• Title/Summary/Keyword: Hospital stay

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A Study on the Factors Affecting the Length of Hospital Stay in Teaching Hospitals (수련병원의 평균재원일수에 영향을 주는 요인에 관한 연구)

  • Seo, Sun Won;Park, Eal Whan
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.34-43
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    • 1994
  • Background: The average hospital stay in most Korean teaching hospitals is longer than that of hospitals in developed countries. The investigation of average hospital stay of teaching hospitals is considered as an important measure to evaluate the effectiveness of hospital management. In this article authors analyzed the relationship of several variables (hospital ownership, number of beds, location of hospitals, number of physician) to length of hospital stay in each clinical department. Methods: The average hospital stay of each clinical department of 184 teaching hospitals was investigated. Authors reviewed the papers of teaching hospitals, that was reported to the Korean Association of Hospitals. Results: The means of hospital stay day of hospitals were not significantly different according to the number of hospital beds and location of hospitals. Only the difference of hospital stay according to ownerships was significant. The length of stay was the highest in public hospitals and the lowest in juridical hospitals. Conclusions: The number of beds and location of hospitals were not associated with the average hospital stay. But ownerships affected the average hospital stay. The national or public hospitals had the longest length of hospital stay. Number of specialists and number of all physicians were closely related to the average hospital stay.

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Factors influencing the appropriateness of hospital stays (재원 적절성에 영향을 미치는 요인)

  • Hwang, Jee In
    • Health Policy and Management
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    • v.15 no.3
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    • pp.94-113
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    • 2005
  • The purpose of this study was to determine the level of appropriateness in hospital stays and factors influencing inappropriate hospital stays. The study was conducted at fifteen general care units in a tertiary university hospital. Appropriateness of hospital stay was assessed using Appropriateness Evaluation Protocol by trained head nurses. The total of 447 patient records were reviewed. Among them, 352 patient data were included in the final data set. A unit of observation was patient day. A rate of appropriate hospital stay was calculated per patient as a unit of analysis. Multiple regression analysis was performed to determine the factors affecting inappropriate hospital stay. The eighty-three percent (2030/2651) of hospital stays were evaluated as appropriate. There were significant differences in appropriateness of hospital stay according to patient's age, type of health insurance, medical specialty, and length of stay(p<0.05). In the multiple regression analysis, medical speciality was the most significant factor to predict the inappropriate hospital stay. The study showed a substantial proportion of hospital stay was found to inappropriate. Level of appropriateness was significantly different from medical specialty. Interdepartmental approach should be required to coordinate and improve appropriate resource utilization.

Effects of a Standardized Critical Pathway for Gastrectomy Patients in a General Hospital (일개 종합병원의 위 절제 환자에 적용한 Critical Pathway의 효과)

  • Kim, Eun-Ok;Kwon, Soon-Man
    • Korea Journal of Hospital Management
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    • v.9 no.3
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    • pp.128-142
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    • 2004
  • To evaluate the effects of critical pathway on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a tertiary care academic medical center. The basic research design is a retrospective case-control comparative study. 470 patients of gastrectomy were included in the study; 180 before pathway development (control), 163 right after pathway implementation (path group I) and 127 one year after pathway implementation (path groupII). 476 patients of modified radical mastectomy were also analyzed to examine whether the reduction of the length of hospital stay is from the hospital-wide trend or due to the critical pathway. Death after operation, ICU stay, unplanned re-operation, readmission after discharge, the length of hospital stay and cost were analyzed. 2-test, one-way ANOVA, Bonferroni and Turkey's test were used for statistical analysis. (1) There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. (2) The length of hospital stay was 13.0 days in control group, 12.2 days in path group I and 10.0 days (p<0.01) in path groupII. (3) The total costs during the hospital stay were reduced. However the cost per day was significantly increased from reduction of hospital stay (358,488won in control, 366,017won in path group I and 413,220won (p<0.01) in path groupII). Critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care.

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Is the Hospital Caseload of Diagnosis Related Groups Related to Medical Charges and Length of Stay? (DRGs(Diagnosis Related Groups)별 환자집중도 수준에 따른 입원진료비와 재원일수의 차이 분석)

  • Kwak, Jin-Mi;Lee, Kwang-Soo
    • The Korean Journal of Health Service Management
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    • v.8 no.4
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    • pp.13-24
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    • 2014
  • This study analyzes the effects of hospital caseload on medical charges and length of stay for inpatients. Hospital caseload, representing the level of concentration of patients, was measured with the Internal Herfindal Index for three diagnosis related group (DRG) codes (appendectomy, operations on anus, and operations on uterus and adnexa). Ordinary least squares regression was used for analysis. Results showed that medical charges per inpatient and average length of stay significantly differed with respect to hospital concentration indices, and that hospital caseload was inversely related to operational performance for appendectomy and operations on uterus and adnexa. The significant negative relationship between concentration index and length of stay may decrease the total medical charges. The results imply that the expansion of the DRG payment system to hospitals will have a negative influence on their gross sales.

The Effects of Hospital Organizational Culture and Work Environment on Nurses' Intent to Stay at the Current Hospital (병원의 조직문화와 직무환경이 간호사의 잔류의도에 미치는 영향)

  • Yun, Myeong Ju;Choi, Mi Young
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.3
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    • pp.273-282
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    • 2018
  • Purpose: This descriptive study was conducted to identify the effects of hospital organizational culture and work environment on nurses' intent to stay at work. Methods: Participants of this study were 234 nurses who have worked at a local general hospital in the Chungcheong province for at least 6 months. The data were collected from July 17 to 28, 2017, using self-reported questionnaires and analyzed with multiple regression using SPSS version 22.0. Results: Clinical experience (${\beta}=.38$, p<.001), institutional support (${\beta}=.33$, p<.001), and relation-oriented culture (${\beta}=.24$, p<.001) affected intent to stay at work among nurses. These variables accounted for 34.8% of the variance in intent to stay at work among nurses. Conclusion: This study confirms the effects of the work environment and organizational culture on nurses' intent to stay at work. Efforts for improving the work environment and organizational culture need for retaining nurses in a hospital. We suggest further research to identify the other factors associated with intent to stay at work among nurses.

Influencing Factors on Nurse's Intention to Stay: Systematic Review and Meta Correlation Analysis (체계적 문헌고찰과 메타상관분석을 이용한 간호사 재직의도 영향요인 고찰)

  • Lim, Ji Young;Shin, Jeong Ae;Kim, Seulki;Lee, Eunmi;Kim, Seonhee
    • Journal of Home Health Care Nursing
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    • v.26 no.3
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    • pp.265-277
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    • 2019
  • Purpose: This study was performed to explore research trends in the intention to stay of hospital nurses and provide basic data to establish nursing management strategies to increase the intention to stay. Methods: Articles published between 2009 and 2018 were searched. The search terminologies were "intention to stay," "nurse", and "hospital". In the first search, 381 articles were extracted from academic databases. Thirty articles were used in the systematic review, and 29 articles were used in the correlation meta-analysis. Results: Thirty-two variables were explored in relation to the intention to stay. In the correlation analysis, job satisfaction and work environment showed statistically significant positive correlations in many studies. In the correlation meta-analysis, 7 variables including organizational commitment showed statistically significant effect sizes. Conclusion: We suggest that structural equation model analysis to identify causal relations among influencing variables of the intention to stay of hospital nurses may be conducted. This study can be used as a guideline to develop intention-to-stay enhancement programs for hospital nurses.

Patient and Hospital Characteristics of Long-Stay Admissions in Long-Term Care Hospitals in Korea (요양병원 장기입원 현황과 관련 노인 및 기관 특성 비교 연구)

  • Jeon, Boyoung;Kim, Hongsoo;Kwon, Soonman
    • Health Policy and Management
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    • v.26 no.1
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    • pp.39-50
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    • 2016
  • Background: This study examined patient and hospital factors related to long-stay admissions in long-term care hospitals (LTCHs) among older people in Korea. Methods: We analyzed health insurance claims data, entitlement data, and institutional administrative data from the National Health Insurance Service databases between 2010 and 2012. At the patient level, we compared characteristics of patients staying in LTCHs for over 180 days (the long-stay group) with those staying in LTCHs for less than 90 days during a calendar year. At the hospital level, we examined the general characteristics and staffing levels of the top 10% of hospitals with the highest proportion of patients whose length of stay (LOS) was 180+ days (the hospitals with long-stay patients) and compared them with the top 10% of hospitals with the highest proportions of patients whose LOS was less than 90 days (hospitals with shorter-stay patients). Results: The long-stay group accounted for about 40% of all LTCH patients. People in the group were more likely to be women, aged 80+, living alone, and experiencing more than two health conditions. Compared to the hospitals with shorter-stay patients, those with long-stay patients were more likely to be occupied by patients with behavior problems and/or impaired cognition, owned by corporate or local governments, have more beds and a longer period of operation, and deliver services with lower staffing levels. Conclusion: This study found long-stay older people in LTCHs and those in LTCHs with high proportions of long-stay older patients had several distinct characteristics compared to their counterparts designated in this study. Patient and hospital characteristics need to be considered in policies aiming to resolve long-stay admissions problems in LTCHs.

The Determinants of Propensity To Stay Among Hospital Nurses (병원간호직 근무자의 근속성향 결정요인)

  • Seo, Young-Joon;Ko, Jong-Wook
    • Korea Journal of Hospital Management
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    • v.2 no.1
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    • pp.137-161
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    • 1997
  • This study purports to investigate the determinants of propensity to stay among nursing staff working at Korean hospitals. The independent variables contains three groups of determinants: environmental variables(job opportunity, spouse support, and parent support), psychological variables(met expectations, work involvement, positive affectivity, and negative affectivity), and structural variables(job autonomy, work unit control. routinization, supervisor support, coworker support, role ambiguity, role conflict, workload, resource inadequacy, distributive justice, promotional chances. job security, job hazards, and pay). The sample used in this study consisted of 329 nurses and 175 nurse aides from two university hospitals in Seoul and its surburbs. Data were collected with self-administered questionnaires and analyzed using path analysis. The results of this study indicate that: (1) the following variables, listed in order of size, have significant positive effects on propensity to stay among hospital nursing staff: job satisfaction, met expectations, supervisor support, job security, and positive affectivity, (2) the following variables, listed in order of size, have significant negative total effects on propensity to stay among hospital nursing staff: job opportunity, negative affectivity, and rutinization, (3) the model explains 44.2 percent of the variance in propensity to stay among nursing staff working at two university hospitals, and (4) managerial support for improving the job autonomy, distributive justice, and promotional opportunity for nurse aides are needed.

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Factors Affecting the Intention of Hospital Nurses to Stay at Work: In Relation to Authentic Leadership and Nursing Organizational Culture (병원간호사의 재직의도에 영향을 미치는 요인: 진정성 리더십과 간호조직문화를 중심으로)

  • Park, Hyunjung;Kim, Phill Ja;Lee, Hye Young;Shin, Yoon Jung;Oh, Kyoung Hwan;Lee, Tae Wha;Seong, Jeong Soon;Hong, Eun-Young
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.1
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    • pp.34-42
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    • 2019
  • Purpose: The purpose of this study was to examine the relationships of authentic leadership and nursing organizational culture to the intention of hospital nurses to stay in their current position. Methods: The participants of this study were 503 nurses in 8 hospitals. We collected data using questionnaires for assessing authentic leadership, nursing organization culture and intention to stay. For data analysis, t-test, ANOVA, Cronbach's ${\alpha}$, Pearson's correlation coefficient, Tukey test, Multiple regression were performed using SAS ver.9.4 (SAS Institute Inc., Cary, NC, USA). Results: Authentic leadership (${\beta}=.12$, p=.008) and relation-oriented culture (${\beta}=.13$, p=.009) affected the intention of the hospital nurses to stay. These variables accounted for 29% of the variance in the intention to stay among hospital nurses. Conclusion: The finding of this study shows that the authentic leadership and nursing organizational culture especially relation-focused can influence nurses' intention to stay in their current position. For retaining nurses, it is suggested to use an authentic leadership training program for nursing leaders and to make efforts to establish a relation-focused culture in the hospital.

An Analysis on the Effectiveness of Hospital Revenues Per Bed by Shortening Length of Stay (재원일별 진료비 변화 및 재원일수 단축의 의료수입 중대 효과)

  • Lee, Hae-Jong;Kim, Young-Hoon;Lee, Eun-Pyo;Kim, Seoung-Woo;Jeoung, Beoung-Han
    • Korea Journal of Hospital Management
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    • v.3 no.1
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    • pp.100-120
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    • 1998
  • Tertiary been increasing rapidly. There has been shortage of beds in hospitals and effective management of beds had to b considered. For the efficient utilization of the exsisting hospital beds, bed turnover rate ha to be high and their length of stay in hospital has to be shortened. The sample of this study was in-patients admitted in 13 clinical departments of a tertiar hospital in Wonju. Daily medical fees through length of stay in hospital were observed an we analyzed the increase of hospital revenues per bed for the shortening of length of stay. The results of the analysis were as follows: 1. The average length of stay by dept. was 11.0 in dept. of internal medicine. 12.4 in dept. of general surgery, 7.1 in dept. of gynecoloty, 6.8 in dept. of pediatrics, 26.1 in dept. of nervous surgery, 21.6 in dept. of orthopedic surgery, 25.5 in dept. of plastic sersury, 7.6 in dept. of ophthalmology, 7.1 in dept. of E.N.T, 8.1 in dept. dermatoloty, 9.0 in dept. urology. 2. The trend of daily medical fees of in-patients was the highest from the first day to the third day. Because most necessary examination and various treatment or operation took place in these period. 3. The estimative model for medical fees by the length of stay at each clinical department was inferred. 4. The increased revenue per bed by shortening the length of stay was calculated by the estimative model. Shortening one day would increase 305,999 thousand won in dept. of internal medicine 232,138 thousand won in dept. of general surgery., 177,795 thousand won in dept. of gynecology medicine, 69,031 thousand won in dept. of pediatrics 360,381 thousand won in dept. of nervous surgery 211.339 thousand won in dept. of orthopedic surgery, 100,249 thousand won in dept of plastic surgery, 10,569 thousand won in dept. of ophthalmology -814,122 thousand won in dept. of E.N.T, 1,582 thousand won in dept. of dermatology, -5,821 thousand won in dept. of urology. It is expected that they can improve their profitability by shortening the length of stay of the in-patients.

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