• Therapeutic Science for Rehabilitation
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• v.9 no.2
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• pp.55-71
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• 2020

Objective : The purpose of this study was to investigate the necessity of occupational therapist's involvement in patient discharge planning, the areas that should be considered for discharge screening and planning, and to provide the basic data required for the development of a discharge assessment tool. Methods : We conducted an online questionnaire survey of 60 occupational therapists who were working at medical institutions and had agreed to participate in the study. The questionnaire was composed of 36 questions regarding the general characteristics of the current discharge planning process and the necessity of discharge assessment and planning. Descriptive statistics, an independent t-test, and a one-way ANOVA were conducted using SPSS 20.0. As for the post-hoc test, Scheffe's test was used. Results : The awareness of occupational therapist's role in discharge planning and the necessity of a discharge assessment tool were high, but the occupational therapist's awareness of discharge-related knowledge was low. The difficulties in discharge planning showed high response rate in the absence of adequate fee-for-service in the patient interview and assessment and the lack of team approach and appropriate assessment tools for discharge planning. The high-needs areas for evaluation during discharge were fall risk and BADL, and the low-needs areas were well-being and functional level prior to onset. Conclusion : This study is expected to provide preliminary information necessary for the development of a discharge assessment tool for effective discharge planning.

• Journal of the Korea Convergence Society
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• v.13 no.2
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• pp.313-320
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• 2022

Discharge plans should be considered during rehabilitation depending on the location specified by the patients. This study aims to compare the demographics and rehabilitation function according to discharge location in people with rehabilitation one month after discharge. Among 300 discharged patients, 146 were discharged to their homes, 154 were transferred to facilities such as nursing homes. The results showed that rehabilitation function that scored using the modified Barthel Index were different according to discharge location. That is, the modified Barthel Index scored greater in home discharged patients than counter group. However, the home discharged patient's physical function and daily activities showed scores that required rehabilitation. Differentiated strategies should be needed for home and facility visit rehabilitation programs for rehabilitated patients.

• Proceedings of the KAIS Fall Conference
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• 2010.05b
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• pp.579-581
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• 2010

2007년1월1일부터 12월 31일까지 퇴원환자조사에서 제외되었던, 100병상미만 의료기관을 조사대상으로 선정하였다. 퇴원환자조사를 위해 조사 기반자료인 의무기록을 토대로 손상퇴원환자의 일반적 특성, 진료비지불방법, 질병 및 수술 양상과 의료이용 실태를 파악하였다. 2007년 한 해동안 전국 100병상미만의 급성기 의료기관을 퇴원한 추정 환자수는 총 4,697,095명으로 이는 전체 인구의 9.7%에 해당 한다. 인구 10만명당 퇴원율은 9,693명이며 평균재원일수는 9.8일이었다. 퇴원후 귀가한 퇴원환자수는 전체 4,538,861명이었고 이중 남성은 1,784,041명, 여성은 2,754,821명이었다. 타병원으로 이송된 환자는 119,378명이었으며 의뢰병원으로 회송된 환자도 8,970명 이었다.

• Journal of Korea Entertainment Industry Association
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• v.15 no.8
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• pp.389-401
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• 2021

This study was performed to generate basic data to establish a health promotion plan for residents of Chungcheongbuk-do by identifying characteristics of discharged patients residing in the Chungcheongbuk-do area from an In-Depth Post-Discharge Injury Survey reported by the Korea Centers for Disease Control and Prevention(KCDCP). The Report provided data on demographic characteristics, medical institution use characteristics, medical use characteristics, and disease characteristics of patients discharged from medical institutions with 100 or more beds from 2013 to 2017. The total number of Chungcheongbuk-do residents who were admitted and discharged from 2013 to 2017 was estimated to be 1,656,590, and the discharge rate was 21,089, which was higher than the national average of 13,882 in 2016. The regions where the discharge rate increased during this period include Goesan, Yeongdong, Boeun, Okcheon, Jeungpyeong, and Eumseong-gun, which are mainly rural areas. Among the patients hospitalized and discharged from hospitals outside the Chungcheongbuk-do area, the discharge rate of patients who used hospitals in Incheon/Gyeonggi areas and Daejeon/Chungnam areas increased slightly. Among the malignant tumor patients, the number of lung cancer(included trachea & bronchial cancer) patients was the highest. In addition, the discharge rate was highest for patients with respiratory diseases. This study suggests that efforts need to be made to lower the discharge rate for infection, circulatory disease, genitourinary disease, and musculoskeletal disorder patients

• Quality Improvement in Health Care
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• v.14 no.2
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• pp.117-123
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• 2008

문제: 장기 입원 치료를 받은 미숙아의 퇴원교육을 퇴원당일 짧은 시간에 시행함으로써 간호사는 제한된 인력으로 교육시간을 길게 할애하지 못하고, 표준화된 지침의 부재로 인해 퇴원교육을 누락하는 경우가 있으며 보호자는 교육내용을 충분히 이해할 시간이 부족하여 퇴원에 대한 필요 이상의 두려움을 가지고 있었다. 목적: 미숙아에 대한 퇴원교육을 표준화된 지침에 따라 단계적이고 체계적인 방법으로 개선함으로써 불필요한 퇴원지연을 예방하여 재원일수 단축시키고 보호자의 양육 자신감을 향상시킨다. 의료기관: 부산광역시에 소재한 대학병원의 신생아실 질 향상 활동: 미숙아의 퇴원을 지연시키는 원인을 분석하고 개선된 미숙아 퇴원교육 방법을 적용한 후 미숙아 재원일수와 보호자의 양육자신감을 측정하였다. 개선효과: 개선 활동 후 미숙아의 재원일수가 11.33일에서 8.28일로 3.05일 단축되었고 보호자 양육자신감 점수는 68점에서 76.25점으로 8.25점 향상되었다. 교훈: 퇴원을 앞둔 미숙아들이 좀 더 개방적으로 가족과 함께 지내면서 퇴원준비를 할 수 있는 여건과 미숙아의 성장과 발달에 대한 보호자들의 이해를 돕기 위한 인터넷강좌나 공개 강좌 등이 필요하다. 보호자들의 양육 자신감 향상과 정보교환을 위해 자조조직을 활성화하고 보다 질 높은 서비스를 위해서는 현실적으로 간호사의 인원 충원이 필요하다.

• The Journal of Korean Physical Therapy
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• v.10 no.2
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• pp.41-55
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• 1998

An analysis of 87 stroke Patients who were enrolled in 7 hospitals in cities of Pusan, Taegu, Kumi, and Andong from January 1 to May 31, 1998 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals : Initial assessment, one month after initial, at discharge, and ore month after discharge. The mean BI score of patients initial assessment was 26.32. and that of PS was 17.34. There were statistically significant between initial score and one month after initial (16.61 : p<0.001), at discharge(33.51 : p<0,001), one month after discharge(43,56 : p<0.001). PS scores were also improved significantly(-2.1, -3. 94, and -5.52(p<0.001), and BI score between discharge and one month after discharge wag significant improvement(10.06 : p <0.001) and in PS score(-1,57 : p<0.001). Age and BI scone were significantly associated with the improved in BI score between initial and discharge (T3-T1)(p<0.05). Below age forty and the lower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial BI score, BI score at discharge, and religion were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, the high. BI score at discharge, and the religious showed significantly higher improvement(T4-T1)(p<0.05). BI score at discharge and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3)(p<0.05). The lower BI score at discharge, the religious showed significantly higher improvement(T4-T3)(p<0.05) Initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score showed significantly hier improvement(T3-T1)(p<0.05). Initial PS score, Bi score at discharge, and patient's attitude for physical therapy after discharge were significantly associated with the improvement of PS score between initial and one month after discharge(T4- T1)(p <0.05). The higher initial PS scorer the lower PS score at discharge, patient's positive attitude for physical therapy after discharge showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, Patient's attitude for Physical therapy after discharge were significantly associated with the improvement of PS score between discharge and one month after discharge(T4-T3)(p<0.05). The higher PS score at discharge, patient's positive attitude for physical therapy after discharge showed significantly higher improvement(T4-T3)(p<0.05). In conclusion, Initial BI score, BI score at discharge, age, and religion were significantly associated with BI score improvement. initial PS score, BI score discharge, and patient's attitude for physical therapy after discharge were significantly associated with PS score improvement in stroke patients.

• Journal of the Korean Data and Information Science Society
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• v.21 no.2
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• pp.279-289
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• 2010

In this study, we propose a simple statistical model for determining the admission or discharge of 668 patients with a chief complaint of dyspnea. For this, we use 11 explanatory variables which are chosen to be important by clinical experts among 55 variables. As a modification process, we determine the discharge interval of each variable by the kernel density functions of the admitted and discharged patients. We then choose the optimal model for determining the discharge of patients based on the number of explanatory variables belonging to the corresponding discharge intervals. Since the numbers of the admitted and discharged patients are not balanced, we use, as the criteria for selecting the optimal model, the arithmetic mean of sensitivity and specificity and the harmonic mean of sensitivity and precision. The selected optimal model predicts the discharge if 7 or more explanatory variables belong to the corresponding discharge intervals.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.7-21
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• 1998

An analysis of 101 stroke patients who were enrolled in 10 hospitals of Cities of Pusan, Taegu, and Andong from November 1, 1996 to April 31. 3997 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals: Initial assessment, one month after initial. at discharge, and one month after discharge. The mean BI score of patients initial assessment was 27.18, and that of PS was 17.54. There were statistically significant between initial score and one month after initial (21.39: p<0.001), at discharge(37.47: p<0.001), one month after discharge(46.49: p<0.001). PS scores were also improved .significantly(-2.62, -4.52. and -6.26(p<0.001). And the score between dischange and one month after discharge was significant (9.01: p<0.001) and in PS score(-1.73: p<0.001). Age and BE score were significantly associated with the improved in BI score between initial and discharge(T3-T1)(p<0.05). Below age forty the Bower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial Bl score, patients' attitude for physical therapy after discharge, age, and surgical operation were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, patients' positive attitude for physical therapy after discharge, below age forty. and no surgical operation showed significantly higher improvement(p<0.05). BI score at discharge, side of hemiparesis and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3) (p<0.05). The lower BI score at discharge. left aide of hemiparesis, with religion showed significantly higher improvement (p<0.05). Age, initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score and below age forty showed significantly higher improvement(T3-T1)(p<0.05). Initial PS score, patient' attitude for physical therapy after discharge, age, educational level, physical therapy hour after discharge, and surgical operation were significantly associated with the improvement of PS score between initial and one month after discharge(T4-T1)(p<0.05). The higher initial PS score, patients' positive attitude for physical therapy after discharge, below age forty, higher education, the shorter physical therapy hour, and no surgical operation showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, educational level, patient' attitude far physical therapy after discharge, physical therapy hour after discharge, and gender were significantly associated with the improvement of PS score between discharge and une month after discharge(T4-T3) (p<0.05), The higher PS non at discharge, higher education, patients' positive attitude for Physical therapy after discharge, the shorter physical therapy hour, and male showed significantly higher improvement (T4-T3)(p<0.05). In conclusion, initial BI score and age were significantly associated with BI score improvement and initial PS score, age, and educational level were also significantly associated with PS score improvement in stoke patients.

• Therapeutic Science for Rehabilitation
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• v.9 no.3
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• pp.7-21
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• 2020

Objective : The aim of this systematic review is to analyze the assessment items and tools used for the discharge of stroke and elderly patients and to help select appropriate assessment tools for discharge planning. Methods : The studies included in this review were collected from the PubMed, Medline Complete (EBSCOhost), and Scopus databases from January 2009 to December 2018. A total 22 studies were selected. The research types, the areas and sub-areas of assessment, as well as the assessment tools according to the areas were analyzed. Results : Descriptive research (59.2%) was the most frequent type of research. The 12 main areas of assessment were medical condition, activities of daily living, swallowing function, sensation, mobility, cognition and perception, communication, emotion, home environment, patient knowledge and readiness for discharge, social support, and well-being. Among the assessment tools, the most frequently used tools were Bathel Index; Functional Independence Measure, to assess activities of daily living; Short-Form Health Survey, to assess well-being, and Timed Up and Go test, to assess mobility. Conclusion : This study will help select the assessment areas and tools to be considered at discharge of stroke patients and serve a basis for the development of comprehensive assessment tools for discharge planning.

• Proceedings of the KAIS Fall Conference
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• 2010.11b
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• pp.517-520
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• 2010

본 연구의 목적은 지방 환자의 거주지 입원과 서울 입원의 퇴원시 사망률을 비교하여 치료결과를 파악함으로써 향후의 효과성 분석을 위한 기초 자료를 제시하는데 있다. 2005년, 2008년도 환자조사 자료 중 지방거주 환자 자료 333,280건과 419,873건을 연구대상으로 하였으며, 자료분석은 기술통계, 카이제곱 검정, 로지스틱 회귀분석을 실시하였다. 퇴원시 사망에 영향을 미치는 요인에 대해 연도, 성, 보험유형, 의료기관유형, 입원경로, 내원경위, 주진단, 거주지의 효과를 통제한 후 살펴본 결과 거주지 입원환자의 퇴원시 사망률이 서울 입원환자에 비해 2.2배 높은 것으로 나타났다. 암환자의 경우도 효과를 통제한 후 퇴원시 사망률을 살펴본 결과 거주지 입원환자의 사망률이 서울 입원환자에 비해 3.4 배 높게 나타났다. 정부는 지역주민의 의료의 접근성을 높이기 위해 의료공급량의 확충과 분배보다는 지역의료의 질적수준을 향상시키는 방향으로 정책을 펼쳐야 한다.