• Title/Summary/Keyword: Ambulatory

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Current Status of Repeated Hospitalization in South Korea: Focused on Ambulatory Care Sensitive Conditions (국내 반복입원의 현황과 환자 특성: 외래진료 민감질환을 중심으로)

  • Jung, Hyemin;Kim, Hyun Joo;Lee, Jin Yong
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.45-56
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    • 2021
  • Purpose: Repeated hospitalization could be a proxy of unnecessary or preventive admission in South Korea where barriers to hospitalization are relatively low. This study aimed to estimate the current status of repeated hospitalization due to ambulatory care sensitive conditions (ACSC) in South Korea. Methods: Using the National Health Information Database, repeated hospitalization databases were constructed in units of episodes for patients who had been admitted more than twice between January 2017 and December 2018. The number of hospitalizations, total in-hospital days, and total medical expenditure were calculated and compared by patient characteristics in both of the entire patient group and the ACSC patient group. Results: Of total hospitalization episodes, 26.6% reported repeated admission, and 6.7% of repeated hospitalization was due to ACSC. A total of 183,110 patients with ACSC had been admitted an average of 2.9 times and spent an average of KRW5,630,118. In other words, KRW1,309 billion had been spent for repeated hospitalization due to ACSC. The scale of medical expenditure was relatively large in the highest and lowest socioeconomic status. Conclusion: Repeated hospitalization for ACSC can be considered a simple and intuitive indicator when assessing unnecessary hospitalizations or evaluating healthcare policy.

A Study on the Performance and the Importance of Ambulatory Nursing Activities (외래 간호인력 업무활동 수행도와 중요도 분석;종합병원${\cdot}$종합전문요양기관 중심으로)

  • Hwang, Hye-Young;Park, Jeong-Hye;Kim, Ji-Soo;Chen, In-Sug;Bae, Kyung-Ok;Seo, Mi-Sook;Yang, Woo-Jeong;Jung, Moon-Young;Chae, Ji-Sun;Hong, Ji-Yeon;Kim, Moon-Sil
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.109-117
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    • 2007
  • Purpose: This study focused on analysing the performance and the perception of importance about workload of ambulatory nurses and nurse-aides for quality of nursing. Method: The subjects of this study were 126 ambulatory nurses and 117 nurse-aides in 6 secondary and 4 tertiary hospitals. The method of data collection was used the questionnaire. Result: As a result, First, nurses' activities that the performance score is above 3.0 are reception, guidance, reservation, confirm, checking medical record, operating report, explanation of disease, explanation of examination discuss with medical part, discuss with supporting part, solving patient problem environment management, and paper work. And the other side, those of nurse-aides are reception, guidance, reservation, preparation for clinic, assistant for clinic, preparation for examination, material transfer & receipt, confirm, checking medical record, and arrangement. Second, nurses-aids perceive above 3.0 performance score activities to be important for themselves. Finally, nurses perceive three categories of patient education/counselling, patient advocacy and quality improvement to be more important and higher performance when compared with nurse-aides. Conclusions: Ambulatory nurse's important nursing activities are therapeutic care, patient education/counselling, patient advocacy, communication, personal management, quality improvement.

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Analysis of the Continuity of Outpatient among Adult Patients with hypertension and its Influential Factors in Korea (우리나라 성인 고혈압환자의 외래진료 지속성과 이에 영향을 미치는 요인 분석)

  • Son, Kyung-Ae;Kim, Yoon-Shin;Hong, Min-Hee;Jeong, Mi-As
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2161-2168
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    • 2010
  • The administration data of the national health insurance and health insurance bills were utilized in this study. The data of 485,953 patients who were at the age of 30 and up and used the out-patient departments of every medical institution located in some regions involving two southern and northern provinces once or more during a 184-day period from July to December, 2008. As a result of analyzing their Continuity of Ambulatory Care and factors affecting it, the following findings were given: The continuity of ambulatory care among the adult patients with hypertension in our country turned out to be on a high level(MMCI $0.96{\pm}0.13$, MFPC $0.96{\pm}0.12$). Given examining the outpatient medical-cure continuity level according to index, the averagely medical-cure continuity level was calculated to be high level with MMCI, $0.96{\pm}0.13$, and MFPC $0.96{\pm}0.12$. Thus, the tendency of visiting only one medical provider was high. The findings of the study illustrated that the average continuity of ambulatory care among the adult patients with hypertension in our country was on a high level, and it seemed that special care should be provided to patients with a low-level continuity of ambulatory care, such as women and elderly people aged 64 and over. The findings of the study are expected to serve as one of the barometers for the health care of patients with hypertension and for the performance of national hypertension management plans.

Characteristics Change of Spatial and Temporal Parameters of Gait in Spastic Hemiplegic Patients by Reciprocal Inhibition (상호억제 기법에 의한 경직성 편마비 환자 보행의 공간적, 시간적 특성 변화)

  • Kim Jong-Soon;Lee Hyun-Ok;Ahn So-Youn;Koo Bong-Oh;Bae Sung-Soo
    • The Journal of Korean Physical Therapy
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    • v.16 no.4
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    • pp.59-79
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    • 2004
  • The purpose of this study was to determined the effects of reciprocal inhibition on spatial-temporal gait parameters in spastic hemiplegic patients through GaitRite system. The subjects were consisted 45 patients who had spastic hemiplegia due to stroke. All subjects randomly assigned to 3 group : manual reciprocal inhibition program group(manual group), neuromuscular electrical stimulation group(NMES group) and control group. The manual group received voluntary isometric contraction of pre-tibia muscle. The NMES group received neuromuscular electrical stimulation on tibialis anterior. The control group was not recieved any therapeutic intervention. Before and after experiments, spatial-temporal gait parameters and functional ambulatory profile was measure in all patients. The data of 30 patients who complete experimental course were statistically analysed. The results of this study were as following : 1. The percentage of change of functional ambulatory profile were markedly increased in manual group but statistically non significant(p>.01). 2. The percentage of change of gait velocity and cadence were markedly increased in manual group but statistically non significant(p>.01). 3. Asymmetry ratio of gait elements were more improved in manual group but statistically non significant(p>.01). 4. There were no statistical difference between pre-test and post-test with functional ambulatory profile, gait velocity, cadence and asymmetry ratios in NMES group(p>.01). 5. There were no statistical difference between pre-test and post-test with unctional ambulatory profile, gait velocity, cadence and asymmetry ratios in control group(p>.01). In conclusion, the present results revealed that reciprocal inhibition which produced by voluntary isometric contraction of pre-tibia muscle can be improved spatial-temporal gait parameters including functional ambulatory profile in hemiplegic patients. Therefore, reciprocal inhibition is useful to improve functional activities in hemiplegic patient. Further study should be done to analyze the effects of intervention duration of reciprocal inhibition, appropriate muscle contraction, optimal time to apply the reciprocal inhibition in more long period.

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Changing Patterns of Ambulatory Care Utilization of a Rural Community in a Regional Medical Insurance Scheme (지역의료보험 가입자의 외래 의료이용 변화)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Sohn, Myong-Sei;Park, Chong-Yon
    • Journal of Preventive Medicine and Public Health
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    • v.21 no.2 s.24
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    • pp.419-430
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    • 1988
  • This study was performed in a rural community, Kanghwa county which was introduced to a regional medical insurance pilot program in 1982. The purposes of this study were, firstly, to observe the changes in ambulatory care utilization in the three years 1982, 1983 and 1987 : secondly, to analyse factors which convert perceived medical care needs to effective medical care demand. During the three periods, a serial interview survey was performed to determine the changes in medical utilization before and after the regional medical insurance program implementation. The number of subjects was 3,356 persons in the year 1982, 3,705 in 1983 and 2,745 in 1987. The results of the study were as follows : 1. Total ambulatory care utilization rates per 100 persons during a 2-week period were 23.6 in the year 1982, 21.8 in 1983, and 29.3 in 1987; and physician visit rates were 6.1 in 1982, 11.7 in 1983, and 14.9 in 1987. Thus, compared to the total utilization rate there was a definite increase in physician visit, and during the study periods there was a decrease in drug store visits whereas an increase in hospital or clinic visits was noticed. 2. The rates of effective demand for medical care need were 70.7% in 1982, 70.5% in 1983 and 75.9% in 1987 : and the rates of patients who visited physicians were 20.2% in 1982, 42.8% in 1983 and 35.6% in 1987. Thus, physician visits increased sharply by introducing the medical insurance program, but after the latent medical care demands were fulfilled, there was a slight decrease in the physician visits. 3. The number of acute symptoms and the number of chronic symptoms were common determinants of total ambulatory care utilization and physician visits. Besides the medical care need factors, age in 1982, sex and accessibility in 1983, and accessibility in 1987 were statistically significant determinants of the total utilization ; sex and accessibility in 1983, and education in 1987 were also statistically significant determinants of the physician visit. 4. For persons with perceived acute symptoms during the 2-week periods, accessibility in total utilization and age in physician visits were common discriminating factors of ambulatory care utilization in the three years, and education and income were also statistically significant variables. For persons with perceived chronic symptoms, occupation and income were statistically significant discriminating variables commonly observed in total utilization and physician visits.

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Contraction Ratio Variation of the Lateral Abdominal Muscles in Elderly Gait

  • Yi, Jae-Hoon
    • PNF and Movement
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    • v.16 no.2
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    • pp.301-306
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    • 2018
  • Purpose: This study aimed to describe and identify the relationship between gait and contracted ratios of the transverse abdominal (TrA), internal oblique (IO), and external oblique (EO) muscles. Methods: This study was conducted on 50 elderly people. The contracted ratios of the lateral abdominal muscles (LAM) were measured using the abdominal drawing-in maneuver (ADIM) and ultrasonographic imaging. Gait was measured using the timed up and go test and the 10 m walk test. Results: The contracted ratios of the TrA and IO muscles significantly increased after ADIM. Those of the TrA muscles showed a significant correlation with gait in the limited community ambulatory group. The contracted ratios of the IO and EO muscles showed a significant correlation with gait in the community ambulatory group. Conclusion: Our findings suggest a specific training on the relationship between gait speed and the activation of the LAM in elderly people.

Calibration and Design of amulatory digital urodynamic study system (휴대용 디지털 요역동학검사장비의 설계와 Calibration)

  • Yoon, Dae-Young;Kim, Keo-Sik;Seo, Jeong-Hwan;Kim, Kyeong-Seop;Song, Chul-Gyu;Yang, Young-Kwang;Lee, Sang-Ok
    • Proceedings of the KIEE Conference
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    • 2004.11c
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    • pp.313-315
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    • 2004
  • Urodynamic study system is widely used for neurogenic bladder patients in various clinical setting. Generally they include 2 pressure sensors from bladder and rectum, and 1 EMG sensor. The rectal pressure catheter is often the source of data error because of gas passage and the fall out of the catheter from anus, and source of discomfort in ambulatory urodynamic system. This study is to design and calibrate the ambulatory digital urodynamic study system that can discard the rectal pressure catheter, which can make patients more comfortable and doctors can get more physiologic data. As a first step, we compared our new system with Dantec $Duet^{(r)}$ urodynamic system (Dantec, Denmark) and wanted to see the possibility of our new system.

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