• Title/Summary/Keyword: Hospitalization program

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Association of Higher Continuity of Primary Care with Lower Risk of Hospitalization among Children and Adolescent Patients (어린이와 청소년 환자에서 일차의료의 지속성과 입원 위험도의 관련성)

  • Choi, Yong-Jun;Kang, Sung-Hyun;Kim, Yong-Ik
    • Health Policy and Management
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    • v.18 no.1
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    • pp.85-107
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    • 2008
  • This study aims to describe levels and distribution of the continuity of primary care among children and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization. Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not. Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34 [1.27-1.41] at the medium level of continuity and 1.47 [1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35 [1.21-1.50] at the medium level of continuity and 1.60 [1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not. This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.

Nutrition Knowledge, Dietary Habits, and Food Intake Frequency According to Hospitalization after Breast Cancer Surgery and Experience of Breast Cancer Among Female Adults in Bucheon Area (경기 부천지역 여성의 유방암 수술 후 입원여부와 유방암 경험 유무에 따른 영양지식, 식습관 및 식품섭취빈도)

  • Kim, Song Hee;Park, So Hyun;Lee, A Reum;Chang, Kyung Ja
    • Journal of the Korean Society of Food Culture
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    • v.32 no.5
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    • pp.373-382
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    • 2017
  • This study investigated the nutrition knowledge, dietary habits, and food intake frequency according to hospitalization after breast cancer surgery and experience of breast cancer among female adults residing in the Bucheon area. Subjects were 52 female breast cancer survivors 27 in the hospitalization group (HG) and 25 in the non-hospitalization group (non-HG)] and 52 controls. Data included the results of self-administered questionnaires, as well as anthropometric data and blood biochemical values of breast cancer survivors collected from electronic medical records. Statistical analysis was performed using SPSS 20.0 program. Nutrition knowledge and dietary habits revealed no significant differences between HG and non-HG, but intake frequency of root and tuber crops and kimchi was significantly higher in the HG group than the non-HG group (p<0.05). According to experience of breast cancer, total scores of nutrition knowledge among survivors (8.2) were significantly higher than those of the control group (6.3) (p<0.001). Fish and shellfish and fruit intake frequencies were significantly higher in the survivors group, whereas intake frequency of fast food, convenience food, and alcohol was significantly lower compared to the control group. Overall, these findings indicate it is necessary to develop and spread nutrition education guidelines to prevent the occurrence and recurrence of breast cancer.

Factors Associated with Length of Stay in Elderly Inpatients in a General Hospital in Seoul (서울소재 3차 의료기관에 재원 중인 노인 환자의 재원기간에 영향을 미치는 관련 요인)

  • Kim, Sun-Ja;Yu, Seung-Hum;Oh, Hyohn-Joo
    • Korea Journal of Hospital Management
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    • v.12 no.2
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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.

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A Comparative Study of Improvement of Neck Pain According to Hospitalization Period in Patients of Neck pain Caused by Traffic Accident (교통사고로 인한 경항통 환자의 입원 기간에 따른 통증 호전도 비교 연구)

  • Kim, Tae Gyu;Seo, Young Woo;Kim, Yoo Jong;Lee, Jeong Ryol;Choi, Jae Young;Kim, Ji Su;Kim, Seh Young;Park, Han Sol;Jeon, Eun Jeong;Kim, Ki Ok;Lee, Min Ho
    • Journal of Acupuncture Research
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    • v.33 no.3
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    • pp.189-195
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    • 2016
  • Objectives : The aim of this study was to compare improvement according to the hospitalization period of patients with neck pain as a result of traffic accidents. Methods : Patients of 59 cases with neck pain induced by traffic accidents were investigated. Based on their hospitalization period, 59 subjects were divided into two groups: A group with a shorter hospitalization period and B group with a longer hospitalization period. Each group was treated by the same therapies including acupuncture, pharmacopuncture, and herbal medicine. To compare the treatment effects of the two groups, the Visual Analog Scale(VAS) was used. Statistical analysis between two groups was assessed using the chi-square test, Mann-Whitney U Test and paired t-test through the SPSS 12.0 Windows program. Results : After admission treatment, both A and B group showed a significant decrease in their VAS scores. In addition, B group, of which the hospitalization period was longer than A group, showed a significant improvement in comparison to A group in its VAS score. Conclusion : This study suggests that pain control is more effectively achieved in patients that received more than 8 days of admission treatment compared to those who received less than 7 days of admission treatment.

Risk Factors and Clinical Outcomes for Vancomycin-Resistant Enterococcus Colonization on Intensive Care Unit Admission (중환자실 환자의 입실시 반코마이신 내성 장구균 집락의 위험요인과 임상적 결과)

  • Byun, Sook-Jin;Kang, Jiyeon
    • Journal of Korean Academy of Nursing
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    • v.43 no.2
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    • pp.287-295
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    • 2013
  • Purpose: The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization. Methods: Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method. Results: During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality. Conclusion: Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.

Effects of Diabetic Education Fortified with Individual Practice on Plasma Glucose, Self-care, and Self Reported Physical Symptom in Type 2 Diabetic Patients (개별실습을 강화한 당뇨교육이 제2형 당뇨병 환자의 혈당, 자가 관리 및 자각증상에 미치는 효과)

  • Kim, Hyeon Jeong;Kim, Hee Seung;Ahn, Sung Hee
    • Korean Journal of Adult Nursing
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    • v.18 no.2
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    • pp.194-201
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    • 2006
  • Purpose: This study was attempted to estimate the effects of diabetic education fortified with individual practice on plasma glucose, self-care, and self reported physical symptoms in type 2 diabetes patients Method: The subjects consisted of 46 patients with type 2 diabetes patients, who took the hospitalization diabetes education program from July 2003 until February 2004 at Seoul C university hospital. The experimental group was assessed at preand post intervention. The diabetes education was provided for one week. The education consisted of diabetes education videos for the diabetic introduction, group education for medication therapy, dietetic treatment and diabetes complication education. Also individual education for nurses examination of glycemia and insulin injection practice. Results: The HbA1c values significantly decreased from 9.6% on the time of hospitalization to 7.4% 3 months after discharge. In respect to the number of days of self-care, medication, diet, exercise, cleansing feet, and carrying sweets to prepare for hypoglycemia all significantly increased 3 months after discharge compared to the values at the time of hospitalization. Self reported physical symptoms were also significantly increased 3 months after discharge compared to the time of hospitalization. Conclusion: The diabetic education fortified with individual practice can be practically used as a plan for managing glycemia, self-care, and self reported physical symptom of diabetes patients.

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Outcomes of Home Care Service for Coronary Artery Bypass Graft (관상동맥우회술 환자의 가정간호 효과)

  • Baek, Hee-Chong
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.10 no.2
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    • pp.123-131
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    • 2003
  • This study was to compare the functional status. complication and readmission rates. and client satisfaction with nursing care of home-based care and hospital-based care for clients with Coronary Artery Bypass Graft. Raw data were collected by interviewing and reviewing charts of 41 clients with Coronary Artery Bypass Graft between June 2001 and July 2002 at an university hospital located in Seoul. Korea. Out of 41 clients. 15 were in home care group and 26 were in hospitalization group. The baseline characteristics of the groups were almost identical. Mean age was 61.7 and 75.6% of clients being male. For home care group. the data collection was made at discharge and at termination of home care. and for hospitalization group. at discharge and at the first visit of outpatient department. Complication and readmission rates were investigated at one month after operation. Collected data were then analysed by conducting Chi-square test. Wilcoxon rank sum test. and Wilcoxon signed ranks test with SPSS program. The level of significance was .05. The results of the study are summarized as follows: 1. Postoperative length of stay of the home care group was shorter than that of hospitalization group by 1. 14 days(8.45 days vs. 9.59 days). On average. 1.8 home visits per client were observed. 2. The functional status (Barthel Index) at the termination of home care was significantly increased from that at discharge. For hospitalization group. a significant increase was observed between the functional status at the discharge and that at the first visit of outpatient department. The differencies in incremental of the scores. between the groups. were however not significant. 3. Complication and readmission rates; no statistically significant difference between the groups was observed. 4. The client satisfaction with nursing care (CSS) at termination of home care was significantly higher than that at hospital discharge. In conclusion. the outcomes of the analysis suggest that the home care benefits clients with Coronary Artery Bypass Graft. Client satisfaction with nursing care rises at termination of home care as compare to that measured at hospital discharge. Meanwhile. there was no significant differences in functional status. and complication and readmission rates. Further. home care reduced the length of stay in hospital.

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Effects of Reduced Ambient PM10 Levels on the Health of Children in Lower-income Families (대기질 개선과 저소득계층 어린이 건강보호 효과)

  • Bae, Hyun-Joo
    • Journal of Environmental Health Sciences
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    • v.36 no.3
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    • pp.182-190
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    • 2010
  • We examined the association of particulate matter with an aerodynamic diameter < $10\;{\mu}m$ ($PM_{10}$) with asthma-related hospitalization, stratified by socioeconomic status (SES), among children less than 15 years of age in Seoul, Korea, between 2003 and 2005. In addition, we estimated the reduction in the number of asthma-related hospitalizations that would result from implementing the World Health Organization (WHO) guideline. SES was defined based on data concerning health insurance premium grades, and grouped into two levels: lower-income group and control group. The lower-income group was classified as having an accumulated income which did not exceed the 50th percentile of the median income. Time-series analysis was performed to evaluate the association between $PM_{10}$ and asthma-related hospitalization. The Environmental Benefits Mapping and Analysis Program was used to analyze the impact on children's health. Based upon an increase of $10\;{\mu}g/m^3$ of $PM_{10}$, the asthma-related hospitalization risk for the lower-income group was increased by 1.78% (95% confidence intervals (CI) = 0.79-2.78%), while the risk for the control group was increased by 0.83% (95% CI = 0.34-1.32%). Attaining the WHO guideline, relative to the concentration in 2007, would result in a reduction in asthma-related hospitalizations of 18 cases per 100,000 of the children population in the lower-income group, and 7 cases in the control group. The health benefits of improved air quality for children in the lower-income group were thus 2.5 times greater than for children in the control group. Our results show that the lower-income group is disproportionately burdened with asthma-related hospitalization arising from air pollution. Therefore, biologically- and socioeconomically-disadvantaged populations should be considered in public health interventions in order to protect the children's health.

Empirical Analysis of Medical Accessibility for People with Disabilities using Health Insurance Big Data (건강보험빅데이터의 고혈압 입원율 분석을 통한 장애인의 의료접근성 실증 분석)

  • Jeon, HuiWon;Hong, MinJung;Jeong, JaeYeon;Kim, YeSoon;Lee, ChangWoo;Lee, HaeJong;Shin, EulChul
    • Korea Journal of Hospital Management
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    • v.27 no.1
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    • pp.1-10
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    • 2022
  • Background: This study aims to empirically compare and evaluate the current status of medical accessibility and health inequality between people with disabilities and without. We calculated the ACSC hospitalization rate, which is a medical accessibility index, for hypertension, a major risk factor for cardiovascular disease that accounts for more than 20% of deaths among people with disabilities using the 2016 National Health Insurance Big Data. Methods: The subjects of the study were a total of 601,520, including 64,018 people with disabilities and 537,501 people without. Logistic regression was performed to analyze the differences in hypertension hospitalization rates adjusted for demographic and sociological characteristics and disease characteristics using SAS 9.4 program. Results: Before adjusting for the characteristics, the hypertension hospitalization rate of people with disabilities was 1.55%, and the people without disabilities were 0.49%. After adjusting, it was found that people with disabilities were 2.11 times higher than people without disabilities, and it was statistically significant. Conclusion: The preventable hospitalization rate of people with disabilities is higher than that of people without, suggesting that the disabled have problems with access to medical care and health inequality. Therefore, the government's policy improvement is required to close the medical gap for the disabled.

The Disagreement of Discourse and Power Through the Experiences of Nursing for Caring of Long-term Hospitalized Patients (장기 입원환자 간호 갈등경험을 통해 본 담론 대립과 권력)

  • Kim, Hae Ok
    • Korean Journal of Adult Nursing
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    • v.19 no.3
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    • pp.495-507
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    • 2007
  • Purpose: This critical ethnography was performed to explore the experiences of nurses who are working with patients in an industrial disaster hospital. During the research process, I focused on the experiences of conflict in caring patients. Methods: Data for the study came from 13 informants with their corresponding patients through interview and observation from March 2002 to February 2004. The data was examined line by line; then compared and contrasted based on a critical discourse analysis. Results: Nurses' conflicts came from discrepancies of the world views from that of the patients. Such conflicts arose because of various issues as follows: Worker as an individual vs patients, nurse as young women vs the medical profession, hospital as an extended home vs health care setting, and hospitalization as a means to enhance work capacity vs a means of treatment. Conclusion: We need more study on the development of adaptive strategy for the nurses to overcome conflicts during their nursing career. Developing a nurses' and patient role intervention program is needed.

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