• Journal of Digital Convergence
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• v.11 no.6
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• pp.221-233
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• 2013

This study aims to develop the severity-adjusted length of stay(LOS) model for acute stroke patients using data from the hospital discharge survey and propose management of length of stay(LOS) for acute stroke patients and using for Hospital management. The dataset was taken from 23,134 database of the hospital discharge survey from 2004 to 2009. The severity-adjusted LOS model for the acute stroke patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of acute stroke patients were acute stroke type. The difference between severity-adjusted LOS from the decision making tree model and real LOS was compared and it was confirmed that insurance type and bed number of hospital, location of hospital were statistically associated with LOS. And to conclude, hospitals should manage the LOS of acute stroke patients applying it into the medical information system.

• Journal of Digital Convergence
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• v.10 no.5
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• pp.289-299
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• 2012

The study was carried out to provide basic data of improving the accessibility of medical service through identifying the factors that make hospital injury inpatient in non-residential area not in their residential area in Gyeongsangnam-do. This study analyzed not only 8,225 cases of discharged patients with damages from 2008, provided by the Korea Centers for Disease Control and Prevention, but also using a census and a research data on the actual condition from health care system. This study conducted a frequency test, a chi-square test and a logistic regression In result, first, the centralization of medical utilization of patients with damages is apparent centrally the city area. Second, medical utilization of injury patients in non-residential areas were significantly higher local area compared to City area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments, for the accessibility of medical services, government is demanded policy for patients with damages in local area.

• The Journal of the Korea Contents Association
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• v.16 no.10
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• pp.196-205
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• 2016

The purpose of this study is to identify factors influencing treatment result in patients with Tuberculosis by patient characteristic, admission and disease characteristic, and hospital characteristic from 2006 to 2012. Survey data was using Korean national hospital discharge in-depth survey data produced by KCDC(Korea Center for Disease Control and Prevention). Study subjects were 8,305 inpatients with TB(A15.0~A19.9) and analyzed frequency, chi-square test, and logistic regression by using SPSS 20(Statistical Package for the Science). The results of this study show that influencing factors of treatment result were ages (20-39, 40-64, and over 65 years), type of insurance(medical aid), disease code (A16, A17, A18, A19), LOS (31-90, and 91-180 days), beds of hospital (300-499, 500-999, over 1,000 beds) and hospital district (non-metropolitan). These findings implied that it is necessary to support successful prevention and management for high risk TB groups and to build middle and long-term policies as well as short -term policy.

• Journal of Digital Convergence
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• v.10 no.3
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• pp.197-205
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• 2012

In this study, we analyzed situation and length of stay(LOS) variations of inpatients with pressure ulcer using patient safety indicators developed by the United States Agency for Healthcare Research and Quality(AHRQ) and proposed management of medical quality and development of policy. The dataset was taken from 1,373 database of the hospital discharge injury survey from 2005 to 2008. Analysis method was used frequency and chi-square test, ANOVA, multiple linear regression analysis. In result, distribution of inpatients with pressure ulcer by sex were 52.5%(male), 47.5%(female), respectively and aged $65{\geqq}years$ was the highest in age group. LOS of inpatients with nervous system principal disease was the longest. Independent variables which were statistically associated with LOS of inpatients with pressure ulcer were year, sex, insurance type, bed size, operation, principal diagnosis. Therefore, hospital should develop the standardized strategy and guidelines to manage pressure ulcer inpatients efficiently and apply it into the medical information system.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.5
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• pp.2293-2303
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• 2013

Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

• Journal of Digital Convergence
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• v.10 no.1
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• pp.413-422
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• 2012

In this study, we developed the severity-adjusted length of stay (LOS) model for acute myocardial infarction patients using data from the hospital discharge survey and proposed management of medical quality and development of policy. The dataset was taken from 2,309 database of the hospital discharge survey from 2004 to 2006. The severity-adjusted LOS model for the acute myocardial infarction (AMI) patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of AMI patients were CABG and comorbidity. The difference between severity-adjusted LOS from the ensemble model and real LOS was compared and it was confirmed that insurance type and location of hospital were statistically associated with LOS. And to conclude, hospitals should develop the severity-adjusted LOS model for frequent diseases to manage LOS variations efficiently and apply it into the medical information system.

• Journal of Digital Convergence
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• v.11 no.6
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• pp.245-256
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• 2013

This study was conducted in order to examine the quantity of health and medical statistics survey in Medical Records Offices which was required by outside institutions and whether it is profitable for the hospitals or not. The thirteen outside institutions required health and medical statistics of the 24 types of the survey to Medical Records Offices. 16.7% of health and medical statistics of the survey was paid to medical records offices such as the National Cancer Registration Survey, Patient Survey, Tuberculosis Patient Survey, and Hospital Discharge Patients Injury Survey. Medical Records Offices' total length of time for the health and medical statistics survey was over 200 hours per year like the National Cancer Registration Survey, Healthcare Accreditation System and Hospital Discharge Patients Injury Survey. The Medical Record Administrators in the hospitals with fewer than 500 beds work full time from 1 to 3. It is indicated in the study that it is necessary to improve the health and medical statistics survey system in Medical Records Offices required by the outside institutions and to employ additional Medical Record Administrator for more accurate Health and Medical Statistics Survey.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.14 no.10
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• pp.4910-4918
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• 2013

This study aims to design a Severity-Adjusted LOS(Length of Stay) Model in order to efficiently manage LOS of AMI(Acute Myocardial Infarction) patients. We designed a Severity-Adjusted LOS Model with using data-mining methods(multiple regression analysis, decision trees, and neural network) which covered 6,074 AMI patients who showed the diagnosis of I21 from 2004-2009 Korean National Hospital Discharge in-depth Injury Survey. A decision tree model was chosen for the final model that produced superior results. This study discovered that the execution of CABG, status at discharge(alive or dead), comorbidity index, etc. were major factors affecting a Sevirity-Adjustment of LOS of AMI patients. The difference between real LOS and adjusted LOS resulted from hospital location and bed size. The efficient management of LOS of AMI patients requires that we need to perform various activities after identifying differentiating factors. These factors can be specified by applying each hospital's data into this newly designed Severity-Adjusted LOS Model.

• The Journal of the Korea Contents Association
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• v.21 no.4
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• pp.487-497
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• 2021

The purpose of this study is to identify factors affecting length of stay(LOS) and death in tuberculosis(TB) patients by disease type, patient characteristic, admission and disease characteristic, and hospital characteristic from 2008 to 2017. Survey data was using Korean national hospital discharge in-depth survey data produced by Korea Disease Control and Prevention Agency. Study subjects were 10,634 inpatients with TB(A15, A16, A17, A18, A19, U88.0, U88.1, U84.30, U84.31) and analyzed frequency, chi-square test, Fisher's exact test, and logistic regression by using STATA 13.0. As a study result, the type of TB(extrapulmonary TB, multidrug-resistant TB, extensively drug-resistant TB), sex(woman), age(35-49, 50-64, 65-74, 75 years old or older), admission type(outpatient department), CCI(1-2 point, 3 point over), hospital location(metropolitan city) and bed size(300-499, 500-999, over 1000) were significantly influence LOS. Also, the type of TB(extrapulmonary TB, extensively drug-resistant TB), sex(woman), age(50-64, 65-74, 75 years old or older), residence(small town/rural), admission type(outpatient department), CCI(1-2 point, 3 point over), hospital location(provincial) were significantly influence death. In conclusion, the existing tuberculosis management has been patient management with rapid diagnosis and treatment following early detection. But other studies should be carried out for the system that identifies and supports high-risk groups of the long-term length of stay in hospital or high mortality rates as a result of treatment.

• Journal of Digital Convergence
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• v.11 no.10
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• pp.459-467
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• 2013

The purpose of this study was to identify the differences in medical care utilization by regional economic status using the National Hospital Discharge Patients Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized 5 quintiles according to their financial self-reliance ratio. The main results are as follows. First, low economic region has high age-standardized admission rate and standardized mortality rate. Second, of 16 major diseases, cerebrovascular and heart diseases, lung cancer, and stomach cancer reported greater changes in standardized mortality rate by regional economic status. Third, the rate of admission via emergency room in low economic region is higher than that of high economic region. Lastly, in the major illnesses, lower economic status led to an increase in average length of stay. Therefore, In order to bridge the gap in health inequality across regions, a regional medical policy tailored for each region and characteristics of the economic status should be established.