• Title/Summary/Keyword: Hospitals, high-volume

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Anticoagulation after pancreatic surgery with venous resection (TIGRESS): What should we do? Results from an international survey

  • Thomas B. Russell;Debora Ciprani;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.4
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    • pp.423-426
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    • 2023
  • Backgrounds/Aims: Patients who undergo pancreatic surgery with venous resection have high rates of morbidity/mortality. Also, they are high-risk for postoperative venous thromboembolism. Whether this group should be routinely anticoagulated is unknown. This study aimed to establish current anticoagulation practices. Methods: A survey (https://form.jotform.com/220242489107048) was sent out to pancreatic surgeons. Questions covered center volume, venous resection/reconstruction techniques and anticoagulation policies. Results: Sixty-five centers from 17 countries responded. Following a "side-bite" venous resection with a patch repair, 40% used an autologous vein patch, 27% used peritoneum, and 27% used a bovine patch. After formally resecting a segment of vein, 17% of centers used an interposition graft (IG). Left renal vein (41%) and polytetrafluoroethylene (73%) grafts were the most commonly used autologous and prosthetic IGs, respectively. Following a prosthetic IG, an autologous IG, and a "side-bite" resection, 59%, 28%, and 19% of centers provided therapeutic anticoagulation, respectively (66% used low molecular-weight heparin). The duration of therapy provided varied from inpatient stay only (14%) to six months (32%). Conclusions: Our global survey indicates that anticoagulation practices are highly variable. Centers do not agree on when to anticoagulate, how to anticoagulate, or the duration of therapy. A robust trial is required to provide clarity.

Public Reporting of Hospital Level Surgical Volumes: Its Influence on Patient Behavior

  • Han, Kyu-Tae;Park, Eun-Cheol;Nam, Chung-Mo;Kim, Tae-Hyun;Hahm, Myung-Il;Lee, Sang-Gyu
    • Quality Improvement in Health Care
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    • v.24 no.2
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    • pp.62-75
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    • 2018
  • Purpose: The objective of this study was to publicly report the hospital-level surgical volume for 7 types of surgery including gastrectomy. Also, to investigate the changes in patient behaviors after the public reporting among patients with gastrectomy. Methods: This study used data from the National Health Insurance Service Cohort. The data comprised of 2,214 patients who were diagnosed with gastric cancer and underwent gastrectomy during 2004-2012. An interrupted time series analysis was performed to investigate the association between patients' choice and public reporting. Results: 79.27% of the patients visited a hospital with high surgical volume. The time trend after introduction of public reporting was positively associated with visiting a high volume hospital (per 1 month, RR: 1.004, p=0.0329). However, after adjusting the health policies by reducing copayment, public reporting on surgical volume was not associated with visiting a high volume hospital. Sub-group analyses had also similar results. Conclusion: Patients were more affected by policies on economic support than on public reporting, and the changes in treatment options may have been affected by the increasing preference for large size hospitals. Thus, public reporting did not significantly improve the options available for patients and their decision making on health care utilization.

The Effectiveness of a Laughter Therapy Program : Focusing on Depression, Cognitive Function and Pulmonary Function among Elderly Patients (기능강화웃음치료가 노인의 우울, 인지 및 폐기능에 미치는 효과)

  • Hwang, Myoung Sook;Yoo, Moon Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.23 no.2
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    • pp.121-128
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    • 2016
  • Purpose: This study was aimed at constructing and examining the effects of a laughter therapy program for elderly patients in long-term care hospitals. Methods: A prospective, two-group quasi-experimental design was used and 50 patients (25 experimental and 25 control group patients) from two long-term care hospitals in Gyeonggido province, South Korea, were study participants. The experimental group received 24 laughter therapy sessions twice a week for 12 weeks, and the control group received laughter therapy after data collection. Data were collected between May 26 and August 17, 2014. Results: The level of cognitive function for the experimental group increased(t=3.27, p=.002). The level of forced vital capacity (t=2.78, p=.008) and forced expiratory volume in 1 second (t=4.94, p<.001) increased among members of the experimental group. Conclusion: These results indicated that the laughter program was effective in improving cognitive and pulmonary functions among older patients who were receiving long-term care in hospitals. This program could be used for community-based elderly patients.

An Importance-Performance Analysis of patient safety activities for inpatients in small and medium-sized hospitals (중소병원 입원환자의 환자안전활동에 대한 중요도와 수행도 분석)

  • Baek, On-Jeon;Shin, Sun-Hwa
    • The Journal of Korean Academic Society of Nursing Education
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    • v.30 no.2
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    • pp.170-181
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    • 2024
  • Purpose: This study aims to assess the importance and performance of patient safety activities for inpatients in small- and medium-sized hospitals. The objective is to identify the need for patient safety education by analyzing differences in importance and performance ratings. Methods: The study involved 300 patients hospitalized in three small- and medium-sized hospitals. Data collection took place in October 2023, focusing on investigating the importance and performance of patient safety activities. Descriptive statistics and an Importance-Performance Analysis (IPA) were conducted using the IBM SPSS statistics 25.0 program. Results: The average importance of patient safety activities was 3.51±0.41, and the average performance was 3.37±0.43, indicating that the importance of patient safety activities was higher than their performance. According to the IPA, the components of patient safety activities that fell into the second quadrant of high importance but low performance included three medication-related items and one test/procedure/surgery-related item. Conclusion: In this study, it was found that inpatients in small- and medium-sized hospitals had a higher importance on patient safety activities than performance and needed ways to increase their performance. Therefore, it is necessary to develop a customized educational program that can increase the practical performance of inpatients' patient safety activities based on the contents that were determined to need improvement.

The Current State of and Barriers to Quality Measurement, and Quality Managers' Reported Evaluation on Quality Indicators in Korea (국내 질 향상부서 중심의 질 지표 측정 현황, 장애요인과 평가)

  • Hwang Jee-In
    • Health Policy and Management
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    • v.15 no.4
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    • pp.26-45
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    • 2005
  • The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

Correlation and Spatial Analysis between the number of Confirmed Cases of the COVID-19 and Traffic Volume based on Taxi Movement Data (택시 이동 데이터 기반 COVID-19 확진자 수와 교통량 간의 상관관계 및 공간분석)

  • Jeon, Seung Bae;Kim, Geon;Jeong, Myeong-hun
    • Journal of the Korean Society of Surveying, Geodesy, Photogrammetry and Cartography
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    • v.39 no.6
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    • pp.609-618
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    • 2021
  • The spread and damage of COVID-19 are putting significant pressure on the world, including Korea. Most countries place restrictions on movement and gathering to minimize contact between citizens and these policies have brought new changes to social patterns. This study generated traffic volume data on the scale of a road network using taxi movement data collected in the early stages of the COVID-19 third pandemic to analyze the impact of COVID-19 on movement patterns. After that, correlation analysis was performed with the data of confirmed cases in Daegu Metropolitan City and Local Moran's I was applied to analyze the effect of spatial characteristics. As a result, in terms of the overall road network, the number of confirmed cases showed a negative correlation with taxi driving and at least -0.615. It was confirmed that citizens' movement anxiety was reflected as the number of confirmed cases increased. The commercial and industrial areas in the center of the city confirmed the cold spot with a negative correlation and low-low local Mona's I. However, the road network around medical institutions such as hospitals and spaces with spatial characteristics such as residential complexes was high-high. In the future, this analysis could be used for preventive measures for policymakers due to COVID-19.

A Study on the Development of a Program to Body Circulation Measurement Using the Machine Learning and Depth Camera

  • Choi, Dong-Gyu;Jang, Jong-Wook
    • International Journal of Internet, Broadcasting and Communication
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    • v.12 no.1
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    • pp.122-129
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    • 2020
  • The circumference of the body is not only an indicator in order to buy clothes in our life but an important factor which can increase the effectiveness healing properly after figuring out the shape of body in a hospital. There are several measurement tools and methods so as to know this, however, it spends a lot of time because of the method measured by hand for accurate identification, compared to the modern advanced societies. Also, the current equipments for automatic body scanning are not easy to use due to their big volume or high price generally. In this papers, OpenPose model which is a deep learning-based Skeleton Tracking is used in order to solve the problems previous methods have and for ease of application. It was researched to find joints and an approximation by applying the data of the deep camera via reference data of the measurement parts provided by the hospitals and to develop a program which is able to measure the circumference of the body lighter and easier by utilizing the elliptical circumference formula.

Lactic Acid Bacteria Isolated from Healthy Korean Having Antimicrobial Activity Against VISA and VRE (한국 성인에서 분리한 유산균의 VISA(Vancomycin-Intermediate Resistant Staphylococcus aureus)와 VRE(Vancomycin Resistant Enterococcus faecium)에 대한 성장 억제)

  • Yun Ji-Hee;Kim Yun-A;Song Moon-Seok;Kang Byung-Yong;Ha Nam-Joo
    • YAKHAK HOEJI
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    • v.50 no.2
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    • pp.78-83
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    • 2006
  • VISA and VRE are the main causes of surgical infection, urinary tract infections and bacteremia in hospitals. In this study; we selected VISA (Vancomycin Intermediate resistant Staphylococcus aureus) and VRE (Vancomycin Resistant Enterococcus) isolated from the clinical isolates. One of the isolated strains indicated the high resistance to severel anti-biotics (Vancomycin, Teicoplanin, Mupirocin, Synercid, Ciprofloxacin, Gentamicin, Lincomycin, Cefotaxim, Meropenem). Antimicrobial activity of Bifidobacterium spp. against VISA and VRE were measured. About $10^4$ cells of VISA or VRE were mixed with 1,5 and 9 ml of Bifidobacterium and the final volume was adjusted to 10 ml with brain heart infusion (BHI) broth. The cell suspension was incubated for 3, 6, 9, and 24 hr, serially diluted and then plated on BHI agar plate. As numbers of Bifidobacterium were increased viable cell count of VISA and VRE decreased. The strongest antimicrobial activity of the Bifidobacterium was observed after 9hr incubation in any mixture, almost completely inhibiting the growth of VISA and VRE.

An Analysis on the Korean Rural Health Care Delivery System (농촌의료(農村醫療)의 문제점(問題點)과 대책(對策) - 의료제도(醫療制度)를 중심(中心)으로-)

  • Song, Oh-Dal
    • Journal of agricultural medicine and community health
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    • v.2 no.1
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    • pp.30-35
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    • 1977
  • Health care conditions in Korea are gradually improving along with the economic and social development. However, the volume of disease is still great, especially in rural areas. This study attempts, therefore, to initiate a comprehensive proposal of rural health care delivery system. The proposal is constructed three parts, problem of health care system, medical cost, medical education system. The proposal consist of the following components: I. The health care system 1. health sub-center is required to be locate in "Myun" the basis administrative unit of local government for delivering primary health care. But, in the viewpoint of medical economics, the primary health care is operated cautiously. 2. Health center is desirable to provide health services in coordinating the health sub-center and other private health institution. 3. The secondary health care is performed in regional combination hospitals, and the attitude that doctors accomodate this system is required. II. The medical cost, Insurance In the expenditure of medical care, the method of a third person's payment is required absolutely. III. The medical education system. 1. The medical education system (process) is changed from the medical education to regional doctor education. 2 In the nurse education system. nursing technical high school is resurrected.

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A Nationwide Study on the Impact of COVID-19 Pandemic on Volume of Spine Surgery in South Korea

  • Lee, Mu Ha;Park, Hye Ran;Chang, Jae Chil;Park, Hyung Ki;Lee, Gwang Soo
    • Journal of Korean Neurosurgical Society
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    • v.65 no.5
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    • pp.741-750
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    • 2022
  • Objective : In March 2020, World Health Organization declared a global pandemic caused by a novel coronavirus (SARS-CoV-2). The disease caused by this virus is called COVID-19. Due to its high contagiousness, many changes have occurred in overall areas of our daily life including hospital use by patients. The aim of this study was to investigate the impact of COVID-19 on volume of spine surgery in South Korea using the National Health Insurance database and compare it with the volume of a homologous period before the pandemic. Methods : Data of related to spine surgery from January 2019 to April 2021 were obtained from the National Health Insurance and Health Insurance Review and Assessment Service database. Primary outcomes were total number of patients, rate of patients per 100000 population, and total number of procedures. The number of patients by hospital size was also analyzed. Results : COVID-19 outbreaks occurred in South Korea in March, August, and December of 2020. Compared to the previous year, the total number of patients who underwent spinal surgery showed a decrease for 2-3 months after the first and second outbreaks. However, it showed an increasing trend after the third outbreak. The same pattern was observed in terms of the ratio of the number of patients per 100000 population. Between 2019 and 2021, the mean number of spine surgeries per month tended to increase. Mean annual medical expenses increased over the years (p=0.001). When the number of spine surgeries was analyzed by hospital size, proportion of tertiary general hospital in 2021 increased compared to those in 2019 and 2020 (vs. 2019, p=0.012; vs. 2020, p=0.016). The proportion of general hospital was significantly decreased in 2020 compared to that in 2019 (p=0.037). Conclusion : After the COVID-19 outbreak, patients tended to postpone spinal surgery temporarily. The number of spinal surgeries decreased for 2-3 months after the first and second outbreaks. However, as the ability to respond to the COVID-19 pandemic at the hospital and society-wide level gradually increased, the number of spine surgeries did not decrease after the third outbreak in December 2020. In addition, the annual number of spine surgeries continued to increase. However, it should be noted that patients tend to be increasingly concentrated in tertiary hospitals for spinal surgery.