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어린이(0-12세) 손상환자의 재원일수에 미치는 요인분석: 퇴원손상심층자료를 중심으로

Analysis of Factors Affecting the Length of Stay in Children(Aged 0 to 12) with Injuries: Centering Around the Data from the Korea National Hospital Discharge In-Depth Injury Surveys

  • 이채경 (가천대학교 의료경영학과)
  • 투고 : 2023.03.20
  • 심사 : 2023.05.01
  • 발행 : 2023.05.31

초록

이 연구는 어린이(0-12세)손상 환자의 특성에 따른 재원일수의 관계를 규명하여, 어린이손상 환자 재원일수에 미치는 요인을 분석하고자 시행하였다. 조사대상은 퇴원손상심층조사 자료에서 2016년 1월1일부터 2020년 12월31일 까지 퇴원한 환자 중 0-12세 이하이며, 주진단이 손상 및 사고의 외인(S00-T98)인 환자 7,804명이었다. 분석은 빈도 분석 및 독립표본 t-검정, ANOVA 검정을 실시하였다. 재원일수에 영향을 미치는 요인을 알아보고자 회귀분석을 시행하였다. 연구대상자의 평균재원일수는 5.5일 이었다. 학령기(7-12세)기 아동이 학령전기(0-6세)보다 재원일수가 길었으며, 진료비 지불방법이 의료급여 및 기타보험 환자가 재원일수가 길었다. 의료기관 소재지가 수도권보다 비수도권(전라도, 경상도)일 때, 병상규모가 100-299병상인 경우 재원일수가 길었다. 내원경로는 외래인 경우 재원일수가 짧았고, 손상기전이 운수사고, 화상인 경우 재원일수가 길었다. 부진단이 있고, 주수술을 시행한 경우 재원일수가 길었으며, 퇴원후 방향이 사망인 경우 재원일수가 길게 나타났다. 이 연구는 전국 단위 자료인 퇴원손상심층조사 자료를 이용하여 우리나라 어린이 손상환자의 재원일수의 특성 및 결정요인을 파악하였다는 점에서 의의를 갖는다. 또한, 안전교육 및 예방 활동만으로도 발생을 줄일 수 있는 어린이 손상의 관련 요인 대한 적극적인 치료와 다양한 예방정책 마련을 위한 기초 자료를 제공했다는 점에서 의의가 있다.

This study was conducted to analyze factors affecting the length of stay in children with injuries by determining relationships between length of stay and characteristics of children(aged 0 to 12) with injuries. 7,804 patients aged 0 to 12 who participated in the Korea Nation Hospital Discharge In-Depth Injury Surveys, got a diagnosis of sequelae of injuries and of other consequences of external causes(S00-T98), and were discharged between 1 January 2016 and 31 December 2020 were investigated. A frequency analysis, independent samples t-test, and ANOVA were performed. Also, to identify factors affecting the length of stay, a regression analysis was performed. The average length of stay for the patients investigated in this study was 5.5 days. The length of stay for school-age children(aged 7 to 12) and children who had either public or private coverage was higher than that for preschoolers(aged 0 to 6) and children who didn't have public or private coverage, respectively. The length of stay for children admitted to a hospital in a rural area(Jeolla-do or Gyeongsang-do) was higher than that for children admitted to a hospital in a metropolitan area and the length of stay for children admitted to a hospital that had 100-299 hospital beds was relatively long. However, children who first visited a hospital for outpatient care stayed relatively short in hospital and children who had been burned or injured in traffic crashes stayed relatively long in hospital. Children who got a secondary diagnosis and had a principal procedure or who died after being discharged were in hospital for a long time. The findings of this study shall be useful, as they identified characteristics related to the length of stay for Korean children with injuries and factors that determine the length of stay for those children by analyzing the national dataset, or more specifically, the data from the Korea National Hospital Discharge In-Depth Injury Surveys. The risk of child injuries can be easily reduced by taking actions to prevent them and providing safety education programs. The present study has provided essential baseline data for the provision of aggressive care for child injuries and the establishment of a range of policies for child injury prevention.

키워드

참고문헌

  1. World health Organization, unicef. World report on child injury prevention : World Health Organization. 2009.
  2. Korea National Hospital Discharge In-depth Injury Survey, Korea Disese Control and Prevention Agency, 2019.
  3. K.Y. Jung, J.H. Jung. "Epidemiology of Childhood Injury in Korea", J Korean Med Assoc, Vol. 51, No. 3, pp208 - 213, 2008. https://doi.org/10.5124/jkma.2008.51.3.208
  4. S.W. Park, Y.J. Heo,S.W. Lee, J.H. Park. "Non-fatal injuries among preschool children in Daegu and Kyungpook", J Prev Med Public Health. Vol. 37, pp274-81, 2004.
  5. J.M. Park. "Child Injury Characteristics and Prevention Strategies".The Korean Society of Emergency Medicine Conference Abstracts, Vol. 2021, No.1, pp. 24-31, 2021.
  6. J.A. KO, E.Y. Choi, S.G. Kim, E.C. OH, Y.K. Jung, H.M.R. Hung, S.H. Yoon. "RESEARCH ON CHILDREN'S SAFETY IN THEIR LIVING ENVIRONMENTS." Child Welfare Research Institute Report, Vol. 2, 2016.
  7. Richard J.M.., "Regional Differences in Outcomes for Hospitalized Injured Patients", The Journal of TRAUMA. Vol. 60, No. 4, pp. 691-698, 2006. https://doi.org/10.1097/01.ta.0000210454.92078.89
  8. H.W. Yoo, "Inpatient care focused strategy and convergence performance in hospitals", Journal of the Korea Convergence Society Vol. 7. No. 4, pp.59-66, 2016. https://doi.org/10.15207/JKCS.2016.7.4.059
  9. http://www.cdc.go.kr
  10. S.H. Kim, M.J. Kim. "Analysis of Factors Affecting Length Of Stay for A Infectious(A00-B99) Patients using Medical Records", Journal of the Korea Academia-Industrial cooperation Society. Vol. 23, No. 10 pp. 377-383, 2022. https://doi.org/10.5762/KAIS.2022.23.10.377
  11. Bhamkar, R., Seth, B., & Setia, M. S. "Profile and Risk Factor Analysis of Unintentional Injuries in Children", The Indian Journal of Pediatrics. Vol. 83, No. 10, pp1114-1120, 2016. https://doi.org/10.1007/s12098-016-2159-2
  12. W.K. LEE , K.H. Park, S.J. Eun, Y. Kim, M.D. J.S. Lee, K.J. Song, S.J. Moon, Y.I. Kim. "Incidence and Patterns of Unintentional Injuries Among Preschool Children in Korea", Journal of the Korean Society of Emergency Medicine. Vol. 20, No. 3, pp288-296, 2009.
  13. K.H. Cho. "A Study of Safety Management and Accident Cases in Day-care Center", Journal of Parent Education. Vol. 12, No. 1, pp63-80, 2015.
  14. Y.J. Kang, H.W. Lee, "Factors Associated with Hospital Length of Stay among Women's Cancer Patients: Based on the In-depth Injury Patient Surveillance System Data", J Health Info Stat. Vol. 47, No. 2, pp 148-158, 2022. https://doi.org/10.21032/jhis.2022.47.2.148
  15. Y.J. Lee. "An study on the inepuality of health care resources distribution affected by regional characteristics", J Crit Soc Welf. Vol. 21, pp 49-78, 2005.
  16. S.H. Kim, J.A. Lee. "Analysis of factors affecting length of stay for a serious patients using medical records", J Korean Soc Sch Community Health Educ. Vol. 20, No. 2, pp69-80, 2019. https://doi.org/10.35133/kssche.20190831.06
  17. H.R. Park. "Experience of Injury and Associated Factors in Toddlers and Preschoolers Using Data from the Korea National Health and Nutrition Examination Survey VI (2013-2015)", Child Health Nursing Graduate School of Nursing Yonsei University. 2018.
  18. Y.R. Song, M.S. Lee, D.R. Kim, K.H. Kim, "A Convergence Study on the Characteristics of Length of Hospital Stays of Injured and Traumatic Death Patients - Based on the Korea National Hospital Discharge Injury Survey Data". Journal of the Korea Convergence Society, Vol. 8, No. 5, pp. 87-96, 2017. https://doi.org/10.15207/JKCS.2017.8.5.087
  19. S.K. Cha, S.S. Kim. "The Determinant of the Length of Stay in Hospital for Schizophrenic Patients: Using Data from the In-depth Injury Patient Surveillance System", The Journal of digital policy & management. Vol. 11, No. 4, pp.351 - 359, 2013.
  20. Tu F, Anan M, Kiyohara Y, Okada Y, Nobutomo K. "Analysis of hospiꠓtal charges for ischemic stroke in Fukuoka, Japan", Health Policy. Vol. 66, No. 3, pp239-246, 2003. https://doi.org/10.1016/S0168-8510(03)00080-0
  21. S.H. Kim, H.J. Lee. "Factors affecting the outcome indicators in patients with stroke", Health Policy Manage. Vol. 25, No. 4, pp31-39, 2015. https://doi.org/10.4332/KJHPA.2015.25.1.31
  22. S.J. Ju, M.G. Jeong, C. Kwak, T.S. Song*, J.H. Cha. "A Study on the Safety Improvement of Child Protected Zone", The Journal of the Convergence on Culture Technology (JCCT), Vol. 6, No. 4, pp.139-147, 2020.