• Journal of Digital Convergence
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• v.13 no.9
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• pp.323-332
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• 2015

This paper examines the level of the primary care continuity for patients with high blood pressure and the effects of the primary care continuity on their convergence health outcomes. We conducted a retrospective cohort study. A total of 315,791 patients who had received new diagnoses of hypertension. We determined standard indices of continuity of care-MFPC, MMCI, and COC and evaluated their association with study outcomes over three years of follow-up. Outcome measures included hospitalization and emergency room visits. The result of the primary care continuity levels and hazard ratios of health outcome showed that, comparing continuity group, non-continuity group had higher rates of hospitalization by 1.655(95% CI: 1.547-1.771) and emergency room visits by 1.669(95% CI: 1.465-1.903). This paper argues that medical costs of chronic diseases will reduce if low continuity of care turns into high continuity of care.

• Proceedings of the Korea Information Processing Society Conference
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• 2017.11a
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• pp.403-406
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• 2017

지오펜스와 하이브리드 비콘을 이용한 입원환자 출입관리시스템은 모바일 앱, 관리자는 웹 화면을 이용해 입원 환자들의 병원 출입을 관리하는 시스템이다. 기존의 외출 시스템은 환자가 외출 신청서를 수기로 작성하고 주치의의 허락 하에 외출하는 형태이지만, 신청서 작성 과정을 거치지 않고 무단으로 외출하는 환자의 경우 외출 시점이나 현재 위치 등을 파악하기 어려운 문제가 있다. 무단 외출 환자를 즉각적으로 파악하지 못하는 경우 해당 환자들이 음주 또는 귀원하지 않는 등의 사고의 원인이 되는 문제가 발생할 수 있다. 본 논문에서는 지오펜스와 하이브리드 비콘을 이용해 환자들의 병원 출입 유무의 정확성을 높이고 무단 외출 환자를 즉각적으로 파악하는 방안을 제시한다.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.37-45
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• 1984

This study was conducted to identify the problems in the medical aid program by reviewing the medical care utilization pattern of the beneficiaries. The data were abstracted from the monthly bills and vouchers for medical care of the whole benefi챠aries(17,527) in Gyeongsan Gun submitted by the physicians to county government for the period of 1 calendar year from October 1981 to September 1982. The number of medical aid beneficiary accounted for 12.7% of the total county population, a higher proportion than the national average-9.5%. Monthly primary care utilization rate per 100 beneficiaries was 9.3 persons with 14.0 visits and 42.9 medication days. for the 2nd and 3rd care, there were 1.7 admissions and 9.3 OPD visits per 100 beneficiaries per year. The beneficiaries of the first class medical aid program had a higher utilization rate of both the primary and secondary/tertiary care facilities. Females utilized more the primary care facilities than males while males utilized more the secondary/tertiary care facilities than females. A significantly lower utilization rate was observed in January than in the other months and this was seemed due to the renewal process of the medical aid certificate. Among 1,931 patients utilized the 2nd/3rd care facilities 84.4% was out-patients and the lowest ratios were in the minor specialties including ENT, ophthalmology, dermatology and urology. The average hospital days per in-patient were 21.2 days and OPD days per out patient were 4.7 days. The average hospital days for a psychiatry in-patient was 74.4 days which was the longest average hospital days among all the specialties. Average medical care cost per beneficiary in a year was W9,821:W24,240 for the 1st class and W7,464 for the 2nd class. The medical care cost for the primary care per patient was W3.901 and W840 per day compared with W49,875 per patient and W5,822 per day for the secondary/tertiary care. From the findings of this study following recommendations were made to improve the medical care program: 1) The renewal process of the medical care certificate should be expedited. 2) Minor specialty clinics should be designated as the primary medical care facility for the medical aid program to reduce the expenses by absorbing more patients referred to the secondary/tertiary care facilities directly. 3) The medical care cost for the primary care facility should be escalated to reduce the differential between the primary and secondary/tertiary care facilities.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.4
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• pp.435-447
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• 2019

In order to prevent unnecessary re-admission, it is necessary to intensively manage the groups with high probability of re-admission. For this, it is necessary to develop a re-admission prediction model. Two - year discharge summary data of one university hospital were collected from 2016 to 2017 to develop a predictive model of re-admission. In this case, the re-admitted patients were defined as those who were discharged more than once during the study period. We conducted descriptive statistics and crosstab analysis to identify the characteristics of rehospitalized patients. The re-admission prediction model was developed using logistic regression, neural network, and decision tree. AUC (Area Under Curve) was used for model evaluation. The logistic regression model was selected as the final re-admission predictive model because the AUC was the best at 0.81. The main variables affecting the selected rehospitalization in the logistic regression model were Residental regions, Age, CCS, Charlson Index Score, Discharge Dept., Via ER, LOS, Operation, Sex, Total payment, and Insurance. The model developed in this study was limited to generalization because it was two years data of one hospital. It is necessary to develop a model that can collect and generalize long-term data from various hospitals in the future. Furthermore, it is necessary to develop a model that can predict the re-admission that was not planned.

• The Journal of the Korea Contents Association
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• v.11 no.5
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• pp.270-279
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• 2011

This study to analyze differences of cancer patient's health utilizations in medical aid program and national health insurance by analysing health insurance claims data, and identify effects of health care systems. The majors results of the research were as follows. First, cancer patients in medical aid program more used total medical expenditures than in national health insurance mostly by many outpatient visits and long term hospitalization. Second, results of multiple regression, cancer patients in medical aid program more used total expenditures and inpatient expenditures. But, outpatient expenditures weren't different, cancer patients in medical aid program more visited medical institutions and hospitalized long term periods than in national health insurance. Therefore, it is too early to conclude that moral hazard is in health utilizations of medical aid program, because cancer patients in medical aid program many use in benefits for many nonbenefit burdens.

• The Journal of the Korea Contents Association
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• v.17 no.12
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• pp.617-627
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• 2017

The purpose of this study was to investigate the effect of medical service quality perceived by general hospital inpatients on satisfaction and loyalty. Data were collected and analyzed through questionnaires of 310 hospitalized patients in general hospital in Gyeonggi-do. The main results of this study are as follows. First, the effect of medical service quality on satisfaction was statistically significant in procedural procedure, hospital life (doctor, nurse), employee friendliness, hospital environment and service satisfaction(p <.001). Second, the effect of medical service quality on loyalty was statistically significant in hospitalization (nurse), hospitalization (doctor), hospital environment and service loyalty(p <.05). Finally, the effect of inpatient satisfaction on loyalty was found to have a significant effect on satisfaction(p <.001). The higher satisfaction with medical service quality affects the loyalty, and it is an important factor in future re-hospitalization and recommendation of hospital to others. Therefore, management should establish policies on quality of medical service to improve the satisfaction and loyalty of hospitalized patients. It should be reflected.

• Journal of Convergence for Information Technology
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• v.10 no.11
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• pp.98-106
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• 2020

This study was conducted to identify the factors influencing the severity of pressure injuries of patients with pressure injuries admitted to acute university hospital. This study was a secondary analysis on the data of the study conducted to identify the factors influencing the deterioration of pressure injuries during hospitalization. The data were collected by retrospectively examining the medical records of patients with pressure injuries who were 18 years of age or older and who were admitted to acute university hospital from May 2017 to November 2018. We used data from 472 patients with pressure injuries at admission for this secondary analysis. In order to identify the factor influencing of severe pressure injuries compare to superficial pressure injuries, we analyzed the data using logistic regression analysis. As a result of the study, gender, body temperature, and patient's movement were identified as factors affecting severe pressure injuries. Therefore, special care is necessary to increased the number of position change for inpatients with pressure injuries, especially for patients with decreased mobility.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.11
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• pp.3444-3450
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• 2009

Our study was carried out to suggest the way of improving the accessibility of medical service through identifying the factors that make patients be hospitalized in non-residential area not in their residential area. The subjects were 523,782 inpatients of the 2005 Patient Survey data. The 2004 Hospital Evaluation data, the 2005 census data which were obtained from the Korean National Statistics Office, and the 2006 Survey on National Healthcare Resources data were used. The data were analyzed using descriptive statistics, chi-square test and logistic regression in a SAS program. The most important factor was quality level of care of local hospitals. In the possibility of being hospitalized in non-residential areas, the region with the score of more than 9.5 per 100,000 people in the hospital evaluation was 8.3 times more than the region with the score of less than 9.5. However patients is hospitalized in the area with the hospitals with above 910 beds per 100,000 people more than in the area with the hospitals with less than 910 beds by 2.0 times. For the accessibility of medical services, government policy should focus on improving the quality of care in local hospitals not on increasing and distributing health care resources.

• Journal of Hospice and Palliative Care
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• v.8 no.1
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• pp.37-44
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• 2005

Purpose: To provide the basic data in developing the nursing intervention for patients who have symptoms of insomnia after undergoing hemopoietic stem cell transplantation (HSCT). This was achieved through investigating sleep quality and sleep patterns according to admission time, and discharge time. Methods: Data was put together by studying 52 HSCT patients who have been admitted to the department of HSCT from August 2002 to August 2003, in a university hospital. Research instruments used were, PSQI for sleep quality and a specified questionnaire for sleep patterns. Results: The PSQI regarding the past mono which was measured at the last day of hospitalization, was 11.8. This was significantly higher than 5.3, which was a measurement for the past month before the hospitalization (t=11.41, P=0.000). Looking at it with 7 categories-quality of sleep, consistency of sleep, sleep period, effectiveness of sleep, sleeping disorder, usage of sleeping pills, impediment of daily life- the PSQI for a month after admission increased significantly compared to the rate measured for a month before admission. Comparing the subjects sleep pattern before and after admission, it showed a significant difference regarding time attending sleep, time it takes to sleep, wake-up time, total time of sleep, day time sleep, number of times waking up during sleep, number of usage of sleeping pills, actions that are taken during sleep disorder, reasons for insomnia. Conclusion: The PSQI score of patients who undergo hemopoietic stem cell transplantation have increased significantly after hospitalization. Compared to the change of sleep patterns when hospitalized, significant changes were observed. Therefore nursing interventions addressing sleep are needed.

• Korean Journal of Clinical Pharmacy
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• v.21 no.3
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• pp.243-248
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• 2011

낙상은 노인의 건강을 위협하는 가장 심각한 문제 중의 하나이며, 조기사망, 신체손상, 운동장애, 심리학적 기능장애를 유발하는 원인이기도 하다. 본 연구의 목적은 국내 노인전문 요양병원 입원 환자들의 의약품 사용이 낙상에 미치는 영향을 평가하는데 있다. 후향적으로 원내 의무기록 정보를 이용하여 환자-대조군 연구를 수행하였고, 2008년 1월부터 2010년 12월까지 3년 기간에 입원한 65세 이상을 대상으로 하였다. 입원기간 중 낙상을 경험한 34명의 노인환자들을 환자군으로 선택하였으며 낙상을 경험하지 않은 68명의 노인환자들을 무작위 추출하여 1:2의 환자군:대조군비율로 연구 대상 환자들을 선정하였다. 환자군이 복용한 의약품을 대조군이 복용한 의약품과 비교하였으며 각 계열별 의약품과 낙상위험도 관계를 평가하였다. 두 그룹간의 인구통계학적 특성은 유사하였고 연령, 성별, 복용 의약품수, 고혈압 유무, 혈중 크레아티닌 수치, 혈중 나트륨 수치, 혈압 또는 심박수에 유의한 차이는 없었다. 항히스타민제와 본 연구에서 유일하게 기타 수면보조제로 분류된 졸피뎀이 유의하게 낙상위험도를 증가시켰다.