• 한국간담췌외과학회지
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• 제26권3호
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• pp.244-250
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• 2022

Backgrounds/Aims: Early recovery after surgery has become a popular trend. The aim of this study was to evaluate effect of nutritional intervention using Encover, an oral nutritional supplement, in patients undergoing hepato-biliary-pancreatic surgery. Methods: This single center, prospective case-control study was conducted in Gangnam Severance Hospital from September 2018 to April 2019. Through randomization, patients were divided into an experimental group (30 patients) and a control group (30 patients). At postoperative seven days, the experimental group was instructed to take two packs of Encover (JW Pharmaceutical, Seoul, Korea) daily for seven days. Body cell mass index was measured at seven days after surgery and 14 days after discharge and Patient-Generated Subjective Global Assessment (PG-SGA) was performed at 14 days after discharge. Results: Body cell mass index during outpatient follow-up was significantly decreased compared to that at discharge in both groups. However, the amount of body cell mass index showed no significant difference between postoperative seven days and outpatient follow-up in either group. During outpatient follow-up, the experimental group had a higher mean value of PG-SGA score than the control group (11.32 ± 3.46 vs. 9.48 ± 3.97; p = 0.037). Conclusions: Short-term Encover doses after surgery may not produce significant results in weight gain or other body cell mass index. Encover did not significantly affect other dietary conditions based on PG-SGA.

• 대한견주관절학회:학술대회논문집
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• 대한견주관절학회 2009년도 제17차 학술대회
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• pp.171-171
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• 2009

• 생물정신의학
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• 제13권1호
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• pp.26-31
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• 2006

Object : To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. Methods : This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. Results : We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. Conclusion : Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

• 대한간호학회지
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• 제21권3호
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• pp.257-267
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• 1991

This study investigated the effects of nursing in formation given verbally and a booklet on the knowledge, Physical symptoms, anxiety and daily activities of patients recovering from open heart surgery from just before discharge to six weeks after discharge. The convenience sample was of patients who had undergone open heart surgery in Seoul National University Hospital. The first 25 patients who agreed to participate in the study became the control group. They did not receive the intentional information but the usual nursing care. The next 28 patients became the experimental group who received a booklet about their post-discharge care which was discussed with them by the researcher before discharge. This study used a non equivalent control group non - synchronized quasiexperimental design. The tools included a 30 item knowledge scale, a 9 item physical symptom scale, Spielberger's state anxiety scale, and a 28 item daily activity scale. The instruments were applied before discharge and at two and six weeks after discharge. For data analysis, frequency, t-test, Pearson's Correlational Coefficient and Cronbach's $\alpha$ were used. The results were as follows : 1. Information given through the booklet was effective in increasing the knowledge of patients recovering from open heart surgery. The experimental group's knowledge was higher at 2 weeks after discharge than prior to discharge (P＜0.05). 2. There was no significant difference in physical symptoms between the two groups at two and six weeks after discharge. 3. Information given through the booklet was effective in decreasing the State Anxiety two weeks after discharge (P＜0.001) but at six weeks after discharge, there was no significant difference in anxiety between the control and the experimental groups. 4. There was no significant difference in daily activity between the two groups at two and six weeks after discharge. 5. There was a negative correlation between knowledge at discharge and at 2 weeks and anxiety at 2 weeks after discharge. There was a positive correlation between knowledge at discharge and daily activity at 2 weeks after discharge. There was a negative correlation between knowledge at 2 weeks and Physical symptom at 6 weeks after discharge.

• 동서간호학연구지
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• 제16권1호
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• pp.1-10
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• 2010

Purpose: This study tested the effects of Nei-Guan acupressure on nausea, vomiting, and anorexia of lung cancer patients on chemotherapy. Methods: A nonequivalent control group pre-post test design was used to identify the effect of Nei-Guan acupressure on nausea, vomiting, and anorexia of lung cancer patients on chemotherapy. The participants were 60 patients who were admitted to a hospital for chemotherapy from February 1 to October 28, 2009. The patients were randomly assigned to the control group (n=30) or experimental group (n=30). The data were analyzed using Mann-Whitney test. Results: Nausea, vomiting, and anorexia were significantly decreased in the experiment group compared to the control group on the day of discharge from the hospital. However, the levels of nausea, vomiting, and anorexia between two groups were not statistically significant seven days after the discharge. Conclusions: Nei-Guan acupressure is effective in decreasing nausea, vomiting and anorexia of the patients with lung cancer on chemotherapy on the on the day of the discharge while the effectiveness is not certain 7 days after the discharge. Further study is needed to confirm these findings.

• 한국병원경영학회지
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• 제10권1호
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• pp.48-70
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• 2005

The purpose of this study was to make an analysis of the impact of the DRG payment system on medical care pattern and cost of cataract surgery in a general hospital. The subjects were 173 patients whose DRG severity grade was zero, selected from among the hospitalized who underwent cataract surgery before and after the joining to the demonstrational operation of the third year DRG payment system. Their medical records and the details of their medical bills were examined to find out the length of hospital stay, medical care pattern provided to them, the cost of medical care, and the quality of medical care. The length of stay and the amount of medical care supplied during being in hospital dropped significantly for both single-eye and double-eyes cataract surgery groups. The amount of antibiotic use went down during the hospitalization and upon discharge from the hospital, but decreased after discharge. The total medical bills and the rate of basic examination implementation increased in the OPD before hospitalization but after discharge dropped. For double-eyes cataract patients, the rate of double-eyes cataract surgery went down. The total medical bills of DRG payment system converted into the fee-for-service system was greater by 113.3% for the single-eye cataract surgery group and by 102.9% for the doble-eyes cataract surgery group, compared to that by the fee-for-service. The contribution shared by the insurance corporation increased for both single-eye and double-eyes cataract surgery groups, but the copayment by the insured went down. Regarding the treatment outcome, no difference was found in complication rate, resurgery rate and mortality rate before and after the joining to the DRG payment system was implemented. The use of special lens lessened significantly. The amount of medical care supplied during hospitalization decreased but the complication rate didn't increase. But the increased use of low-price artificial cataract and the avoidance of double-eyes cataract surgery was observed. The phenomenon decreased number of OPD visit and the decreased total medical bills of OPD care after discharge in this hospital required further evaluation.

• 한국의료질향상학회지
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• 제20권1호
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• pp.76-88
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• 2014

Objectives: Parents of a premature baby feel a pressure on their baby's growth and they are highly in need for proper education. However, the lack of proper education can cause the difficulty of follow-up care and rehospitalization. Currently, methods of education among each nurse are based on verbal explanation and can be often different. Therfore, it is true that the psychological burden is great during education. Hence, by enforcing discharge education activities, we intend to provide information; induce participation of parents; promote the level of performance; standardize education program; and increase the job satisfaction of nurses. Methods: NICU conducted a questionnaire survey of the demand and satisfaction for discharge education among mothers that left hospital. And before and after the improvement activity, the satisfaction level of mothers and nurses were studied, and rehospitalization rate were analyzed. Results 1)The survey results of the satisfaction level of mothers towards education program as followes: The level of understanding of content, general babysitting, special situation, education method, and educator attitude showed statistically significant increase. 2)The survey results of the satisfaction level of nurses towards education program as followes: While, the need for education program decreased, the adequacy of education content and method, consistency of education, understanding of learner, and learner's performance increased. All the factors except for the need for education program and the adequacy of education content showed statistically significant difference. 3)Rehospitalization rate of premature babies decreased. According to analysis of the cause of rehospitalization, breast-feeding related apnea turned out to be the highest. Conclusion: Through QI, satisfaction of mothers and nurses improved more than 10%. And rehospitalization rate of premature babies decreased by the same amount as well. Therefore, with the help of the standardized discharge education program, mothers who is not easy to take care of after leaving hospital can be seen to significantly affect their healthy growth and development.

• 한국병원경영학회지
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• 제26권1호
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• pp.17-25
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• 2021

This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.

• 지역사회간호학회지
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• 제10권1호
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• pp.70-79
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• 1999

This study attempts to encourage the development of a rehabilitation delivery system as a substitute service for hospitalization such as a community based intermediate facility or home health care. We need substitute services for hospitalization to curtail the length of stay for inpatients due to car accidents. It focused on developing an estimation for early discharge based on a detailed statement of treatment from medical records of 109 inpatients who were hospitalized at General Hospital in 1997. This study has three specific purposes: First, to find the mean length of stay and mean medical expenditure. Second, to estimate the mean of early discharge from the mean length of stay. Third, to analyize the income effect per bed from early discharge. In order to analyze the length of stay and medical expenditure of inpatients the author conducted a micro and macro-analysis with medical expenditure records. To estimate the early discharge we examined with a group of 4 experts decreases in the amount of treatment after surgery, in treatments, in tests, in drug methods. We also looked their vital signs, the start of ROM exercise, the time removel, a patient's visitations, and possible stable conditions. In addition to identifing the income effect due to an early discharge, the data was analyzed by an SPSS-PC for windows and Excell program with a regression analysis model. The research findings are as follows: First, the mean length of stay was 47.56 days, but the mean length of stay due to early discharge was 32.26 days. The estimation of early discharge days was shown to depend on the length of stay. The longer the length of stay, the longer the length before discharge. For example, if the patient stayed under 14 days the mean length of stay was 7.09 while an early discharge was 6.39, whereas if the mean length of stay was 155.73, the early discharge time was 107.43. The mean medical expenditure per day of car accident patients was found to be 169,085 Won, whereas the mean medical expenditure per day was shown to be in a negative linear form according to the length of stay. That is the mean expenditure for under 14 days of stay was 303,015 Won and the period of the hospitalization of 15 days to 29 days was 170,338 Won and those of 30 days to 59 days was 113,333 Won. The estimation of the income effect due to being discharged 16 days was around 2,350,000 Won with a regression analysis model. However, this does not show the real benefits from an early discharge, but only the income increasing amount without considering prime medical cost at a general hospital. Therefore, we need further analysis on cost containments and benefits incending turn over rates and medical prime costs. From these research findings, the following suggestions have been drawn, we need to develop strategies on a rehabilitation delivery system focused on consumers for the 21st century. Varions intermediate facilities and home health care should be developed in the community as a substitute for shortening the length of stay in hospitals. In home health care cases, patients who want rehabilitation services as a substitute for hospitalization in cooperation with private health insurance companies might be available immediately.

• 대한영양사협회학술지
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• 제18권1호
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• pp.16-29
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• 2012

The purpose of this study was to investigate the changes in nutritional status of gastrectomy patients. The anthropometric and biochemical data were measured at pre-operation, at discharge, 1 month after discharge, and 3 months after discharge. Nutrient intake levels, nutrients adequacy ratio (NAR), mean adequacy ratio (MAR), and the proportion of patients with intake levels inferior to those of dietary reference intakes (DRIs) were analyzed at discharge, 1 month after discharge, and 3 months after discharge. Finally, the data on 23 patients (15 male and 8 female) were collected and used for statistical analysis. Fifteen patients underwent subtotal gastrectomy, and 8 patients underwent total gastrectomy. Compared to pre-operation, body weight and body mass index of subjects significantly decreased at discharge, 1 month after discharge, and 3 months after discharge (P<0.001). Serum albumin (P<0.001), total lympocyte count (P<0.001), total cholesterol (P<0.001), hemoglobin (P<0.001), hematocrit (P<0.001), and mean corpuscular hemoglobin concentration (P<0.05) were significantly different between pre-operation, at discharge, 1 month after discharge, and 3 months after discharge. The proportions of patients with lower nutrient intake levels than DRIs were substantial. MAR at discharge, 1 month after discharge, and 3 months after discharge were 0.70, 0.80 and 0.91, respectively. Especially, the NARs of folate, niacin, vitamin $B_2$, vitamin C, and zinc were all low. Considering the various nutritional problems of gastrectomy patients, systematic medical nutrition therapy is needed after gastrectomy.