• Title/Summary/Keyword: 상급종합병원

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Quality of Life and its Related Factors in Patients with Benign Prostatic Hyperplasia in One General Hospital (일개 상급전문종합병원 전립샘비대증 환자들의 삶의 질 영향 요인)

  • Seok, Yoon Hee;Yi, Myungsun
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.332-340
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    • 2017
  • Purpose: This study was to identify the quality of life and its related factors in patients with benign prostatic hyperplasia. Methods: A cross-sectional survey design was utilized. Data were collected using questionnaires from 128 patients with benign prostatic hyperplasia who visited an outpatient department at one general hospital in 2016. Data were analyzed using Mann-Whitney U test, Kruskal Wallis test, Pearson's correlation coefficient and hierarchical multiple regression analysis. Results: Mean age of the participant was $67.81{\pm}6.94$. Mean years since diagnosis was $6.41{\pm}5.20$. The mean score of quality of life was $0.82{\pm}0.09$, indicating that QOL was relatively low. Lower urinary tract symptoms (p=.029), anxiety, depression, Activities of daily living were significantly correlated to with quality of life (p<.001). Activities of daily living accounted for 54% (p<.001) of the variance in quality of life as a result of hierarchical multiple regression analysis. Conclusion: The results of the study showed that nursing intervention may improve the quality of life of patients with benign prostatic hyperplasia by increasing their Activities of daily living.

Changes in National Health Insurance Medical Expenses and Long-Term Care Costs between the Long-Term Care Group and General Older Adults Group before and after Long-Term Care Use (노인장기요양급여 이용 전후 장기요양군과 일반노인군 간 국민건강보험 및 노인장기요양보험 비용 추이)

  • Seung-Jin Oh;Kang Ju Son
    • Health Policy and Management
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    • v.34 no.3
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    • pp.249-260
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    • 2024
  • Background: The Republic of Korea's aging population escalates medical and long-term care costs. While prior research has suggested that long-term care might reduce these costs, these studies had limitations in their subjects and duration, making it difficult to generalize the results. This study aims to evaluate cost changes between the long-term care group and the general older adults group after addressing these limitations. Methods: A cohort was derived from the 2015 national population using stratified sampling. Subsequently, 15,114 individuals (7,557 in each group) were identified through 1:1 propensity score matching. The study employed a difference-in-differences analysis to explore variances in medical costs and long-term care benefits post-utilization of long-term care services. Results: Compared to the general older adults group, the long-term care group experienced a reduction in monthly per capita total medical costs by 56,459 Korean won (KRW). Although costs at tertiary and general hospitals increased, those related to long-term care hospitals decreased by 90,687 KRW. Including long-term care benefits, overall expenditures increased by 948,038 KRW. Conclusion: The analysis reveals that the long-term care group faces higher medical costs in acute care than the general older adults group, emphasizing a greater need for medical services within this group. To meet the increasing medical demands of the long-term care group, a collaborative strategy linking community resources, healthcare, and long-term care facilities is imperative. Additionally, developing and implementing preventive health habit management strategies for middle-aged and older adults is essential to diminish the future requirement for long-term care.

Technical Efficiency of Medical Resource Supply and Demand (의료자원 공급, 수요의 성과 효율성에 대한 실증분석)

  • Chang, Insu;Ahn, Hyeong Seok;Kim, Brian H.S.
    • Journal of the Korean Regional Science Association
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    • v.34 no.2
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    • pp.3-19
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    • 2018
  • The objective of this study is to observe the efficiency of clinical performance on the supply and demand of medical resources in Korea. For the empirical analysis, we constructed the dataset on age standardized mortality rate, the number of physician, specialist, surgery, medical institution, ratio of general hospitals of 16 provinces in Korea from 2006 to 2013. The panel probability frontier model is employed as an analysis method and considered heteroscedasticity and autocorrelation of the error in panel data. In addition, the demographic and socioeconomic characteristics of the 16 provinces, unemployment rate, elderly population ratio, GRDP per capita, and ratio of hospitals in comparison to the general hospitals are used to find the effect on the technical efficiency of clinical performance on supply and demand of medical resources. The results are as follows. First, for the clinical performance, the supply side of human resources such as doctors and specialists and the demand side factors such as chronic illness clinic per unit population have a significant influence, respectively. Second, the technical efficiency of clinical performance on the supply and demand of medical resources of each input component was 59-70% in terms of clinical efficiency in each region. Third. estimates of technical efficiency of inputs that affect clinical performance showed a slight increase in all regions during the analysis period, but the increase trend decreased slightly. Fourth, the ratio of the elderly population and GRDP per capita have a positive influence on the technical efficiency of clinical performance on the supply and demand of medical resources. The difference of each efficiency by region is due to the regional differences of the input medical resources and the combination of them and the demographic and socioeconomic characteristics of the region. It is understood that the differences in technological efficiency due to the complexity of supply and demand of medical resources, demographic structure and economic difference affecting clinical performance by region are different.

Recovery and Associated Factors of Cognitive Function in Patients with Hemorrhagic Stroke (출혈성 뇌졸중 환자의 인지기능 변화 및 연관 요인에 대한 추적조사)

  • Park, Minsu;Min, Ji Hong;Ko, Sung Hwa;Lee, Sang Won;Ko, Hyun-Yoon;Shin, Yong-Il
    • 재활복지
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    • v.21 no.2
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    • pp.247-259
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    • 2017
  • We investigated the improvement of cognitive functions, activity of daily living (ADL), and quality of life (QoL) after hemorrhagic stroke and identified associated factors. For this research, twenty-five patients with a hemorrhagic stroke were enrolled. We measured cognitive function, activity of daily living (ADL), and quality of life (QoL) from 7 days to 12 months after onset of stroke. Then we analyzed the correlation between cognitive function and other risk factors. According to results, cognitive functions improved during 12 months with statistically significant differences. Other functions were similar to cognitive functions. Improvement of cognitive functions were correlated with age, the type of hemorrhagic stroke and Glasgow coma scale at 7 days after stroke. Overall, cognitive function in patients with hemorrhagic stroke recovered from acute to 12 months after onset of stroke. And, improvement of cognitive function at this phase were associated with age, the type of hemorrhagic stroke and GCS score at 7 days. These results would provide us an information to plan cognitive rehabilitation in patients with hemorrhagic stroke.

Factor affecting Unplanned Readmissions after Cardiac Valve Surgery: Analysis of Electric Medical Record (심장판막수술 환자의 비계획적 재입원 영향요인: 전자의무기록분석)

  • Lee, Jung Sun;Shin, Yong Soon
    • The Journal of the Korea Contents Association
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    • v.22 no.2
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    • pp.794-802
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    • 2022
  • This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.

Current Status of Ophthalmic Optometry Laboratory Personnel in Korea, Japan, and the United States (한국, 일본, 미국 안과검사인력의 현황)

  • Okhwan, Jeon;Junbeom, Park;Dae Jin, Kim;Dae Eun, Kim;Cheol, Moon;Bon-Kyeong, Koo
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.285-292
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    • 2022
  • The education and training system, the ISCO (International Standard Classification of Occupations), and the legal systems of Japan and the United States consider all ophthalmic optometry laboratory personnel as ophthalmologists. They encompass optometrists, orthoptists, optometric technicians, and ophthalmic medical technicians. Data retrieved from the KOSIS (Korean Statistical Information Service) revealed that the number of opticians associated with the department of ophthalmology in 2022 could be appraised by classifying their medical institutions; contrarily, the number of clinical laboratory technologists could not be assessed. However, the current research investigated a general tertiary hospital and determined that clinical laboratory technologists outnumber opticians. Classification in Korea is based on ophthalmic optometry laboratory personnel, ISCO, ISCED (International Standard Classification of Education), the medical service act, the act on medical service technologists, and the higher education act. These results cannot be compared to the optometrists evaluated in the United States. Ophthalmology is a suitable profession for optometric technologists and technicians who perform under the instructions of ophthalmologists and optometrists. The field of eye healthcare would be benefitted by assigning the management based on their qualification according to the requirement of the job title, such as 'Clinical Optometry Technologist' to be given to clinical laboratory technologists and opticians who work in the ophthalmic optometry laboratories after obtaining a private qualification endowed by the Korean Ophthalmological Society and the Korean Optometry Society.

The Impact of Outpatient Coinsurance Rate Increase on Outpatient Healthcare Service Utilization in Tertiary and General Hospital (외래 본인부담률 인상이 상급종합병원과 종합병원 외래 의료이용에 미친 영향)

  • Kim, Hyo-Jeong;Kim, Young-Hoon;Kim, Han-Sung;Woo, Jung-Sik;Oh, Su-Jin
    • Health Policy and Management
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    • v.23 no.1
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    • pp.19-34
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    • 2013
  • Background: The study describes the changes resulted from imposition on tertiary hospital outpatient coinsurance rate rise policy and in tertiary or general hospital drug coverage rise policy on healthcare service utilization. Methods: Accordingly, the hypothesis about outpatient healthcare utilization after rise policy in outpatient coinsurance rate and drug coverage was established, using interrupted time-series analysis and segmented regression analysis to test the hypothesis. 5-year analysis period (2007. 3-2012. 3) from the outset year was designated, the data about most common 10 high-ranking of the main diseases targeting visiting patient from age of 6 to 64 were collected. Results: The summary on the major research is followed. First, the medical expense and duration of treatment tends to be increased in case of imposition about rise policy in outpatient coinsurance rate in the tertiary hospital under the interrupted time-series analysis. It showed temporary increase and slow down on account of influenza A even after the policy enforcement. In segmented regression analysis, duration of visit and medical expense in the tertiary hospital increased temporally right after the policy implementation and the decreased rapidly depends on period. Both rise and fall is statistically significant. The second, In case of tertiary or general hospital outpatient drug coverage rise policy, all of the tertiary hospital healthcare service utilization variables by the interrupted time-series analysis, drug coverage policy in the general hospital deeply declined according to decreasing trend before policy implementation. The third, in case of segmented regression analysis, the visit duration and medical expense statistically declined right after the policy implementation in both the tertiary and general hospital. Meanwhile, administration day was statistically meaningful only for the decrease right after the policy implementation. Otherwise, general hospital changes are not statistically meaningful. And the medicine cost was statistically, meaningfully decreased after the increase in drug coverage. Conclusion: Finally, the result demonstrated according to the analysis is only 1 hypothesis is denied, the other 2 are partially supported. Then, tertiary hospital outpatient coinsurance rate increase policy comparatively makes decrease effect on long-term healthcare utilization, and tertiary or general hospital outpatient drug coverage policy showed partially short-term effect is assured.

Predictors of Blood Transfusion in Hepatoma Embolization (간종양 색전술 환자의 수혈 영향 요인)

  • Kim, Sang-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.12
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    • pp.384-389
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    • 2017
  • This study was conducted to investigate the patient and hospital characteristics that affect receiving and non-receiving blood transfusion for hepatoma embolization. We analyzed data describing 757 patients of the Health Insurance Review and Assessment Service's 2011 claims sample data. Chi-squared and logistic regression analysis was performed using STATA 12.0. Logistic regression analysis revealed that anemia (Odds ratio (OR)=9.544, 95% confidence interval (CI)=3.362-27.097), female (OR=2.186, Cl=l.240-3.854), age 65-74 (OR=0.506, CI=0.269-0.952), 1000 over bed (OR=0.053, CI=0.018-0.151), out-department (OR=0.211, CI=0.081-0.551), and 700-999 bed (OR=0.105, CI=0.036-0.304) were significant predictors of blood transfusion in tertiary hospitals. Additionally, anemia (OR=69.681, CI=8.545-568.246) and aged 75 or over (OR=0.112, CI=0.025-0.506) were significant predictors of blood transfusion in general hospitals. This research would expected to cost effective and preliminary data of blood transfusion quality.

Clinical Nutrition Service in Korean Tertiary Hospitals and General Hospitals: Result of Nationwide Cross-Sectional Survey (국내 상급종합병원과 전국 분포 종합병원의 임상영양서비스 실태 조사 연구: 전국 규모 설문조사를 통하여)

  • Um, Mi Hyang;Park, Yoo Kyung;Lee, Song Mi;Lee, Seung Min;Lee, Eun;Cha, Jin A;Park, Mi Sun;Lee, Ho Sun;Rha, Mi Yong;Lyu, Eun Soon
    • Journal of the Korean Dietetic Association
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    • v.20 no.3
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    • pp.183-198
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    • 2014
  • The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.

Factors Influencing Health Status by the salutogenic Theory of Radiologists (방사선사의 건강생성이론에 의한 건강상태 영향요인)

  • Seo, Young-Ho;Kim, Keon-Yeop;Nam, Hang-Me;Park, Chang-Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.1
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    • pp.291-299
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    • 2020
  • This study is based on the theory of salutogenesis, and investigates factors affecting the health status of radiologists who experience high stress and health problems in the rapidly changing medical environment. The study enrolled 379 radiologists working at hospitals in Daegu. A health structure model was established by applying the theory of salutogenesis. Sense of coherence had a direct effect on the health status of radiologists. Psychological stress, social support, and drinking were also influential factors, due to their mediating effect on the sense of coherence. Moreover, social support was also found to be lower when job stresses were higher. Hence, increased psychological stress resulted in lower levels of sense of coherence, social support and exercise. Taken together, results of this study indicate that effects on the sense of coherence have maximum influence on the health status of radiologists, and social support among general resistance resources is an important factor for enhancing sense of coherence. In addition to social support and health behaviors, researches involving various resources and the development of organizational strategies and health promotion intervention programs are required in future, to enable radiologists to cope with their stresses and improve health.