its real hospital situation and result.

A study on the current status and development of the new health technology assessment of Korean medicine field (한의 신의료기술 평가 활성화 방안 제언)

  • Park, Minjung;Jung, Youjin;Son, Soo Kyung;Kwon, Soohyun;Kim, Nankwen;Kim, Jong Woo;Park, Dong Ah;Chung, Seok-Hee
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.59-75
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    • 2019
  • Objectives: The purpose of this study is to examine the current status of Korean medicine health technology assessment and explore realistic plans to activate it. Methods: We investigated all the applications for new health technology assessment related to Korean medicine from 2007 to 2016. The several expert meetings were held to draw out the barriers and improvement strategies of the new health technology assessment of Korean medicine field. Results: There were 31 cases in total except for duplications or reapplies falling into 3 main types. First, 19 of them were to try to enter a medical market and be covered by National Health Insurance. Eight cases were to apply western medicine technology as new health technology in Korean medicine area. The rest was 4 cases, which were totally not appropriate for the purpose of new health technology assessment system. According to the expert opinion, the obstacles of activation in new health technology assessment of Korean medicine were application of unstandardized technology, lack of understanding and experience, lack of clinical trial supporting system for Korean medicine, lack of committee members within the nHTA(new Health Technology Assessment) review board, ambiguous definition of medical practice and sharp conflict between western medicine and Korean medicine. Conclusions: Several suggestions were derived. First of all, to activate Korean medicine in the nHTA system, the existing system should be used sufficiently, and multifaceted efforts are needed to upgrade the system, if necessary. Also, self-help efforts, Korean medicine clinical trial supporting system and increasing R&D investment, establishing extra-committee for Korean medicine in nHTA could be needed. Finally, long-term strategy for improving collaboration between Korean medicine and western medicine should be considered.

Critical Pathway for Spinal Stenosis Patients (척추관 협착증 환자 진료 프로세스 개발)

  • Lee, Hwan Mo;Kim, Ho Jung;Kim, Keung Nyun;Ahn, Poong Gi;Chun, Jahae;Shin, Hyun-Ju;Kim, Yang Soo;Shin, Hye Sun;Kim, In Sook;Chung, Hye Kyung;Kim, Young Ah;Chae, Hyung Ki;Park, In Young
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.83-86
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    • 2009
  • 연구배경: 수술적 치료가 필요한 척추관 협착증 환자들은 주로 60세 이상의 고령환자로 장기간의 입원 시 기회 감염의 증대와 불필요한 의료비의 증대를 가져오게 되며, 수술 후 환자들의 재원일수의 증가는 병원의 병상가동률을 감소시키고, 전공의에게는 불필요한 업무를 증가시킨다. 연구목적: 비용 효과면에서 최적화된 진료 지침의 개발은 불필요한 의료비의 감소 및 Hospital Induced Complication을 줄여 환자 만족도를 증진시킬 수 있으며, 각 환자에 대한 전공의 업무를 줄일 수 있다. 의료기관: 서울특별시에 소재한 2,075병상의 종합전문요양기관 연구방법: 정형외과 및 신경외과의 척추관 협착증 환자의 처방을 비교하여 최적의 표준진료지침을 개발하고 최종적으로 CP Master Program(EMR 프로그램)에 입력하여 환자에게 적용하였다. 연구결과: CP 적용 전, 후 비교를 통해 재원일수는 3.8일이 감소하였으며, 이에 따라 병상 가동률 및 진료수익이 증가했으리라고 예상되며 현재 비교 검토 중이다. 또한, CP 개발 및 CP Master Program의 사용을 통한 전공의 업무 감소에 대해 검토하고 있다.

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A Case Report on Ossification of Posterior Longitudinal Ligament Treated by Korean Medicine: Focusing on Chuna Therapy (경추간판 장애 및 척수병증을 동반한 후종인대골화증 환자에 대한 한의 복합 치료 1례 증례보고: 추나 요법을 중심으로)

  • Hong, Min-Woo;Kim, Jae-Kyoun;Park, Min-Jung;Yoon, Young-Heum;Kim, Su-Yong;Kim, Nam-Kwen
    • The Journal of Korea CHUNA Manual Medicine for Spine and Nerves
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    • v.15 no.1
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    • pp.135-145
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    • 2020
  • Objectives : This study reports the clinical case of a patient diagnosed with ossification of the posterior longitudinal ligament treated with Korean Medicine focusing on Chuna therapy. Methods : The patient was treated by a doctor from July 18th, 2019 to November 28th, 2019. The patient was diagnosed with ossification of the posterior longitudinal ligament based on magnetic resonance imaging results and was recommended to undergo surgery at another hospital. The primary complaint of the patient was left neck pain, left arm sensation, right leg sensation, and right leg loss of strength. The doctor treated the patient with Chuna therapy, acupuncture, cupping, herbal medicine, and pharmacopuncture. The effect of treatment was evaluated using visual analogue scale, neck disability index, pain rating score and Japanese Orthopedic Association score. Spurling, compression, and distraction tests were utilized. Results : Visual analogue scale decreased from 10 at the arm and 10 at the leg to 1 and 2, respectively. Neck disability index decreased from 25 to 11, pain rating score decreased from 66 to 1, and Japanese Orthopedic Association score recovered from 12 to 17 points. In addition, positive spurling test, compression test, and distraction test all improved to negative. Conclusions : Korean medicine treatment can be effective for ossification of the posterior longitudinal ligament patients, even when surgery is recommended. Further clinical studies, such as case series and case-control studies, are required to verify these findings.

Effects of a Standardized Critical Pathway for Laparoscopic Gastrectomy Patients in a General Hospital (일개 종합병원 복강경 위절제술 환자의 표준진료지침 적용효과)

  • Park, Hyo-Jin;Park, Jong;Ryu, So-Yeon;Choi, Seong-Woo
    • The Journal of the Korea Contents Association
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    • v.16 no.9
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    • pp.649-657
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    • 2016
  • This study is aim to investigate how applying a critical pathway(CP) to stomach cancer patients affects their recovery and treatment. The subjects were 165 patients over the age of 20 who were diagnosed with stomach cancer at the gastrointestinal clinic of C hospital and who underwent laparoscopic subtotal gastrectomy. The case group inclueded 102 patients who underwent laparoscopic subtotal gastrectomy with applying the CP from October 2008 to September 2009. The control group included 63 patients who underwent laparoscopic subtotal gastrectomy without applying the CP from September 2007 to September 2008. Pain at the time of discharge was significantly lower in the CP applicated group than in the non-applicated group (Odds ratio [OR], 0.07; 95% Confidence interval [CI], 0.03-0.21). The CP applied group was significantly lower than non-applied group in total hospitalization days (CP applied group: 8.95[1.33], non-applied group: 10.69[4.04], p<0.001) and in postoperative hospitalization days (CP applied group: 7.16[0.94], non-applied group: 8.79[3.90], p<0.001). In conclusion, application of a critical pathway to laparoscopic subtotal gastrectomy reduced pain at the time of discharge, total hospitalization days and postoperative hospitalization days.

Database study for clinical guidelines of children with pneumonia who visited an emergency department (응급의료센터에 내원한 소아 폐렴의 진료 지침을 위한 기초 자료 연구)

  • Hong, Dae Young;Lee, Kyung Mi;Kim, Ji Hye;Kim, Jun Sig;Han, Seung Baik;Lim, Dae-Hyun;Son, Byoung Kwan;Lee, Hun Jae;Lee, Kyung-Hee
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.757-762
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    • 2006
  • Purpose : Pneumonia is one of the most common infections in children who visit emergency departments(ED), but standard clinical guidelines for children with pneumonia in Korea have not been studied. This study was performed to collect and evaluate a data-base of children with pneumonia for establishing clinical guidelines in ED. Methods : This study reviewed 304 children who were diagnosed and treated for pneumonia in the ED at one tertiary hospital between January 2003 and December 2003 retrospectively by reviewing the charts and analyzing the clinical characteristics, laboratory findings, and radiologic findings between an admission group and a discharge group. Results : The 2 year-5 year age group was the top of age distribution and the peak incidence of monthly distribution was December. Two hundred forty seven(81.3 percent) children were hospitalized(admission group), and the mean length of hospitalization was $7.24{\pm}3.24$ days. The most common indications of admission were fever, tachypnea and an age of less than three months. There was statistical differences in the outpatient department follow-up between the two groups(85.8 percent in admission group vs 35.1 percent in discharge group). Conclusion : More prospective studies are needed to establish clinical standard guidelines for children with pneumonia. This will be helpful in ED management and will aid the prevention of pneumonia.