• 보건행정학회지
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• 제19권1호
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• pp.81-96
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• 2009

The expansion of long-term care hospitals (LTCHs) is expected to contribute to meeting the long-term care needs of the elderly with chronic diseases in a rapidly aging society. It is also expected to increase efficiency of health resource use and decrease elderly health expenditures by transferring patients from acute care hospitals (ACHs) to LTCHs. This study aimed to empirically examine how the expansion of LTCHs had influences on the length of hospitalization of the elderly in ACHs. Panel regression analysis was employed as an analytic tool using data of the National Health Insurance and the National Statistical Office from 2002 to 2006. The expansion of LTCHs was measured as location quotient (LQ) of LTCHs, denoting the share of LTCHs in a large city or province relative to the share of LTCHs at the national level. In addition, per capita GRDP (gross regional domestic product) and the proportion of population over 65 were included as control variables. The main findings are as follows. First, it was observed that LQ of LTCHs showed a statistically significant negative association with the length of hospitalization of the elderly in ACHs. Second, the negative correlation was evident among general hospitals with over 100 beds while it was not among hospitals with less than 100 beds. Third, LQ of LTCHs had more influences among the elderly over 85. In conclusion, the expansion of LTCHs seems to contribute to decrease in the inpatient cost of the elderly in ACHs and to increase efficiency in the utilization of health resources.

• 한국병원경영학회지
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• 제12권2호
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• pp.25-42
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• 2007

To identify characteristics of elderly inpatients who had long term hospitalization in a general hospital, this study categorized into two groups who were hospitalized for less than 30 days and a group hospitalized for more than 30 days. To compare the groups the independent variables were the sociodemographical characteristics, the medical care utility characteristics, and the disease characteristics and finally analyzed factors affecting the hospitalization period. The data of 18,727 inpatients who were older than 65 years of age by the year 2005 were used and the data were analyzed using SPSS for Windows 12.0. With the results, it is necessary to provide intensive and positive management to elderly inpatients who belong to the more than 30 days group and also necessary to share roles and functions of hospital by medical network with local hospitals and clinics in order to manage long-term elderly inpatients and offer continuous post-management to discharged patients by encouraging them to use a long-term care center or by implementing an early discharge program. This study should provide many studies on how to manage the period of hospitalization efficiently on long-stay elderly inpatients in the future.

• 동서간호학연구지
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• 제15권2호
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• pp.63-70
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• 2009

Purpose: The purpose of this study was to evaluate hospital service utilization by the types of hospitals in Type I Medicaid claims frequently cited by elderly beneficiaries. Methods: Three frequently claimed inpatient diseases were selected: cerebral infarction, hypertension and diabetes mellitus. Relevant data were collected for the year 2008 from the computer database of the National Health Insurance Corporation. The data was analyzed using SPSS by descriptive statistics, ANOVA and coefficient of variation. Results: The coefficient of variance of hospitalization per episode was higher than daily hospital expenditure among hospitals for all three diseases. The coefficient of variance of hospitalization per episode was highest for cerebral infarction. The coefficient of variation of hospital expenditure per hospital day was highest for hypertension. Conclusions: Evaluating of the volume and pattern of hospital service utilization and the appropriateness for hospital admission for Type-I Medicaid elderly beneficiaries is important for Medicaid-based case management.

• Asian Pacific Journal of Cancer Prevention
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• 제16권2호
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• pp.783-786
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• 2015

Background: Utilizing geriatric screening tools for the identification of vulnerable older patients with cancer is important. The aim of this study is to evaluate the hospitalization risk of elderly hematologic cancer patients based on geriatric assessment and laboratory parameters. Materials and Methods: In this cross sectional study 61 patients with hematologic malignancies, age 65 years and older, were assessed at a hematology outpatient clinic. Standard geriatric screening tests; activities of daily living (ADL), instrumental activities of daily living (IADL), Mini Nutritional Assessment (MNA), Mini Mental State Examination (MMSE), timed up and go test (TUG), geriatrics depression scale (GDS) were administered. Demographic and medical data were obtained from patient medical records. The number of hospitalizations in the following six months was then recorded to allow analysis of associations with geriatric assessment tools and laboratory parameters. Results: The median age of the patients, 37 being males, was 66 years. Positive TUG test and declined ADL was found as significant risk factors for hospitalization (p=0.028 and p=0.015 respectively). Correlations of hospitalization with thrombocytopenia, vitamin B12 and folic acid deficiency were statistically significant (p=0.004, p=0.011 and p=0.05 respectively). Conclusions: In this study, geriatric conditions which are usually unrecognized in a regular oncology office visit were identified. Our study indicates TUG and ADL might be use as predictive tests for hospitalization in elderly oncology populations. Also thrombocytopenia, and vitamin B12 and folic acid deficiencies are among the risk factors for hospitalization. The importance of vitamin B12 and folic acid vitamin replacement should not be underestimated in this population.

• Journal of Preventive Medicine and Public Health
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• 제41권3호
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• pp.147-152
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• 2008

Objectives : Fluoridation of drinking water is known to decrease dental caries, particularly in children. However, the effects of fluoridated water on bone over several decades are still in controversy. To assess the risk of hip fracture related to water fluoridation, we evaluated the hip fracture-related hospitalizations of the elderly between a fluoridated city and non-fluoridated cities in Korea. Methods : Cheongju as a fluoridated area and Chungju, Chuncheon, Suwon, Wonju as non-fluoridated areas were chosen for the study. We established a database of hip fracture hospitalization episode based on the claims data submitted to the Health Insurance Review Agency from January 1995 to December 2002. The hip fracture hospitalization episodes that satisfied the conditions were those that occurred in patients over 65 years old, the injuries had a hip fracture code (ICD-9 820, ICD-10 S72) and the patients were hospitalized for at least 7days. A total of 80,558 cases of hip fracture hospitalization episodes were analyzed. Results : The admission rates for hip fracture increased with the age of the men and women in both a fluoridated city and the non-fluoridated cities (p<0.01). The relative risk of hip fracture increased significantly both for men and women as their age increased. However, any difference in the hip fracture admission rates was not consistently observed between the fluoridated city and the non-fluoridated cities. Conclusions : We cannot conclude that fluoridation of drinking water increases the risk of hip fracture in the elderly.

• 성인간호학회지
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• 제13권4호
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• pp.601-609
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• 2001

Purpose: The purpose of this study was to identify the degree of perceived powerlessness in hospitalized elderly patients of the medical and surgical unit. Method: The instrument for this study was the Powerlessness Behavioral Assessment Tool(Miller, 1983). The reliability of the instruments was .85. The data was analyzed by descriptive statistics, t-test, and ANOVA. Results: The results were as follows ; 1. The mean score of powerlessness was $35.02(SD={\pm}9.24)$ in a range of 19 to 64, and the mean of powerlessness was total 1.84. Among 4 subscales, the highest score was in the area of verbal response (M=1.98), and the lowest score for powerlessness was in the area of daily activities(M=1.74). In all items, 'verbal expression of fatalism' showed the highest score(M=2.78), and 'verbal expressions of giving up' showed the lowest score(M=1.38). 2. There were significant differences in the level of powerlessness according to hospitalization experience(t=-3.03, p=0.006), medical treatment experience(t=.291, p=.004). Especially, there was significant difference according to the hospitalization experience of the hospital in all sub- scales. Conclusion: Based on these conclusions, nursing education for patient's diseases and treatment can be used for proper nursing intervention in reducing the level of powerlessness of hospitalized elderly.

• 보건의료생명과학 논문지
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• 제9권1호
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• pp.95-102
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• 2021

본 연구는 강원도 영북권역에 소재하는 모든 의료기관을 대상으로 지역주민 중 65세 이상 노인인구의 의료기관 이용도를 2003년부터 2017년까지 입원 질환을 '요양병원을 포함'과 '요양병원을 제외'로 나누어 분석하였다. 그 결과 영북권역 노인인구 입원이용(요양병원 포함)에서 고혈압과 치매, 근골계 질환, 소화기계 질환, 기타 질환 순으로 차지하고 있으며, 노인인구 입원이용(요양병원 제외)의 경우 고혈압을 포함하는 혈액·순환기계 질병, 소화·비뇨기계 질환, 정신질환, 기타 질환 순으로 나타났다. 따라서 노인들의 치료 및 건강관리가 매우 중요하며 이를 위한 공공 의료조직의 확충이 필요하며 이를 위해 지역 내 의료기관, 단체, 대학 등과 거버넌스 구축이 필요하며 이를 바탕으로 강원도 영북지역 노인의 건강한 삶을 유지 할 수 있도록 예방적 차원의 보건사업이 수행되어야 한다.

• 보건의료산업학회지
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• 제9권4호
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• pp.145-155
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• 2015

Objectives : The purpose of this study was to test the influencing effects of health perception and family support on depression in elderly patients. Methods : Two-hundred forty-nine hospitalized geriatric patients were recruited in B city, South Korea. They were asked to complete a questionnaire, and 214 data sets were included in multiple regression analysis. Results : Subjects perceived a higher level of depression. Influencing factors of depression were hospitalization experience (t=3.476, p=.001), health perception (t=-3.310, p=.001), education (t=2.684, p=.008), economic satisfaction (t=2.579, p=.011), satisfaction with allowance (t=2.262, p=.025), and family support (t=-2.200, p=.029). The model was statistically significant explaining 36.3% of the variance (F=21.257, p<.001). Conclusions : In dealing with depression, nurses in elderly care facilities should be more concerned about patients with hospitalization experiences. Interventions to improve health perception should be provided to elderly patients, and educational programs on how to support patients are needed for the families of patients.

• 보건행정학회지
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• 제23권2호
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• pp.132-144
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• 2013

Background: The purpose of this study was to analyze the medical expense change and influencing factors after introducing longterm care insurance system. The study period was 2 years before and after introduction of the system. Methods: We analyzed data collected from two divided group lived in Incheon. Four hundred and eighty-five elderly who received long-term care wage for one year were selected for experimental group. For control group, 1,940 elderly were selected by gender and age stratified random sampling. Difference-In-difference analyses was used for evaluating policy effectiveness. Also multiple regression analyses were conducted to identify the factors associated with total medical expenditures. The control variables were demographic variables, economic status, diseases, and medical examination variables. Results: Difference-in-difference analyses showed that total average medical expenses among long-term patients has decreased by 61.85%. Of these, the hospitalization expenses have decreased by 91.63% and the drug expenses have increased by 31.85%. Multiple regression analyses results showed that total average medical expenses among long-term patients have significantly decreased by 46.5% after introducing the long-term care insurance. The hospitalization expenses have significantly decreased by 148.5%, whereas the drug expenses have increased by 53.6%. And outpatient expenses have increased by 10.4%, but the differences were not statistically significant. Conclusion: The results showed that total medical expenses and hospitalization expenses have decreased after introducing the long-term care insurance. These results could support the opinion that the health insurance spending among long-term patients will be reduced gradually by long-term care insurance through changing medical demand.

• 사회복지연구
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• 제42권2호
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• pp.303-322
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• 2011

만성질환보유 저소득 노인의 삶의 질 향상과 의료비절감을 위해서는 지역사회 보건복지서비스와 병의원서비스간의 연계가 중요하다. 본 논문은 서울시 복지패널데이터를 이용하여 병의원 의료서비스와 지역사회 보건복지서비스간의 연계 욕구 및 실태를 분석하기 위하여 병의원서비스 이용경험이 지역사회 보건복지서비스 이용(욕구)에 미치는 영향을 로짓분석하였다. 분석결과 입원경험이 있는 노인들은 입원경험이 없는 노인에 비해 지역사회 보건복지서비스에의 욕구가 더 높음에도 불구하고 실제로 해당 서비스를 더 많이 받지 못하고 있었다. 또한 외래이용경험이 없는 저소득 만성질환노인은 외래경험이 있는 노인에 비해 지역사회 보건서비스에의 욕구는 더 높았으나 실제 이용률은 더 높지 않았다. 결론적으로 볼 때 우리나라 병의원 의료서비스와 지역사회 서비스간의 연계가 긴밀하게 이루어지지 않고 있음을 알 수 있다.