• Title/Summary/Keyword: Admission rate

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Changing Pattern and Comparison of Nutritional States before and after Nasogastric Tube Feeding for the Severe Brain Injury Patients in Critical Period (초급성기 중증 뇌 손상 환자의 영양 상태 변화양상과 인공영양 전·후의 영양 상태에 대한 비교)

  • Park, Jong-Suk;Oh, Hyun-Soo;Seo, Wha-Sook;Seo, Yeon-Ok
    • Korean Journal of Adult Nursing
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    • v.20 no.1
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    • pp.44-54
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    • 2008
  • Purpose: The purpose of the study were to examine the nutritional status of severe brain injury adult patients in critical period, and to compare the nutritional states before and after tube feeding. Methods: Data from 19 patients admitted to the SICU in a university hospital due to severe brain injury were analyzed. Nutritional states were measured by anthropometric and blood biochemical indicators. Results: MAC and MAMC were significantly decreased only at 7 days after admission compared with those on the day of admission. TSF was significantly decreased from 7 days to 14 days after admission. Fat rate was significantly decreased from 3 days to 14 days after admission. Hb was significantly decreased only at 3 days after admission. Albumin was significantly decreased from 3 days to 14 days after admission. However, lymphocyte was significantly increased at 14 days after admission. TSF and Albumin became significantly worse even after initiating tube feeding. Conclusions: Nutritional status of severe brain injury patients in SICU became worse after admission whichever indicators were adopted to evaluate nutritional status, anthropometric or blood biochemical indicators, and became worse even after initiating tube feeding.

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An Effective Training Pattern Processing Method for ATM Connection Admission Control Using the Neural Network (신경회로망을 이용한 ATM 연결 수락 제어를 위한 효율적인 학습패턴 처리 기법)

  • Kwon, Oh-Jun;Jeon, Hyoung-Goo;Kwon, Soon-Kak;Kim, Tai-Suk;Lee, Jeong-Bae
    • The KIPS Transactions:PartB
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    • v.9B no.2
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    • pp.173-180
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    • 2002
  • The virtual cell loss rate was introduced for the training pattern of the neural network in the VOB(Virtual Output Buffer) model. The VOB model shows that the neural network can find the connection admission boundary without the real cell loss rate. But the VOB model tends to overestimate the cell loss rate, so the utilization of network is low. In this paper, we uses the reference curve of the cell loss rate, which contains the information about the cell loss rate at the connection admission boundary. We process the patterns of the virtual cell loss rate using the reference curve, We performed the simulation with two major ATM traffic classes. One is On-Off traffic class that has the traffic characteristic of LAN data and other is Auto-Regressive traffic class that has the traffic characteristic of a video image communication.

Diagnosis-Specific Analysis of Small Area Variations in Hospital Services (일부 다빈도 진단명들의 지역간 의료이용 변이)

  • 이선희;조우현;남정모;김석일
    • Health Policy and Management
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    • v.4 no.1
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    • pp.49-76
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    • 1994
  • Small area variations in health care utilization have long been studied as an important issue related to boto cost containment and quality assurance. This study was conducted to investigate if variations in hospital services across small geographic areas in Korea existed. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows : 1. Extremal Quotients(EQ) of hospital expenditure per capita and hospital days per capita varied among diagnosis types. The EQ ranged from 2.05(cataract) to 41.67(pneumonia) in hospital expenditure per capita and from 1.86(cataract) to 45.89(pneumonia) in hospital days per capita. The diagnosis groups which showed high variation were pneumonia, cephalo-pelvic disproportion, gastritis and duodenitis, fracture of rib, and acute bronchitis. Those which showed low variation were acute appendicitis and cataract. 2. The EQ level of admission rate was different in terms of diagnosis types, ranging from 2.57(catarct) to 44.45(pneumonia). The variations were high in medical disorders such as pneumonia, oephalo-pelvic disproportion, gastritis and duodenitis and acute bronchitis, while relatively low in surgical conditions such as acute appendicitis and cataract. 3. As an indicator of service intensity, the EQ of expenditure per admission ranged from 1.67(acute appendicitis) to 31.27(essential hypertension). The diagnoses which had high variation were essential hypertension, gastric ulcer, whereas those which had low variation were cephalopelvic disproportion and acute appendicitis. With regard to hospital days per admission, the EQ ranged from 1.55(acute appendicitis) to 28.13(gastric ulcer) by diagnosis types. The diagnosis groups with showed high variation were gastric ulcer, essential hypertension, and acute bronchitis, whereas those with low variation were cephalo-pelvic disproportion, intervertebral disc disorders, and acute appendicitis. Both the expenditure and hospital days per admission showed lewwer variations than the expenditure per capita, hospital days per capita and admission rate. 4. Comparing patterns of variation in utilization indices, diagnoses such as essential hypertension, gastric ulcer, fracture of rib showed higher variations in expenditure per admission than in admission rates, whereas diagnoses such as pneumonia, cephalo-pelvic disproportion and gastric ulcer showed higher variations in admission rate than expenditure per admission. These findings suggest that wide variations existed in several diagnoses groups across small areas in Korea. Further research should be performed to investigate factors related to small area variations including provider behavior.

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Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission (중환자실 환자의 입실 시 욕창 유병률과 위험요인)

  • Kwak, Hye Ran;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.27 no.3
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    • pp.347-357
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    • 2015
  • Purpose: This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by ${\chi}^2$-test, t-test, and multi-variate logistic regression with forward stepwise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage.

Does the Mean Arterial Pressure Influence Mortality Rate in Patients with Acute Hypoxemic Respiratory Failure under Mechanical Ventilation?

  • Gjonbrataj, Juarda;Kim, Hyun Jung;Jung, Hye In;Choi, Won-Il
    • Tuberculosis and Respiratory Diseases
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    • v.78 no.2
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    • pp.85-91
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    • 2015
  • Background: In sepsis patients, target mean arterial pressures (MAPs) greater than 65 mm Hg are recommended. However, there is no such recommendation for patients receiving mechanical ventilation. We aimed to evaluate the influence of MAP over the first 24 hours after intensive care unit (ICU) admission on the mortality rate at 60 days post-admission in patients showing acute hypoxemic respiratory failure under mechanical ventilation. Methods: This prospective, multicenter study included 22 ICUs and compared the mortality and clinical outcomes in patients showing acute hypoxemic respiratory failure with high (75-90 mm Hg) and low (65-74.9 mm Hg) MAPs over the first 24 hours of admission to the ICU. Results: Of the 844 patients with acute hypoxemic respiratory failure, 338 had a sustained MAP of 65-90 mm Hg over the first 24 hours of admission to the ICU. At 60 days, the mortality rates in the low (26.2%) and high (24.5%) MAP groups were not significantly different. The ICU days, hospital days, and 60-day mortality rate did not differ between the groups. Conclusion: In the first 24 hours of ICU admission, MAP range between 65 and 90 mm Hg in patients with acute hypoxemic respiratory failure under mechanical ventilation may not cause significantly differences in 60-day mortality.

A Study on the Organic Rankine Cycle Using R245fa (냉매(R245fa)를 이용한 유기랭킨 사이클에 관한 연구)

  • Cho, Soo-Yong;Cho, Chong-Hyun;Kim, Jinhan
    • The KSFM Journal of Fluid Machinery
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    • v.16 no.3
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    • pp.10-17
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    • 2013
  • The organic Rankine cycle has been widely used to convert the renewable energy such as the solar energy, the geothermal energy, or the waste energy etc., to the electric power. Some previous studies focused to find what kind of refrigerant would be a best working fluid for the organic Rankine cycle. In this study, R245fa was chosen to the working fluid, and the cycle analysis was conducted for the output power of 30kW or less. In addition, properties (temperature, pressure, entropy, and enthalpy etc.) of the working fluid on the cycle were predicted when the turbine output power was controlled by adjusting the mass flowrate. The configuration of the turbine was a radial-type and the supersonic nozzles were applied as the stator. So, the turbine was operated in partial admission. The turbine efficiency and the optimum velocity ratio were considered in the cycle analysis for the low partial admission rate. The computed results show that the system efficiency is affected by the partial admission rate more than the temperature of the evaporator.

End-to-End Quality of Service Constrained Routing and Admission Control for MPLS Networks

  • Oulai, Desire;Chamberland, Steven;Pierre, Samuel
    • Journal of Communications and Networks
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    • v.11 no.3
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    • pp.297-305
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    • 2009
  • Multiprotocol label switching (MPLS) networks require dynamic flow admission control to guarantee end-to-end quality of service (QoS) for each Internet protocol (IP) traffic flow. In this paper, we propose to tackle the joint routing and admission control problem for the IP traffic flows in MPLS networks without rerouting already admitted flows. We propose two mathematical programming models for this problem. The first model includes end-to-end delay constraints and the second one, end-to-end packet loss constraints. These end-to-end QoS constraints are imposed not only for the new traffic flow, but also for all already admitted flows in the network. The objective function of both models is to minimize the end-to-end delay for the new flow. Numerical results show that considering end-to-end delay (or packet loss) constraints for all flows has a small impact on the flow blocking rate. Moreover, we reduces significantly the mean end-to-end delay (or the mean packet loss rate) and the proposed approach is able to make its decision within 250 msec.

Factors Related to Admission via Emergency Room in Korean Hospitals with an Emergency Medical Center (응급의료센터를 보유한 의료기관 입원 중 응급실경유입원 관련 요인)

  • Na, Baeg-Ju;Lee, Sun-Kyung;Oh, Kyung-Hee;Kim, Keon-Yeop;Chung, Seol-Hee
    • Health Policy and Management
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    • v.19 no.2
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    • pp.71-84
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    • 2009
  • Objectives : The purpose of this study is to analyze the proportion of admission via the emergency room(the rest is ER) in an emergency medical center and to examine the factors related to admission. Methods : This study used 2005 National Health Insurance claims data for admitted patients of 112 hospitals having emergency medical centers in Korea. The study sample had 2,335,610 patients. The data was classified into emergency admission and non-emergency admission. To investigate the factors affecting the type of admission, the following were included as independent variables: type of health assurance_(national health insurance beneficiaries or medical aid beneficiaries), demographic characteristics_ (sex, age), cause of admission_ (disease or injury), whether an operation was performed or not, DRG severity level, the number of beds, and the location of the hospital. Data were analyzed using the Chi-square test for the differences in emergency admission rates for each variables, and multiple logistic regression analysis was used for identifying the factors affecting admission type. Results : The proportion of admission via the ER accounted for 40.6% of the total admission among hospitals having emergency medical centers. The risk of admission via ER was relatively high for patients who were male, the aged, the injured, the surgical patients, the patients having more severe symptoms, and the patients admitted the hospitals located in metropolitan areas, and the patients admitted the hospitals having 300-699 beds. Medical aid patients were more likely admitted through the emergency room than health insurance patients after other variables ware adjusted. Conclusions and Discussion : We analyzed the proportion of admission via the ER for the total admission rate of hospitals having an emergency medical center in Korea. And we explored the factors related to admission via the ER. This proportion may be used as an indicator of the adequacy of medical utilization or low accessibility to hospitals of patients with low socioeconomic status.

Fuzzy Logic based Admission Control for On-grid Energy Saving in Hybrid Energy Powered Cellular Networks

  • Wang, Heng;Tang, Chaowei;Zhao, Zhenzhen;Tang, Hui
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.10 no.10
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    • pp.4724-4747
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    • 2016
  • To efficiently reduce on-grid energy consumption, the admission control algorithm in the hybrid energy powered cellular network (HybE-Net) with base stations (BSs) powered by on-grid energy and solar energy is studied. In HybE-Net, the fluctuation of solar energy harvesting and energy consumption may result in the imbalance of solar energy utilization among BSs, i.e., some BSs may be surplus in solar energy, while others may maintain operation with on-grid energy supply. Obviously, it makes solar energy not completely useable, and on-grid energy cannot be reduced at capacity. Thus, how to control user admission to improve solar energy utilization and to reduce on-grid energy consumption is a great challenge. Motivated by this, we first model the energy flow behavior by using stochastic queue model, and dynamic energy characteristics are analyzed mathematically. Then, fuzzy logic based admission control algorithm is proposed, which comprehensively considers admission judgment parameters, e.g., transmission rate, bandwidth, energy state of BSs. Moreover, the index of solar energy utilization balancing is proposed to improve the balance of energy utilization among different BSs in the proposed algorithm. Finally, simulation results demonstrate that the proposed algorithm performs excellently in improving solar energy utilization and reducing on-grid energy consumption of the HybE-Net.

Relationship between Admission and Clinical Features of Children Who Visited the Emergency Department with Seizures (경련을 주소로 응급실을 방문한 아이의 임상양상과 입원과의 관계)

  • Yoon, Sung Kwan;Kim, Eun Young;Yang, Eun Seok;Moon, Kyung Rye;Park, Sang Kee;Park, Young Bong;Rho, Young Il;Cho, Soo Hyeong
    • Clinical and Experimental Pediatrics
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    • v.46 no.10
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    • pp.1003-1007
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    • 2003
  • Purpose : To review the seizure-related complaints and analyze the relationship between admission rates and clinical features in children who had visited the emergency department with seizures. Methods : Retrospectively, we reviewed 180 patients(male 100, female 80) suffering from seizures, who had visited to the emergency department of Chosun University Hospital from January 2000 to June 2002. We have analyzed the correlation between admission rate and clinical features such as age, seizure type, seizure duration and individual laboratory findings(CT or MRI, and CSF). Results : Out of 4,865 total children who visited the emergency department, 180 patients(3.7%) were seizure related. The most common seizure type was simple febrile seizure(52.2%). The admission rate of children with seizures was 48.9%. The admission rate according to age, sex and abnormal laboratory findings revealed no significant correlations(P>0.05). There was a significant correlation between admission and both status epilepticus 82.4%(14/17) and complex febrile seizure 63.6%(14/22) (P<0.05). According to the duration of convulsions, admission rates were 41.2% when within five minutes, 60% when six-15 minutes, 58.8% when 16-30 minutes, 85.7% when 30 minutes, to one hour and 66.7% when above one hour of duration. According to the seizure frequency, admission rates of recurrent seizure patients(61.4%=43/70) was higher compared to the first time seizure patients(40.9%=45/110). Conclusion : We found that the admission rate of children visiting the emergency department for seizure treatment was 48.9% and significantly correlated with duration, type and frequency of seizure.