제 2 주제 : 의료의 질 향상 개념과 기법 / 질 향상 활동의 개념

송정흡 한국병원경영학회 2000 한국병원경영학회 학술대회연제집 Vol.2000 No.1

입.퇴원 module 시스템의 효과 분석 -ocs 입원 관리 시스템 효과 분석-

송정흡,Song, Jung Hup 한국의료질향상학회 2006 한국의료질향상학회지 Vol.12 No.1

Background : There were so many patients who are waiting for admission in Emergency room in spite of more than one hundred empty beds everyday. This study was conducted to evaluate admission-discharge module system by OCS which reduce empty beds. Methods : The data of bed utilization in general beds from 2004 were reviewed. For evaluation of performance at admission-discharge module system by OCS, the change of Occupancy of bed were calculated. Results : The percentage of Average Bed Emptiness was changed from 13.8% to 9.2%. The residents in surgery(100%) and in internal medicine(75.5%) approved this system. Conclusion : The personnel in hospital recognized that it was very important to manage bed. The management of beds by OCS was helpful to reduce empty beds and was important.

Notes on the Aloe Vera Aphid, Aloephagus myersi Essig (Hemiptera: Aphididae) on Non-native Aloe Plants in Korea

송정흡,서수정,Song, Jeong-Heub,Suh, Soo-Jung Korean Society of Applied Entomology 2014 한국응용곤충학회지 Vol.53 No.3

온실에서 재배되는 수입 알로에묘목에 알로에베라진딧물, Aloephagus myersi Essig, 이 채집되었다. 이 종의 원산지는 아프리카로 알려져 있고 수입된 식물을 통해 온실에 도입된 것으로 추정된다. 우리나라의 자연환경에 도입과 정착을 방지하기 위한 이들 종의 진단형질, 사진자료, 기주 및 분포정보를 제공하고자 한다. The aloe vera aphid, Aloephagus myersi Essig, was collected on imported Aloe vera (L.) Burm.f. (Xanthorrhoeaceae) grown in greenhouses in Korea. This species is native to tropical Africa and probably was introduced into greenhouses via the aloe plant trade. This introduction reinforces the need to focus attention on the eradication from collected localities, and for constant surveillance and detection at ports of entry to prevent introduction and establishment of new pests in the Korean environment. In this paper, additional information for the aloe vera aphid is provided with diagnoses and photographs along with host plant and distribution data for accurate species identification.

비외상성 급성 복부 통증 환자에게 시행한 복부 전산화단층촬 영과 복부 단순 촬영의 적정성 비교

송정흡,염헌규,Song, Jung-Hup,Ryeom, Hun-Kyu 한국의료질향상학회 2018 한국의료질향상학회지 Vol.24 No.2

Purpose: To compare the Appropriateness of abdominal CT to abdominal radiography as an imaging modality in terms of the diagnostic value, medical costs and decision making times for patients presented to the emergency department with nontraumatic abdominal pain. Methods: This study used the records of 530 cases presented to the emergency department(ED) with nontraumatic abdominal pain from February to March 2012. Imaging modalities were categorized into abdominal radiography and CT (radiography first or CT first) or radiography alone or CT alone. The diagnostic value, total medical costs and effect on decision making time of the each imaging modalities were compared. Especially, in retrospective review, to evaluate the predictability of the abdominal radiography, alit was assumed that all the 530 cases performed that exam as initial imaging. Results: Among 530 cases, 255 cases underwent abdominal radiography only, 28 cases underwent abdominal CT only and the remnant 247 cases underwent abdominal CT with plain abdominal radiography. The diagnostic value was higher in the cases with abdominal CT (268/275, 97.5%) than in the cases with plain abdominal radiography (19/255, 7.5%).The number of cases predicted by abdominal radiography only as initial imaging were 39/530 (7.4%). In cases where the patients performed the abdominal CT as the first imaging modality thereby omitting the abdominal radiography, the total diagnostic imaging fee was lower than in cases with plain abdominal radiography first followed by the abdominal CT (277,140 vs. 284,226(mean, Korean Won)). Although diagnostic value of the plain abdominal radiography as first imaging modality was lower than the abdominal CT, Decision making time, average duration of hospital stay was longer and the total medical costs was higher than abdominal CT. Conclusion: As an imaging modality in the ED for patients with acute nontraumatic abdominal pain, plain abdominal radiography is an avoidable procedure when viewed in terms of the diagnostic value and total medical costs and decision making times comparing with abdominal CT.

외래 항암 화학요법 주사실 모델의 적정성 분석

송정흡 한국의료QA학회 2004 한국의료질향상학회지 Vol.11 No.1

Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient to outpatient is occurred. So the capacities for chemitherapy incrcased and the shifted rooms were occupied with new non-chcmotherapy patients. The incotne of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outparient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outoatient chemotherapy administration. The 91.7% of doctors said there were vo differences in treatment outcome between outpatient and onpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemitherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was - 185,294,614 won. Conclusion: The outpatient chemitherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to uotpatent was not occurreed. In econornic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of uotpatient chemotherapy. It is necessary to raise the level of health case fees for oupatient chemotherapy administration.

감귤원에서 가을철 귤응애 성충의 공간분포와 표본조사

송정흡,김수남,류기중 한국응용곤충학회 2003 한국응용곤충학회지 Vol.42 No.1

Dispersion pattern for adult citrus red mite (CRM), Panonychus citri (McGregor) using by Taylor's power law (TPL) and Iwao's patchiness regression (IPR) was determined to develop a monitoring method on citrus orchards, on Jeju, in Autumn season, during 2001 and 2002.CRM population was sampled by collecting leaves and fruits. The relationships of CRM adults between leaf and fruit were analyzed by different season. The regression equation for CRM adults between leaf (X) and fruit (Y) was ln(Y+1) : 1.029 ln(X+1) ( $r^2$ : 0.80). The density of CRM was higher on fruit than on leaf according to fruit maturing level. TPL provided better description of mean-variance relation-ship for the dispersion indices compared to IPR. Slopes and intercepts of TPL from leaf and fruit samples did not differ between sample units and surveyed years. Fixed-precision levels (D) of a sequential sampling plan were developed using Taylor's power law parameters generated from adults of CRM in leaf sample. Sequential sampling plans for adults of CRM were developed for decision making CRM population level based on the different action threshold levels (2.0,2.5 and 3.0 mites per leaf) with 0.25 precision. The maximum number of trees and required number of trees sampled on fixed sample size plan on 2.0,2.5 and 3.0 thresholds with 0.25 precision level were 19, 16 and 15 and their critical values T$_{critical}$ at were 554,609 and 659, respectively. were 554,609 and 659, respectively. 귤응애 성충의 표본추출법을 개발하기 위하여 2개년(2001-2002년)동안 8월부터 11월까지 잎과 열매에 대해 각 조사일에 평균밀도를 조사하였다. 잎과 열매에서 귤응애 성충 밀도의 관계를 시기별로 비교하였으며, Taylor's power law (TPL)와 Iwao's patchiness regression (IPR)을 이용하여 분산지수를 비교하였다. 잎(X)과 열매(Y)에서 귤응애 성충 밀도의 관계는 ln(Y+l)=1.029 ln(X+l)($r^2$=0.80)의 직선적인 관계가 있었으며, 열매가 성숙될수록 잎보다 열매에서 귤응애 밀도가 높아지는 경향이었다. 잎과 열매의 표본조사에서 TPL이 IPR보다 평균-분산 관계를 더 잘 나타내었으며, TPL의 기울기와 절편은 두 표본단위간, 연도간에 차이가 없었다. 정착도 0.25일 때 요방제밀도 2.0, 2.5와 3.0에서의 의사결정을 위한 표본추출조사법을 개발하였으며, 조사에 필요한 최대조사나무수(고정표본크기에서 필요 나무수)는 각각 19, 16과 15주였으며, 이 때의 의사결정임 계값 $T_{critical}$은 각각 554,609와 659였다.,609와 659였다.

시설토마토에서 황색트랩을 이용한 담배가루이 표본조사법

송정흡,이광주,양영택,이신찬,Song, Jeong Heub,Lee, Kwang Ju,Yang, Young Taek,Lee, Shin Chan 한국응용곤충학회 2014 한국응용곤충학회지 Vol.53 No.4

담배가루이, Bemisia tabaci는 바이러스병의 매개로 인해 제주지역 시설재배 토마토에서 가장 중요한 해충으로 인식되고 있다. 황색끈끈이 트랩을 이용한 담배가루이 성충의 실용적인 발생밀도 추정방법을 개발하기 위하여 2011과 2012년 제주 서부지역의 농가재배 토마토 포장에서 포장 상황에 따라 20~30개의 트랩을 설치하여 7~10일 간격으로 조사하였다. 황색끈끈이트랩을 지상 60 cm 높이에 수평방향으로 설치한 것이 작물 상단 10 cm 위에 수직으로 설치한 것보다 더 많은 담배가루이가 유인되었다. 황색끈끈이트랩에 유인된 담배가루이 성충의 분포형태를 Taylor's power law (TPL)과 Iwao's patchiness regression (IPR)을 이용 분석한 결과 두 회귀식의 기울기값이 모두 "1"보다 커 담배가루이 성충이 집중분포를 하고 있었다. TPL의 결정계수($r^2$)값이 IPR보다 더 높아 TPL이 담배가루이 성충의 공간분포 특성을 더 잘 설명하고 있었다. 담배가루이 성충 밀도를 추정하는데 필요한 황색끈끈이트랩의 수를 TPL 상수를 이용하여 추정하였는데 정확도 수준이 높을수록, 평균밀도가 낮을수록 필요한 트랩수는 증가하는 경향이었다. TPL 상수를 이용하여 고정 정확도 수준에서 조사를 중지하더라도 트랩당 평균밀도를 추정이 가능한 누적밀도를 계산하였다. 담배가루이 성충의 방제시기를 트랩 최고 밀도 10마리로 가정했을 때 이 밀도에서 필요한 포장당 트랩수는 고정정확도 0.25수준에서 15개이었다. 담배가루이 성충의 트랩당 평균밀도는 트랩마다 모든 성충수를 계수하는 것보다 2마리 이상 유인된 트랩의 비율을 가지고 추정하는 이항모델 [${\ln}(m)=1.19+0.90{\ln}(-{\ln}(1-p_T))$]을 이용하는 것이 더 효율적이었다. 본 연구결과는 담배가루이 성충에 대한 정확한 방제의사 결정을 통해 담배가루이가 매개하는 바이러스병 확산을 막는데 일조할 것으로 기대된다. The sweetpotato whitefly (SPW), Bemisia tabaci Gennadius, is a major pest in tomato greenhouses on Jeju Island because they transmit viral diseases. To develop practical sampling methods for adult SPWs, yellow-color sticky traps were used in commercial tomato greenhouses throughout the western part of Jeju Island in 2011 and 2012. On the basis of the size and growing conditions in the tomato greenhouses, 20 to 30 traps were installed in each greenhouse for developing a sampling plan. Adult SPWs were more attracted to horizontal traps placed 60 cm above the ground than to vertical trap placed 10 cm above the plant canopy. The spatial patterns of the adult SPWs were evaluated using Taylor's power law (TPL) and Iwao's patchiness regression (IPR). The results showed that adult SPWs were aggregated in each surveyed greenhouse. In this study, TPL showed better performance because of the coefficient of determination ($r^2$). On the basis of the fixed-precision level sampling plan using TPL parameters, more traps were required for higher precision in lower SPW densities per trap. A sequential sampling stop line was constructed using TPL parameters. If the treatment threshold was greater than 10 maximum adult SPWs on a trap, the required traps numbered 15 at a fixed-precision level of 0.25. In estimating the mean density per trap, the proportion of traps with two or more adult SPWs was more efficient than whole counting: ${\ln}(m)=1.19+0.90{\ln}(-{\ln}(1-p_T))$. The results of this study could be used to prevent the dissemination of SPW as a viral disease vector by using accurate control decision in SPW management programs.

제주지역 무에서 벼룩잎벌레와 무잎벌의 색트랩과 집합페로몬에 대한 반응과 연중 발생특성

송정흡,양영택,양철준,최병렬,좌창숙,Song, Jeong Heub,Yang, Young Taek,Yang, Cheol Jun,Choi, Byeong Ryul,Jwa, Chang Sook 한국응용곤충학회 2015 한국응용곤충학회지 Vol.54 No.4

벼룩잎벌레(Phyllotreta striolata)와 무잎벌(Athalia rosae ruficornis)는 제주지역 무에서 돌발적으로 발생하여 피해를 주는 해충이다. 본 연구는 벼룩잎벌레와 무잎벌 성충의 트랩 색(황색과 청색)과 벼룩잎벌레 집합페로몬(+)-(6R,7S)-himachala-9,11-diene과 기주식물 휘발성 물질인 allyl isothiocyanate의 혼합물을 이용 두 해충의 발생을 간편하게 예찰하는 방법을 개발하기 위하여 수행하였다. 벼룩잎벌레는 트랩 색에 관계없이 집합페로몬이 부착된 점착트랩에 더 많은 성충이 유인되었으며, 무잎벌은 황색점착트랩이 청색트랩보다 더 많이 유인되었고 벼룩잎벌레 집합페로몬은 유인량에 관계가 없었다. 따라서 벼룩잎벌레 집합페로몬을 부착한 황색점착트랩을 이용하면 벼룩잎벌레와 무잎벌 성충 발생을 효율적으로 예찰할 수 있었다. 점착트랩의 높이는 기주식물에 가까울수록 두 해충의 유인수가 많아 기주식물 상단 10 cm 높이로 설치하는 것이 좋을 것으로 판단되었다. 벼룩잎벌레와 무잎벌의 연간 발생피크는 각각 3회와 5회정도 나타났으며, 두 해충의 첫 주발생시기는 벼룩잎벌레는 3월중하순, 무잎벌은 4월 중하순이었다. 벼룩잎벌레와 무잎벌 성충의 연간 발생특성을 이용하면 두 해충의 무에서의 피해를 최소화하는데 중요한 정보로 활용될 것으로 기대된다. Striped flea beetle, Phyllotreta striolata (SFB) and turnip sawfly, Athalia rosae ruficornis (TSF) are two economically important sporadic pests in radish fields on Jeju island. The response of adult SFB and TSF to a mixture of aggregation pheromone, (+)-(6R,7S)-himachala-9,11-diene and host plant volatile, allyl isothiocyanate (HAI), as well as to yellow and blue sticky traps was examined in radish fields. Adult SFB was more attracted to the sticky trap with HAI, regardless of the color of the sticky trap; however, adult TSF was more attracted on the yellow sticky trap than blue, and no effect of HAI was observed. The adult SFB and TSF can be effectively monitored using yellow sticky traps placed 10 cm above the plant canopy. SFB and TSF had 3 and 5 peak times in a year, respectively. The first peak occurred in the middle of March for SFB and mid-late of April for TSF. We expect that the results of the present study can facilitate minimizing the damage caused by the two important pests in commercial radish fields.

만보계를 활용한 응급실 간호 업무량 측정

송정흡,배명순 한국의료QA학회 2009 가을학술대회 Vol.2009 No.2

성페로몬 트랩에 유인된 수컷 성충에 의한 귤애가루깍지벌레의 연중 발생특성

송정흡,최경산,홍순영,이신찬,Song, Jeong-Heub,Choi, Kyung-San,Hong, Soon-Yeong,Lee, Shin-Chan 한국응용곤충학회 2012 한국응용곤충학회지 Vol.51 No.3

최근 들어 하우스재배 감귤을 중심으로 발생이 증가하고 있는 귤애가루깍지벌레에 대해 효율적인 발생예찰과 함께 방제시기를 결정하기 위하여 합성 성페로몬을 이용하여 시기별 발생특성을 조사하였다. 귤애가루깍지벌레의 수컷 성충은 합성 성페로몬뿐만 아니라 색에도 반응하였다. 성페로몬의 농도는 5.0 mg까지 농도가 증가할수록 유인력이 높았다. 귤애가루깍지벌레 수컷 성충은 연 4회 발생되고 있었으며, 월동 후 수컷 성충이 처음 발생되기 시작하는 시기는 4월 중하순이었다. 수컷 성충발생이 가장 많은 시기는 제 1세대 발생기인 7월 상중순이었다. 성페로몬트 랩에 유인된 귤애가루깍지벌레 수컷 성충은 한 세대 내에서 3회의 발생성기가 나타났으며, 이는 귤애가루깍지벌레가 1~3령 약충으로 월동하기 때문인 것으로 추정되었다. 트랩에 유인된 수컷 성충의 밀도와 나무의 가지당 평균밀도와는 높은 정(+)의 상관을 갖고 있었다. 수컷 성충의 최대 유인시기를 이용하여 1령 약충 발생 시기를 추정할 수 있었으며, 그 적산온도는 산란전 기간과 비슷한 350DD이었다. The cryptic mealybug, Pseudococcus cryptus, has been increasingly damaging citrus, particularly those plants grown in plastic greenhouses. This study was conducted to monitor the seasonal phenology of adult male cryptic mealybugs and to determine the timing for control using a sex pheromone trap. Adult males responded to a synthetic sex pheromone and trap color. An increasing number of males were attracted to the traps with increasing concentrations of sex pheromone up to 5 mg. The males occurred annually four times and had three cohorts at a time due to different overwintering developmental stages. After overwintering the adult males began to in mid-late April. A positive correlation was observed between the number of adult males caught in traps and the mean density per twig of all motile stages except first stage nymphs of the cryptic mealybugs. The peak time for the first nymph to occur was estimated from the maximum attraction time of the males, and the cumulative degree days (DD) was 350 DD, similar with the preoviposition period.