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The impact of admission decided by patients or their family on the length of stay and medical expenses of the elderly  

Son, Yehrhee (Dept. of Health Administration, Yonsei University)
Kim, Kyuna (Dept. of Health Administration, Yonsei University)
Seo, Youngjoon (Dept. of Health Administration, Yonsei University)
Publication Information
Korea Journal of Hospital Management / v.27, no.1, 2022 , pp. 31-42 More about this Journal
Abstract
Purposes: This study aims to investigate the changes in the length of stay and medical expenses by the impact of the admission decided by patients or their family. Methodology: The analysis was conducted using data from elder patients aged 65 or older who have used admission services more than once from year 6(2012) to year 12(2017) of the Korean Medical Panel Data(KOWEPS). The statistical analysis was performed through the Chi-square test, mean difference analysis, and generalized estimation equation analysis. Findings: Compared to the patients who used admission services decided by doctors, those who used admission services decided by patients or their family had a longer length of stay and a lower daily medical expense. Practical Implications: Inappropriate admission decided by patients or their family can increase the risk of hospital-acquired infections, impairing the health of elderly patients, and has a negative impact on the efficiency of health resources. Therefore, it is necessary to prevent and properly manage inappropriate admission decided by patients or their family
Keywords
admission decided by patients or their family; length of stay; medical expenses; the elderly;
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Times Cited By KSCI : 4  (Citation Analysis)
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1 Lim SJ, Lee HB. A study on the current status and improvement of out-of-pocket maximum on health care utilizations in nursing hospital patients. The Korean Social Security Association. 2019;35(1):129-149.
2 Jeong SH, Oh JY, Lee HJ, Yoon SY. A study on appropriate management of long-term admission for long-term care. Journal of Health Insurance Review and Assessment Service, 2012.
3 Lim, SC., Doshi, V., Castasus, B., Lim, JKH, Mamun, K. Factors causing delay in discharge of elderly patients in an acute care hospital. Annals-Academy of Medicine Singapore, 2006;35(1):27.
4 Jeon BY, Choi, SM, Kim CY, Socioeconomic equity in regional distribution of health care resources in Korea. Korean Journal of health policy and management, 2012;22(1):85-108.   DOI
5 Kim, JH, Kim GH, Kim BY, A region-based analysis for availability of social welfare Facilities, Korea institute for health and social affiars, 2015.
6 You, KS, Park, HS, Comparison of health status between senior people living alone and those who live with their families, Journal of the Korea gerontological society, 2003;23(4):163-179.
7 Rueda S, Artazcoz L. Gender inequality in health among elderly people in a combined framework of socioeconomic position, family characteristics and social support. Journal of Ageing And Society. 2009;29:625-647.   DOI
8 Kim SJ, Yu SH, Oh HJ, Factors associated with length of stay in elderly inpatients in a general hospital in Seoul, Korean Journal of Hospital Management, 2007;12(2):25-42.
9 An BK. Appearance on the utilization of hospital admissions decided by patient or their families with disabilities. Journal of the Korean Public Health Association. 2019;45(2):41-50.
10 Kang GS, Kim JS. Change of life of the older due to social admission in long-term Care Hospital. Journal of Gerontology. 2017;37(1):103-123.
11 Andrew, MK,, Powell, C. An approach to 'The Social Admission', Canadian. Journal of General Internal Medicine, 2015;10(4):20-22.   DOI
12 Park KS, Song JE, Joo SY, Lee SY. Mid- to long-term reprojection and factor analysis of medical expenses for the elderly. National Health Insurance, 2020.
13 Kim YH, Moon JW, Kim KH, The determinant factors and medical charges pattern by length of stay in hospital, Korea Journal of Hospital Management, 2010;15(2):15-26.
14 Hayashi M. The care of older people in Japan: myths and realities of family 'care' [Internet]. London: History & Policy Institute of Historical Research; 2011 [cited 2022 Feb 28]. Available from https://www.historyandpolicy.org/policypapers/papers/the-care-of-older-people-in-japan-myths-and-realities-of-family-care.
15 Tamiya, M., Noguchi, H., Nishi, A., Reich, M. R, Ikegami, N., Hashimoto, H. et. al. Population ageing and wellbeing: lessons from Japan's long-term care insurance policy. The lancet, 2011, 378(9797):1183-1192.   DOI
16 Park EJ, Jeong Y, Seo JH, Bae JE, Lee NK, Kim EJ, et al. A study of strategies for the 2nd Korea Health Panel Project. Korea Institute for Health and Social Affairs, 2019.
17 Oh SY. The Syakaiteki Nyuin Hospitalization for the long-term care as the increase factor of health expenditure for the elderly in Japan. Korean Journal of Gerontological Social Welfare. 2005;28(6):207-230.
18 Lee JT. Nursing Hospital Status and Improvement Tasks. Insurance Research Institute. 2017;14:8-16.
19 Dutton D. Financial, organizational and professional factors affecting health care utilization. Journal of Social Science and Medicine. 1986;23(7):721-735.   DOI
20 An BK. Appearance on the utilization of hospital admissions decided by patients or their families. The Journal of Korean Health Economic Association. 2017;23(3):87-105.
21 Kang JH. Social admission status and its influencing factors in long-term care hospitals [dissertation]. Seoul: Korea University;2013.
22 Bianco A, Pileggi C, Rizza P, Greco, MA, Angelillo IF, An assessment of inappropriate hospital bed utilization by elderly patients in southern Italy. Aging Clinical and Experimental Research, 2006;18(3):249-256.   DOI
23 Okamoto, Y. Health care for the elderly in Japan: Medicine and welfare in an aging society facing a crisis in long term care. British Medical Journal, 1992;305(6850):403-405.   DOI
24 Roh OH, Lee CH, Park A, Kim KH, A Study on characteristics of medical expenses and the hospitalization period of hospitalized patients using diem payment system at convalescent hospitals. Journal of the Korea Academia-Industrial Cooperation Society, 2016;17(8):407-414.   DOI
25 Yoon, JY. Issues of geriatric care hospitals for cost containment and effective elderly care delivery system. Research Paper, 2009:5-28.
26 Lee YJ, Lee SG, You CH, Kim BG, Kim, TH. Factors associated with the long-stay admissions in geriatric hospitals - focused on dementia's inpatients -. Korean Journal of Hospital Management 2020;25(3):29-37.
27 Statistics Korea. 2020 Senior Statistics (Press Release). [Internet]. Seoul: Statistics Korea; 2020. Available from http://kostat.go.kr/portal/korea/kor_nw/1/1/index.board?bmode=read&aSeq=385322. Cited from Yoon JR. Response to Super-aged Society, Health aging Policy urgently need [E-Newsletter]. Korean Academy of Medical Sciences 2021 [cited 2022 Feb 28]. Available from https://kams.or.kr/webzine/21vol124/sub02.php.
28 National Health Insurance Service & Health Insurance Review and Assessment service. 2019 National Health Insurance Statistical yearbook co-published press release [Internet]. wonju: 2020 [cited 2022 Feb 28]. Avilable from http://kiri.or.kr/PDF/%EC%A3%BC%EA%B0%84%EB%B3%B4%ED%97%98%EB%8F%99%ED%96%A5/20201123/trend20201123_2.pdf.
29 Park GR, Choe BH, Association between unmet healthcare needs and unmet long-term care needs among the Korean elderly. Journal of Health and Social Welfare Review. 2018;38(4):40-56.   DOI
30 Chiu, HC, Lee, LJ, Hsieh, HM, Mau LW. Inappropriate hospital utilization for long-stay patients in southern Taiwan. The Kaohsiung Journal of Medical Sciences, 2003;19(5):225-232.   DOI
31 Chou, M., Chen, L. Social admissions of the elderly: more medical attention should be paid. Journal of Clinical Gerontology & Geriatrics, 2010;2(1):27-28.   DOI
32 Min IS, Choi PS. Advanced Panel Data Analysis STATA. Korea: Paper-Based Media Publishing; 2015. p.112-121.
33 Jeon BY, Kim HS, Kwon SM. Patient and hospital characteristics of long-stay admissions in long-term care hospitals in Korea. Korean Academy of Health Policy and Management. 2016;26(1):39-50.   DOI
34 Chang WH, Park JH, Choi JE, Kim HS. Multifactor analysis of carer satisfaction in geriatric hospitals. Korean Journal of Clinical Geriatrics. 2007;8(4):401-411.
35 McDonagh, MS, Smith DH, Goddard M. Measuring appropriate use of acute beds a systematic review of methods and results. Health Policy. 2000;53:157-184.   DOI
36 Choi ID, Lee EM. Study on the efficient integration of long-term care facilities and geriatric hospitals by using NHIC survey data. Journal of the Korea Gerontological Society 2010;30(3):855-869.
37 Inowue Y, Jung EY, Jung SW, Seo YJ. A factor analysis of social hospitalization of elderly in Japan and Korea. Proceedings of the 51th Health Policy and Management. 2013 Nov7-8; Busan, Korea.
38 Andersen, R., Newman, J. F. Societal and individual determinants of medical care utilization in the United States. The Milbank Memorial Fund Quarterly. Journal of Health and Society, 1973;51:95-124.