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데이터마이닝을 이용한 의료의 질 측정지표 분석 및 의사결정지원시스템 개발
김혜숙,채영문,탁관철,박현주,호승희 한국의료QA학회 2001 한국의료질향상학회지 Vol.8 No.2
Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.
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의학적 의사결정으로써 공동의사결정 실현을 위한 환자의사결정도구(PtDAs) 연구
이은영 이화여자대학교 생명의료법연구소 2014 생명윤리정책연구 Vol.8 No.1
Shared decision making (SDM) is a collaborative process involving the patient and doctor in which possible treatments, information, and potential medical problems related to the patient’ condition can be considered. Encouraging patient involvement in SDM is increasingly common as clinical practice guidelines explicitly recognize the need for decisions to be guided by patients’ preferences. To support SDM, researchers have developed tools called patient decision aids (PtDAs). PtDAs are evidence-based tools designed to facilitate the SDM process. They have been developed as supplements in order to prepare patients for discussing treatment options with their doctors. This paper reviews the PtDAs for SDM process in medical decisions. 공동의사결정(shared decision making)은 환자에게 가능한 치료 방법 및 관련 사실을 제공하고 환자의 질병과 관련된 의학적 문제를 의사와 환자가 공동으로 고려하는 과정이다. 임상진료지침에서 환자의 선호에 따른 의사결정의 필요성이 명시되어 있는 바, 공동의사결정에 환자의 참여를 독려하는 경우가 점점 더 많아지고 있다. 공동의사결정을 뒷받침하기 위해 연구자들은 환자의사결정지원도구(PtDAs)를 개발했다. PtDAs는 공동의사결정 과정을 촉진하기 위해 설계된 근거 기반 도구이다. 공동의사결정 과정을 간소화하고 효율을 높이기 위해, PtDAs는 임상의와 치료방법을 논의하기 전에 환자 스스로 준비를 할 수 있도록, 의료진과의 상담을 대체하는 것이 아니라 상담에 대한 부가적인 방법으로 개발되었다. 본 논문에서는 의학적 의사결정으로써 공동의사결정을 실현하는 데 필수 요소인 PtDAs에 관해 살펴본다.
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