The purpose of this study was to determine the change trend of emergency department visits among elderly patients with chronic diseases. Using the National Emergency Department Information System data, from January 1, 2014 to December 31, 2019, the selected patient data were evaluated for the emergency department discharge main diagnosis codes for eight chronic diseases. The incidence of elderly chronic diseases, emergency department visits, and admission rates were analyzed. Since 2014, there has been a consistent increase in the number of elderly patients visiting the emergency department, especially among those aged over 85 years. The number of emergency department visits among the elderly chronically ill patients also increased, with a significant increase in ischemic heart disease and arthrosis cases. Furthermore, there was a significant difference in the number of chronically ill patients in each year from 2014-2019 (P<0.001). With respect to the trend of admission rates to the emergency department by chronic disease, most diseases showed an increasing trend (P<0.001). however, hyperlipidemia showed a continuous decreasing trend in all age groups since 2014 (P<0.001). Among the elderly chronically ill patients, a greater increase in the admission rate following emergency department visits was noted in those over 85 years of age, with a significant difference in all diseases, except for hyperlipidemia, hypertension, and tuberculosis (P<0.001). As the aging population grows, the emergency department admission rates among the elderly chronically ill patients will rise rapidly. This could create issues with respect to the use and consumption of emergency medical resources. Hence, it is necessary to manage chronic diseases effectively in the elderly.
The purpose of this study is to investigate the effects of peer tutoring and feedback on academic learning in university mathematics. We compared subject satisfaction and academic achievement between the test group and the control group. We classified the test group(82 participants) and the control group(134 non-participants) and then applied peer tutoring and feedback to the test group. The rest of the environment was the same except for participation in the program. According to results, it was confirmed that the subject satisfaction were significantly higher(significance level .05) in the test group, where the subject satisfaction were learning objectives and expectation, learning satisfaction, and learning effect. Furthermore, in the change of academic achievement, the rate of decrease was lower and the rate of increase was higher in the test group than the control group. The satisfaction of participants was 4.33(Likert scale 5), and this trend tended to be same regardless of gender, high school course, or admission process.
This study is to grasp a trend of profitability classified by characteristics of hospitals and to analyze related factors. Subjects are 145 hospitals which have gotten the standardization audit by Korean Hospital Association during 1998-200l. Profitability was measured in the aspect of operation profit rate with operating margin to gross revenue as proxy variables. Independent variables were classified by general factors (ownership, number of beds, period of establishment, competition), financial factors (liabilities to total assets, current ratio, fixed ratio, total asset turnover, inventories turnover), and factors related to patient treatment (average length of stay, bed occupancy rate, new outpatient ratio, admission ratio of outpatients, number of patients per specialist, personnel costs per adjusted inpatient, administrative costs per adjusted inpatient). Hierarchical multiple regression analysis model was used in this study. As a result of hierarchical multiple regression analyzation of operating margin to gross revenue, adjustive $R^2$ of general factors was relatively more powerful. The factors had significant effect on operating margin to gross revenue were ownership(+), number of beds(+), competition(+), current ratio(+), fixed ratio(+), total asset turnover(+), personnel costs per adjusted inpatient(-).
For the purpose of evaluation of clinical characteristics and histopathological properties in mediastinal tumors, 130 patients with mediastinal tumors treated during the period from 1958 to 1982 were reviewed. Cancers of unidentified primary site of origin, nonneoplastic lesions and the cases with clinical diagnosis only were excluded from this report. There were 69 males and 61 females, and their ages ranged from 2 months to 66 years, with the average age of 31.3 years. 19.2% of patients were younger than 15 years of age. The most frequently encountered tumors were teratodermoids, followed by neurogenic tumors, thymic tumors, benign cysts, malignant lymphomas and miscellaneous tumors in order of decreasing frequency. 75.4% of the mediastinal tumors were benign and 24.6% were malignant. 16.6% of the patients were asymptomatic at admission. There were 2 postoperative deaths with 1.7% of operative mortality rate, and 2 other deaths who were not operated upon, showing overall hospital mortality rate of 3.1%. Postoperative follow up was possible in 84 cases, and there were 4 late deaths.
Neuroblastoma is a solid tumor derived from neural crest cells of the sympathetic nervous system. It is the most common extracranial solid tumor in children. Although it has the highest rate of spontaneous regression, it has a bad prognosis. Recent reports indicate a much improved outcomes utilizing the multitreatment approaches and early diagnosis as a result of patient screening. We have studied 42 patients managed in the last decade at the Severance and Yongdong Severance Hospitals. The patients were followed until January 1998 and analyzed in terms of age, sex, admission period, stage, diagnostic studies, clinical symptoms, physical findings, operative time, treatment modalities, and survival rate. Twenty eight patients underwent operative procedures, 16 patients had postoperative chemotherapy, and 19 patients had preoperative chemotherapy. Sexual difference was 1.33:1 in favor of males, and 43 % of patients were under one year of age. The patients were initially diagnosed as a result of symptoms and signs. An abdominal mass was the most common clinical finding. Eighty six percent of the patients were in advanced stages (>Stage III of INSS). The 2 year survival rate was 59.2 % and the 5 year survival rate was 29.6 %.
During 9 months the clinical study on the 45 cases constipation patients caused by C.V.A, who were treated with Bo-Riu Enema, was done in the Department of Oriental Internal Medicine II, Oriental Medicine Hospital, Taejon University. The result of this study is compared with glycerin-enema treated group. The results were as follows ; 1. The incidence rate of constipation caused by C.V.A is higher in old aged group. 2. The incidence rate of constipation caused by C.V.A is higher in Tae-Um-In(太陰人). 3. The improvement rate of constipation caused by C.V.A is higher in Bo-Riu Enema treated group than in glycerin-enema. 4. The admission period is shorter in Bo-Riu Enema treated group than in glycerin-enema. 5. In case of paralytic ileus, the improvement rate of constipation caused by C.V.A is higher in Bo-Riu Enema treated group than in glycerin-enema.
Although much health services research has been conducted using national health insurance claims data in Korea, the validity of this method has not been ascertained. The objective of this study was to validate the use of claims data for health services research by comparing incidence rate of cancers found using insurance claims data against rates of the national cancer registry of Korea. An algorithm to estimate incidence rates using claims data was developed and applied. The claims data from 2005-2008 were acquired and the patients admitted to hospitals due to cancer in 2008 without admission to hospital from 2005-2007 by the same diagnosis code were regarded as incident cases. The acquired results were compared with the values from the National Cancer Registry of Korea. The incidence rate of all cancers found using claims data was 363.1 per 100,000 people, which is very similar to the 361.9 per 100,000 rate of the national cancer registry. Also the age-, gender- and disease-specific rates between the two data sources were similar. Therefore, national health insurance claims data may be a worthwhile resource for health services research if appropriate algorithms are applied, especially considering the cost effectiveness of this method.
1. Purpose The accurate diagnosis and proper treatment of group A streptococcus should be emphasized concerning about possible development of late sequelae, such as acute rheumatic fever and acute glomerulonephritis. We would like to know the recover rate of beta-hemolytic streptococci by throat swab culture at the in-patient 2. Methods The throat swab cultures and filled up flow-sheets were undertaken on 619 children who had admitted to hospital, KyungHee university hospital from may 1994 to april 1995 prospectively. At the same time on admission, throat culture was performed. 3. Results The highest recover rate of BHS(Beta-Hemolytic Streptococci)and GAS(Group A Streptococci) were seen in above 10 years old, as 9.1% and 1.9%. BHS were obtained in 39 cases(6.3%) among 619 children while GAS was obtained in 3 cases (0.4%). Among 39 specimens of BHS, 33 specimens were classified as non-grouping streptococcus. 4. Conclusion The poor recovery rate of GAS inpatient compared with normal carrier rate is likely due to possible antibiotic abuse, errors in processing samples, and epidemiologic factors such as seasons and geographic areas. It is necessary to evaluate the clinical significance of non-A,B,C,G streptococcal infections and carriers.
Kim, Hwi Jong;Ham, Hyoun Seok;Cho, Yu Ji;Kim, Ho Cheol;Lee, Jong Deok;Hwang, Young Sil
Tuberculosis and Respiratory Diseases
/
v.59
no.1
/
pp.53-61
/
2005
Background : Cardiac troponin I (cTnI) is a specific marker of myocardial injury. It is known that a higher level of cTnI is associated with a poor clinical outcome in patients with acute coronary syndrome. An elevation in cTnI is also observed in various noncardiac critical illnesses. This study evaluated whether cTnI is useful for predicting the prognosis in noncardiac critically ill patients. Methods : From June 2003 to July 2004 at Gyeongsang National University Hospital, we enrolled 215 patients (male:142, female:73, mean age:$63{\pm}15$ years ) who were admitted for critical illness other than acute coronary syndrome at the medical intensive care unit(ICU). The severity score of critical illness (SAPS II and SOFA) was determined and serum cTnI level was measured within 24 hours after admission to the ICU. The mortality rate was compared between the cTnI-positive (${\geq}0.1{\mu}g/L$) and cTnI-negative ($cTnI<0.1{\mu}g/L$) patients at the $10^{th}$ and $30^{th}$ day after admission to the ICU. The mean cTnI value was compared between the survivors and non-survivors at the $10^{th}$ and $30^{th}$ day after admission to the ICU in the cTnI-positive patients. The correlation between cTnI and the severity of the critical illness score (SAPS II and SOFA) was also analyzed in cTnI-positive patients. Results : 1) The number of cTnI-negative and positive patients were 95(44%) and 120(56%), respectively. 2) The mortality rate at the $10^{th}$ and $30^{th}$ day after admission to the ICU was significantly higher in the cTnI-positive patients (29%, 41%) than in the cTnI-negative patients (12%, 21%)(p<0.01). 3) In the cTnI-positive patients, the mean value of the cTnI at the $10^{th}$ and $30^{th}$ day after admission to the ICU was significantly higher in the non-survivors ($4.5{\pm}9.2{\mu}g/L$, $3.5{\pm}7.9{\mu}g/L$) than in the survivors($1.8{\pm}3.6{\mu}g/L$, $2.0{\pm}3.9{\mu}g/L$) (p < 0.05). 4) In the cTnI-positive patients, the cTnI level was significantly correlated with the SAPS II score (r=0.24, p<0.001) and SOFA score (r=0.30, p<0.001). Conclusion : The cTnI may be a useful prognostic marker in noncardiac critically ill patients.
Ham, Tae-Hoon;Lee, Kyung-Woo;Sohn, Tae-Yong;Yu, Seung-Hum
Korea Journal of Hospital Management
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v.14
no.4
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pp.149-162
/
2009
The purpose of this study is to design strategic hospital service based on each hospital's features. For this study, an assessment was conducted by 398 in-patents of one university hospital located in Seoul. The self-questionnaires, which were investigated from Oct. 15th to 29th in 2008, compared central reception desk with ward reception desk in satisfaction and re-use rate of patients. The major results of this study are as follow. First, according to each reception desk user, they have different satisfaction of it. As for the staff kindness, admission procedure, discharge procedure and manner of staff, those made patients be gratified as well. Second, when it comes to the intention of re-use, there were no significant features between them. Only convenience in admission and discharge procedure, however, was an attractive factor for the recommendation. Third, this study found out the reasons for higher re-use rate of central reception desk users. Regarding service, they were contented with the time for test and treatment. As for the hospital service, they would like to re-use this hospital because of convenient steps of paying interim fee and getting certificates. Forth, this study found out the reasons for higher re-use rate of ward reception desk users. As a point of hospital service view, they responded that respected privacy, hospital facility and general service were good for staying. As for the manner of staff, they mentioned nurses and staff in charge and whole staff members were kind. When it comes to the procedures of patient management, steps of discharge and paying interim fee were convenience. In conclusion, the results of this study suggest that providing a ward reception desk service can boost the satisfaction and re-use rate of in-patients. Furthermore, this strategic management method would be good for not only cutting the moving line but also efficient in-patient care system. These results can be used for the strategic hospital marketing field, as well. Even though this study has a limitation of the targeted populations which were only in a ward reception desk running hospital, it can say that having competitiveness in satisfaction of hospital service is good for promoting and differencing each hospital. Consequently, whole general management system would be adjusted first for differencing each hospital; however, this sort of additional factor should be concerned as well. I expect that this study would give meaningful data for designing strategic and differencing marketing method to lots of hospitals.
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