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박하영,신의철,맹광호,Park, Ha-Young,Shin, Eui-Chul,Meng, Kwang-Ho 대한예방의학회 1990 Journal of Preventive Medicine and Public Health Vol.23 No.4
The variation in resource utilization for hospitalized patients who had a group of similar diseases -- a Korean Diagnosis Related Group (KDRG) -- among the same type of hospitals was studied to assess the utillization variation due to the practice pattern of hospitals. Information about inpatients who were beneficiaries of the medical insurance for teachers and government officials discharged from 20 large university teaching hospitals in Seoul during 1986 and information about the hospitals were analyzed to achieve the study objective. A total of 20,223 non-outlier patients in 100 most frequent KDRGs were included in the analysis. Case charges after the review and length of stay (LOS) were used as measures of resource utilization during a hospitalization. A substantial variation among hospitals was found in most KDRGs : o the ratio of the maximum and the minimum among the mean case charges of hospitals was greater than 2 in 83 KDRGs ; o the difference between the maximum and the minimum among the mean case charges of hospitals was greater than 100,000 Won in 94 KDRGs : o the ratio of the maximum and the minimum among the mom LOS of hospitals was greater than 2 in 82 KDRGs ; o the difference between the maximum and the minimum among the mean LOS of hospitals was greater than 3 days in 94 KDRGs. The practice pattern of hospitals explained more than 20% of charge variation in 49 KDRGs and more than 20% of LOS variation in 43 KDRGs. The study results indicated need for a new health policy initiative for cost containment and quality assurance.
'퇴원설명문'에 의한 72시간내 부적절한 응급센터 재방문의 감소
박하영,심민섭,송형곤,송근정,Park, Ha Young,Sim, Min Seob,Song, Hyoung Gon,Song, Keun Jeong 한국의료질향상학회 2006 한국의료질향상학회지 Vol.12 No.1
Background : Patients who were discharged from the emergency department(ED) may revisit. These patients are divided into two groups; one is expected scheduled condition, the other is unexpected condition. These patients of inappropriate revisits to the ED would be unsatisfied, difficult to make rapport and take legal action as a result of additional medical charges. The purpose of this study was to reduce inappropriate revisits to the ED with a new method which was developed by analyzing inappropriate revisits in 2002. Methods : This study was conducted in a tertiary hospital consisting of 1,278 beds. The most common cause of inappropriate revisits was the medical team's lack of explanation about a disease. Thus we decided that the effective method was to offer full explanations to patients to understand the clinical pathway of a disease. We made four types of stickers to explain most common 4 diseases in 2003. An emergency physician completed 'discharge explanation report' and explained it to patients in 2004. Results : In 2002 inappropriate revisited patients were 164, patients with four diseases were 79. During the same period of 2003, inappropriate revisited patients were 56 (-65.9%), four disease patients were 6 (-92.4%) and in 2004 inappropriate revisited patients were 52, four disease patients were 19. Causes of revisits were lack of explanation about a disease in 35 patients (44.3%) in 2003, and 5 patients (83.3%) in 2003, and 16 patients (84.2%). Conclusions : Application of 'explanation stickers' at discharge reduced inappropriate revisits from 34.5% in 2002 to 15.9% in 2003. Application of 'Discharge explanation report' by emergency physician reduced inappropriate revisits from 15.9% in 2003 to 13.5% in 2004. Reduction of inappropriate revisits elevated the quality of medical treatment, and decreased patients' dissatisfaction in ED.
무선 ad hoc 망에서 QoS 보장을 위한 가변 우선순위 MAC 프로토콜
박하영,김창욱,한정안,김병기,Park, Ha-Young,Kim, Chang-Wook,Han, Jung-Ahn,Kim, Byoung-Gi 한국통신학회 2007 韓國通信學會論文誌 Vol.32 No.7b
Ad hoc 무선망의 동적인 특성으로 인하여 히든노드 문제가 나타날 수 있기 때문에 ad hoc 무선망에서는 분산방식으로 네트워크가 동작되어야 한다. Ad hoc 무선망에서 CSMA/CA는 비동기적 데이터 트래픽을 위해 가장 많이 사용되는 MAC Protocol 중의 하나이다. 그러나 CSMA/CA는 멀티미디어 데이터의 특성을 보장하지 못한다. 또한 경쟁형(Contention)이므로 채널을 먼저 잡은 하나의 스테이션이 채널을 독점해서 사용하여 채널 기아(starvation)로 인한 공평성문제(fairness problem)가 발생한다. 본 논문에서는 무선 ad hoc망에서 멀티미디어 데이터의 특성을 고려하여, QoS 보장을 위한 MAC protocol을 제안한다. Because of MANET's dynamic characteristic, the hidden node problem can happen. Thus it must use with distributed channel access. In Ad hoc networks, carrier sense multiple access with collision avoidance(CSMA/CA) is one of the most widely used medium access control(MAC) schemes for asynchronous data traffics. However, CSMA/CA could not guarantee the quality of multimedia traffics. CSMA is a contention based protocol. Therefor once a node gets a channel, it can momopolze. Thus the fairness problem with channel starvation will happen. We will propose a new MAC protocol to guarantee QoS for multimedia data in ad hoc networks.
박하영,( Hyung Joo Oh ),( Chul Kyu Park ),( Hong Jun Shin ),( Hee Jung Ban ),( Yong Soo Kwon ),( In Jae Oh ),( Yu Il Kim ),( Sung Chul Lim ),( Young Chul Kim ),( Yoo Duk Choi ) 대한결핵 및 호흡기학회 2015 대한결핵 및 호흡기학회 추계학술대회 초록집 Vol.120 No.-
Background: Epidermal growth factor receptor (EGFR) mutation is a reliable predictive factor for response to EGFR tyrosine kinase inhibitors (TKIs) compared to wild type. We investigated the quantified EGFR value can also predict response and survival within EGFR mutated group. Methods: This was a retrospective study of 836 lung cancer patients performed EGFR mutation test by peptide nucleic acid (PNA)-mediated clamping polymerase chain reaction (PCR) from January 2013 to December 2014. The efficiency of PCR clamping was determined by measuring the cycle threshold (Ct) value and the EGFR quantification was determined by corrected delta Ct (ΔCt) value which was subtracted non-PNA corrected sample Ct value from standard Ct value. Results: The positivity of EGFR mutation was 32.3% and there were 235 single activating mutations (131 cases of 19 deletion and 104 cases of L858R). Response to EGFR-TKIs was significantly better in female (p<0.001), non-smoker (p=0.012), EGFR mutation (p<0.001) and first line treatment group (p<0.001). In EGFR single activating mutation group, the mean corrected ΔCt value was 6. The high corrected ΔCt group was significantly better response (70.9% vs. 54.9%, p=0.022) and median progression-free survival (303.4 days vs. 223.9 days, p=0.05). But overall survival was not different between two groups (379.7 days vs 356.2 days, p=0.655). Conclusion: The quantified EGFR value by PNA-mediated PCR clamping can predict response and progression-free survival of EGFR-TKIs in patients with 19 deletion and L858R mutations.