Browsing by Author "Chang, Pei-Yeh"

Now showing 1 - 3 of 3

AN AHP MODEL FOR BRINGING EXPERTS TO CONSENSUS ON MEDICAL PAYMENT STANDARDS
(2006-05-01)
Huang, Yuan-Huei
;
Chang, Pei-Yeh
;
Hung, Chih-Young
;
Wang, Kuei-Ing
;
Chang, King-Jen
Many countries with health insurance systems conduct periodic payment standards reform. How to reach consensus in setting payment standards among different specialties with different agendas has become a critical issue. The purpose of this study is to construct an analytic hierarchy process (AHP) model to obtain judgments from experts about the importance of "factors related to establishing payment standards in the national health insurance program". Under this goal, the first tier contains four evaluation aspects, and the second tier contains sixteen evaluation criteria divided into four groups. The AHP model was then used to collect and combine the opinions of experts through an empirical study. The results can be directly used to formulate standard values as the basis for establishing payment standards. The results of our study strongly support that an AHP model is effective in forming a consensus among surgical specialists.
Analysis of changes to the anterior chest wall after the Nuss procedure-an objective measurement of pectus excavatum
(2009-12-01)
Chang, Pei-Yeh
;
Chang, Chaur-Hsiang
;
Lai, Jin-Yao
;
Chen, Jeng-Chang
;
Perng, Der-Baau
Introduction: We report a noninvasive method for recording the deviation of the anterior chest wall (ACW) in patients with pectus excavatum before and after the insertion and removal of a Nuss bar. Patients and Method: All patients undergoing the Nuss procedure at our institutions between June 2008 and February 2009 were enrolled in this study. A thermal plastic strip was used to cast the ACW at the skin level along the area corresponding to the tract of the inserted bar. The height of the ACW was defined as the perpendicular length from the xiphoid process to the transverse line drawn between the 2 midaxillary points. Results: Bar insertion caused a significant increase in ACW height and width. Bar removal reduced the corrective effects in terms of a significant decrease in ACW height; at the same time, an increase in ACW width was noted. Conclusion: Feature extraction and analyses of permanent contour casts of the ACW help to understand immediate changes in the ACW after the Nuss procedure and may assist in the design of the bar at insertion. The Nuss bar in situ helped to maintain cosmetic benefits to the ACW. (C) 2009 Elsevier Inc. All rights reserved.
Increase in intrathoracic volume in pectus excavatum patients after the Nuss procedure
(2010-02-01)
Chang, Pei-Yeh
;
Hsu, Zhen-Yu
;
Lai, Jin-Yao
;
Wang, Chao-Jan
;
Ching, Yu-Tai
In this study, we present finite element analysis models to calculate the increase in intrathoracic volume of pectus excavatum patients after the Nuss procedure. One virtue of our approach is that the measurement of the intrathoracic volume has no time difference and is not affected by postoperative pain, which cannot be achieved with a 2-year difference between pre- and postoperative pulmonary function testing or any other clinical method. The calculations show that the intrathoracic volume of pectus excavatum patients increased by approximately 2.72-8.88% after the Nuss procedure. The increment curve was patient-dependent, although the increment behavior was similar among the six patients examined. The curve of the increase became flat when the elevating force exceeded 80 N or the displacement of the lower sternal end exceeded 2.6 cm in half of our cases.