• Title/Summary/Keyword: 입원환자 관리

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A Study on Small Area Variations of Hospital Services Utilization in Some Acute diseases -Focused on Gastric Diseases and Acute Appendicitis (일부 급성질환의 지역간 입원의료이용 변이에 관한 연구 -위장질환과 충수염질환을 중심으로-)

  • Kwon, Young-Chae;Kim, Kwang-Hwan;Chang, Dong-Min
    • Journal of Digital Convergence
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    • v.10 no.7
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    • pp.193-200
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    • 2012
  • This study aims to provide an important base resource for the effective medical supply system construction by figuring out the characteristics and changes of admission medical use of gastritis in 160 middle treatment areas classified by 2008 patient examination resources, and by figuring out factors affecting on changes. As a result, in terms of admission rate according to sex and age standardization per small area, there were differences as EQ was 15.1 and CV was 0.4. Top 10 variations were mainly in rural areas. It showed significant positive relations between admission and the number of bed, doctor and special medical equipment per 10,000 population. It is recommended that the government set a priority in the management of regional bed supply and the distribution of efficient medical resources.

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.

A study on the variation of severity adjusted LOS on Injry inpatient in Korea (손상입원환자의 중증도 보정 재원일수의 변이에 관한 연구)

  • Kim, Sung-Soo;Kim, Won-Joong;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.6
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    • pp.2668-2676
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    • 2011
  • In order to analyze the variation in length of stay(LOS) of injury inpatients, we developed severity-adjusted LOS model using Korean National Discharge In-depth Injury Survey data of Center for Disease Control. Appling this model, we calculated predicted values and, after standardizing LOS using the differences from the actual values, analyzed the variation in LOS. Major factors affecting severity-adjusted LOS of injury inpatients were found to be severity, surgery(or no surgery), age, injury mechanism and channel of hospitalization. Result of analysis of the differences between the actual values and predicted values adjusted by decision tree model suggested that there were statistically significant differences by hospital size(number of beds), type of insurance and location of institution. In order to reduce the variation in LOS, efforts should be exerted in developing nationwide treatment protocol, inducing medical institutions to utilize it, and furthermore systematically evaluating it to reduce the variation continually.

Factors for Intentional Self-harm among the Elderly Patients with Depression (고의적 자해 노인 환자의 우울증 관련 요인)

  • Lee, Hyun Sook;Lee, Je Jung;Kim, Sang Mi
    • 한국노년학
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    • v.39 no.4
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    • pp.883-893
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    • 2019
  • The purpose of this study is to analyze the characteristics of the elderly patients with depression who were admitted to the hospital with intentional self-harm. 3,280 patients were selected from KCDC database(2011-2015) using STATA 12.0. Analysis results show that gender(female), residence(micropolitan city), result of suicide(death), risk factors(financial problems, psychological problems, physical disease, conflicts with family, place(non-residence) method of suicide(poisoning) were statistically significant. The hospital should detect the elderly patient with depression when they admitted.

Comparison of Nurses' Job Satisfaction, Patients' Satisfaction and Direct Nursing Time according to the Change in Grade of the Nursing Management Fee (입원환자 간호관리료 차등제 변화에 따른 간호사 직무만족, 환자만족도 및 직접간호시간 비교)

  • Kim, Sea Joung;Lee, Ja Yin;Lee, Yun Mi
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.9-18
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    • 2017
  • Purpose : This study aimed to identify nurses' job satisfaction, patients' satisfaction, and direct nursing time according to the change in grade of nursing management fee. Methods : Descriptive design was used in this study. Nurses (n = 200) and patients (n = 200) were recruited from one university hospital in Busan. Four aspects were measured: direct nursing time, overtime, nurses' job satisfaction, and patients' satisfaction. Data were analyzed using descriptive statistics, ${\chi}^2-tests$, and t-tests. Results : There was a significant difference in patient satisfaction (t = -2.09, p = .038) and direct nursing time (t = -4.77, p < .001) when the nurse staffing grade was changed from the level two to the level one. Conclusion : The findings from this study showed that a higher nurse-to-patient ratio can provide a greater amount of direct nursing time for individual patients and increase patient satisfaction.

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YOLO models based Bounding-Box Ensemble Method for Patient Detection In Homecare Place Images (조호환경 내 환자 탐지를 위한 YOLO 모델 기반 바운딩 박스 앙상블 기법)

  • Park, Junhwi;Kim, Beomjun;Kim, Inki;Gwak, Jeonghwan
    • Annual Conference of KIPS
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    • 2022.11a
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    • pp.562-564
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    • 2022
  • 조호환경이란 환자의 지속적인 추적 및 관찰이 필요한 환경으로써, 병원 입원실, 요양원 등을 의미한다. 조호환경 내 환자의 이상 증세가 발생하는 시간 및 이상 증세의 종류는 예측할 수 없기에 인력을 통한 상시 관리는 필수적이다. 또한, 환자의 이상 증세 발견 시간은 발병 시점부터의 소요 시간이 생사와 즉결되기에 빠른 발견이 매우 중요하다. 하지만, 인력을 통한 상시 관리는 많은 경제적 비용을 수반하기에 독거 노인, 빈민층 등 요양 비용을 충당하지 못하는 환자들이 수혜받는 것은 어려우며, 인력을 통해 이루어지기 때문에 이상 증세 발병 즉시 발견에 한계를 가진다. 즉, 기존까지 조호환경 내 환자 관리 방식은 경제적 비용과 이상 증세 발병 즉시 발견에 한계를 가진다는 문제점을 가진다. 따라서 본 논문은 YOLO 모델의 조호환경 내 환자 탐지 성능 비교 및 바운딩 박스 앙상블 기법을 제안한다. 이를 통해, 딥러닝 모델을 통한 환자 상시 관리가 이루어지기에 높은 경제적 비용문제를 해소할 수 있다. 또한, YOLO 모델 바운딩 박스 앙상블 기법 WBF를 통해 폐색이 짙은 조호환경 영상 데이터 내에 객체 탐지 영역 정확도 향상 방법을 연구하였다.

Treatment of Patients with Cancer in a Secondary Hospital in Korea (국내 일개 2차 병원의 암환자 치료 실태)

  • Son, Myoung Kyun
    • Journal of Hospice and Palliative Care
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    • v.21 no.3
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    • pp.84-91
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    • 2018
  • Purpose: This study aims to investigate treatment of cancer patients at a secondary hospital. Methods: A retrospective analysis was performed with electronic medical records of cancer patients admitted to a secondary hospital from January 1, 2009 through September 31, 2017. Results: A total of 223 patients were studied. Sixty-nine patients were hospitalized for supportive care after receiving a surgery, chemotherapy, and radiotherapy at a tertiary hospital, 58 patients for other supportive care, 53 patients for symptom control, 16 patients with a decision not to take active cancer treatment, and 27 patients for treatment of cancer that was diagnosed during their hospital stay. Among 75 patients who were discharged to other institutions, 50 were transferred to tertiary hospitals, 10 to long-term care hospitals, eight to hospice hospitals, four to nursing homes and two to secondary hospitals. Comorbidities were found in 120 patients (53.8%). For patients who consulted with more than one department, more consultations were for non-cancer diseases than cancer. Seventy-three patients had a do-not-resuscitate order. Conclusion: For treatment of cancer patients, it is needed to establish a cooperation system among medical institutions and provide comprehensive management including treatment of comorbidities.

A Study on the Development of Readmission Predictive Model (재입원 예측 모형 개발에 관한 연구)

  • Cho, Yun-Jung;Kim, Yoo-Mi;Han, Seung-Woo;Choe, Jun-Yeong;Baek, Seol-Gyeong;Kang, Sung-Hong
    • 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.

Validation of the Developed Nutritional Screening Tool for Hospital Patients (입원환자를 위해 개발된 영양검색 도구의 타당성 검증)

  • Lee, Jeong-Sook;Cho, Mi-Ran;Lee, Geum-Ju
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.189-196
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    • 2010
  • Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGSGA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

A Study on Determinats of Cancer Patients's Length of Hospital Stay on Medical Charges Pattern (암 환자 재원일별 진료비 발생 양상에 미치는 결정요인)

  • Kim, Han-Kyoul;Lee, Kyoung-Sook;Kim, Yong-Ha;Kim, Kwang-Hwan
    • Journal of the Korea Convergence Society
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    • v.2 no.4
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    • pp.53-58
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    • 2011
  • This Study is to propose the resonable management for cancer patients by identifying correlation among the treatment, their length of hospital stay and medical charges. Research subjbject is 144 patient that breast cancer, uterine cancer and Family Medical patients of inpatients in K University Hospital in Korea during six month, from January 1, 2010 to June 30, 2010. The analysis shows that the emergecy is superior range thag outpatient because each of them has 97.9%, 2.1% by looking at the path to admission. And the age of 40-49 is the higest group by age. When matrix components of breast cancer patients, principal component is composed of two axes. Factors associated with the first component appeared correlations between all variables without the age. Following results, this study is considered similar types of disease or treatments are need to introduce the DRG.