• 보건행정학회지
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• 제25권3호
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• pp.221-228
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• 2015

Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.

• Journal of Preventive Medicine and Public Health
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• 제17권1호
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• pp.5-24
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• 1984

There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.

• Tuberculosis and Respiratory Diseases
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• 제83권2호
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• pp.167-174
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• 2020

Background: The purpose of this study was to investigate the effect of early tracheostomy on clinical outcomes in patients requiring prolonged acute mechanical ventilation (≥96 hours). Methods: Data from 575 patients (69.4% male; median age, 68 years), hospitalized in the medical intensive care unit (ICU) of a university-affiliated tertiary care hospital March 2008-February 2017, were retrospectively evaluated. Early and late tracheostomy were designated as 2-10 days and >10 days after translaryngeal intubation, respectively. Results: The 90-day cumulative mortality rate was 47.5% (n=273) and 258 patients (44.9%) underwent tracheostomy. In comparison with the late group (n=115), the early group (n=125) had lower 90-day mortality (31.2% vs. 47.8%, p=0.012), shorter stays in hospital and ICU, shorter ventilator length of stay (median, 43 vs. 54; 24 vs. 33; 23 vs. 28 days; all p<0.001), and a higher rate of transfer to secondary care hospitals with post-intensive care settings (67.2% vs. 43.5% p<0.001). Also, the total medical costs of the early group were lower during hospital stays than those of the late group (26,609 vs. 36,973 USD, p<0.001). Conclusion: Early tracheostomy was associated with lower 90-day mortality, shorter ventilator length of stay and shorter lengths of stays in hospital and ICU, as well as lower hospital costs than late tracheostomy.

• 동아시아식생활학회지
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• 제25권4호
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• pp.631-642
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• 2015

The purpose of the study was to examine health status and mini nutritional assessment (MNA) according to self-esteem status of elderly in care hospital. The survey was carried out from $13^{th}$ to $31^{st}$ of September, 2014 in five care hospitals. Analysis was performed for 226 subjects. Evaluation criteria included demographics, clinical status, MNA, health-related quality of life (EQ-5D) and self-esteem. The SE I, SE II and SE III groups were divided by self-esteem scores. Data were analyzed one-way ANOVA, Duncan' multiple range test and Pearson's correlation using SPSS 15.0. Education level, religion, dental condition and medical endurance type were significantly different in all groups. Many elderly people were normal BMI ($20.94{\sim}21.67kg/m^2$). Self-esteem significantly increased in order of SE I, SE II and SE III. Mobility, usual activity and anxiety or depression were significantly different in all groups, and EQ-5D of SE II and SE III groups were significantly higher than that of SE I group. Comparison of MNA screening score in elderly patients was as follows : Score for food intake, psychological stress or acute disease, neuropsychological problems, pressure scores or skin ulcer, protein intake, mode of feeding, nutritional status and health status in SE I group were significantly lower than those of SE II and SE III groups. Mobility and drug intake of SE I group were significantly lower than those of SE III groups. Fruit and vegetable intake SE I group were significantly higher than those of SE II and SE III groups. MIS (Malnutrition Indicator Score) was significantly different among the SE I, SE II and SE III groups. We conclude that self-esteem score is positively correlated with protein intake, nutrition status, health status and MIS in elderly care hospital. To improve nutritional status of elderly in care hospitals, systematic nutrition management and self-esteem education program should be implemented.

• 한국병원경영학회지
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• 제6권1호
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• pp.1-17
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• 2001

According to the increase of the proportion of aged people, the medical demand for a senile chronic disease has been increased; therefore, aged people call for a geriatric hospital for special geriatric medical service. The main purpose of this study was to analyze the general characteristics and financial status of geriatric hospitals. For the study, a questionnaire was designed and sent to the geriatric hospitals to fill out the patient statistics, number of headcount by department, etc. to find out the stability, profitability, activity and so on financial statements of the hospitals were analyzed. The major findings of this study were as belows. 1. The ratio of the medical expenses to the revenue of the geriatric hospitals is much lower than acute care hospitals. But the probability of bankruptcy is higher due to the high ratio of the liabilities therefore it is required to stabilize the financial position by donating more money. 2. Government budget for the elderly people is not enough. To support the geriatric hospitals by going subsides, government should increase the budget. 3. Portion's of the patient of the geriatric hospitals are government support patient. Since the government doesn't pay the medical charges quickly, geriatric hospitals have a serious cash flow problem. Therefore, it is required that government is to prepay the bill. 4. Since geriatric hospitals treat elderly patient and most patients are government support patients, geriatric hospitals can be said to operate under the strict. 5. When we introduce the daily medical charge, the self-liability will be reduced on approximately 50% of current. This affection will bring a huge progressing financial structure to the medical profit of the geriatric hospital, and also patient family will feel less economical burden.

• 동서간호학연구지
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• 제24권2호
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• pp.163-170
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• 2018

Purpose: The purpose of this study was to identify the influences of type D personality, burnout and work environment on nurses' intention to stay at the hospitals among nurses. Methods: A cross-sectional descriptive design was used. Participants were 135 nurses working at general hospitals. Data were collected using self-report questionnaires. Data were analyzed using the SPSS/WIN 23.0 program for descriptive statistics, independent t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation, and hierarchical multiple regression. Results: The score of nurses' intention to stay was 4.78. 39.3% of participants were classified as type D personality group. The scores of burnout and work environment were 2.92 and 2.39, respectively. Intention to stay was negatively correlated with burnout and positively correlated with nurse participation in hospital affairs, nursing foundations for quality of care, nurse manager ability, leadership, and support of nurses, staffing and resource adequacy. Burnout and manager ability, leadership, and support for nurses explained 46.0% of variance of nurses' intention to stay in the hospitals. Conclusion: The results of the study indicate that nursing intervention programs for increasing intention to stay for nurses should include strategies for decreasing the burnout and increasing manager ability, leadership, and support for nurses.

• 한국콘텐츠학회논문지
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• 제9권10호
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• pp.258-267
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• 2009

이 연구는 GIS 방법론을 적용하여 병원의 적지평가 모형을 개발하며, 그리고 모형에서 계산된 적지점수와 병원의 성과변수(환자 수) 간의 관계를 분석하였다. 대전광역시에 있는 7개 병원급 의료기관을 대상으로 연구를 진행하였으며, 적지평가 모형은 의료서비스에 영향을 미치는 인구 사회 경제학적 요인을 반영하여 구축하였다. 적지평가 인자의 주제도(Thematic Map) 생성을 위해 1:25,000 축척의 수치도면으로 구축된 행정구역도, 도로망 지도를 이용하였으며, 대전광역시 각 구에서 발간된 2004년 통계자료집을 이용하여 동별로 자료를 DB화하였다. 병원을 중심으로 한 버퍼링(0.5km, 1.0km, 1.5km 그리고 2.0km) 변화에 따른 병원별 적지점수와 병원에 온 병상 당 입원환자와 외래환자 수와의 관계를 분석하였다. 병원의 성과지표로 사용된 환자 수 지표와 병원의 적지점수 간의 상관관계의 크기는 버퍼링 크기에 따라 차이가 있었으며, 0.5km의 버퍼링을 사용하였을 때에는 적지점수와 환자 수 사이에 양(+)의 관계를 보였지만, 그 이상에서는 음(-)의 관계를 보였다. 이러한 결과는 병원급 의료기관은 평가점수가 높은 지역에 가까이 위치한 병원일수록 성과가 높을 수 있다는 것을 제시하고 있다.

• 보건행정학회지
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• 제25권3호
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• pp.229-239
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• 2015

Background: The hospital accreditation program in Korea has been conducted since 2011 in order to improve patient safety and healthcare service quality. This study was conducted to find factors associated with satisfaction as surveyor and reliability of surveyors in hospital accreditation program. Methods: This study was performed targeting 217 responded to the survey among 412 surveyors who had participated in the accreditation survey for acute care hospitals from December 2010 to February 2014. Results: The average number of survey per surveyor is 2.35. We divided surveyors into those who participated in the survey more than 3 times and less than 3 times in order to judge the professionalism of surveyors according to the number of survey participation. Those factors that have an influence on the satisfaction as surveyors include: activity period as surveyor, role in the survey team, experience of survey in other fields, experience as consultant and the useful education and proper composition of survey team (p<0.05). Those factors that have an influence on the reliability for fellow surveyors include: number of beds of hospitals they belong, experience of survey in other fields, useful education, proper composition of survey team and difficulty in leadership interview (p<0.05). Conclusion: It is important to provide useful education and proper composition of survey team to increase the satisfaction as surveyors and the reliability for fellow surveyors.

• 한국직업건강간호학회지
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• 제25권3호
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• pp.148-155
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• 2016

Purpose: This study aimed to understand the degree of clinical nurses' emotional labor that they perceive in the relationships with people related to their work. Methods: This study was a descriptive research, and its subjects were 167 nurses in five university hospitals located in B and Y city. The degree of emotional labor was measured with Visual Analogue Scale (VAS). Data were collected from April to May in 2015, and analyzed by descriptive statistics, t-test, ANOVA, $Scheff{\acute{e}}$ and Games-Howell examination. Results: The score of the emotional labor of health care providers and visitors were higher than non-health care providers. Among health care providers, doctors had the highest emotional scores, and fellow nurse and nurses other departments were followed after that. Among visitors in hospital, patients and their family had the higher emotional labor scores than care givers. There was statistically significant difference in the emotional labor, according to the subjects' educational level, age, wages, job position, and working departments. Conclusion: Clinical nurses perceived emotional labor not only from the interaction with patients, but also from the interaction with the various other persons concerned such as health care providers, non-health care providers and visitors.

• 대한간호학회지
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• 제54권2호
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• pp.151-161
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• 2024

Purpose: Patients' perception of fall risk is a promising new indicator for fall prevention. Therefore, a fall risk perception questionnaire that can be used rapidly and repeatedly in acute care settings is required. This study aimed to develop a short version of the fall risk perception questionnaire (Short-FRPQ) for inpatients. Methods: For the psychometric measurements, 246 inpatients were recruited from an acute care hospital. The construct (using confirmatory factor analysis and discriminant validity of each item), convergent, and known-group validities were tested to determine the validity of the Short-FRPQ. McDonald's omega coefficient was used to examine the internal consistency of reliability. Results: In the confirmatory factor analysis, the fit indices of the Short-FRPQ, comprising 14 items and three factors, appeared to be satisfactory. The Short-FRPQ had a significantly positive correlation with the original scale, the Korean Falls Efficacy Scale-International, and the Morse Fall Scale. The risk of falls group, assessed using the Morse Fall Scale, had a higher score on the Short-FRPQ. McDonald's omega coefficient was .90. Conclusion: The Short-FRPQ presents good reliability and validity. As patient participation is essential in fall interventions, evaluating the fall risk perception of inpatients quickly and repeatedly using scales of acceptable validity and reliability is necessary.