• Research in Community and Public Health Nursing
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• v.13 no.3
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• pp.444-455
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• 2002

Purpose: This study was performed to develop the case management program that can provide the qualitative health care service to satisfy the increasing needs for health care elderly and prevent the increase in medical cost cased by prolonged and repetitive hospitalization. Method: The survey was completed as follows. First, 290 elderly patients who would be soon discharged in 4 hospitals are participated in the survey on needs of nursing care and case management programs. Second, 70 professionals working at 5 hospitals including doctors, nurses, social workers and so on are participated in the survey on the case management team operation. Result: Level of needs to Nursing care and case management programs showed so high. Professionals suggested on the case management team operation. Finally, based on the survey and literature review, the case management program was developed. Conclusion: In this study, the specific models for the five case management services were suggested. It is thought that the service provision by the case management team based on the multi-disciplinary case management program model suggested in this study would be suggested as a constituent of the effective health care delivery system for the hospitalized elderly patients.

• Journal of Society of Preventive Korean Medicine
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• v.15 no.1
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• pp.71-87
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• 2011

Objective : The present study is aimed at providing basic data to help oriental medical hospitals devise efficient operational plans by analyzing the medical expenses of in-patients in an oriental medical hospital and the factors affecting such expenses. Methods : PASW 18.0 was used to analyze the medical insurance program data of 929 patients who were discharged from a university oriental medical hospital(with 105 sick-beds) during the period from January 1 to December 31, 2010 after treatment under the coverage of health insurance and medical aid. Results : 1) Of all the patients hospitalized, 63.3% were females, their mean age was 52.73 years old, and 87.7% was covered by the health insurance program. The biggest number or 31.2% of the patients were treated by the department of acupuncture, 31.5% suffered mainly from the diseases of musculoskeletal system and connective tissues, and the average length of stay at the hospital was 19.49 days. 2) There were statistically significant differences in total medical expenses by age, clinical department in charge, principal diagnosis, and number of days hospitalized while daily average medical expenses differed depending on age, type of medical security, clinical department, principal diagnosis, and number of days staying at the hospital. 3) Total medical expenses were found significantly influenced by age, type of medical security, clinical department, principal diagnosis, and number of days hospitalized(explanatory power : 95.9%), whereas type of medical security, clinical department and principal diagnosis turned out to exercise significant influence on the daily average medical expenses(explanatory power : 26.9%). Conclusion : Oriental medical hospitals are suggested to make efforts to ensure geographical and economical accessibility for their main clients, the elderly and middle-aged, as well as to improve satisfaction of the clients with the medical service provided. They are also encouraged to work out systems to specialize in treatment with a focus on chronic degenerative and adult diseases. In addition, they are expected to try to enhance people's awareness of oriental medicine in an attempt to diversify the brackets of clients and increase frequency of their utilization.

• Journal of muscle and joint health
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• v.25 no.3
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• pp.167-175
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• 2018

Purpose: The aim of this study was to test the effects of passive exercise on upper extremities muscle spasticity, finger edema, and depression for chronic stroke patients. Methods: A non-equivalent pretest-posttest design was employed for this study. The subjects were 30 elderly patients who were hospitalized to treat chronic stroke. 15 patients were assigned to the experimental and control groups respectively. Passive exercise for 20 minutes per day, five days a week for 8 weeks (total 40 times) was provided for the experimental group. Outcome measurements included manual spasticity test to measure upper extremities' muscle spasticity, the ring measurement method for finger edema and the Korean version of Short-form Geriatric Depression Scale (SGDS-K) for depression. Results: The upper extremities' muscle spasticity (Z=-2.52 p=.012) and the degree of depression (F=5.56, p=.006) in the experimental group were significantly reduced compared to those of the control group. But the degree of finger edema did not significantly differ between the two groups (F=1.46, p=.240). Conclusion: Passive exercise for upper extremities should be encouraged for elderly patients with chronic stroke to enhance the upper extremities' functional capacity as well as depression.

• Korean Journal of Adult Nursing
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• v.26 no.1
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• pp.89-97
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• 2014

Purpose: During hospitalization, confusion occurs in 15~20% of older adults and persists in 5~10% of them. This study was designed to investigate effects of a five-day nursing intervention program designed to reduce confusion in hospitalized older adults. Subjects were inpatients over the age of 60 years old and were admitted in a surgical care unit. Methods: Data were collected from 111 patients. Subjects divided into one of two groups, 58 patients of the control group which received the usual nursing care; and 53 patients of the intervention group which received the usual nursing care plus nursing intervention program for reducing acute confusion. The Delirium Observation Screening Scale (DOS) and the Korean Mini-Mental Screening Examination (MMSE-K) were utilized. Results: 1) Acute delirium was significantly reduced in the intervention group compared to the control group ($x^2$=4.22, p=.034) as well as the duration of the delirious state was significantly shortened (F=56.62, p<.001). Cognitive function of the intervention group was improved (F=21.14, p<.001). Conclusion: The nursing intervention program reduced the incidence and duration of acute delirium of the elderly inpatients, as well as it helps them keep better cognitive function than the control group.

• 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.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.246-255
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• 2017

Purpose: This study was designed to identify factors affecting depression among hospitalized older adults prior to discharge from an acute care hospital. Methods: This descriptive study included adults aged 65 or older who were hospitalized in a general hospital in Seoul, Korea. Depression was measured by the Short Form Geriatric Depression Scale and illness perception was evaluated by the Brief Illness Perception Questionnaire. Social support was examined using the Perceived Geriatric Social Support Scale. Data were collected from August 25 to October 12, 2015. Data analysis included descriptive statistics, independent t-test, Kruskal-Wallis test, Pearson's correlation coefficient, and hierarchical multiple regression. Results: Among a total of 120 participants, 57 patients (47.5%) experienced depression. Mean depression score was $7.37{\pm}3.67$. Depression was associated with illness perception (r=.53, p<.001), social support (r=-.19, p=.043), number of admission due to the recurrence (r=.31, p=.001), and time to recognize discharge plan (r=.25, p=.044). In hierarchical multiple regression, illness perception (${\beta}=.45$, p<.001) and time to recognize discharge plan (${\beta}=.21$, p=.039) were predictors of depression (F=7.68, p<.001, Adjusted $R^2=.38$). Conclusion: The findings of this study suggest that management of illness perception and timely notice of discharge are important to reduce depression in hospitalized elderly patients.

• Nutrition Research and Practice
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• v.9 no.6
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• pp.637-643
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• 2015

BACKGROUND/OBJECTIVES: Malnutrition in the elderly is a serious problem, prevalent in both hospitals and care homes. Due to the absence of a gold standard for malnutrition, herein we evaluate the efficacy of five nutritional screening tools developed or used for the elderly. SUBJECTS/METHODS: Elected medical records of 141 elderly patients (86 men and 55 women, aged $73.5{\pm}5.2years$) hospitalized at a geriatric care hospital were analyzed. Nutritional screening was performed using the following tools: Mini Nutrition Assessment (MNA), Mini Nutrition Assessment-Short Form (MNA-SF), Geriatric Nutritional Risk Index (GNRI), Malnutrition Universal Screening Tool (MUST) and Nutritional Risk Screening 2002 (NRS 2002). A combined index for malnutrition was also calculated as a reference tool. Each patient evaluated as malnourished to any degree or at risk of malnutrition according to at least four out of five of the aforementioned tools was categorized as malnourished in the combined index classification. RESULTS: According to the combined index, 44.0% of the patients were at risk of malnutrition to some degree. While the nutritional risk and/or malnutrition varied greatly depending on the tool applied, ranging from 36.2% (MUST) to 72.3% (MNA-SF). MUST showed good validity (sensitivity 80.6%, specificity 98.7%) and almost perfect agreement (k = 0.81) with the combined index. In contrast, MNA-SF showed poor validity (sensitivity 100%, specificity 49.4%) and only moderate agreement (k = 0.46) with the combined index. CONCLUSIONS: MNA-SF was found to overestimate the nutritional risk in the elderly. MUST appeared to be the most valid and useful screening tool to predict malnutrition in the elderly at a geriatric care hospital.

• Quality Improvement in Health Care
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• v.23 no.2
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• pp.69-78
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• 2017

Background: The purpose of this study was to examine associations between classification of the Geriatric Screening for Care-10 (GSC-10) and the Morse Fall Scale (MFS) among elderly inpatients. Methods: Among elderly inpatients aged over 65 admitted to hospital (from November 1, 2016 to July 31, 2017), the data for 5,780 patients (who were evaluated using the Morse Fall Scale and the Geriatric Screening for Care-10) were analyzed using x2-tests and t-tests to examine differences between the GSC-10 and MFS, according to general characteristics of elderly inpatients (i.e., gender) using IBM SPSS Statistics 24. Results: : Scores for the GSC-10 were significantly higher in women than men for depression (p<.001), delirium (p=.048), functional decline (p<.001), incontinence (p<.001), and pain (p<.001). Statistically significant differences in all domains of the GSC-10 for elderly hospitalized patients were found for the classification of fall risk. Conclusion: The findings of this study, as supported by the GSC-10, indicate that the most common problems experienced by the elderly are related to the risk of falling. In order to reduce the incidence of falls in elderly inpatients, customized fall prevention based on the GSC-10 results is necessary.

• Korea Journal of Hospital Management
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• v.26 no.4
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• pp.29-37
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• 2021

Purpose: The purpose of this study is to identify the characteristics and factors affecting falls among elderly inpatients with chronic diseases based on the data from the discharge damage depth survey of the Korea Disease Control and Prevention Agency(KDCA) from 2014 to 2018. Method: The study selected elderly inpatients aged over 65 who were hospitalized(n=1,173). Their data were analyzed after being assigned to either a fall group(KSCD, W00-W19) or a non-fall group. Frequency analysis, cross-tabulation analysis, and binary logistic regression analysis were conducted, using SPSS 28. Results: According to the analysis on category of fall and non-fall group were statistically significant difference in age and having chronic diseases. Based on the binary logistic regression analysis of factors affecting falls, The risk of falls was 1.058 times higher with age, and E11-E14 and I63 as main diagnostic codes, the risk of falls was 2.049 times and 2.437 times higher. Conclusion: It is necessary to develop customized educational manuals and muscle exercise programs considering the characteristics of chronic diseases and to create a safe hospital room environment, and this result is expected to be used as basic data for fall prevention education and manual development for elderly inpatients with chronic diseases.

• The Journal of Korean Physical Therapy
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• v.23 no.2
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• pp.17-21
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• 2011

Purpose: The purpose of this study was to determine the correlations, if any, between SPPB (Short physical performance battery), FRT (Functional reach test), and TUG (Timed up and go test) in hospitalized frail people. Methods: Seventy frail elderly patients (male/female: 16/54) participated in this study. All subjects could walk with or without an assisting device and they had no mental problems. Subjects were scored on physical functioning using the SPPB, FRT, and TUG. The data were analyzed using Pearson Correlation Coefficients. Results: There was a statistically significant difference between (a) SPPB and (b) FRT (p<0.01) and TUG (p<0.01). SPPB and FRT scores showed a positive correlation (r = 0.38) and SPPB and TUG scores showed a negative correlation (r = -0.56). Conclusion: SPPB, FRT, TUG scores are correlated with each other. From these results, we conclude that the SPPB is a useful method for predicting walking, balance, and physical function in frail elderly people.