• Title/Summary/Keyword: 입원환자 관리

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A Hospital-based Case-control Study on the Risk Factors of Cerebrovascular Disease (뇌혈관질환의 위험요인에 대한 환자 - 대조군 연구)

  • Kim, Jang-Rak;Hong, Dae-Yong;Park, Sung-Hak
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.2 s.50
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    • pp.473-486
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    • 1995
  • A hospital-based, matched case-control study was carried out to evaluate the relation ship of various suspected risk factors including snoring and serum level of cholesterol to cerebrovascular disease in Korea. A total of 127 incident cases of cerebrovascular disease(74 cases of cerebral infarction and 53 cases of intracerebral hemorrhage) admitted to. the department of neurology in a university hospital from December, 1993 to March, 1995 were compared with 127 matched controls admitted to same hospital in same period. A multivariate analysis suggested that ECG abnormality(left ventricular hypertrophy and atrial fibrillation), family history of cerebrovascular disease, fundoscopic abnormality, previous history of transient ischemic attack and hypercholesterolemia were risk factors of cerebrovascular disease, ECG abnormality, fundoscopic abnormality, smoking and hypercholesterolemia were also suggested as risk factors of cerebral infarction.

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Patient Distribution and Hospital Admission Costs in Neonatal Intensive Care Units: Collective Study of 7 Hospitals in Korea during 2006 (2006년도 전국 7개 병원 신생아중환자실 입원 현황 및 입원비용 분석)

  • Bae, Chong-Woo;Kim, Ki-Soo;Kim, Byeong-Il;Shin, Son-Moon;Lee, Sang-Lak;Lim, Baek-Keun;Choi, Young-Youn
    • Neonatal Medicine
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    • v.16 no.1
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    • pp.25-35
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    • 2009
  • Purpose: The characteristics of hospitalized patients in neonatal intensive care units (NICUs), including hospitalization costs (HC) and National Health Insurance (NHI) status were studied. Methods: We gathered the following data from 7 hospitals in Korea during 2006: the distribution of patients according to birth weight (BW), and the duration of the hospital stay according to BW and He. Results: The patients who were admitted to the NICU consisted of high-risk neonates, including low birth weight or premature neonates, which comprised 50% of all neonates admitted to the NICU. The duration of hospitalization was 75-90 days for neonates with BW <1,000 g, 45-60 days for neonates with BW between 1,000 and 1,499 g, and approximately 15 days for neonates with BW between 2,000 and 2,499 g. The portion of the HC covered by the NHI was 77.1%, 22.9% of the total HC was not covered by the NHI (19.5% was included in the list, but not covered by the NHI and 3.4% was not listed, but covered by the NHI). The average total HC per person was 4,360,000 won, and the HC covered and not covered by the NHI were 3,677,000 won and 1,007,000 won, respectively. The mean HC were as follows; 35,000,000 won for a BW <500 g, 18,000,000 won for a BW between 500 and 999 g, 16,000,000 won for a BW between 1,000 and 1,499 g, and 4,200,000 won for a BW between 1,500 and 1,999 g. Conclusion: Not only premature, but also ill neonates were under the care of the NICU. The HC increased as the BW decreased and the hospitalization period increased. The proportion of the patient's financial burden is >25% of the total He. For this matter, additional NHI is needed.

Nursing Case Management Program Development for the Elderly at Hospital (입원노인환자의 사례관리 프로그램 개발 연구)

  • Shin, Eun-Young
    • Research in Community and Public Health Nursing
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    • v.13 no.3
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    • pp.444-455
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    • 2002
  • Purpose: This study was performed to develop the case management program that can provide the qualitative health care service to satisfy the increasing needs for health care elderly and prevent the increase in medical cost cased by prolonged and repetitive hospitalization. Method: The survey was completed as follows. First, 290 elderly patients who would be soon discharged in 4 hospitals are participated in the survey on needs of nursing care and case management programs. Second, 70 professionals working at 5 hospitals including doctors, nurses, social workers and so on are participated in the survey on the case management team operation. Result: Level of needs to Nursing care and case management programs showed so high. Professionals suggested on the case management team operation. Finally, based on the survey and literature review, the case management program was developed. Conclusion: In this study, the specific models for the five case management services were suggested. It is thought that the service provision by the case management team based on the multi-disciplinary case management program model suggested in this study would be suggested as a constituent of the effective health care delivery system for the hospitalized elderly patients.

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Uncertainty and Performance of Infection Control in Caregivers of Vancomycin-Resistant Enterococci Patients (반코마이신 내성 장구균 환자 보호자의 질병 불확실성과 감염관리 수행)

  • Lee, Eunsuk
    • The Journal of the Korea Contents Association
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    • v.15 no.6
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    • pp.346-357
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    • 2015
  • Purpose: This descriptive study was to examine uncertainty and performance of infection control in the VRE patients' caregivers. Methods: The participants were 82 caregivers who involved with the VRE patients care in D tertiary hospital in D metropolitan city. Data were analyzed with number, percentage, t-test, and ANOVA using SPSS/Win 21.0. Results: The participants' uncertainty was 56.99 and performance of infection control was 35.09. Performance of infection control was significantly different by age (F=121.38, p<.001), education (F=102.77, p<.001), relationship with the patient (F=17.80, p<.001), hours of caring per day (t=3.14, p=.002), and type of family (t=-8.65, p<.001). There was a significant negative correlation between participants' uncertainty and performance of infection control (r=-.96, p<.001). Conclusion: The results of the study will be used to develop nursing intervention program and standard protocol for infection control for the VRE patients' caregivers.

Evaluation of the Adequacy of Pain Management in the Admitted Cancer Patients (입원중인 암환자에 대한 통증관리의 적절성평가 - 한 3차 의료기관 내과 전공의를 대상으로 -)

  • Kim, Kuk-Hyoe;Jang, Won-Il;Joh, Yo-Han;Choi, In-Sil;Park, Sook-Ryun;Lee, Sang-Yoon;Kim, Jee-Hyun;Kim, Do-Yeun;Lee, Se-Hoon;Kim, Tae-You;Bang, Yung-Jue;Kim, Noe-Kyeong;Heo, Dae-Seog
    • Journal of Hospice and Palliative Care
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    • v.4 no.2
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    • pp.137-144
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    • 2001
  • Purpose : Pain is the most serious symptom that cancer patients experience. About $60{\sim}90%$ of advanced cancer patients and four million patients worldwide, according to the WHO statistics, are reported to suffer from cancer pain. Although about $70{\sim}80%$ of the pain could be controlled according to the pain control principles, to our regret, only $30{\sim}40%$ are managed appropriately. This research was aimed to (1) investigates the prevalence of pain among cancer patients, (2) compare patients' perception of pain with physician's recognition and (3) evaluate appropriateness of the doctor's prescription of analgesic. Materials and Methods : Patients with advanced or terminal cancers admitted at department of internal medicine of Seoul National University Hospital for at least 7 days were enrolled. A questionnaire for the patients and the physicians in charge were given and the answers were compared for each other. We also examined their medical records and the physician's orders. Results : Total 59 patients were enrolled. Among them, 43 patients answered the questionnaire, and 27 patients (62.8%) suffered hem cancer pain. The survey also showed that physicians underestimated the severity of pain, overlooked frequently analgesic prescription principle, and that as the patients' pain became severe, the less adequate was pain managements. Conclusion : For cancer patients, pain was frequently overlooked, and treatment still inadequate. Based on this evidence, it seemed that more active practice and education about evaluation and management of cancer pain are needed.

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Study on Clinical Patient-oriented Education System for Medical Organizations (의료기관에서의 환자 중심 교육 시스템 연구)

  • Park, Hwagyoo
    • Journal of The Korean Association of Information Education
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    • v.17 no.4
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    • pp.475-486
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    • 2013
  • Recent healthcare studies evaluate the effective impacts of a patient educational information intervention in hospitals on adherence to communicating knowledge, life quality, and therapeutic response in patients treated with highly active therapy in medical organizations. Therefore, the aim of this study is to design and implement the effective and systematic frameworks by providing clinical patient-oriented education system(CPES), which enhances health promotion and medical cures. CPES initiatives accelerate positive financial returns with network-driven educational system. To validate the CPES, the author analyzes the efficiency and effectiveness using statistical survey works. With this outcome, it is compared with previous system. One of the findings is that the system can improve compliance with treatment right dietetics and give patients self-manage their conditions in S hospital. Patients' acknowledge of their condition and its treatment process can be improved through the educational systems.

The Prognostic Factors in Progression of Pneumoconiosis (진폐증의 예후에 영향을 미치는 인자)

  • Kim, Hyung-Ju;Jang, An-Soo;Kim, Sang-Guk;Choi, Soo-In;Park, Sang-Hoo;Yang, Seung-Won;Seo, Jeong-Pyeong;Lee, Soong;Park, Hong-Bae;Son, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.57-65
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    • 1999
  • Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

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Analysis of Medical Expenses Structure for Patients on Percutaneous Coronary Intervention by Medical Security Type (의료보장형태에 따른 관상동맥중재술 환자의 진료비 구조분석)

  • Son, Mi-Kyung;Lee, Sok-Goo
    • Journal of agricultural medicine and community health
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    • v.44 no.4
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    • pp.195-208
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    • 2019
  • Objectives: The purpose of this study was to analyze whether there are differences in medical expenses according to medical security type in the use of medical services with high disease burden such as coronary intervention. Methods: Chi-square test and covariance analysis(ANCOVA) were conducted to identify the differences in the characteristics and costs according to medical security type of 1,904 patients who underwent coronary intervention in a university hospital from 2011 to 2012. Hierarchical regression analysis was conducted to determine whether the cost affects medical expenses. Results: In the medical aid group, the proportion of women, those without a job, those without a spouse, and those who received hemodialysis was high, length of stay was high, patients using the emergency room and those who died was high. The medical aid patients were significantly higher in the non-benefit medical expenses, optional medical expenses, physician and admission, meals, medications and injections. National health insurance patients were significantly higher in procedure. The medical security type was found to be significant as a variable affecting the medical expenses. Conclusions: Provision of medical expenses should be managed in advance by providing prevention and education services for the vulnerable, and care services in the region should be provided to suppress the occurrence of medical expenses due to the increase in the number of days spent. In addition, it is necessary to support medical expenses to prevent unsatisfactory medical services from occurring for non-benefit and optional care.

Comparison of Safety Perception between Patients and Nurses and Factors Affecting Nurses Safety Management Activities in Tertiary Hospitals (상급종합병원 환자와 간호사의 안전 인식 비교와 간호사의 환자안전관리 직무수행 영향요인)

  • Kim, Youn-Hong;Choe, Yon-Jeong;Kang, Da-Hui;Jung, Ji-Young;Gil, Cho-Rong;Chang, Hee-Kyung
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.1
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    • pp.69-82
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    • 2020
  • This study is a descriptive research study to compare the safety perception between patients and nurses and to identify the factors affecting the nurses' safety management activities in tertiary hospitals. Data were collected with structured questionnaires from 147 patients and 147 nurses from a university hospital in J city, Gyeongnam, from July 24 to September 23, 2019, and analyzed using SPSS 23.0. The result showed that the patient's safety perception was significantly higher than the nurse's perception. The significant factors affecting patient management activity were nurse's educational level, position, effective communication, patient safety perception, and perception of importance on patient safety management. In the multiple regression analysis, knowledge about 'effective communication', and 'concerned about patient safety management', explained 54.8% of the nurses' patient management activity. Based on the results of this study, it is emphasized that nurses need to develop strategies to improve the communication and attention between patients and hospital members to improve patient safety management activities in tertiary hospitals.

Development of Guidelines for Raid Response to Acute Deteriorating of Hospitalized Patients (입원환자의 급성 악화 신속대응 가이드라인 개발)

  • Lee, Ha-Nui;Park, Jeong-Sook
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.359-373
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    • 2022
  • The purpose of this study was to develop evidence-based practice guideline for rapid response to acute deterioration of hospitalized patients. The guideline was developed according to the Clinical Practice Guideline Adaptation Manual. and evaluated using AGREE II tool. The guidelines were checked content validation by an expert group, final 130 recommendations in 5 sections including management, recognition, activation, response, and evaluation. The average of the overall practical application to the guidelines was 4.41±0.78 out of 5, which showed high applicability in clinical work.