• Quality Improvement in Health Care
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• v.30 no.1
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• pp.15-32
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• 2024

Purpose: The number of severely ill patients requiring post-acute care has been increasing. Careful discharge planning minimizes unplanned emergency room visits and readmissions. This study aimed to survey the knowledge, experience, confidence, and obstacles faced by medical residents and fellows regarding the discharge process of severely ill patients. Methods: A survey consisting of 27 questions was sent electronically to residents and fellows who had experience in discharging severely ill patients from a tertiary hospital in Korea. The survey was conducted over a two-week period from September 29, 2022. Results: A total of 98 residents and fellows responded to the survey. Of these, 94% experienced difficulties related to the discharge process. The main obstacle was changes in the patient's condition during discharge planning (92.3%). Although 95% of the respondents acknowledged the need for providing discharge information, only 53.1% of the residents and fellows practiced this. Only 42.9% of the respondents and 20.4% of residents and fellows explained local community healthcare and welfare resources to patients because of a lack of relevant knowledge (69.7%) and feeling no responsibility to explain (40.4%). Conclusion: This study revealed that residents and fellows experienced difficulties in devising discharge plans and providing post-acute care related information, despite recognizing the importance of these. These gaps result from the lack of a discharge planning curriculum regarding critically ill patients and appropriate training in the discharge process. This suggests that an integrated discharge planning curriculum should be developed and adopted in residents' training programs for the differentiated treatment of critically ill patients.

• Journal of Technologic Dentistry
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• v.33 no.4
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• pp.539-550
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• 2011

Purpose: The aim of this study was to investigate distribution of the admitted patients with disease of oral cavity, salivary glands and jaws, current clinical treatment condition and clinical dental practice. Methods: The subject were 4,564 patients with disease of oral cavity, salivary glands and jaws of the Korean National Hospital Discharge Injury Survey 2004-2008 data. This study was carried out using the administrative database including patients' characteristics and comorbidity. The statistical analysis for ratio, gender, age, region, primary diagnosis, comorbidity, operation, hospital location and bed size of inpatients in Korean National Hospital Discharge Injury Survey was conducted by frequency analysis. Results: Among the total discharge injury patients in 2004-2008, the trend showed decrease of ratio of patients with disease of oral cavity, salivary glands and jaws. The portion of male was higher than female, and 20~29 age group was the highest portion compared with other age groups. Seoul-Gyunggi region was the highest among the other residences. patients with Dentofacial anomalies[including malocclusion] as primary diagnosis, digestive system as comorbidity and operations on facial bones and joins showed the highest portion respectively. Seoul-Gyunggi region was the highest portion compared with other residences. 500~999 bed size showed the highest portion. Conclusion: In this study showed that distribution of patients with disease of oral cavity, salivary glands and jaws, current dental clinical treatment condition using the Korean National Hospital data.

• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.376-386
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• 2001

I. Background The problem of discharging patients from hospital have been well documented in the literature over the last 20 years. They included poor communication between hospital and community, inadequate notice of discharge, over-reliance on informal support and lack of statutory support, inattention to patients needs before leaving hospital, and wasted or duplicated visits by community nurses. Most patients discharged from hospital are able to return home with little or no support, while others will require a 'package of care' to support them back to good health. Patient with complex care needs, including the frail elderly and those with mental health problems, may require continuing care in special housing, residential, or nursing homes. With this population,effective discharge arrangement is needed and the study on this problem is urgent in Korea because the Medical Reform Project is on suspension of success. II. Results of the Study: 1. Discharge service needs assessed on 360 elderly patients who were hospitalized during the survey period at four university hospitals. Patients want to know the information on disease management after discharge. Follow-up telephone service is the most frequently checked service. 2. Multidisciplinary Discharge Planning is recommended at the hospital level to reduce the readmission and decrease the length of stay. 3. Further research is needed to validate and test the assumption of the solution which is developed in this research.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.4
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• pp.392-401
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• 2009

Purpose: This study was a descriptive survey of nursing needs for post surgical colon cancer patients at discharge. Method: A survey was done utilizing questionnaires about the nursing needs a target sample of 61 patients who had colon cancer surgery during April May 2006 in a general hospital in Seoul. Results: Levels for treatment & prognosis were the highest in all domain, high in order of psychological support & stability, complications & discomfort, diet, daily life style, recovery & health promotion, and support system. Patient factors affecting nursing needs were age, job, duration of colon cancer and handling of stoma. Conclusion: Using discharge education for colon cancer patients based on the results of this study, nurses should focus on the domains of treatment & prognosis, psychological support & stability and complication & discomfort, and should tailor teaching content to be specified for age, job, duration of colon cancer, and handling of stoma.

• Journal of Digital Convergence
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• v.11 no.5
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• pp.371-384
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• 2013

The purpose of this study was to develop the risk-adjusted mortality model using Korean Hospital Discharge Injury data and US National Hospital Discharge Survey data and to suggest some ways to manage hospital mortality rates through comparison of Korea and United States Hospital Standardized Mortality Ratios(HSMR). This study used data mining techniques, decision tree and logistic regression, for developing Korea and United States risk-adjustment model of in-hospital mortality. By comparing Hospital Standardized Mortality Ratio(HSMR) with standardized variables, analysis shows the concrete differences between the two countries. While Korean Hospital Standardized Mortality Ratio(HSMR) is increasing every year(101.0 in 2006, 101.3 in 2007, 103.3 in 2008), HSMR appeared to be reduced in the United States(102.3 in 2006, 100.7 in 2007, 95.9 in 2008). Korean Hospital Standardized Mortality Ratios(HSMR) by hospital beds were higher than that of the United States. A two-aspect approach to management of hospital mortality rates is suggested; national and hospital levels. The government is to release Hospital Standardized Mortality Ratio(HSMR) of large hospitals and to offer consulting on effective hospital mortality management to small and medium hospitals.

• Journal of Digital Convergence
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• v.11 no.6
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• pp.221-233
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• 2013

This study aims to develop the severity-adjusted length of stay(LOS) model for acute stroke patients using data from the hospital discharge survey and propose management of length of stay(LOS) for acute stroke patients and using for Hospital management. The dataset was taken from 23,134 database of the hospital discharge survey from 2004 to 2009. The severity-adjusted LOS model for the acute stroke patients was developed by data mining analysis. From decision making tree model, the main reasons for LOS of acute stroke patients were acute stroke type. The difference between severity-adjusted LOS from the decision making tree model and real LOS was compared and it was confirmed that insurance type and bed number of hospital, location of hospital were statistically associated with LOS. And to conclude, hospitals should manage the LOS of acute stroke patients applying it into the medical information system.

• Child Health Nursing Research
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• v.26 no.1
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• pp.107-120
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• 2020

Purpose: This study was conducted to investigate the educational needs of parents of infants and toddlers with congenital heart disease (CHD) after hospital discharge. Methods: Qualitative content analysis was conducted of in-depth interviews of eight parents, and the results of an online survey of 171 parents were analyzed quantitatively. Results: Only 16.4% of parents reported that they had received education after hospital discharge on how to provide care for a child with CHD at home. The main reason why parents did not receive education on this topic was that they did not have sufficient opportunities or information (75.5%). In addition, 97.1% of parents stated that they needed educational programs that would be available at home after discharge. In terms of specific educational content, parents expressed the highest needs for education on the symptoms of CHD and ways to cope with them, the prognosis of CHD, and the growth and development of infants and toddlers with CHD. Conclusion: The study showed that parents' educational needs were high in many ways. However, the information and educational opportunities offered after discharge were insufficient compared to those needs. Further research is needed to develop post-hospital educational programs that meet their needs.

• The Korean Journal of Applied Statistics
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• v.24 no.2
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• pp.393-400
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• 2011

In a large scale survey, cluster sampling design in which a set of observation units called clusters are selected is often used to satisfy practical restrictions on time and cost. Especially, a two stage cluster sampling design is preferred when a strong intra-class correlation exists among observation units. The sample Primary Sampling Unit(PSU) and Secondary Sampling Unit(SSU) size for a two stage cluster sample is determined by the survey cost and precision of the estimator calculated. For this study, we derive the optimal sample PSU and SSU size when the population SSU size across the PSU are di erent by extending the result obtained under the assumption that all PSU have the same number of SSU. The results on the sample size are then applied to the $4^{th}$ Korea Hospital Discharge results and is compared to the conventional method. We also propose the optimal sample SSU (discharged patients) size for the $7^{th}$ Korea Hospital Discharge Survey.

• Korea Journal of Hospital Management
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• v.26 no.1
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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.

• Korea Journal of Hospital Management
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• v.19 no.4
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• pp.21-33
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• 2014

This study was conducted to propose an insight into the appropriateness of hospital length of stay(LOS) by developing a severity-adjusted LOS model for patients with pneumonia, organism unspecified. The pneumonia risk-adjustment model developed in this paper is based upon the 2006-2010 the Korean National Hospital Discharge in-depth Injury Survey. Decision tree analysis revealed that age, admission type, insurance type, and the presence of additional disorders(pleural effusion, respiratory failure, sepsis, congestive heart failure etc.) were major factors affecting the severity-adjusted model using the Clinical Classifications Software(CCS). Also there was a difference in LOS among the regional hospitals, especially the hospital LOS has not been efficiently managed in Gyeongsangbuk-do, Jeollanam-do, Jeollabuk-do, Daejeon, and Busan. To appropriately manage hospital LOS, reliable statistical information about severity-adjusted LOS should be generated on a national level to make sure that hospitals voluntarily reduce excessive LOS and manage main causes of delayed discharge.